BILL NUMBER: S3964A
SPONSOR: RIVERA
 
TITLE OF BILL:
An act to amend the public health law, in relation to including rescue
inhaler prescriptions for asthma and other chronic respiratory diseases
for individuals under age nineteen in the statewide immunization infor-
mation system
 
SUMMARY OF SPECIFIC PROVISIONS:
Section 1 amends paragraphs (a) and (c) of subdivision 1, paragraphs
(b), (c) and (d) of subdivision 2, paragraph (a) of subdivision 3, para-
graphs (b), (c) and (d) of subdivision 8, and subdivisions 10 and 11 of
section 2168 of the public health law, paragraphs (a) and (c) of subdi-
vision 1, paragraphs (b), (c) and (d) of subdivision 2, and subdivision
10 as amended by section 7 of part A of chapter 58 of the laws of 2009,
paragraph (a) of subdivision 3 as amended by section 2-a of part DD of
chapter 57 of the laws of 2018, paragraphs (b) and (c) of subdivision 8
and subdivision 11 as amended by chapter 829 of the laws of 2022, and
paragraph (d) of subdivision 8 as amended by chapter 532 of the laws of
2022 and subparagraph (i) of paragraph (d) as separately amended by
chapter 44 of the laws of 2022 of the Public Health Law, as it relates
to the immunization information system, to mandate the reporting rescue
inhaler treatment prescriptions for asthma and other chronic diseases
for individuals under nineteen years of age in the statewide immuniza-
tion information system (SIIS). For the purpose of this bill, this
section also defines the terms "statewide immunization information
system," "citywide immunization registry," "health care provider", and
"rescue inhaler".
Section 2 provides the effective date.
 
JUSTIFICATION:
Rescue inhaler prescriptions, also known as quick-relief medications,
are drugs that rapidly relax airway muscles and increase airflow,
providing quick relief from acute respiratory symptoms such as coughing,
wheezing, chest tightness, and shortness of breath. Their effects typi-
cally begin within 5 to 10 minutes and last for three to six hours.
While they are occasionally used for rare chronic respiratory conditions
like pulmonary hypertension, rescue inhalers remain a cornerstone of
emergency treatment for acute asthma exacerbations in children.
Asthma is the most common chronic disease among children in the United
States, affecting over 315,000 children in New York. The condition is
characterized by significant racial and socioeconomic disparities,
disproportionately impacting racial minorities, particularly Black and
Puerto Rican children, as well as those from lower socioeconomic back-
grounds. Neighborhoods like the Bronx are especially affected, with high
rates of asthma-related exacerbations, as measured by emergency depart-
ment visits.
Asthma is also one of the leading causes of school absenteeism, with
students with asthma missing an average of 2.3 more school days per year
than those without asthma. To address these challenges and ensure the
safe management of asthma exacerbations in schools, 24 states, including
New York, have passed laws or issued administrative guidelines allowing
schools to stock rescue inhaler medications for students with asthma.
Despite the implementation of laws and guidelines, medication adherence
among NYC public school students remains low. According to the New York
State Department of Health's report Asthma Burden in NYC- January 2023,
one of the primary barriers to effective medication delivery is the low
completion and return rate of Medication Administration Forms
(MAFs)among students in high-need areas like the Bronx, compared to
other parts of the state. MAFs play a crucial role in enabling school
administrators and staff, including nurses, to identify students who
require medications such as rescue inhalers. However, many families face
challenges in navigating the process of completing and submitting these
forms.
Streamlining this process and centralizing the information-similar to
the state's approach to immunization records and blood lead level
analyses-would provide schools with timely and accurate information
about children's asthma conditions. This, in turn, would empower school
staff to better manage and respond to asthma exacerbations. Addi-
tionally, integrating rescue inhaler prescriptions into a centralized
registry would not only facilitate better care but also allow for data-
driven policies in the future by providing insights into inhaler usage
patterns.
The statewide immunization information system currently records and
verifies immunizations and blood lead level data, ensuring schools,
daycares, and camps have access to these critical details. Expanding
this system to include asthma and other respiratory diseases for which
rescue inhalers are prescribed would enhance the ability of caregivers
and educators to respond promptly and effectively to medical emergencies
related to these diseases.
This proposal is consistent with expert's recommendations made during
the Senate Health and Environmental Conservation Committees' Roundtable
Discussion on Asthma, held in the Bronx in November 2019. One key
recommendation from this discussion was to include information about
children's asthma and other respiratory conditions in the statewide
immunization registry. Implementing this change would equip schools with
the necessary information to better assist children in managing their
asthma, ultimately improving health outcomes and ensuring safer school
environments.
 
LEGISLATIVE HISTORY:
2019-20: S7337/A10085 Reyes
2021-22: S 1410/A2431 Reyes
2023-24: S4783/A6594 Reyes
2025: S3964/A5194A Reyes
 
FISCAL IMPLICATIONS:
Minimal cost as the registry already exists and savings to the state
Medicaid program are anticipated as better care coordination for
students is achieved.
 
EFFECTIVE DATE:
This act shall be effective immediately.