BILL NUMBER: S3220
SPONSOR: KAVANAGH
 
TITLE OF BILL:
An act to amend the public health law, in relation to establishing an
office of antibiotic-resistance control; to amend the state finance law,
in relation to establishing the antibiotics education fund; and to amend
the labor law, in relation to including methicillin-resistant staphylo-
coccus aureus (MRSA) and other antibiotic-resistant infections in the
definition of airborne infectious disease
 
PURPOSE OR GENERAL IDEA OF BILL:
The legislation establishes an Office of Antibiotic-Resistance Control
in the Department of Health to coordinate, monitor, and intervene to
reduce the overuse and misuse of antibiotics in New York State. The
legislation provides oversight of antibiotic stewardship programs in
health care settings, and imposes new limits on use of medically impor-
tant antibiotics in food-producing animals. The goal of this legislation
is to eliminate the overuse and misuse of antibiotics by using a "One
Health" approach in order to control the development and spread of anti-
biotic-resistant infections and to preserve the effectiveness of antibi-
otics for future generations.
 
SUMMARY OF PROVISIONS:
Section 1 of the bill sets forth legislative findings.
Section 2 of the bill amends the public health law by adding a new Title
8 Article 269-A through M.
Article 269-A sets forth definitions.
Article 269-B creates an Office of Antibiotic-Resistance Control within
the Department of Health and describes its duties. It establishes goals
for the state of reducing health-care associated resistant infections by
20%, community-acquired resistant infections by 10%, by 2025, and
medically important antibiotic use in food animals by 50%, by 2028. The
first two goals were established by the federal National Action Plan
2020-2025 on antibiotic resistance. The third goal parallels the goal of
the European Union and can be achieved by eliminating use of medically
important antibiotics in food animals for disease prevention, which
currently accounts for a majority of food animal antibiotic usage. The
Office shall work with the Antibiotic-Resistance Control Board to
achieve these goals and otherwise carry out its duties.
Article 269-C creates an antibiotic-resistance control board consisting
of the heads of relevant state departments, a public member, and an
advisory board consisting of stakeholders and experts.
Article 269-D and E establish that the Commissioner of Health shall be
chair of the Board, and it shall meet every three months.
Article 269-F and G establishes the functions, powers, and duties of the
Board. These include developing policy, promoting training programs,
coordinating among relevant state agencies, recommending rules and regu-
lations, collecting data, informing the public, and coordinating with
other state and federal agencies where appropriate.
Article 269-H requires the Commissioner of Health to evaluate the effec-
tiveness of state efforts to control antibiotic resistance and to report
annually to the governor and legislature.
Article 269-I authorizes the Department of Health to collect data on
antibiotic use within the state from official sources and cooperate with
federal data collection efforts.
Article 269-J tasks the Department of Health with gathering information
on antibiotic stewardship programs in health care settings and in coop-
eration with other departments and relevant experts developing antibiot-
ic stewardship guidelines for food animal production.
Article 269-K states that medically important antibiotics may not be
administered to food animals except if authorized by a veterinarian, who
has determined that the antibiotic is necessary to control or treat a
diagnosed disease or for certain surgical procedures, and who has speci-
fied an end date for use. Use solely for purposes of growth promotion,
feed efficiency, or disease prevention is prohibited. Use for purposes
of selective dry cow therapy is acceptable, but use for blanket dry cow
therapy is not.
Article 269-L requires veterinarians to report prescriptions for use of
medically important antibiotics on food animals to the Department of
Health. Veterinary Feed Directives required by FDA may be submitted to
meet this requirement. Article 269-M establishes penalties for noncom-
pliance.
Section 3 of the bill amends the state finance law by adding a section
97-j, which creates an "Antibiotics Education Fund" administered by the
state comptroller, consisting of all monies recovered from penalties and
fines authorized by Article 269-M.
Section 4 amends the labor law by adding a sentence to section
218-b.1.(e) to ensure that it covers antibiotic-resistant infections.
Section 5 of the bill sets forth the effective date.
 
JUSTIFICATION:
Antibiotic resistance is a naturally occurring phenomenon, but its
development and spread increases when bacteria are repeatedly exposed to
antibiotics, as happens in hospitals and nursing homes, and in livestock
production. The antibiotics kill off the bacteria that don't have
resistance, leaving resistant "superbugs" to multiply, mutate, and
spread.
The World Health Organization (WHO), the United Nations General Assem-
bly, the U.S. Centers for Disease Control and Prevention, the New York
State Department of Health, and many other major public health organiza-
tions have recognized antibiotic-resistant infections as a major public
health crisis. Currently in the U.S., at least 2.8 million get ill and
at least 35,000 - and by some estimates as many as 162,000 - die per
year from antibiotic-resistant infections. These numbers are growing. A
study sponsored by the British government predicted 10 million deaths
per year worldwide by 2050 - more than from cancer. A more recent study
in Lancet found that the number of annual global deaths already exceeds
one million.
The WHO and the CDC have called for a "One Health" approach, recognizing
the interconnectedness of humans and animals, and the need for cooper-
ation across agencies and disciplines, in order to achieve optimal
public health outcomes.
The COVID-19 pandemic, during which desperate doctors around the globe
liberally dispensed broad-spectrum antibiotics under the assumption that
sick COVID-19 patients were highly susceptible to secondary bacterial
infections, has exacerbated the problem. In 2021, New York passed a law
requiring all hospitals and nursing homes in the state to implement
antibiotic stewardship programs. Yet, too little has been done to coor-
dinate and monitor the state's response to this growing public health
threat, with even less efforts made in the agricultural sector. Given
that antibiotic resistance has no geographic boundaries, a centralized
approach is necessary to coordinate the state's responses.
According to FDA data, two-thirds of medically important antibiotics are
also sold for use in food-producing animals, including cattle, dairy
cows, pigs, chickens, and turkeys. Most of these animals are not actual-
ly sick; rather the routine administration of antibiotics in their food
and/or water allows them to survive in often overcrowded and unsanitary
living conditions.
Overuse and misuse of antibiotics in food-producing animals is a key
driver in the emergence and spread of superbugs that infect humans.
Antibiotic-resistant bacteria can travel easily from farm settings to
people, via food, air, and water. They spread easily between people,
including farm workers, via skin-to-skin contact, coughing, sneezing,
poor hygiene, and sharing of personal items. Antibiotic-resistant bacte-
ria can also transfer their resistance to other bacteria, making them
resistant to medically important antibiotics, too.
According to the CDC, approximately 661,000 Americans get sick each year
by eating food contaminated with antibiotic-resistant bacteria and 24%
of all antibiotic-resistant infections are caused by germs from food and
animals. California and Maryland and now the European Union, have passed
laws prohibiting use of medically important antibiotics solely for
disease prevention in food animal production. Left unchallenged, the
threat of antibiotic resistance may return us to an era where strep
throat, urinary tract infections, tuberculosis, childbirth, tooth
infections, skin scrapes, and routine surgery are associated with high
rates of mortality.With a lack of meaningful regulation at the federal
level, states like New York must take action to preserve the effective-
ness of antibiotics in both medicine and agriculture for ourselves and
future generations.
Thus, this legislation seeks to centralize the state's efforts to combat
antibiotic resistance into one office contained within the health
department.
This new office would coordinate responses, collect data, recommend
public health interventions, guide policy making now and in the future,
and identify emerging and existing threats with adequate policy
responses. This legislation would enact New York's version of "One
Health."
 
PRIOR LEGISLATIVE HISTORY:
2024:S4021(Kavanagh)- REFERRED TO HEALTH /A1675(Rosenthal L)- referred
to health
2023:54021(Kavanagh)- REFERRED TO HEALTH /A1675(Rosenthal L)- referred
to health
2022: S8847(Kavanagh)- REFERRED TO HEALTH /A10097(Rosenthal L)- referred
to health
 
FISCAL IMPLICATIONS:
To be determined.
 
EFFECTIVE DATE:
This act shall take effect one year after the act shall have become law.

Statutes affected:
S3220: 218-b labor law, 218-b(1) labor law