Part 40 - State Aid For Public Health Services: Counties And Cities

Effective Date: 
Wednesday, November 23, 2016
Doc Status: 
Complete
Statutory Authority: 
Public Health Law, art. 6

SubPart 40-1 - Application and Payment

Effective Date: 
Wednesday, December 31, 2014
Doc Status: 
Complete

Section 40-1.0 - Applications for State aid

Section 40-1.0 Applications for State Aid

(a) To be eligible for State Aid, local health departments shall annually submit to the department a detailed application for State Aid in a form specified by the commissioner.

(b) Each local health department shall submit its application for State Aid to the department no later than two months after the commencement of the fiscal year for which it is seeking State Aid.

(c) The application for State Aid shall include:
(1) an organizational chart of the local health agency and a list of the number of employees by job title providing public health services;

(2) a budget of proposed expenditures; (3) a description of how the local health department will provide public health services in a form determined by the commissioner;

(4) an attestation by the chief executive officer of the municipality that sufficient local funds have been appropriated to provide the public health services for which the local health department is seeking State Aid; (5) an attestation by the public health commissioner or director that the local health department has exercised due diligence in reviewing the State Aid application and that the application seeks State Aid only for eligible public health services; (6) a list of public health services provided by the local health department that are not eligible for State Aid, and the cost of each service; (7) a projection of the fees and revenues to be collected for public health services eligible for State Aid; and (8) any other information or documents required by the commissioner.

Effective Date: 
Wednesday, December 31, 2014
Doc Status: 
Complete

Section 40-1.10 - Performance and accountability; reporting

Section 40-1.10 Performance and accountability; reporting

(a) The commissioner shall establish, in consultation with the local health departments and the New York State Association of County Health Officials, uniform statewide performance standards for the services funded pursuant to Article 6 of the Public Health Law; provided, however, that upon request the commissioner may approve a modification of a specific standard for a local health department if such local health department demonstrates adequate justification. The commissioner shall recognize the particular needs and capabilities of the various local health departments. The commissioner shall monitor the performance and expenditures of each local health department to ensure that each one satisfies the performance standards.

(b) The commissioner shall establish, in consultation with the local health departments and the New York State Association of County Health Officials, a uniform accounting system for monitoring the expenditures for services of each local health department to which aid is granted and the amount of state aid received including any performance payments pursuant to section six hundred nineteen-a of Article 6 of the Public Health Law. Such reporting system shall require information on the amount of public health moneys received from the federal government, the private sector, grants, and fees.

Effective Date: 
Wednesday, December 31, 2014
Doc Status: 
Complete

Section 40-1.20 - Personnel

Section 40-1.20 Personnel

(a) Local health department personnel must meet the entry and supervisory level qualifications established by Part 11 of the State Sanitary Code (10 NYCRR Part 11), as applicable.

(b) All public health services shall be supervised by a local commissioner of health or public health director, to ensure that such services are provided in accordance with the approved State Aid application. Such supervising official shall devote his or her entire time to public health duties, provided that:

(1) such official may serve as the head of a merged agency or multiple agencies if the approval of the commissioner is obtained; or

(2) such official may serve as the local commissioner of health or public health director of additional counties when authorized pursuant to section 351 of the public health law.

(c) All local health departments referred to herein shall not be in violation of the Civil Rights Act of 1964 (42 USCA 2000 et seq.) and the regulations promulgated by the United States Department of Health and Human Services (45 CFR part 80). The purpose of such statute and regulations is to assure that no person in the United States shall, on the ground of race, color or national origin, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any program activity receiving Federal financial assistance from the Department of Health and Human Services. The local health department shall submit to the commissioner, in triplicate, the Assurance of Compliance form required by the Department of Health and Human Services. Such form must be submitted by present recipients of State Aid as well as by all future applicants.

Effective Date: 
Wednesday, December 31, 2014
Doc Status: 
Complete

Section 40-1.30 - Maintenance of effort

Section 40-1.30 Maintenance of effort

(a) A local health department shall maintain public health programs and services and gross expenditures for those services at “base year” levels, as defined below.

(b) The base year shall be the most recent local health department fiscal year for which the local health department has filed all quarterly claim forms with the department.

(c) Maintenance of effort shall be monitored by the department throughout the fiscal year.

(d) Adjustment to State Aid reimbursement shall be made when a local health department reduces its expenditures beneath the amount expended in its base year. State Aid shall be reduced by the percentage reduction in expenditures between the base year and the current fiscal year. When calculating the amount by which a local health department has reduced its expenditure, the Commissioner shall exclude extraordinary expenditures of a temporary nature, such as disaster relief; unavoidable or justifiable program reductions, such as a program being subsumed by another agency; or expenditures for which the local health department can demonstrate to the Commissioner’s satisfaction that the need for the expenditure no longer exists.

Effective Date: 
Wednesday, December 31, 2014
Doc Status: 
Complete

Section 40-1.40 - Limitation on State Aid

Section 40-1.40 Limitation on State Aid

(a) State Aid may be limited, in whole in or part, if the commissioner determines, upon review of a local health department’s State Aid application, that the local health department will not deliver a core public health service required by Subpart 40-2 of this title. In that event, the Commissioner may use the proportionate share that is not granted to the local health department to contract with agencies, associations, or organizations to provide such services, or expend such share to provide such services upon approval of the director of the division of budget, as authorized by section 605 of the Public Health Law.

(b) Partial service counties.The commissioner may approve a State Aid application that seeks funding for fewer than all core public health services required pursuant to Subpart 40-2 of this Part, provided that:

(1) a community health assessment is completed by the municipality pursuant to section 40-2.40 of this Part;

(2) the selected core services meet all standards for those services set forth in this Part; and

(3) the State Aid application identifies the availability of core public health services not provided by the local health department, who will provide those services and the manner in which the services will be provided and financed.

Effective Date: 
Wednesday, December 31, 2014
Doc Status: 
Complete

Section 40-1.41 - Withholding of State Aid

Section 40-1.41 Withholding of State Aid

(a) State Aid may be withheld, in whole or in part, if the commissioner determines, upon program review, that:

(1) core public health services were not performed in accordance with this Part, Article 6 of the Public Health Law, or the approved application for State Aid; or

(2) the local health department has not made every reasonable effort to collect fees for services set forth in section 40-1.51 of this Part.

(b) If, after notification that State Aid will be withheld pursuant this section, the local health department provides written justification within 60 days why such action is not warranted that is satisfactory to the commissioner, the commissioner may, within his or her discretion, adjust or cancel the withholding of State Aid.

(c) If the commissioner withholds funds pursuant to this section, the amount withheld shall be based on the cost of providing the missing or inadequate services by another agency or by the State.

Effective Date: 
Wednesday, December 31, 2014
Doc Status: 
Complete

Section 40-1.50 - Fees and revenue; quarterly reporting

Section 40-1.50 Fees and revenue; quarterly reporting

Each local health department shall:

(a) make every reasonable effort to collect fees and third-party billings revenue;

(b) maintain a written protocol for third-party billing and for assessment and collection of fees, including follow-up procedures for unpaid claims; and

(c) report quarterly to the commissioner, with its State Aid claim, each category of revenue collected.

Effective Date: 
Wednesday, December 31, 2014
Doc Status: 
Complete

Section 40-1.51 - Fees and revenue; services for which fees are charged

Section 40-1.51 Fees and revenue; services for which fees are charged

(a) Environmental health services. Each local health department must charge a fee for the granting of a permit, inspections and other services prerequisite to the issuance of a permit:
X-ray and radioactive materials (authorized programs only)Food service establishments (all types)Camps and recreation facilitiesIndividual water and sewerageRealty subdivisionsMobile home parksCommunity and noncommunity water systemsTanning facilities
Bathing beaches
Swimming pools
Recreational aquatic spray grounds
Temporary residences (hotels/motels/bungalow colonies/cottage colonies, cabins)
Mass gatherings and public functions
Children’s camps
Agricultural fairgrounds
Migrant farm worker housing
Multipurpose recreational facility
Plan review

(b) Clinic health services. Where third-party reimbursement is not available, the local health department shall charge a fee for the following clinic health services, regardless of whether such services are provided directly or by contract. Subject to subdivision (b) of section 40-1.52 of this Part, where third-party reimbursement is available, the local health department shall ensure that every reasonable effort is made to collect such reimbursement and any relevant co-payments.

Sexually transmitted diseases, consistent with Public Health Law § 2304
HIV counseling, testing, diagnosis and prevention
Family planning
Prenatal and postpartum care
Primary care for children less than 21 years of age;
Immunization

(c) Tuberculosis control. Fees for clinical health services related to tuberculosis control shall be governed by Part 43 of this Title.

(d) Rabies control. Local health departments shall make every reasonable effort to collect third-party reimbursement for the clinical health services for rabies control, when such services are provided by the local health department.

(e) Nothing in this section shall be deemed as prohibiting local health departments from charging fees for other public health services.

Effective Date: 
Wednesday, December 31, 2014
Doc Status: 
Complete

Section 40-1.52 - Fees and revenue; calculation

Section 40-1.52 Fees and revenue; calculation

(a) For all fees, the calculation of fees shall be based on the cost to the municipality of providing the service and shall not exceed the cost to the local health department of providing the service for which the fee is to be charged.

(b) For those clinic health services for which a fee is authorized, the fee to the individual shall be based upon the ability of the recipient to pay. A sliding fee schedule shall be established for this purpose and made available to all recipients of service.

(c) The local health department may request the commissioner’s approval to waive fee assessments, based on documentation that charging a fee would create a substantial barrier to obtaining the public health service. The commissioner's decision on whether or not to grant such waivers shall be conclusive.

Effective Date: 
Wednesday, December 31, 2014
Doc Status: 
Complete

Section 40-1.53 - Fees and revenue; deduction and offset

Section 40-1.53 Fees and revenue; deduction and offset

(a) All revenues collected by the local health department or the contractor shall be deducted from eligible expenditures to produce a net amount of expenditures eligible for State Aid, except that municipalities may provide accounting documentation for the withholding from deduction any earned revenue attributable to projects and services ineligible for State Aid reimbursement, as enumerated in 40-2.3. The commissioner may exclude such revenue from deduction limited to documentation submitted.

Effective Date: 
Wednesday, December 31, 2014
Doc Status: 
Complete

Section 40-1.60 - Submission of claims

Section 40-1.60 Submission of claims

(a) Quarterly claims for State Aid reimbursement must be accompanied by supporting documentation to enable calculation of State Aid amounts as shall be determined by the commissioner or his or her designee. Such documentation shall include, but not be limited to:

(1) a duly certified State Aid claim form;

(2) a clear statement of expenditures for each service included in the State Aid application; and

(3) a clear statement of each item of revenue earned during the reporting period.

(b) All expenses for which a claim is submitted shall be accounted for and reported using the cash basis method of accounting.

(c) Claims shall be prepared in accordance with 2 CFR Part 200 – “Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards.”

(d) A claim shall be deemed complete if it complies with subdivisions (a), (b) and (c) of this section.

(e) Complete claims for the first three quarters of a program year must be submitted by the local health department for State Aid no later than two months after the end of the quarter in which the expenditures claimed occurred. Complete fourth quarter claims must be submitted no later than three months from the end of the program year in which expenditures claimed occurred. Claims received later than such prescribed time limits may be returned unpaid by the commissioner. Returned claims may not be resubmitted.

(f) In the event that a local health department submits any quarterly claim later than six months after the end of the program year in which the expenditures claimed occurred, the commissioner may accept such claim only if the local health department has submitted a written statement which, in the commissioner’s discretion, adequately explains the extraordinary circumstances justifying the delay.

(g) Claims for State Aid reimbursement must be supported by expenditure and revenue records, to be retained and made available to facilitate concurrent or post audit, until concurrent or post audit is completed. Records supporting actual revenues and costs incurred shall be maintained by the municipality for the period of six years after the close of the fiscal year to which they pertain and are subject to audit and review by the State.

Effective Date: 
Wednesday, December 31, 2014
Doc Status: 
Complete

Section 40-1.61 - Method of payment

Section 40-1.61 Method of payment

Expenditures by local health departments shall be reimbursed as follows, provided all requirements of this Part are met:

(a) Base grant:

(1) For local health departments providing all of the core services set forth in Subpart 40-2 of this Part, the State Aid base grant shall be 100 percent of net eligible expenditures for performance of these services to a maximum of $650,000 or the amount representing 65 cents per capita, whichever is greater.

(2) For local health departments that the commissioner has approved to provide fewer than all of the core services set forth in Subpart 40-2 of this Part, the State Aid base grant shall be 100 percent of net eligible expenditures for performance of approved core services to a maximum amount determined by the commissioner that reflects the reduced scope of services.

(3) For the purposes of this section, population shall be determined by the local population data published as of January 1 of each calendar year by the New York State Department of Health.

(b) A local health department’s net eligible expenses for performance of core public health services, in excess of the base grant, shall be reimbursed at a rate consistent with section 616 of the Public Health Law, after review and approval of all State Aid applications.

Effective Date: 
Wednesday, December 31, 2014
Doc Status: 
Complete

Section 40-1.62 - Claims and method of payment; State Aid for physically handicapped children

Section 40-1.62 Claims and method of payment; State Aid for physically handicapped children

(a) For local health departments, State Aid for authorized medical services for physically handicapped children shall be paid at 50% of net expenses, where net expenses means total expenses less revenues received for such services. State Aid may be withheld if, on post-audit and review, the Commissioner finds that a medical service rendered was not in conformance with a plan submitted by the municipality or that the recipient of the medical service was not a physically handicapped child as defined in section 2581 of the Public Health Law.

(b) For American Indian children residing on a reservation, State Aid for authorized medical services for physically handicapped children shall be paid at 100% of net expenses for such services.

(c) To receive State Aid, the clerk of the board of supervisors or other similar governing body of each county, or chief fiscal officer of the city of New York, shall quarterly transmit to the Commissioner a certified statement stating the amount expended for the purposes specified herein, the date of each expenditure and date of service, and the purpose for which it was made.

(d) To receive State Aid, complete claims for physically handicapped children must be received by the Commissioner within two years of the date of service.

Effective Date: 
Wednesday, December 31, 2014
Doc Status: 
Complete

SubPart 40-2 - Performance Standards and Minimum Requirements for Core Public Health Services

Effective Date: 
Wednesday, November 23, 2016
Doc Status: 
Complete
Statutory Authority: 
Public Health Law, art. 6, Sections 602, 603

GENERAL PROVISIONS

Section 40-2.0 - Scope of Subpart 40-2

GENERAL PROVISIONS
Section 40-2.0 Scope of Subpart 40-2. In accordance with applicable provisions of article 6 of the Public Health Law, this Subpart establishes standards of performance and minimum requirements for core public health services relating to Family Health, Communicable Disease Control, Chronic Disease Prevention, Community Health Assessment, Environmental Health, and Emergency Preparedness and Response.

Effective Date: 
Wednesday, December 31, 2014
Doc Status: 
Complete

Section 40-2.1 - General provisions concerning State Aid eligibility

Section 40-2.1 General provisions concerning State Aid eligibility

(a) Core public health services are eligible for State Aid reimbursement only if such services are included in an approved State Aid application and only if performed in accordance with this Subpart.

(b) Local health departments may contract for core public health services provided, however, that:

(1) to remain eligible for State Aid, any contract for core public health services must require that:

(i) core public health services shall be performed under the general supervision and control of the local health department commissioner or public health director;

(ii) if a contract relates to a core public health service for which a fee must be collected pursuant to section 40-1.51 of this Part, the contractor shall make every reasonable effort to collect such fee and, for clinic health services, the contractor shall make every reasonable effort to collect third-party reimbursement and any relevant co-payments; and

(iii) the contractor shall report to the local health department all fees, co-payments, and third-party reimbursement collected;

(2) pursuant to section 616 of the Public Health Law, the local health department shall not claim as State Aid eligible expenses any portion of the contract cost relating to indirect costs or fringe benefits, including but not limited to retirement funds, health insurance and federal old age and survivors insurance; and

(3) when the local health department provides clinic services pursuant to section 40-2.2 of this Part through a contract with another provider, the Commissioner has discretion to review and approve or disapprove the contract. When exercising such discretion, the Commissioner shall examine factors including, but not limited to, the quality of the proposed contractor’s services, the ability the local health department to oversee the contracted services, and the contractor’s efficiency in delivering services.

(c) The following costs related to the facility space used by the local health department are eligible for State Aid:

(1) Rent paid to a person, a private entity, or a public entity other than the municipality that operates the local health department.

(2) For space owned by the municipality that operates the local health department, the cost of maintenance of space in lieu of rent (MILOR).

Effective Date: 
Wednesday, March 16, 2016
Doc Status: 
Complete

Section 40-2.2 - State Aid eligibility; clinic services

Section 40-2.2 State Aid eligibility; clinic services

The cost of public health clinic services is allowable for only the following:

(a) clinic health services identified in subdivision (b) of section 40-1.51 of this Part, including clinics for sexually transmitted diseases, consistent with Public Health Law § 2304; HIV counseling, testing, diagnosis and prevention; family planning; immunization; primary care for children less than 21 years of age, provided that such services are only eligible for State Aid to the extent that the local health department makes good faith efforts to assist such persons with Medicaid or insurance enrollment, as applicable, and only until such time as insurance coverage becomes effective; and prenatal and postpartum care, provided that such services are only eligible for State Aid to the extent that the local health department makes good faith efforts to assist such women with Medicaid or insurance enrollment, as applicable, and only until such time as insurance coverage becomes effective;

(b) tuberculosis control;

(c) rabies control;

(d) dispensing countermeasures in the event of an actual or threatened public health emergency;

(e) other services consistent with section 602 of the Public Health Law and approved by the commissioner for State Aid reimbursement.

Effective Date: 
Wednesday, December 31, 2014
Doc Status: 
Complete

Section 40-2.3 - Projects and services ineligible for State Aid

Section 40-2.3 Projects and services ineligible for State Aid

Activities, services, and costs that are ineligible for State Aid include, but are not limited to, the following:

(a) activities and services involving other agencies:

(1) Joint activities. If joint State-local or Federal-local activities have been approved in the State Aid Application, the portion financed from State funds, other than State Aid under this section, and Federal funds will be excluded from consideration for reimbursement.

(2) Activities carried out by any other agency. The cost of activities for which any other government agency has been given legal responsibility.

(b) health care programs and services:

(1) Primary care and medical treatment, except as specified in this Subpart.

(2) Hospitals and other health facilities. The construction, establishment, maintenance and operation of hospitals, clinics, laboratories, dispensaries or similar facilities, except for the costs of providing eligible public health services in public health clinics as specified in section 40-2.2 of this Part.

(3) The cost of inpatient hospital care of patients with communicable disease, except tuberculosis and syphilis patients.

(4) Home health services provided by a local health department, except for public health home visiting as described in this Subpart.

(5) Laboratory services unrelated to eligible services. The cost of laboratory services related to public health services that are ineligible for State Aid are also ineligible for State Aid.

(6) Emergency Medical Service or Ambulance service. The maintenance and operation of Emergency Medical Service and ambulance service or the dispatching of ambulances.

(7) Medical examiner programs, services or activities.

(8) Jail medical services. The cost of providing routine medical treatment to inmates of jails operated by the local health department or in the municipality, including routine admission screenings and primary care to inmates older than 21 years of age.

(9) Any and all health care services for the screening or treatment of chronic diseases.

(c) environmental health programs and services:

(1) The cost of abatement, remediation, management in place or any action that removes a public health nuisance from a property, or the cost of relocating persons exposed to public health nuisances, consistent with section 40-2.55 of this Part.

(2) The cost of removal or covering lead paint or of relocating persons exposed to lead paint, consistent with section 40-2.58 of this Part.

(d) infrastructure and administration costs:

(1) Treatment plants and other facilities. The construction, maintenance and operation of water or waste water treatment plants, swimming pools and bathing beaches, and public bathhouses.
(2) Treatment of water supplies. The cost of treatment of public water supplies, including costs of chemicals for fluoridation.
(3) Garbage and refuse disposal facilities. The cost of construction, maintenance and operation of facilities for garbage and refuse collection, incineration or disposal and air cleaning facilities.

(4) Plumbing inspection. Plumbing inspection for the purpose of checking conformity with building code provisions.

(5) Boards of examiners. Compensation or expenses paid to boards of examiners (e.g., boards of examiners for plumbers and barbers).

(6) Insurance coverage of local health department employees. The cost of personal liability or malpractice insurance purchased by the local health department or the cost of funded self-insurance for such liability when such expense is related to protection against personal liability or malpractice of its employees.

(7) Real property. The cost of acquisition or development of real property.

(8) Depreciation and interest on funding, including:

(i) The cost of depreciation of the space utilized by a health agency in a building owned by the same municipality that operates the health agency.

(ii) The cost of interest on the funding of buildings utilized by a health agency and owned by the same municipality that operates the health agency.

(9) Rent paid to city or county. All rent for space utilized for health agency purposes, if such rent is payable to the same municipality that operates the health agency.
(10) Indirect costs and fringe benefits. Contributions by the local health department for indirect costs and fringe benefits, including but not limited to contractor fringe and indirect costs, employee retirement funds, health insurance, workers' compensation, and Federal old age and survivor's insurance.

(e) other programs and services that the commissioner reasonably determines are not eligible under this Part.

Effective Date: 
Wednesday, December 31, 2014
Doc Status: 
Complete

FAMILY HEALTH

Section 40-2.10 - Family health; performance standards

Section 40-2.10 Family health; performance standards

(a) The local health department shall maintain a family health program designed to achieve the following goals:

(1) improve the health of persons under the age of 21, including children with special health care needs;

(2) increase the proportion of persons under the age of 21 who receive comprehensive well child primary and preventive care, including oral health care;

(3) improve birth outcomes, decrease maternal and infant mortality and morbidity, and increase the number of pregnant and postpartum women who receive early, continuous and comprehensive prenatal and postpartum care, including oral health care, and other supportive services to address risks and needs; and

(4) decrease the rate of unintended pregnancies, increase optimal spacing of pregnancies, decrease the prevalence and morbidity of sexually transmitted disease, and improve availability and accessibility of comprehensive reproductive health care and family planning services to men and women of reproductive age.

(b) To be eligible for State Aid, the local health department shall conduct public health activities in the following areas:

(1) Child Health;

(2) Maternal and Infant Health; and

(3) Reproductive Health.

(c) The activities required under this subdivision (b) of this section shall include, at a minimum:

(1) utilization of available public health data and information to shape strategies related to child health, maternal and infant health and reproductive health, including:

(i) using available data from

the community health assessment, other local assessments, and local knowledge;

(ii) identifying communities and/or neighborhoods where children, women and families are potentially in need of services;

(iii) identifying any specific local factors that influence children's health status, health care needs, maternal and infant birth outcomes, unintended pregnancy, and use of reproductive health care services; and

(iv) assess currently available services;

(2) public health marketing and communication, including developing or adapting public education materials or campaigns, and promoting and disseminating such materials or campaigns, to:

(i) promote the use of comprehensive health care services for children, women and families;

(ii) promote healthy behaviors, including the preconception, prenatal, postpartum and interconception periods; and

(iii) reduce risk factors associated with poor maternal and infant outcomes, unintended pregnancy, and sexually transmitted diseases and related health disparities;

(3) information, referral and assistance to women and families in accessing and effectively utilizing available services;

(4) outreach, education, training and technical assistance for health and human service providers, designed to improve the delivery of comprehensive primary and preventive care to women and families, including, at least one annual communication to health care providers on health data and interventions related to family health;

(5) efforts with multiple sectors in the community to promote policy, environmental and systems change to address population and community level factors that influence child health outcomes and use of health care services, birth outcomes, and reproductive health outcomes and services; and

(6) activities to identify uninsured women and families and to provide such persons, either directly or through referral, with assistance with enrollment in health insurance coverage and comprehensive prenatal care, child health care, primary care services, and reproductive health services.

Effective Date: 
Wednesday, December 31, 2014
Doc Status: 
Complete

Section 40-2.11 - Family health; services eligible, but not required, for State Aid

Section 40-2.11

Family health; services eligible, but not required, for State Aid

The following public health services are eligible for State Aid but not required as a condition of State Aid eligibility:

(a) primary care services to uninsured persons under 21 years of age, in a clinic setting, provided that such services shall be eligible for State Aid only to the extent that the local health department makes good faith efforts to assist such persons with Medicaid or other insurance enrollment, as applicable, and only until such time as insurance coverage becomes effective;

(b) provision of public health home visits associated with eligible services. Such public health home visits may include visits only for the following purposes: assessing women’s preconception, prenatal, postpartum and interconception health and social support needs; assessing child and family health and social support needs; providing information to promote positive birth outcomes and child health; and referring persons to needed services. Activities undertaken in relation to the Child Find System under the Early Intervention Program, as required pursuant to 10 NYCRR 69-4.1(c) and 69-4.2, shall not be eligible for State Aid;

(c) provision of reproductive health care and family planning services for men and women of reproductive age, in a clinic setting; and

(d) prenatal and postpartum care, in a clinic setting, provided that such services shall be eligible for State Aid only to the extent that the local health department makes good faith efforts to assist such women with Medicaid or insurance enrollment, as applicable, and only until such time as insurance coverage becomes effective.

Effective Date: 
Wednesday, December 31, 2014
Doc Status: 
Complete

COMMUNICABLE DISEASE CONTROL

Section 40-2.20 - Sexually Transmitted Diseases (STDs) and Human Immunodeficiency Virus (HIV); performance standards

Section 40-2.20 Sexually Transmitted Diseases (STDs) and Human Immunodeficiency Virus (HIV); performance standards

The local health department shall maintain a program designed to minimize the incidence of STDs and HIV. The program shall include, at a minimum, activities to ensure:
(a) epidemiologic case finding, timely disease surveillance and reporting, in accordance with Part 2 of this Title;

(b) availability of accessible laboratory testing for STDs and HIV;

(c) provision of adequate facilities for diagnosis and treatment of STDs, directly or by contract, pursuant to Article 23 of the Public Health Law;

(d) provision of partner notification and referral services for priority patients, as determined in an investigation undertaken pursuant to 10 NYCRR 2.6;

(e) provision of prophylactic treatment to exposed partners for STDs;

(f) information, referral and assistance in utilizing appropriate community service programs;

(g) public health marketing and communication, including developing or adapting public education materials or campaigns, and promoting and disseminating such materials and campaigns, to promote healthy behaviors and reduce risk factors associated with STDs, HIV and related health disparities; and

(h) distribution of at least one communication per year to health care providers, clinics and laboratories on local and regional morbidity rates, CDC guidelines, diagnostic and treatment modalities and Department reporting requirements for STDs and HIV.

Effective Date: 
Wednesday, December 31, 2014
Doc Status: 
Complete

Section 40-2.21 - Tuberculosis; performance standards

Section 40-2.21 Tuberculosis; performance standards

The local health department shall maintain a program designed to minimize the incidence of tuberculosis. The program shall include, at a minimum, activities to ensure:

(a) timely tuberculosis surveillance and reporting;

(b) detection and follow-up with individuals identified as infected with tuberculosis, including contact investigations performed in close collaboration with healthcare facilities, schools, workplaces, and other settings;

(c) provision of clinical services for tuberculosis disease or infection, either directly,

through referral, or by contract;

(d) provision, or activities to ensure provision, of directly observed therapy for persons with tuberculosis, regardless of whether the local health department is the primary medical provider; and

(e) distribution of at least one communication per year to healthcare providers, clinics and laboratories regarding local and regional morbidity rates, CDC guidelines, diagnostic and treatment modalities, and Department reporting requirements for tuberculosis.

Effective Date: 
Wednesday, December 31, 2014
Doc Status: 
Complete

Section 40-2.22 - Communicable disease control; performance standards

Section 40-2.22 Communicable disease control; performance standards

The local health department shall maintain a program designed to minimize the incidence of communicable disease. The program shall include, at a minimum, activities to ensure:

(a) compliance with disease specific protocols, as established by the Department or, for New York City, the Department of Health and Mental Hygiene, for:

(1) disease surveillance;

(2) timely disease investigation;

(3) reporting of diseases to the commissioner, pursuant to Part 2 of this Title;

(b) verification and diagnosis of infections in a timely manner, ascertainment of the sources of infections, and follow up with infected persons as needed;

(c) minimization of the spread of disease, through the identification and, when appropriate, prophylaxis of persons possibly exposed to disease;

(d) performance of multiple, simultaneous investigations of communicable diseases, and maintenance of capacity to do so; and

(e) distribution of at least one communication per year to healthcare providers, clinics and laboratories regarding local and regional morbidity rates, CDC guidelines, diagnostic and treatment modalities, and Department reporting requirements for reportable diseases.

Effective Date: 
Wednesday, December 31, 2014
Doc Status: 
Complete

Section 40-2.23 - Immunization; performance standards

Section 40-2.23 Immunization; performance standards

The local health department shall maintain a program designed to minimize the occurrence and transmission of vaccine-preventable diseases. The program shall include, at a minimum, activities to ensure:
(a) compliance with all statutes and regulations concerning immunization applicable to local health departments, including but not limited to:

(1) Public Health Law § 613, concerning programs of immunization for children;

(2) Public Health Law § 2164, concerning vaccination of school children against certain diseases;

(3) Public Health Law § 2165, concerning vaccination of post-secondary students against certain diseases;

(4) Public Health Law § 2168 concerning the New York Statewide Immunization Information System (NYSIIS);

(5) Subpart 69-3 of this Title, concerning pregnant women, testing for Hepatitis B, and follow-up care;

(b) disease surveillance for vaccine preventable diseases, in accordance with Part 2 of this Title;

(c) assistance with and follow-up on school immunization surveys;

(d) educational efforts in the community, including:

(1) collaboration and communication with healthcare providers and schools to maintain required immunization levels in schools; and

(2) public health marketing and communication, including developing or adapting public education materials or campaigns, and promoting and disseminating such materials or campaigns, to increase awareness of diseases and the control measures required to prevent the spread of disease;

(e) coordination with medical providers and laboratories to encourage and advise them to conduct recommended diagnostic testing in the event of a disease outbreak; and

(f) engagement in quality assurance activities with providers in the community to improve immunization practices, including but not limited to, improving compliance with the NYSIIS reporting requirements, as applicable.

Effective Date: 
Wednesday, December 31, 2014
Doc Status: 
Complete

Section 40-2.24 - Zika Action Plan; performance standards

40-2.24 Zika Action Plan; performance standards. 

(a) By April 15, 2016, the local health department shall adopt and implement a Zika Action Plan (ZAP), in accordance with guidance to be issued by the Department, and which shall include, but not be limited to, the following activities: 

(1) for all local health departments: 

(i) human disease monitoring, response and control; and 

(ii) education about Zika virus and its prevention; and 

(2) in addition, for those local health departments identified by the Department as jurisdictions where mosquitoes capable of transmitting the Zika virus are currently located or may be located in the future: 

(i) enhanced human disease monitoring, response, control;  

(ii) enhanced education about Zika virus and its prevention;  

(iii) mosquito trapping, testing and habitat inspections specific to Aedes albopictus, and for such other species as the Department may deem appropriate; 

(iv) mosquito control; and 

(v) identification and commitment of appropriate staff available to join State-coordinated rapid response teams, which may be deployed to those areas where the Department determines that there is the potential for transmission of Zika virus by mosquitoes. 

(b) Local health departments shall update their ZAPs annually, or as directed by the Department, to include activities identified by the Department in guidance issued pursuant to subdivision (a) of this section.

(c) Local health departments shall submit such plans to the Department as part of the annual Application for State Aid made pursuant to section 40-1.0 of this Part.  State Aid shall only be available for activities within ZAPs determined by the Department to be necessary and appropriate to control the spread of the Zika virus in guidance issued pursuant to subdivision (a) of this section.

 

Effective Date: 
Wednesday, November 23, 2016
Statutory Authority: 
Public Health Law, Sections 602, 603, 619

CHRONIC DISEASE PREVENTION

Section 40-2.30 - Chronic disease prevention; performance standards

Section 40-2.30 Chronic disease prevention; performance standards

(a) The local health department shall maintain a program designed to reduce the prevalence or incidence of chronic diseases and conditions such as

cancer, cardiovascular diseases, diabetes, asthma, arthritis and obesity, and the underlying risk factors of tobacco use, physical inactivity and poor nutrition. The activities required in this program shall include, at a minimum:

(1) Analysis and utilization of public health data and information to shape objectives and strategies related to chronic disease prevention. This analysis shall:

(i) use available data from the community health assessment and other local assessments;

(ii) identify communities and/or neighborhoods where the population is at increased risk of chronic diseases and conditions and underlying risk factors;

(iii) identify the specific local factors and available policies, practices, underlying risk factors, and interventions that influence chronic disease;

(2) leadership of, or participation in, efforts with multiple sectors in the community to improve social and physical environments to support healthy behaviors;

(3) public health marketing and communication, including developing or adapting public education materials or campaigns, and promoting or disseminating such materials or campaigns, to reduce risk factors for chronic disease morbidity, mortality and related health disparities; and

(4) activities to promote the delivery of early detection and guideline-concordant health care by health care providers.

(b) Any and all health care services for the screening or treatment of chronic diseases are ineligible for State Aid.

Effective Date: 
Wednesday, December 31, 2014
Doc Status: 
Complete

COMMUNITY HEALTH ASSESSMENT

Section 40-2.40 - Community health assessment; performance standards

Section 40-2.40 Community health assessment; performance standards

Local health departments shall work with community partners to conduct a Community Health Assessment (“Assessment”) and a Community Health Improvement Plan (“Plan”). Together, the Assessment and Plan shall include, at a minimum:

(a) an analysis of secondary data and, where available, primary data on health status and demographics;

(b) a description of the demographics of the population of the jurisdiction served by the local health department,

(c) a description of the health issues of the population, the distribution of health issues, and the contributing causes of the health challenges based on the data analyzed,

(d) the identification of priority areas for health improvement based on valid criteria;

(e) a description of public health services in the community and other resources that can be mobilized to improve population health, particularly in the priority areas;

(f) improvement strategies and measurable objectives through which the municipality and its community partners will address areas for health improvement and performance targets that will be used to track progress toward improvement of public health outcomes;

(g) methods by which access to the reports is to be provided to interested stakeholders including hospitals, nursing homes, medical societies, libraries, schools, government facilities, or other agencies and other organizations; and

(h) a description of the community partners that participated in the development of the community health assessment and improvement plan and their roles in the plan.

Effective Date: 
Wednesday, December 31, 2014
Doc Status: 
Complete

ENVIRONMENTAL HEALTH

Section 40-2.50 - Public water supply protection; performance standards

Section 40-2.50 Public water supply protection; performance standards

The local health department shall maintain a program that ensures public water systems are operated pursuant to the New York State Public Health Law, Part 5 of the State Sanitary Code (10 NYCRR Part 5), and applicable federal Safe Drinking Water Act (SDWA) requirements.

Effective Date: 
Wednesday, December 31, 2014
Doc Status: 
Complete

Section 40-2.51 - Environmental radiation protection; performance standards

Section 40-2.51 Environmental radiation protection; performance standards

The local health department shall maintain a program to conduct environmental radiation surveillance activities, if the Department has authorized the local health department to conduct such a program. Such program shall, at a minimum, maintain appropriate equipment and supplies, ensure that personnel are properly trained, and collect environmental samples for radiological analysis.

Effective Date: 
Wednesday, December 31, 2014
Doc Status: 
Complete

Section 40-2.52 - Community environmental health and food protection; performance standards

Section 40-2.52 Community environmental health and food protection; performance standards

The local health department shall maintain a program that ensures that facilities operated pursuant to Parts 6, 7, 14, 15 and 17 of the State Sanitary Code comply with all relevant provisions of the State Sanitary Code and the Public Health Law.

Effective Date: 
Wednesday, December 31, 2014
Doc Status: 
Complete

Section 40-2.53 - Realty subdivisions; performance standards

Section 40-2.53 Realty subdivisions; performance standards

The local health department shall maintain a program for approving realty subdivisions and assuring construction is in accordance with approved plans; provided that this provision shall not apply to New York City. The program shall include, at a minimum:

(a) procedures for approval of all realty subdivisions in accordance with the Public Health Law, Environmental Conservation Law, Education Law, and applicable State regulations prior to the start of construction activities; and

(b) provisions for site evaluation and construction inspections as necessary to assure that approved plans are followed.

Effective Date: 
Wednesday, December 31, 2014
Doc Status: 
Complete

Section 40-2.54 - Individual water and sewage systems; performance standards

Section 40-2.54 Individual water and sewage systems; performance standards

The local health department shall, at a minimum, maintain a program for providing technical assistance to property owners regarding the installation, maintenance and operation of individual water supplies and individual sewage systems.

Effective Date: 
Wednesday, December 31, 2014
Doc Status: 
Complete

Section 40-2.55 - Public health nuisances; performance standards

Section 40-2.55 Public health nuisances; performance standards

The local health department shall:

(a) respond to all reported nuisances which may affect public health and safety; and

(b) maintain a program, consistent with Part 8 of the State Sanitary Code, as applicable, for responding to public health nuisances and ensuring abatement of such public health nuisances; provided, however, that abatement, remediation, management in place or any action that removes the public health nuisance from a property or relocating persons exposed to public health nuisances shall not be eligible for State Aid.

Effective Date: 
Wednesday, December 31, 2014
Doc Status: 
Complete

Section 40-2.56 - Injury prevention and control; performance standards

Section 40-2.56 Injury prevention and control; performance standards

The local health department shall maintain a program designed to reduce morbidity and mortality associated with injuries, utilizing reasonably available data. The program shall include, at a minimum, development and implementation of education programs to inform the public and providers of measures to avoid intentional and unintentional injury.

Effective Date: 
Wednesday, December 31, 2014
Doc Status: 
Complete

Section 40-2.57 - Environmental health exposure investigation, assessment and response; performance standards

Section 40-2.57 Environmental health exposure investigation, assessment and response; performance standards

The local health department shall maintain and conduct a program that includes, at a minimum:

(a) responding to reports of exposure to chemical and non-infectious biological hazards attributable to environmental and occupational settings. Such responses shall include, at a minimum, preliminary evaluation and exposure investigation; appropriate environmental, biological, clinical or epidemiological monitoring; appropriate public health interventions to reduce and/or eliminate exposures; public or professional information and education; and consultation and referral as needed; and

(b) maintaining a log of reported exposures and alleged health effects, including a timeline and description of the response provided.

Effective Date: 
Wednesday, December 31, 2014
Doc Status: 
Complete

Section 40-2.58 - Lead poisoning prevention; performance standards

Section 40-2.58 Lead poisoning prevention; performance standards

(a) The local health department shall maintain a lead poisoning prevention program, which shall include, at a minimum:

(1) activities to identify risk factors for childhood lead poisoning, including locations in the municipality where exposure of children to lead is likely;

(2) activities to educate the community as to the dangers of lead toxicity;

(3) for all children aged one and two years old, and other children at risk of exposure to lead, ensuring provision of:

(i) access to blood lead testing services;

(ii) appropriate case coordination; and

(iii) environmental intervention;

(4) reporting of pertinent blood lead testing information and follow up activities in a manner acceptable to the Commissioner, provided that this provision shall not be interpreted to limit the jurisdiction of the local health department to require additional reporting in accordance with local law.

(b) The cost of removal or covering lead paint or of relocating persons exposed to lead paint shall not be eligible for State Aid.

Effective Date: 
Wednesday, December 31, 2014
Doc Status: 
Complete

ENVIRONMENTAL HEALTH – ONLY WHERE AUTHORIZED

Section 40-2.60 - Authorized radioactive materials licensing and inspection program; performance standards

Section 40-2.60 Authorized radioactive materials licensing and inspection program; performance standards

Where a local health department has received authorization to maintain a radioactive materials licensing and inspection program pursuant to Part 16 of this Title, the municipality shall conduct such program consistent with that Part.

Effective Date: 
Wednesday, December 31, 2014
Doc Status: 
Complete

Section 40-2.61 - Authorized radiation-producing equipment inspection program; performance standards

Section 40-2.61 Authorized radiation-producing equipment inspection program; performance standards

Where a local health department has been certified to maintain a radiation producing equipment inspection program pursuant to Part 16 of this Title, the municipality shall conduct such program consistent with that Part.

Effective Date: 
Wednesday, December 31, 2014
Doc Status: 
Complete

Section 40-2.62 - Authorized tanning facilities licensing and inspection program; performance standards

Section 40-2.62 Authorized tanning facilities licensing and inspection program; performance standards

Where a local health department’s health officer has received authorization to act as a permit-issuing official for the licensing and inspection of tanning facilities pursuant to Subpart 72-1 of this Title, the municipality shall conduct such program consistent with that Subpart or, if applicable, local regulations issued pursuant to 10 NYCRR 72-1.2.

Effective Date: 
Wednesday, December 31, 2014
Doc Status: 
Complete

EMERGENCY PREPAREDNESS AND RESPONSE

Section 40-2.70 - Emergency preparedness and response; performance standards

Section 40-2.70 Emergency preparedness and response; performance standards

The local health department shall conduct a program designed to ensure readiness to respond to health emergencies, whether naturally occurring or deliberate, to protect the health of its residents. The program shall include at a minimum:

(a) development and maintenance of an All Hazards Health Emergency Preparedness and Response Plan;

(b) activities designed to maintain readiness to provide appropriate medical countermeasures to the public in response to an emergency;

(c) ensure training and health education to local health department staff, health care providers and the community on health emergency preparedness;

(d) participation and implementation of exercises and drills that include appropriate response partners; and

(e) responding to emergencies as described in the All Hazards Health Emergency Preparedness and Response Plan.

Effective Date: 
Wednesday, December 31, 2014
Doc Status: 
Complete

SubPart 40-3 - REPEALED

Effective Date: 
Wednesday, July 7, 2010

SubPart 40-4 - Fee and Revenue Plan for Departmental Services

Doc Status: 
Complete
Statutory Authority: 
Public Health Law, art. 6, Section 606

Section 40-4.0 - Fee and revenue plan

Section 40-4.0 Fee and revenue plan.

(a) Fees and revenues received by the department pursuant to section 606 of the Public Health Law shall be deposited in a local public health services program account, and distributed to municipalities as supplemental health services grants.

(b) Such revenues shall include fees for services provided by the department, fines levied and collected by the department from enforcement actions associated with these services, and monies received or recovered as a result of State aid audit exceptions.
 

Doc Status: 
Complete

Section 40-4.1 - Fees for departmental services

40-4.1 Fees for departmental services.

(a) The department must charge a fee for the granting of a permit, inspections, or other services prerequisite to the issuance of a permit, or for other environmental health services. Such fee shall be nonrefundable.

(b) Annual fees for facility inspection and permit issuance services, where such services are provided by the department and not directly by the municipality, are based on the costs of providing such services and shall be revised periodically.

(c) Cumulative fees for a single operator at a single location shall not exceed $1,000 per year.

(d) Definitions. (1) As used in this Subpart, "multipurpose recreational facilities," are defined as large tracts of land upon which a recreational facility owned and operated by a single person, partnership or corporation is located. Such facilities may encompass multiple food, swimming or recreational facilities permittable under the State Sanitary Code. In completing a Fee Determination Schedule, the facility operator may exercise an option to pay either a registration fee as provided for in paragraph (10) of subdivision (e) of this section or fees separately calculated for each individual activity.

(2) "Primary service" is defined as the principal or major function of such multipurpose recreational facilities (e.g. water slides). All such primary services are covered by the base fee. Other services, (e.g. food,) are chargeable as add-ons for each individual facility (e.g., 10 food booths x $50. = $500.00 additional fee).

(3) "Seasonal facility," for the purpose of determining the annual fee levels for such facility, is defined as a facility permittable under the provisions of the State Sanitary Code which operates 26 weeks or less in a calendar year. Such seasonal facility must be designated as such on any permit issued to it, which shall also state the starting and ending dates of the seasonal operating period. Such seasonal facility shall be entitled to a 10% reduction from the normal annual fee.

(e) Fees for departmental environmental services, excluding plan review unless otherwise stated, are established as follows:

(1) Food service establishments, taverns, bars (includes $25 frozen dessert fee except for free-standing soft ice cream and slush machine units, etc.).

Seating Capacity 100 or less, including takeout or stand up service $ 75.00 101 or more 150.00

(2) Caterers and Commissaries. 200.00

(3) Temporary Food Service Mobile 30.00 Vendors.

(4) Hotels, Motels, Bungalow Colonies, Cabins, Cottage Colonies. (Base fee (i) and added fees (ii-iv))

(i) Number of rental units 1-20 units 50.00 21-50 100.00 51-100 150.00 101-200 200.00 201+ 400.00

(ii) Food service dining areas (which may include a cocktail lounge, night club, etc.)

Capacity 1 - 100 add 50.00 for each separate area/facility

Capacity 101 or more add 100.00 for each separate area/facility

(iii) Pool add 30.00 for each separate pool

(iv) Beach add 20.00 for each separate beach

(5) Campgrounds and Travel Trailer Parks. (Base fee (i) and added fees (ii-iv))

(i) Number of Sites

50 or less 50.00 51 - 200 75.00 201 - 500 100.00 501 - 750 150.00 751 or more 250.00

(ii) Food service dining areas (which may include a cocktail lounge, night club, etc.)

Capacity 1 - 100 add 50.00 for each separate area/facility

Capacity 101 or more add 100.00 for each sep area/facility

(iii) Pool add 30.00 for each separate pool

(iv) Beach add 20.00 for each beach

(6) Mobile Home Parks. Base fee (i) and added fees (ii-iv))

(i) Number of Sites

Less than 50 50.00 50-100 100.00 101 or more 200.00

(ii) Food service dining areas (which may include a cocktail lounge, night club, etc.) Capacity 1-100 add 50.00 for each separate area/facility

Capacity 101 or more add 100.00 for each separate area/facility

(iii) Pool add 30.00 for each separate pool

(iv) Beach add 20.00 for each separate beach

(7) Migrant Labor Camps.

Occupancy 5 - 50 50.00 51 or more 100.00

(8) Swimming Pools and Common Use Spa Pools.

Maximum number of Bathers (25 sq. ft./bather) 1 - 100 50.00 101 or more plus wave pools and slides 100.00

(9) Bathing Beaches.

Less than 5000 sq. ft. 30.00 5000 sq. ft. or more 70.00

(10) Multipurpose Recreational Facilities.

(i) Base fee for primary service 500.00 (food, pool, beach, etc. as as designated by operator)

(ii) Additional services (other than primary)

Food service add 50.00 for each separate area/facility

Pool add 30.00 for each separate area/facility

Beach add 20.00 for each separate area/facility

(11) Community Water Supplies.

Population Served: Less than 1000 100.00 1000 - 9999 500.00 10,000 or more 1000.00

(12) Unpermitted Noncommunity Water Supplies. 100.00

(13) Mass Gatherings, Including Plan Review. 500.00

(14) Public Functions of Over 5000 People Not Constituting Mass Gatherings.

Number of emergency health care units Less than 3 100.00 3 or more 200.00

(15) Children's Camps. 100.00

(16) Frozen Desserts. (soft ice cream) 25.00

(f) Plan review fee (per project):

(1) Food Service Establishments, 75.00 Caterers, Commissaries, etc.

(2) Hotels, Motels, Bungalow Colonies, Cabins, Cottage Colonies.

Number of stories or structures 1 or 2 50.00 3 or more 200.00

(3) Campgrounds and Travel Trailer Parks. 100.00

(4) Mobile Home Parks. 100.00

(5) Migrant Labor Camps. 50.00

(6) Swimming Pools and Bathing Beaches.

100 - 5000 sq. ft. 100.00 5001 sq. ft. or more 150.00 Wavepools, slides, spa pools 150.00

(7) Realty Subdivisions (as prescribed by Public Health Law, section 1119) 25.00/lot

(8) Community and Noncommunity Water Supply.

Cost of Project Less than $10,000 50.00 10,000 - 100,000 100.00 More than 100,000 200.00

(9) Individual Sewage System. (alternative design) 50.00
 

Effective Date: 
Wednesday, January 25, 1989
Doc Status: 
Complete

Section 40-4.2 - Applicability

40-4.2 Applicability. (a) It shall be the responsibility of each facility rendering to the public services covered by the fee schedule provided in section 40-4.1 of this Subpart to remit the annual fee in the form and by the date required by the department, except that no fee shall be charged in the case of a facility operated by a person, firm or corporation or association for charitable, philanthropic or religious purposes or by a municipality.
(b) Failure to pay the prescribed fee shall result in nonissuance of a permit to operate or summary suspension of any existing permit until such fee is paid.

Doc Status: 
Complete