Chapter 24: This chapter amends chapter 676 of the Laws of 2007, which specified the manner in which a residential care facility could obtain state designation as a Comprehensive Care Center for Eating Disorders. It authorizes the Department of Health to designate certain qualified applicants, provisionally for periods not to exceed two years, as such centers. This chapter also authorizes the Office of Mental Health to establish regulations for residential care facilities which provide care to individuals with eating disorders. Signed on March 4, 2008, the provisions of this chapter are deemed to have been effective as of August 28, 2007 (S.6418-B/A.9357-A)

Chapter 32 (Hannon): This chapter amends chapter 621 of the Laws of 2007, which added six persons who have or have had breast cancer and are active in community-based breast cancer organizations to the Health Research Science Board. It clarifies the manner in which such members are appointed. Signed by the governor on March 17, 2008, it is deemed to have been in full force and effect as of August 28, 2007. (S.6552/A.9464)

Chapter 33: The Dormitory Authority of the State of New York (DASNY) is authorized, as a successor to the New York State Medical Facilities Finance Agency, to issue project bonds and notes to hospitals and nursing homes. This chapter increases the aggregate principal dollar amounts of such bonds and notes from $13.4 billion dollars to $14.2 billion dollars. Such an increase is necessary to ensure DASNY’s ability to meet the financial needs of all of its private not-for-profit health care clients. It is particularly important at the current time because, as of September 30, 2007, DASNY had been requested to finance five hospital and nursing home projects, totaling approximately $658 million dollars, which, in addition to its then existing financial commitments, would exceed the $13.4 billion dollar statutory limitation. Signed by Governor Paterson on March 25, 2008, this chapter became effective immediately. (S.7013/A.10039)

Chapter 36: This chapter extends, until March 31, 2013, a demonstration program related to ensuring that physicians who have substance abuse or mental health problems receive appropriate treatment. Originally enacted in 1983, the law exempts members of physician health committees organized within the Medical Society of the State of New York, the New York State Osteopathic Society or county medical societies from certain medical misconduct reporting requirements. A member is not required to report information pertaining to a physician’s alcoholism, drug abuse or mental illness, provided that such information was discovered solely as a result of the member’s participation on the committee. The chapter includes a corresponding extension regarding a requirement that an applicable physician health committee submit a report to the legislature and the commissioner of health detailing its activities. Signed by Governor Paterson on March 31, 2008, this chapter became effective immediately. (S.6999/A.10052)

Chapter 46: This chapter amends chapter 628 of the Laws of 2007, which established the "Child Food Choking Prevention Act," also known as "J.T.’s Law." It adds a new section 2500-i to the public health law, which requires the Department of Health to: establish criteria for determining food and food products that may pose a significant choking risk for children in various age groups; conduct an ongoing public awareness and education program on choking risks, precaution and life-saving procedures, including listing information on the Department's website to assist members of the public in locating infant and child cardiopulmonary resuscitation classes; periodically review available data on choking incidents in children and update the information on choking risks, precautionary measures, and life-saving procedures provided in its educational materials and on its website; and, report annually to the governor and the legislature on the implementation of this legislation and any recommendations to further its purpose. Signed by Governor Paterson on April 23, 2008, the provisions of this chapter are deemed to have been in full force and effect as of August 28, 2007. (S.6504/A9471)

Chapter 91: This chapter makes technical amendments to chapter 665 of the Laws of 2007, which established a task force to examine air quality at toll plazas in New York City. In addition to refining the manner in which the seventeen members of the task force are appointed, this chapter ensures that a primary focus of the task force will be evaluating the health impact of toll plaza air quality on toll plaza employees. Signed by Governor Paterson on May 27, 2008, certain sections of this chapter are deemed to have been in full force and effect as of August 27, 2008, while the remaining sections became effective April 1, 2008. (S.6488-B/A.9458)

Chapter 99: This chapter extends, until January 1st, 2011, certain Emergency Medical Service (EMS) restrictions in Suffolk County. The original law (Chapter 572 of the Laws of 1994) was enacted when municipalities requested the authority to establish local ordinances to outlaw for-profit ambulance units from responding to calls for service dispatched to volunteer emergency medical or ambulance units, which created chaos in the provision of emergency medical services. The municipalities that requested this legislation report that the authority to designate providers who could respond to radio calls has enabled them to effectively solve the underlying obstacles that led to the problem. Specifically, this chapter precludes certain EMS providers from responding to EMS requests, requires all EMS providers to note in advance any fees for services they render, and requires all EMS providers to immediately report emergencies to the publicly operated dispatch authority, to evaluate the need to transport any patient to a hospital, and to comply with the instructions of the dispatching authority. This chapter was signed by Governor Paterson on June 3, 2008 and became effective immediately. (S.7015/A.10062)

Chapter 125: This chapter authorized certain out-of-state physicians, physician assistants, massage therapists, chiropractors, dentists, optometrists, nurses, nurse practitioners and podiatrists to provide professional services to approximately 2,000 competitors at the Ironman USA event held in Lake Placid, New York on July 20, 2008. The event, which enjoys significant corporate sponsorship, promotes and creates tourism in New York State. Signed by Governor Paterson on June 30, 2008, the provisions of this chapter became effective on July 16, 2008 and were deemed repealed July 21, 2008. (S.7347/A.10423)

Chapter 147: This chapter extends, until July 1, 2013, the emergency technician five year re-certification demonstration program created in Chapter 563 of the Laws of 2001. The original law was enacted to test the effectiveness of changing the re-certification requirements for emergency medical technicians and advanced emergency medical technicians (EMTs) from three years to five years. The Bureau of Emergency Medical Services has reported 57,396 certified providers statewide as of January 2008, a decrease of 2,009 providers since 1996. Volunteer EMTs are a vital asset to the medical community and to New York residents. This chapter, by extending the period for re-certification from three years to five years, is an effort to curtail their dwindling numbers. This chapter was signed by Governor Paterson on June 30, 2008 and became effective immediately. (S.7694/A.10677)

Chapter 149: This chapter extends, until June 30, 2010, the expiration date of a demonstration program established in 1997 to study the cost effectiveness of Medicaid coverage for portable x-ray services. Portable x-ray services are necessary for the aged, infirm and chronically ill citizens of New York State, particularly those who are residents of long term care facilities or are home bound. If an individual cannot access portable x-ray services when an x-ray is ordered by an authorized health care practitioner, then the person must be transported by ambulance to a stationary radiological site. Such transportation is costly and often traumatizing for the patient. Signed by Governor Paterson on June 30, 2008, this chapter became effective immediately.

Chapter 153: The failure of dog owners to remove their pet’s waste from streets and sidewalks is both inconsiderate and unhealthy. The existing maximum fine of one hundred dollars for non-compliance with canine waste laws, however, has not proven an effective deterrent, particularly in large cities. This chapter will increase the maximum fine amount to two hundred and fifty dollars. Applicable in cities with populations of four hundred thousand and more, as well as in the cities of Yonkers and Albany, this chapter was signed by Governor Paterson on July 7, 2008 and becomes effective October 5, 2008. (S.3437/A.373)

Chapter 154: This chapter prohibits smoking in dormitories, residence halls and other residential facilities of public and private colleges, universities and other educational and vocational institutions. Its enactment is intended to eliminate the adverse health effects of second-hand

smoke on nonsmokers, mitigate the risk of fire and reduce the number of college students that become regular smokers. Notably, a recent study by Harvard University found that students entering college as nonsmokers are 40 percent less likely to take up smoking when they live in smoke-free dorms. Signed by Governor Paterson on July 7, 2008, this chapter becomes effective August 15, 2008. (S.1955-A/A.538-A)

Chapter 158: This chapter requires that a registered nurse, qualified by training and experience in operating room nursing, shall be present, for the duration of the operative procedure, as a circulating nurse in any and each separate operating room where surgery is being performed. The role of the circulating nurse in the operating setting is vital to the provision of optimal and safe patient care. This chapter was signed by Governor Paterson on July 7, 2008 and becomes effective October 5, 2008. (S.1608/A.1206-A)

Chapter 169: This chapter is an act to amend the public health law, in relation to prohibiting animal irritancy tests for cosmetics. Specifically, it prohibits and restricts unnecessary animal testing for which there is a valid alternative method recommended by the Inter-Agency Coordinating Committee for the Validation of Alternative Methods (ICCVAM). ICCVAM was created by the National Institute for Environmental Health Sciences to develop a uniform process for assessing the validation of testing methods that reduce or eliminate the use of animals to test product safety. Traditional animal tests are often unnecessary and impose extreme cruelty upon the animals being tested. This legislation does not ban animal tests, rather, it requires manufacturers to use alternative methods in the specific instances and for specific products when such methods have been validated by ICCVAM. It does not apply to any animal testing conducted for the use of medical research and shall not pre-empt any state law or regulation. This chapter was signed by Governor Paterson on July 7, 2008 and becomes effective January 7, 2009. (S.3528-A/A.7402-B)

Chapter 197: This chapter extends statewide and makes permanent a demonstration

program, undertaken in Monroe and Onondoga counties pursuant to chapter 325 of the Laws of 2006, which permits an alternative "do-not-resuscitate" (DNR) form to be used in non-hospital settings. The form employed in that demonstration program, the Medical Orders for Life Sustaining Treatment form (MOLST), has proven successful in ensuring that a patient’s wishes are known and abided by. Signed by Governor Paterson on July 7, 2008, the provisions of this chapter became effective immediately. (S.7683/A.10764)

Chapter 206: This chapter amends § 3011 (10) of the Public Health Law by extending, for a period of 12 months following an individual’s separation from active military duty, the individual's certification as an emergency medical technician, an advanced emergency medical technician, or a certified first responder, if the individual was ordered to such duty after September 11, 2001 and his or her certification is scheduled to expire within six months of his or her separation from active duty. It is intended to provide military personnel with the additional time needed to complete a refresher course (which typically takes from four to six months) to prepare for the examinations required for recertification as an emergency medical technician, advanced emergency medical technician, or certified first responder. It also allows such service members to return to their prior employment or volunteer positions, or find new such positions, helping them transition as easily as possible back into civilian life. Signed by Governor Paterson on July 7, 2008, the provisions of this chapter became effective immediately. (S.7775/A.10970)

Chapter 210: This chapter authorizes, on a demonstration basis, the use of a simplified advance health care directives form for exclusive use by persons with mental retardation and developmental disabilities. A duly appointed health care agent is not normally authorized to make health care decisions on a principal’s behalf unless and until the principal has been determined to lack capacity. In contrast, the advance health care directives form authorized for use pursuant to this chapter will permit an agent, during the demonstration period, to make health care decisions immediately upon his or her designation as the principal’s proxy. Furthermore, recognizing the value and need of a comprehensive dialogue between principal and agent, particularly within the mentally retarded and developmentally disabled communities exclusively impacted here, the form advanced by this chapter uses elementary school-level language and illustrations to educate such individuals about choosing a health care agent and the health care choices available to them. Thus furthering New York’s established public policy of ensuring that persons with intellectual and other developmental disabilities be granted the right to designate health care agents (Public Health Law § 2991), the simplified advance directives form can provide greater control and independence to individuals whose limitations might otherwise prevent them from making their health care wishes known. Signed by Governor Paterson on July 7, 2008, this chapter shall become effective upon the date of the approval and availability of the simplified advance health care directives form authorized by subdivision (e) of § 33.03 of the mental hygiene law. (S.7751-A/A.11054-A)

Chapter 225: In 2002, special legislation created the Schenectady Health Care Practitioner Volunteer Program, which authorized the delivery, by volunteers, of free primary health care services to uninsured low income individuals. Since opening in 2003, that program has provided free medical care, lab tests, and medications valued at over $1 million to over 3,500 individuals. Retired and active physicians, and other volunteers including nurses, have donated over 6,200 hours of time. Medical specialists have accepted over 585 referrals, at no charge. Following publicity regarding its success, the Schenectady program has been approached by physicians and community leaders in several other parts of the State interested in replicating the program. This chapter permits the Commissioner of Health to authorize such additional programs throughout the State. Signed into law by Governor Paterson on July 7, 2008, the provisions of this chapter became effective immediately. (S.1562-A/A.9910-A)

Chapter 262 (Hannon): This chapter authorizes Surrogate Decision Making Committees to make a decision, for persons with mental retardation who are not represented by an involved family member or guardian, to withhold or withdraw life-sustaining treatment.

The Health Care Decisions Act for Persons with Mental Retardation (chapter 500 of the laws of 2002) was enacted to prevent the extreme suffering of individuals with intellectual developmental disabilities who, as a result of such disabilities, are unable to make their end-of-life wishes known in clear and convincing terms. Pursuant to the act (HCDA), guardians and family members are authorized, subject to extreme end-of-life circumstances and rigorous oversight, to make decisions to withdraw or withhold life-sustaining treatment. As it minimizes the likelihood that "mentally retarded patients [are] forced to suffer painful, intrusive life-sustaining medical treatments after it [becomes] clear that they [will] never regain any quality of life" (Matter of M.B., 6 NY3d 437, 440 [2006]), the HCDA has rightfully been described as a comprehensive and compassionate law of landmark proportions in New York State.

This chapter is necessary, however, for those individuals with mental retardation who have no guardian or committed family member to advocate for them. Many are elderly without living family members, while others were institutionalized and abandoned by their families years ago. They, the most vulnerable, are disproportionately victimized by futile medical care which only serves to prolong the agony of death. This chapter, by authorizing Surrogate Decision Making Committees to advocate on their behalf, can rectify this unanticipated injustice.

Signed by Governor Paterson on July 7, 2008, this chapter becomes effective January 3, 2009. (S.7752/A.10833)

Chapter 273 (Hannon): This chapter extends, for an additional five years, the authority of the Terence Cardinal Cooke Health Care Center to obtain financing and construction services from the Dormitory Authority of the State of New York (DASNY). Terence Cardinal Cooke Health Care Center is a 729-bed continuing-care facility with a multitude of special care units, as well as two large outpatient clinics. This chapter will ensure it remains eligible to obtain financing and construction services from DASNY, which enhance its ability to provide services to aged, disabled, chronically impaired, mentally retarded and developmentally challenged individuals. Signed by Governor Paterson on July 7, 2008, this chapter became effective immediately. (S.8234/A.11687)

Chapter 292: This chapter clarifies that physician assistants may be sexual assault forensic examiners (SAFEs). Certified sexual assault forensic examiners are trained to provide rape victims with prompt, compassionate, professional treatment, and to ensure the quality of the collection, documentation and preservation of forensic evidence. Although the Department of Health has, properly, historically recognized physician assistants as health care professionals eligible for SAFE certification, pertinent law (Public Health Law § 2805-i) specifically identified only physicians, registered nurses and nurse practitioners as candidates to become SAFEs. Pursuant to this chapter, physician assistants are statutorily recognized as eligible for SAFE certification. Signed by Governor Paterson on July 21, 2008, this chapter became effective immediately. (S.7629/A.10395)

Chapter 335: This chapter requires the Commissioner of the Department of Health to establish best protocols, for use by pediatric primary care providers, for the early screening of children for autism spectrum disorders. Although there are no cures for autism spectrum disorders, research has shown that early therapy can lessen their severity. Early diagnosis of developmental delays, especially between birth and age three, is an important component of well child care and can lead to appropriate referrals for interventions. For that reason, screening for such disorders should be a routine practice for pediatric primary care providers. This chapter will ensure that such providers utilize best practice screening protocols at regular intervals during critical childhood development stages, particularly from birth until age three, which will enhance their ability to identify developmental delays and refer parents to appropriate therapeutic resources. Pediatric primary care providers have regular contact with children and are able to detect early problems in a child’s ability to communicate, learn and interact with others. Inasmuch as recent information suggests that autism spectrum disorders afflict as many as six out of every one thousand children, it is important that all children be routinely screened. Signed by Governor Paterson on July 21, 2008, this chapter becomes effective January 1, 2009. (S.6527-B/A.9512-A)

Chapter 339: This chapter ensures the provision of health insurance coverage to the surviving spouses and children of members of the fire department employed as emergency medical technicians (EMTs), advanced EMTs, and their supervisors whose deaths are the natural and proximate result of an accident or injury sustained while in the performance of duty. Health insurance coverage for said surviving spouses and children would be predicated on the enrollment of the insured fire department member in the city's hospital and medical program. This chapter also permits the surviving spouses of retired fire department EMTs to purchase health insurance coverage for one hundred two percent of the group rate for such coverage, within one year of the death of his or her spouse. This chapter was signed by Governor Paterson on July 21, 2008 and became effective immediately. The provision in the chapter relating to the provision of health insurance coverage to the surviving spouses and children of certain members of the fire department, however, is deemed to have been in full force and effect as of September 11, 2001. (S.8014/A.10107)

Chapter 362 (Hannon): This chapter provides an option to register and enroll in the New York State Donate Life Registry on statewide application forms for voter registration. Thousands of people die every year waiting for donated organs. In New York alone, as demand for organs outpaces supply, nearly 9,000 people are on a waiting list for donated organs. Recognizing that New Yorkers deserve a better opportunity to receive the organs and tissues their health requires, this chapter reduces barriers for individuals to become organ donors by allowing for convenient registration and enrollment in the Donate Life Registry for the hundreds of thousands of New Yorkers who fill out voter registration applications every year. Notably, one organ donor can save or enhance the lives of up to fifty people through an organ or tissue donation that may restore eyesight, help fight infections in burn patients or delay the onset of end-stage organ failure. Signed by Governor Paterson on July 21, 2008, this chapter becomes effective January 1, 2009. (S.7058/A.10301)

Chapter 389 (Hannon): This chapter changes the financial eligibility standards for participation in the Care at Home Medicaid Waiver Program. New York’s Care at Home program, created in 1984, is intended to avoid the unnecessary institutionalization of children under 18 years of age whose physical disabilities would otherwise require that they receive care in a nursing facility or hospital. Under prior law, children were deemed eligible to participate in the program if the costs of their care at home did not exceed what it would cost to provide care for them in an institution. Eligibility was thus contingent upon the specific costs of care in either setting, at home or in an institution, for a specific child. This chapter, by authorizing participation in the program based on a statewide aggregate standard as opposed to an individual assurance of cost neutrality, will ensure that more of New York’s disabled children are eligible for care in their homes. Now, seriously ill children who might not have qualified for home care under the program because the costs of their care were too high on an individual basis, may qualify under the aggregate, statewide standard.

This change in law is, furthermore, consistent with changes made to similar programs, such as Bridges to Health for children in foster care, the Nursing Home Transition and Diversion Waiver Program, into which participants of Care at Home may transition, and the Traumatic Brain Injury Waiver Program. New York’s Care at Home program gives families the flexibility to have their children remain at home. This chapter expands that option to even more families, ensuring high quality care in a patient-centered environment. Signed by Governor Paterson on July 21, 2008, this chapter is deemed to have been in effect as of July 1, 2008.

(S.8702/A.11416-A)

Chapter 415: This chapter authorizes the Medicaid program to continue paying for Medicare Part B premiums for certain Medicare recipients from December 31, 2008 through December 31, 2010. Section 4732 of the Balanced Budget Act of 1997 (BBA) created two new eligibility groups for the purpose of assisting Medicare beneficiaries in meeting the cost of Part B premiums. The first group covers individuals whose income is between 120 percent and 135 percent of the federal poverty level. This group is eligible to obtain assistance to pay their entire share of the Part B premium cost. The second group, composed of individuals whose incomes are between 135 percent and 175 percent of the poverty level, is eligible for assistance only with

the portion of the Part B premium increase that is attributable to the impact of the Medicare changes made by the BBA. For each calendar year beginning with 1998, from the amount of the federal allocation for the State for the fiscal year ending in such calendar year, the State shall

select qualifying individuals who apply for the assistance in the order in which they apply. The eligibility for these programs terminates upon exhaustion of the federal allotment. This chapter ensures New York State remains in compliance with the Federal Balanced Budget Act of 1997. Signed by Governor Paterson on August 5, 2008, this chapter became effective immediately. (S.8133/A.8570-B)

Chapter 428: This chapter adds the word "association" to the list of entities which operate certain children’s camps and are required to ascertain whether an employee or volunteer is listed on the state sex offender registry. Such ascertainment must be made prior to the day each employee or volunteer commences work at said camp and annually thereafter prior to his or her arrival at camp. Signed by Governor Paterson on August 5, 2008, this chapter became effective immediately.

Chapter 477 (Hannon): This chapter enhances infection control training and practices and clarifies and strengthens the authority of the board for professional medical conduct to discipline physicians. Combining provisions from a "safe injection practices" bill (S.8104/Hannon) with a Governor’s Program "patient safety" bill (S.8298), this chapter represents the culmination of diligent and collaborative efforts by the Legislature, Department of Health, medical experts, advocates and the Governor’s office to ensure the safety of New York’s patients. It is a necessary first step toward restoring the public’s faith in a medical profession which has been fractured. Specifically, this chapter improves upon patient safety by clarifying the Department’s authority to take action against physicians who have engaged in poor medical practices; ensuring the public’s access to information regarding a physician’s involvement with disciplinary proceedings while, at the same time, acknowledging that any physician involved in such disciplinary proceedings should be entitled to due process considerations which protect against unsubstantiated complaints; and by improving infection control education and practices, including a study on the efficacy of restricting the use of multi-dose vials and transitioning to the mandatory use of disposable medical equipment engineered for single use.

This legislation significantly enhances New York’s ability to continue to provide a patient centered and safe health care system. This chapter was signed by Governor Paterson on August 5, 2008.

Select patient safety provisions of the chapter include:

Section one amends subdivision seven of § 230 of the Public Health Law by authorizing the office of professional medical conduct to obtain medical records, and other protected health information pertaining to a licensee’s physical or mental condition, when a committee on professional conduct has reason to believe the licensee may be impaired by alcohol, drugs, physical disability or mental disability, or that information regarding the licensee’s medical condition may be relevant to an inquiry into a report of a communicable disease.

Section one also authorizes a committee on professional conduct to direct a licensee to undergo a clinical competency examination.

Section three of the bill amends subparagraph (v) of paragraph (a) of subdivision (10) of § 230 of the Public Health Law to provide that in office of professional medical conduct cases and investigations pertaining to a public health threat, the Commissioner of Health is authorized to disclose information to the public as needed, notwithstanding otherwise applicable confidentiality provisions.

One provision in section four of the bill amends subparagraph (iv) of paragraph (a) of subdivision (10) of § 230 of the Public Health Law to provide that if the investigation committee is unanimous in its concurrence that a hearing is warranted, the charges shall be made public. If the investigation committee is not unanimous in its concurrence that a hearing is warranted, the members of such committee shall vote on whether the charges should be made public, and if all of the committee members vote in favor of publication, the charges shall be made public.

A second provision in section four of the bill adds paragraph (vii) to subdivision (10) (a) of § 230 of the Public Health Law to require the office of professional medical conduct, in consultation with the Patient Safety Center of the Department of Health (DOH), to conduct a continuous review of medical malpractice claims and disposition information reported to DOH under § 315 of the Insurance Law, to identify potential misconduct, and when found, conduct an investigation.

Section six of the bill amends paragraph (d) of subdivision (10) of § 230 of the Public Health Law to provide that the charges in professional discipline proceedings shall be made public, pursuant to the conditions described in subparagraph (iv) of paragraph (a) of subdivision (10) of § 230 of the Public Health Law, no earlier than five business days after such charges are served upon the licensee.

Section eleven of the bill amends paragraph (a) of subdivision (12) of § 230 of the Public Health Law by authorizing the Commissioner of Health, after being presented with information that a physician is causing, engaging in or maintaining a condition that has or is likely to lead to transmission of a communicable disease or HIV, and it would not be in the public's interest to delay action until a hearing, to order the physician to immediately discontinue such dangerous activity or take other action.

Section fifteen of the bill amends § 230-d of the Public Health Law to require licensees who

conduct office-based surgery to report any suspected transmission of a blood-borne communicable disease resulting from improper infection control practices originating in their practices in connection with such office-based surgery to the Department of Health’s Patient Safety Center within one business day.

Section sixteen of the bill amends § 239 of the Public Health Law to: (1) provide that every medical student, medical resident and physician assistant student, as part of the orientation offered by medical schools, medical residency programs and physician assistant programs, complete course work or training in infection control practices, as currently required for

licensees; (2) require that documentation be provided to the Department of Health demonstrating competency in such course work or training; (3) require eligible licensees to reapply for exemptions from such coursework requirements every four years; (4) include HCV, in addition to HIV and HBV, as one of the infections addressed by the required training; and (5) provide that by September 1, 2008 and periodically thereafter, the Department of Health, including the Patient Safety Center and in consultation with the Council on Graduate Medical Education, review and revise the content of infection control training to ensure that it reflects current practices and standards, with a particular emphasis on outpatient and ambulatory settings.

Section seventeen of the bill adds § 239-a to the Public Health Law, which requires the Department of Health to develop evidence-based infection control guidelines, including safe injection practices. The department is directed to distribute the guidelines to physicians and make them available to the public on or before January 1, 2009 and every year thereafter.

Section eighteen of the bill adds § 239-b to the Public Health Law, which requires the Department of Health to conduct a study and report to the Governor and the Legislature by January 1, 2009, on whether restricting the use of multi-dose vials for the packaging of

medications and requiring the use of disposable medical equipment engineered for single use is viable and would improve infection control practices.