S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   4021
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                             February 2, 2023
                                ___________
 
 Introduced by Sens. KAVANAGH, ADDABBO, CLEARE, GOUNARDES, HOYLMAN-SIGAL,
   JACKSON,  MYRIE -- read twice and ordered printed, and when printed to
   be committed to the Committee on Health
 
 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
   staphylococcus aureus (MRSA) and other antibiotic-resistant infections
   in the definition of airborne infectious disease
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Legislative findings. Antibiotics are rightfully considered
 one of the medical miracles of the last century because of their  power-
 ful  ability  to  fight  illness and disease caused by bacteria. But the
 effectiveness of medically important antibiotics is now  at  great  risk
 due  to  their  misuse  and  overuse  in  medicine and agriculture. Many
 strains of bacteria have  evolved  resistance  to  antibiotics,  meaning
 instead  of  being  killed  by  the  drugs,  they survive, multiply, and
 spread. In fact, the more antibiotics are used, the  faster  antibiotic-
 resistant  bacteria  (aka  "superbugs")  emerge,  increasing the risk of
 contracting an antibiotic-resistant infection. If effective policy meas-
 ures are not soon adopted, some experts predict that by 2050,  antibiot-
 ic-resistant  infections will be responsible for more annual deaths than
 cancer.
   In recognition of the serious public health threat posed by  antibiot-
 ic-resistant  infections,  the  United  Nations General Assembly in 2016
 committed to taking action. The World Health Organization (WHO)  consid-
 ers it to be one of the biggest threats to global health, food security,
 and  international  development  today.  The  United  States Centers for
 Disease Control and Prevention  (CDC)  has  stated  that  fighting  this
 threat is a public health priority and estimates that each year, antibi-
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD05817-01-3
              

 S. 4021                             2
 
 otic-resistant  bacteria  are  responsible  for  at  least  2.8  million
 infections in the United States and at  least  35,000  deaths.  A  study
 commissioned by the United Kingdom government predicts that if action is
 not  taken now to combat antibiotic resistance, by 2050 the annual death
 toll will have risen to 10 million  globally.  Most  major  medical  and
 health groups in the United States, including the American Medical Asso-
 ciation, American Academy of Pediatrics, and Infectious Diseases Society
 of  America,  have  recognized  the urgency of the antibiotic-resistance
 crisis. New York State, in its Prevention Agenda 2019-2024,  established
 Antibiotic  Resistance  and  Healthcare-Associated  Infections as one of
 five major focus areas.
   Antibiotic-resistant bacteria are bacteria  that  are  immune  to  the
 effect of antibiotics. These so-called "superbugs" can infect humans and
 animals, and the infections they cause are harder and sometimes impossi-
 ble to treat. Antibiotic resistance is a naturally occurring phenomenon,
 but  the speed at which superbugs are emerging and spreading is acceler-
 ating due to overuse and misuse of antibiotics in  humans  and  animals.
 Antibiotic-resistant bacteria are most prevalent in environments associ-
 ated  with  high antibiotic use: healthcare settings and animal agricul-
 ture. Two-thirds of all medically important antibiotics are sold for use
 in animals. Bacteria that  are  resistant  can  spread  from  person  to
 person,  and  from  animal  to  person--via  the  natural environment or
 contaminated food--and resistance genes can transfer  from  bacteria  to
 bacteria.  Some bacteria have developed resistance to multiple antibiot-
 ics, making common infectious diseases such as tuberculosis,  pneumonia,
 food  poisoning,  urinary  tract infections (UTIs), and gonorrhea harder
 and sometimes impossible to treat. Everyone is at risk  of  exposure  to
 antibiotic-resistant bacteria, but those who work in hospitals and nurs-
 ing  homes, patients in such facilities, and those who work in livestock
 farming, slaughterhouses, and large animal veterinarian practices have a
 greater risk of getting antibiotic-resistant infections.
   Given the current and growing threat posed by  antibiotic  resistance,
 the  state  of  New York must organize itself to adequately respond. The
 WHO and the CDC recommend taking a "One Health" approach,  which  recog-
 nizes  the interconnectedness of humans and animals in achieving optimal
 health outcomes.
   § 2. Article 2 of the public health law is amended  by  adding  a  new
 title 9 to read as follows:
                                   TITLE 9
                       ANTIBIOTIC-RESISTANCE CONTROL
 SECTION 269-A. STATEMENT OF POLICY AND PURPOSES.
         269-B. DEFINITIONS.
         269-C. OFFICE OF ANTIBIOTIC-RESISTANCE CONTROL.
         269-D. ANTIBIOTIC-RESISTANCE CONTROL BOARD.
         269-E. ORGANIZATION OF ANTIBIOTIC-RESISTANCE CONTROL BOARD.
         269-F. MEETINGS.
         269-G. FUNCTIONS, POWERS AND DUTIES.
         269-H. COOPERATION WITH OTHER DEPARTMENTS.
         269-I. EVALUATION REQUIREMENTS.
         269-J. ANTIBIOTIC-RESISTANCE DATA COLLECTION.
         269-K. ANTIBIOTIC STEWARDSHIP IMPLEMENTATION.
         269-L. ANTIBIOTIC-RESISTANCE CONTROL IN AGRICULTURE.
         269-M. REPORTING REQUIREMENTS.
         269-N. VIOLATIONS.
   § 269-A. STATEMENT  OF  POLICY AND PURPOSES. THE PURPOSE OF THIS TITLE
 IS TO CODIFY THE ESTABLISHMENT OF AN  OFFICE  TO  ORGANIZE  THE  STATE'S
 S. 4021                             3
 
 EFFORTS  TO  CONTROL THE SPREAD OF ANTIBIOTIC RESISTANCE, COORDINATE ALL
 AGENCIES' RESPONSES, AND  RELY  ON  BEST  PRACTICES  TO  COMPREHENSIVELY
 ADDRESS THE PUBLIC HEALTH THREAT POSED BY ANTIBIOTIC RESISTANCE.
   § 269-B. DEFINITIONS. AS USED IN THIS SECTION:
   1. "ANTIBIOTIC" MEANS A DRUG USED TO TREAT INFECTIONS CAUSED BY BACTE-
 RIA.  ANTIBIOTICS MAY EITHER KILL OR INHIBIT THE GROWTH OF BACTERIA.
   2.  "ANTIBIOTIC  CLASS" MEANS ANTIBIOTIC AGENTS WITH RELATED MOLECULAR
 STRUCTURES, OFTEN WITH A SIMILAR MODE OF ACTION BECAUSE  OF  INTERACTION
 WITH A SIMILAR TARGET AND THUS SUBJECT TO A SIMILAR MECHANISM OF RESIST-
 ANCE.
   3.  "ANTIBIOTIC RESISTANCE" MEANS THE ABILITY OF A BACTERIUM TO MULTI-
 PLY OR PERSIST IN THE PRESENCE OF AN INCREASED LEVEL  OF  AN  ANTIBIOTIC
 RELATIVE TO THE SUSCEPTIBLE COUNTERPART OF THE SAME SPECIES.
   4. "ANTIBIOTIC STEWARDSHIP" MEANS USING THE OPTIMAL SELECTION, DOSAGE,
 AND  DURATION  OF ANTIBIOTIC TREATMENT THAT RESULTS IN THE BEST CLINICAL
 OUTCOME FOR THE TREATMENT OF INFECTION, WITH  MINIMAL  TOXICITY  TO  THE
 PATIENT AND MINIMAL IMPACT ON SUBSEQUENT RESISTANCE. ANTIBIOTIC STEWARD-
 SHIP  MAY ALSO INCLUDE MEASURES TO PREVENT SPREAD OF INFECTION IN HOSPI-
 TALS AND ANIMAL HUSBANDRY PRACTICES THAT PREVENT SPREAD OF INFECTIONS ON
 FARMS.
   5. "BOARD"  MEANS  THE  ANTIBIOTIC-RESISTANCE  CONTROL  BOARD  CREATED
 PURSUANT TO SECTION TWO HUNDRED SIXTY-NINE-D OF THIS TITLE.
   6. "DISEASE CONTROL" MEANS ADMINISTRATION OF ANTIBIOTICS TO A GROUP OF
 ANIMALS  ONCE  A  PROPORTION OF THE ANIMALS IN THE GROUP HAVE BEEN DIAG-
 NOSED (BASED ON CLINICAL SIGNS OR OTHER APPROPRIATE DIAGNOSTIC  METHODS)
 WITH AN INDICATED DISEASE.
   7. "DISEASE PREVENTION" MEANS ADMINISTRATION OF ANTIBIOTICS TO A GROUP
 OF ANIMALS, NONE OF WHICH HAVE BEEN DIAGNOSED WITH AN INDICATED DISEASE,
 WHEN  TRANSMISSION  OF EXISTING UNDIAGNOSED INFECTIONS, OR THE INTRODUC-
 TION OF PATHOGENS, IS ANTICIPATED BASED ON HISTORY,  CLINICAL  JUDGMENT,
 OR EPIDEMIOLOGICAL KNOWLEDGE.
   8.  (A) "DISEASE TREATMENT" MEANS ADMINISTRATION OF AN ANTIBIOTIC ONLY
 TO ANIMALS DIAGNOSED (BASED ON CLINICAL SIGNS OR OTHER APPROPRIATE DIAG-
 NOSTIC METHODS) WITH AN INDICATED DISEASE.
   (B) DISEASE TREATMENT INCLUDES BUT IS NOT LIMITED TO SELECTIVE DRY COW
 THERAPY, WHEREBY INDIVIDUAL DAIRY COWS WITHIN  A  HERD  ARE  DETERMINED,
 WHEN  ENTERING A DRY CYCLE, TO BE LIKELY INFECTED WITH MASTITIS BASED ON
 KEY INDICATORS INCLUDING THEIR PREVIOUS HISTORY OF DISEASE, SOMATIC CELL
 COUNTS  AND/OR  CELL  CULTURES,  AND  ARE  ADMINISTERED  ANTIBIOTICS  AS
 PRESCRIBED BY A LICENSED VETERINARIAN.
   9.  "FOODBORNE DISEASE" (ALSO REFERRED TO AS FOODBORNE ILLNESS OR FOOD
 POISONING): MEANS ANY ILLNESS THAT RESULTS FROM THE CONSUMPTION OF FOOD,
 CONTAMINATED WITH PATHOGENIC BACTERIA, VIRUSES, OR PARASITES.
   10. "FOOD-PRODUCING ANIMAL" MEANS:
   (A) ALL CATTLE, SWINE, OR POULTRY, REGARDLESS OF WHETHER THE  SPECIFIC
 ANIMAL  IS  RAISED  FOR THE PURPOSE OF PRODUCING FOOD FOR HUMAN CONSUMP-
 TION; OR
   (B) ANY ANIMAL OF A  TYPE  THAT  THE  DEPARTMENT  OF  AGRICULTURE  AND
 MARKETS  IDENTIFIES  BY RULE AS LIVESTOCK TYPICALLY USED TO PRODUCE FOOD
 FOR HUMAN CONSUMPTION, INCLUDING AQUATIC AND AMPHIBIAN SPECIES.
   11. "LIVESTOCK PRODUCER"  MEANS  A  PERSON  RAISING  A  FOOD-PRODUCING
 ANIMAL FOR COMMERCIAL PURPOSES.
   12.  "MEDICALLY IMPORTANT ANTIBIOTIC" MEANS A DRUG THAT IS COMPOSED IN
 WHOLE OR IN PART OF:
 S. 4021                             4
 
   (A) A FORM OF THE  ANTIBIOTIC  CLASSES  OF  PENICILLIN,  TETRACYCLINE,
 MACROLIDE,   LINCOSAMIDE,  STREPTOGRAMIN,  AMINOGLYCOSIDE,  SULFONAMIDE,
 FLUOROQUINOLONES, AMPHENICOLS, POLYMYXINS, OR CEPHALOSPORIN; OR
   (B)  A DRUG FROM AN ANTIBIOTIC CLASS THAT IS CATEGORIZED AS CRITICALLY
 IMPORTANT, HIGHLY IMPORTANT, OR IMPORTANT IN THE WORLD HEALTH  ORGANIZA-
 TION LIST OF CRITICALLY IMPORTANT ANTIMICROBIALS FOR HUMAN MEDICINE (6TH
 REVISION,  2019),  OR A SUBSEQUENT REVISION OR SUCCESSOR DOCUMENT ISSUED
 BY THE WORLD HEALTH ORGANIZATION THAT  IS  RECOGNIZED  BY  RULE  BY  THE
 DEPARTMENT.
   13. "OFFICE" MEANS THE OFFICE OF ANTIBIOTIC-RESISTANCE CONTROL CREATED
 PURSUANT TO SECTION TWO HUNDRED SIXTY-NINE-C OF THIS TITLE.
   14.  "ONE  HEALTH"  MEANS  TAKING  A COLLABORATIVE, MULTISECTORAL, AND
 TRANSDISCIPLINARY APPROACH TO CONTROLLING ANTIBIOTIC RESISTANCE,  RECOG-
 NIZING  THE  INTERCONNECTION  BETWEEN PEOPLE, ANIMALS, PLANTS, AND THEIR
 SHARED ENVIRONMENT.
   15. "VETERINARY FEED DIRECTIVE" HAS THE SAME DEFINITION AS IN  SECTION
 558.3 OF TITLE 21 OF THE CODE OF FEDERAL REGULATIONS.
   §  269-C.  OFFICE  OF  ANTIBIOTIC-RESISTANCE  CONTROL. THERE IS HEREBY
 CREATED  WITHIN  THE  DEPARTMENT  AN  OFFICE  OF   ANTIBIOTIC-RESISTANCE
 CONTROL. SUCH OFFICE SHALL:
   1.  INTEGRATE  AND  COORDINATE SELECTED STATE HEALTH ANTIBIOTIC-RESIS-
 TANCE MONITORING, OVERSIGHT, AND EDUCATION PROGRAMS BASED ON THE CENTERS
 FOR DISEASE  CONTROL'S  ONE  HEALTH  APPROACH  TO  COMBATING  ANTIBIOTIC
 RESISTANCE.   AS PART OF THIS FUNCTION, THE OFFICE SHALL DEVELOP A COOR-
 DINATED, COMPREHENSIVE STRATEGY AND PLAN TO END THE  MISUSE  AND  REDUCE
 THE  OVERUSE OF ANTIBIOTICS IN MEDICINE AND AGRICULTURE IN THE STATE. IN
 LINE WITH THE NATIONAL ACTION PLAN 2020-2025 CREATED BY THE FEDERAL TASK
 FORCE ON COMBATING ANTIBIOTIC-RESISTANT BACTERIA, THE OFFICE SHALL  HAVE
 A  GOAL  FOR THE STATE OF REDUCING HEALTH CARE-ASSOCIATED ANTIBIOTIC-RE-
 SISTANT INFECTIONS BY TWENTY PERCENT BY  TWO  THOUSAND  TWENTY-FIVE  AND
 COMMUNITY-ACQUIRED ANTIBIOTIC-RESISTANT INFECTIONS BY TEN PERCENT BY TWO
 THOUSAND  TWENTY-FIVE. IT SHALL HAVE A FURTHER GOAL, CONSISTENT WITH THE
 EXISTING GOAL OF THE EUROPEAN UNION, OF REDUCING USE OF MEDICALLY IMPOR-
 TANT ANTIBIOTICS IN FOOD ANIMAL PRODUCTION BY FIFTY PERCENT WITHIN  FIVE
 YEARS  AFTER  THE  EFFECTIVE DATE OF THIS TITLE, USING A BASELINE ESTAB-
 LISHED TWO YEARS AFTER THE EFFECTIVE DATE OF THIS TITLE.
   2. APPLY FOR GRANTS, AND ACCEPT GIFTS FROM PRIVATE AND PUBLIC SOURCES,
 FOR RESEARCH TO IMPROVE THE APPROPRIATE USE OF ANTIBIOTICS.
   3. TOGETHER WITH THE ANTIBIOTIC-RESISTANCE  CONTROL  BOARD,  SERVE  AS
 LIAISON  AND ADVOCATE ON MATTERS RELATING TO THE JUDICIOUS USE, UNNECES-
 SARY USE, AND MISUSE OF ANTIBIOTICS. THIS  FUNCTION  SHALL  INCLUDE  THE
 PROVISION  OF  STAFF  SUPPORT TO THE ANTIBIOTIC-RESISTANCE CONTROL BOARD
 AND THE ESTABLISHMENT  OF  APPROPRIATE  PROGRAM  LINKAGES  WITH  RELATED
 FEDERAL, STATE, AND LOCAL AGENCIES AND PROGRAMS.
   4. ASSIST MEDICAL SCHOOLS, VETERINARIAN SCHOOLS, AGRICULTURAL SCHOOLS,
 AND  STATE  AGENCIES IN THE DEVELOPMENT OF ANTIBIOTIC-RESISTANCE CONTROL
 TRAINING PROGRAMS FOR DOCTORS,  VETERINARIANS,  MEDICAL  AND  VETERINARY
 SUPPORT  STAFF,  AND  FARMERS,  AND  IN  THE  DEVELOPMENT OF EDUCATIONAL
 COURSEWORK FOR MEDICAL, VETERINARY, AND AGRICULTURAL STUDENTS.
   5. PROMOTE COMMUNITY STRATEGIC PLANNING AND  NEW  OR  IMPROVED  HEALTH
 CARE  DELIVERY  SYSTEMS  TO REDUCE THE USE OF ANTIBIOTICS IN HEALTH CARE
 SETTINGS AND AGRICULTURAL SETTINGS.
   6. REVIEW THE IMPACT OF  ANTIBIOTIC-RESISTANCE  CONTROL  PROGRAMS  AND
 REGULATIONS  ON  LEVELS OF ANTIBIOTIC-RESISTANT BACTERIA FOUND IN HEALTH
 CARE SETTINGS AND AGRICULTURAL SETTINGS, AND THAT ARE FOODBORNE.
 S. 4021                             5

   § 269-D. ANTIBIOTIC-RESISTANCE CONTROL BOARD. 1. AN  ANTIBIOTIC-RESIS-
 TANCE CONTROL BOARD IS HEREBY CREATED. SUCH BOARD SHALL HAVE FIVE VOTING
 MEMBERS,  WHO  SHALL  BE  THE  COMMISSIONERS  OF HEALTH, AGRICULTURE AND
 MARKETS, ENVIRONMENTAL CONSERVATION, EDUCATION, AND A PUBLIC MEMBER.  IN
 ADDITION, AS ADVISORY MEMBERS, THERE SHALL BE A DEAN OF A NEW YORK STATE
 MEDICAL  COLLEGE,  A  DEAN  OF  A NEW YORK STATE VETERINARY COLLEGE, TWO
 EPIDEMIOLOGISTS  WITH  EXPERTISE  IN  ANTIBIOTIC  RESISTANCE,  AND,  SIX
 MEMBERS, TO BE APPOINTED BY THE GOVERNOR, HOWEVER, TWO SHALL BE UPON THE
 RECOMMENDATION  OF THE SPEAKER OF THE ASSEMBLY AND TWO SHALL BE UPON THE
 RECOMMENDATION OF THE TEMPORARY PRESIDENT OF THE SENATE. AT LEAST ONE OF
 THE SIX MEMBERS SHALL BE A REPRESENTATIVE OF THE  PHARMACEUTICAL  INDUS-
 TRY,  ONE  A REPRESENTATIVE OF THE FARMING COMMUNITY, AND FOUR REPRESEN-
 TATIVES OF THE PUBLIC WITH RELEVANT EXPERTISE IN, BUT  NOT  LIMITED  TO,
 THE  FIELDS  OF PUBLIC HEALTH, PATIENT EXPERIENCE, OR ANTIBIOTIC RESIST-
 ANCE. TO THE EXTENT PRACTICABLE, THESE PUBLIC MEMBERS SHALL BE REPRESEN-
 TATIVE OF THE DIVERSITY OF THE STATE.
   2. ADVISORY MEMBERS APPOINTED BY THE GOVERNOR SHALL SERVE FOR TERMS OF
 THREE YEARS, SUCH TERMS TO COMMENCE ON JULY FIRST AND TO EXPIRE ON  JUNE
 THIRTIETH;  PROVIDED,  HOWEVER,  THAT  OF  THE  ADVISORY  MEMBERS  FIRST
 APPOINTED, TWO SHALL BE APPOINTED FOR A ONE-YEAR TERM EXPIRING ONE  YEAR
 AFTER  THE  EFFECTIVE  DATE  OF THIS TITLE, TWO SHALL BE APPOINTED FOR A
 TWO-YEAR TERM EXPIRING TWO YEARS AFTER THE EFFECTIVE DATE OF THIS TITLE,
 AND THE REMAINING TWO SHALL BE APPOINTED FOR FULL THREE-YEAR TERMS. EACH
 SUCH ADVISORY MEMBER SHALL HOLD OFFICE UNTIL A SUCCESSOR SHALL HAVE BEEN
 APPOINTED AND QUALIFIED.
   3. EACH VOTING MEMBER AND EACH ADVISORY MEMBER OF SUCH BOARD  MAY,  BY
 OFFICIAL  ORDER  FILED IN THE OFFICE OF THE BOARD, DESIGNATE A DEPUTY OR
 OTHER REPRESENTATIVE IN THEIR DEPARTMENT TO PERFORM THEIR  DUTIES  UNDER
 THIS ARTICLE.
   4.  THE  MEMBERS  OF  THE  BOARD  OR  THEIR RESPECTIVE DESIGNEES SHALL
 RECEIVE NO ADDITIONAL COMPENSATION FOR THEIR SERVICES AS MEMBERS OF  THE
 BOARD, BUT SHALL BE ALLOWED THEIR ACTUAL AND NECESSARY EXPENSES INCURRED
 IN THE PERFORMANCE OF THEIR DUTIES UNDER THIS TITLE.
   §  269-E. ORGANIZATION OF ANTIBIOTIC-RESISTANCE CONTROL BOARD.  1. THE
 CHAIR OF THE BOARD SHALL BE THE COMMISSIONER.
   2. THE BOARD SHALL APPOINT AN EXECUTIVE SECRETARY WHO SHALL ACT AS THE
 ADMINISTRATIVE AGENT OF THE BOARD, KEEP A RECORD OF ALL MEETINGS OF  THE
 BOARD  AND  PERFORM  SUCH  OTHER  FUNCTIONS  AND DUTIES AS THE BOARD MAY
 DIRECT.
   3. THE BOARD MAY MAKE AND ADOPT BY-LAWS TO REGULATE ITS PROCEEDINGS.
   § 269-F. MEETINGS. 1. THE BOARD SHALL MEET AT LEAST ONCE  EVERY  THREE
 MONTHS.  SPECIAL  MEETINGS  SHALL  BE  CALLED  BY THE CHAIR ON THEIR OWN
 INITIATIVE OR UPON THE WRITTEN REQUEST OF TWO VOTING MEMBERS. NOTICE  OF
 THE TIME, PLACE, AND PURPOSE OF EACH MEETING SHALL BE TRANSMITTED TO ALL
 MEMBERS OF THE BOARD AT LEAST TEN DAYS PRIOR TO ANY MEETING.
   2.  THREE  VOTING  MEMBERS  OF  THE BOARD SHALL CONSTITUTE A QUORUM TO
 TRANSACT THE BUSINESS OF THE BOARD. A MAJORITY VOTE OF  MEMBERS  PRESENT
 AT  THE  MEETING  SHALL  BE NECESSARY FOR ANY ACTION TAKEN BY THE BOARD.
 MEETINGS SHALL BE OPEN TO PUBLIC OBSERVERS, AND MEETING RECORDS SHALL BE
 PUBLICLY AVAILABLE.
   § 269-G. FUNCTIONS, POWERS AND DUTIES. 1. THE BOARD  (A)  MAY  PREPARE
 AND RECOMMEND RULES AND REGULATIONS, OR AMENDMENT OR REPEAL THEREOF, FOR
 CONTROLLING  THE  USE  OF  ANTIBIOTICS  IN  HEALTH CARE AND AGRICULTURAL
 SETTINGS CONSISTENT WITH THE DECLARED PURPOSE  OF  THIS  TITLE  AND  (B)
 SHALL  DESIGNATE  THE  DEPARTMENT  OR  DEPARTMENTS BY WHOM SUCH RULES OR
 REGULATIONS SHALL BE PROMULGATED, ADMINISTERED, AND ENFORCED IN  ACCORD-
 S. 4021                             6
 
 ANCE  WITH  THE  FUNCTIONS,  POWERS,  AND  DUTIES  OF SUCH DEPARTMENT OR
 DEPARTMENTS PRESCRIBED BY LAW. SUCH RULES AND REGULATIONS SHALL  NOT  BE
 EFFECTIVE UNTIL FILED IN THE OFFICE OF THE DEPARTMENT OF STATE. ANY SUCH
 ACTION  SHALL  BE  TAKEN  ONLY AT A MEETING UPON THE AFFIRMATIVE VOTE IN
 PERSON, ELECTRONICALLY OR BY MAIL OF AT LEAST FOUR VOTING MEMBERS OF THE
 BOARD, EXCLUSIVE OF ANY DEPUTY OR OTHER REPRESENTATIVE, AFTER A  MEETING
 WITH  THE  ADVISORY  MEMBERS OF THE BOARD AND CONSIDERATION OF AVAILABLE
 SCIENTIFIC EVIDENCE.
   2. TO FURTHER THE DECLARED PURPOSE OF THIS TITLE, THE BOARD SHALL HAVE
 THE FOLLOWING FUNCTIONS, POWERS, AND DUTIES:
   (A) TO PREPARE AND RECOMMEND RULES AND REGULATIONS REGARDING  THE  USE
 OF  ANTIBIOTICS  IN  HEALTH  CARE  AND AGRICULTURAL SETTINGS IN ORDER TO
 PREVENT THEIR MISUSE AND OVERUSE AND  CONTROL,  AND  PREVENT  ANTIBIOTIC
 RESISTANCE.
   (B)  TO COORDINATE THE ACTIVITIES AND PROGRAMS OF MEMBERS' DEPARTMENTS
 CONCERNED WITH THE USE OF ANTIBIOTICS AND THE DEVELOPMENT AND SPREAD  OF
 ANTIBIOTIC RESISTANCE.
   (C)  TO PROMOTE AND ENCOURAGE TRAINING PROGRAMS AND PRACTICES, INCLUD-
 ING INNOVATIVE CONCEPTS, THAT CAN REDUCE ANTIBIOTIC USE IN  HEALTH  CARE
 AND AGRICULTURAL SETTINGS.
   (D)  TO CAUSE SUCH STUDIES, RESEARCH, AND INVESTIGATIONS TO BE MADE AS
 IT MAY DEEM ADVISABLE AND NECESSARY.
   (E) TO HOLD AND APPEAR AT PUBLIC HEARINGS.
   (F) TO COLLECT AND COMPILE INFORMATION AND DATA RELATING TO  THE  USE,
 OVERUSE, AND MISUSE OF ANTIBIOTICS AND DEVELOPMENT AND SPREAD OF ANTIBI-
 OTIC RESISTANCE.
   (G) TO ADVISE AND ASSIST STATE DEPARTMENTS AND AGENCIES UPON REQUEST.
   (H)  TO  INFORM  THE PUBLIC CONCERNING THE STATE'S EFFORTS TO REGULATE
 THE USE OF ANTIBIOTICS AND TO PROVIDE INFORMATION  CONCERNING  ANTIBIOT-
 ICS, INCLUDING THOSE USED IN AGRICULTURE.
   (I)  TO RECOMMEND, WHERE APPROPRIATE, THAT THE USE OF SPECIFIC ANTIBI-
 OTICS BE PROHIBITED UNDER SPECIFIED CONDITIONS.
   (J) TO CONSULT AND COOPERATE WITH  THE  APPROPRIATE  AGENCIES  OF  THE
 FEDERAL  GOVERNMENT  OR  OF  OTHER  STATES  OR LOCAL GOVERNMENTS TO MORE
 EFFECTIVELY CARRY OUT ITS  FUNCTIONS,  POWERS,  AND  DUTIES  UNDER  THIS
 TITLE.
   (K)  TO DO ALL THINGS NECESSARY OR REASONABLE TO CARRY OUT THE FOREGO-
 ING FUNCTIONS, POWERS, AND DUTIES.
   § 269-H. COOPERATION WITH OTHER DEPARTMENTS.  THE  BOARD  MAY  REQUEST
 FROM ANY DEPARTMENT, DIVISION, BOARD, BUREAU, COMMISSION, OR OTHER AGEN-
 CY  OF  THE STATE, AND THE SAME ARE AUTHORIZED TO PROVIDE, WITHOUT ADDI-
 TIONAL COMPENSATION, SUCH ASSISTANCE, SERVICES AND DATA AS MAY BE NECES-
 SARY TO CARRY OUT THE PURPOSE OF  THIS  TITLE.  THE  BOARD  MAY,  WITHIN
 APPROPRIATIONS  AVAILABLE  THEREFORE, EMPLOY SUCH OTHER PERSONNEL AS MAY
 BE NECESSARY TO CARRY OUT ITS RESPONSIBILITIES UNDER THIS TITLE.
   § 269-I. EVALUATION REQUIREMENTS. 1. THE COMMISSIONER  SHALL  EVALUATE
 THE  EFFECTIVENESS  OF THE EFFORTS BY THE STATE GOVERNMENT TO REDUCE THE
 OVERUSE AND MISUSE OF ANTIBIOTICS.
   2. THE COMMISSIONER SHALL ENSURE THAT, TO THE EXTENT PRACTICABLE,  THE
 MOST CURRENT RESEARCH FINDINGS REGARDING MECHANISMS TO REDUCE AND CHANGE
 ATTITUDES TOWARD THE USE OF ANTIBIOTICS ARE INCORPORATED INTO THE EDUCA-
 TION AND TRAINING PROGRAMS ADMINISTERED BY THE DEPARTMENT.
   3.  TO  DIMINISH  THE  OVERUSE AND MISUSE OF ANTIBIOTICS AND TO ENSURE
 THAT THE STATE'S PROGRAMS ARE EFFECTIVE, THE  OFFICE  SHALL  CONDUCT  AN
 INDEPENDENT  EVALUATION OF THE STATEWIDE ANTIBIOTIC-RESISTANCE PROGRAMS.
 THE PURPOSE OF THIS EVALUATION IS TO DIRECT  THE  MOST  EFFICIENT  ALLO-
 S. 4021                             7
 
 CATION  OF  STATE RESOURCES DEVOTED TO CONTROLLING ANTIBIOTIC-RESISTANCE
 WITHIN HEALTH CARE SETTINGS AND AGRICULTURAL SETTINGS.  SUCH  EVALUATION
 SHALL  BE  MADE  PUBLICLY  AVAILABLE  ON  THE  DEPARTMENT'S  WEBSITE AND
 PROVIDED  ANNUALLY  TO  THE  GOVERNOR,  THE  TEMPORARY  PRESIDENT OF THE
 SENATE, AND THE SPEAKER OF THE ASSEMBLY ON OR BEFORE  OCTOBER  FIRST  OF
 EACH  CALENDAR YEAR. THE COMPREHENSIVE EVALUATION DESIGN SHALL BE GUIDED
 BY THE FOLLOWING:
   (A) SOUND EVALUATION PRINCIPLES INCLUDING,  TO  THE  EXTENT  FEASIBLE,
 ELEMENTS OF CONTROLLED EXPERIMENTS;
   (B)  AN  EVALUATION  OF  THE  COMPARATIVE  EFFECTIVENESS OF INDIVIDUAL
 PROGRAM DESIGNS THAT SHALL BE USED  IN  FUNDING  DECISIONS  AND  PROGRAM
 MODIFICATIONS; AND
   (C)  AN  EVALUATION  OF  OTHER  PROGRAMS IDENTIFIED BY STATE AGENCIES,
 LOCAL LEAD AGENCIES, AND FEDERAL AGENCIES.
   § 269-J. ANTIBIOTIC-RESISTANCE DATA COLLECTION. 1. NOTWITHSTANDING ANY
 OTHER LAW, ALL ANTIBIOTIC-RESISTANCE AND INFECTION DATA COLLECTED BY THE
 DEPARTMENT, AND DOCUMENTS PERTAINING TO  ANTIBIOTIC-RESISTANCE  STEWARD-
 SHIP PROGRAMS, VETERINARY REPORTS REQUIRED BY FEDERAL OR STATE LAWS, AND
 ANY  OTHER  RELATED INFORMATION AS DETERMINED BY THE COMMISSIONER, SHALL
 BE MADE AVAILABLE TO THE OFFICE.
   2. THE DEPARTMENT HAS THE AUTHORITY TO REQUEST AND RECEIVE  COPIES  OF
 ALL  VETERINARY FEED DIRECTIVES ISSUED IN THE STATE, FROM VETERINARIANS,
 LIVESTOCK OWNERS, FEED MILLS, OR DISTRIBUTORS  TO  FULLY  IMPLEMENT  THE
 PROVISIONS OF THIS TITLE.
   3.  THE  STATE  BOARD  OF VETERINARY MEDICINE, THE DEPARTMENT, AND THE
 DEPARTMENT OF AGRICULTURE AND MARKETS SHALL COORDINATE WITH  THE  UNITED
 STATES DEPARTMENT OF AGRICULTURE, THE UNITED STATES FOOD AND DRUG ADMIN-
 ISTRATION,  AND  THE  UNITED  STATES  CENTERS  FOR  DISEASE  CONTROL AND
 PREVENTION TO IMPLEMENT THE EXPANDED ANTIBIOTIC RESISTANCE  SURVEILLANCE
 EFFORTS  INCLUDED  IN THE NATIONAL ACTION PLAN FOR COMBATING ANTIBIOTIC-
 RESISTANT BACTERIA, TO  OBTAIN  A  BETTER  UNDERSTANDING  OF  THE  LINKS
 BETWEEN  ANTIBIOTIC  USE  PATTERNS  IN  LIVESTOCK AND THE DEVELOPMENT OF
 ANTIBIOTIC-RESISTANT BACTERIAL INFECTIONS.
   4. (A) THE DEPARTMENT, THE STATE BOARD  OF  VETERINARY  MEDICINE,  THE
 DEPARTMENT  OF  AGRICULTURE  AND  MARKETS,  VETERINARIANS, AND LIVESTOCK
 PRODUCERS SHALL GATHER INFORMATION  ON  MEDICALLY  IMPORTANT  ANTIBIOTIC
 SALES  AND  USAGE AS WELL AS ANTIBIOTIC-RESISTANT BACTERIA AND LIVESTOCK
 MANAGEMENT PRACTICE DATA. MONITORING EFFORTS SHALL NOT BE DUPLICATIVE OF
 THE NATIONAL ANIMAL HEALTH MONITORING SYSTEM OR THE NATIONAL  ANTIMICRO-
 BIAL  RESISTANCE  MONITORING  SYSTEM,  AND, TO THE EXTENT FEASIBLE, WILL
 COORDINATE WITH THE UNITED STATES DEPARTMENT OF AGRICULTURE, THE CENTERS
 FOR DISEASE CONTROL AND PREVENTION, AND THE UNITED STATES FOOD AND  DRUG
 ADMINISTRATION IN THE DEVELOPMENT OF THESE EFFORTS.
   (B)  IN COORDINATING WITH THE NATIONAL ANIMAL HEALTH MONITORING SYSTEM
 AND THE NATIONAL ANTIMICROBIAL RESISTANCE MONITORING SYSTEM, THE DEPART-
 MENT, THE STATE BOARD OF VETERINARY  MEDICINE,  AND  THE  DEPARTMENT  OF
 AGRICULTURE  AND  MARKETS SHALL GATHER REPRESENTATIVE SAMPLES OF BIOLOG-
 ICAL ISOLATES FROM ALL OF THE FOLLOWING:
   (I) NEW YORK STATE'S MAJOR LIVESTOCK SEGMENTS;
   (II) REGIONS WITH CONSIDERABLE LIVESTOCK PRODUCTION; AND
   (III) REPRESENTATIVE SEGMENTS OF THE FOOD PRODUCTION CHAIN.
   (C) THE DEPARTMENT, THE STATE BOARD OF VETERINARY  MEDICINE,  AND  THE
 DEPARTMENT  OF  AGRICULTURE  AND MARKETS SHALL REPORT TO THE LEGISLATURE
 THREE YEARS FROM THE EFFECTIVE DATE OF THIS TITLE THE RESULTS  OF  THEIR
 OUTREACH ACTIVITIES AND MONITORING EFFORTS.
 S. 4021                             8
 
   § 269-K. ANTIBIOTIC STEWARDSHIP IMPLEMENTATION. 1. NOTWITHSTANDING ANY
 LAW TO THE CONTRARY, THE OFFICE MAY REQUEST AND SHALL RECEIVE REPORTS ON
 HOSPITALS'   AND  NURSING  HOMES'  ANTIBIOTIC-RESISTANCE  AND  INFECTION
 STEWARDSHIP PROGRAMS.
   2.  THE DEPARTMENT, IN CONSULTATION WITH THE STATE BOARD OF VETERINARY
 MEDICINE, THE DEPARTMENT OF AGRICULTURE AND MARKETS,  UNIVERSITIES,  AND
 COOPERATIVE  EXTENSIONS, SHALL DEVELOP ANTIBIOTIC STEWARDSHIP GUIDELINES
 AND BEST MANAGEMENT PRACTICES FOR VETERINARIANS, LIVESTOCK  OWNERS,  AND
 THEIR  EMPLOYEES  WHO  ARE  INVOLVED WITH THE ADMINISTERING OF MEDICALLY
 IMPORTANT ANTIBIOTICS ON THE PROPER USE OF MEDICALLY IMPORTANT ANTIBIOT-
 ICS FOR DISEASE TREATMENT AND CONTROL IN FOOD  ANIMALS.  THE  GUIDELINES
 SHALL INCLUDE SCIENTIFICALLY VALIDATED PRACTICAL ALTERNATIVES TO THE USE
 OF  MEDICALLY IMPORTANT ANTIBIOTICS, INCLUDING, BUT NOT LIMITED TO, GOOD
 HYGIENE AND MANAGEMENT PRACTICES. THE GUIDELINES SHALL BE  REVIEWED  AND
 UPDATED PERIODICALLY, AS NECESSARY.
   3.  THE DEPARTMENT, IN CONSULTATION WITH THE STATE BOARD OF VETERINARY
 MEDICINE AND THE DEPARTMENT OF AGRICULTURE AND  MARKETS,  SHALL  CONSULT
 WITH  LIVESTOCK  PRODUCERS,  LICENSED  VETERINARIANS, AND OTHER RELEVANT
 STAKEHOLDERS ON ENSURING THAT LIVESTOCK GROWN IN RURAL AREAS WITH LIMIT-
 ED ACCESS TO VETERINARY CARE HAVE TIMELY ACCESS TO TREATMENT.
   4. FOR THE PURPOSES OF  THIS  SECTION,  "ANTIBIOTIC  STEWARDSHIP"  FOR
 FOOD-PRODUCING ANIMALS IS A COMMITMENT TO DO ALL OF THE FOLLOWING:
   (A)  TO  USE  MEDICALLY  IMPORTANT  ANTIBIOTICS ONLY WHEN NECESSARY TO
 TREAT OR CONTROL DISEASE;
   (B) TO SELECT THE APPROPRIATE MEDICALLY IMPORTANT ANTIBIOTIC  AND  THE
 APPROPRIATE DOSE, DURATION, AND ROUTE OF ADMINISTRATION;
   (C)  TO  USE MEDICALLY IMPORTANT ANTIBIOTICS FOR THE SHORTEST DURATION
 NECESSARY AND ALLOWABLE, AND TO ADMINISTER THEM TO  THE  FEWEST  ANIMALS
 NECESSARY; AND
   (D)  TO  RAISE  ANIMALS  UNDER  CONDITIONS  THAT MINIMIZE THE NEED FOR
 MEDICALLY IMPORTANT ANTIBIOTICS BY  USING  VACCINES,  PROVIDING  HEALTHY
 DIETS, MAINTAINING SANITARY HOUSING AND OTHER APPROPRIATE GOOD HUSBANDRY
 PRACTICES.
   §  269-L.  ANTIBIOTIC-RESISTANCE  CONTROL IN AGRICULTURE. 1. BEGINNING
 ONE YEAR FROM THE EFFECTIVE DATE  OF  THIS  TITLE,  MEDICALLY  IMPORTANT
 ANTIBIOTICS  SHALL NOT BE ADMINISTERED TO A FOOD-PRODUCING ANIMAL UNLESS
 ORDERED BY A LICENSED VETERINARIAN WHO HAS VISITED  THE  FARM  OPERATION
 WITHIN  THE  PREVIOUS  SIX  MONTHS, THROUGH A PRESCRIPTION OR VETERINARY
 FEED DIRECTIVE, PURSUANT TO A  VETERINARIAN-CLIENT-PATIENT  RELATIONSHIP
 THAT   MEETS  THE  REQUIREMENTS  AS  DEFINED  BY  THE  STATE  OFFICE  OF
 PROFESSIONS.
   2. (A) BEGINNING TWO YEARS FROM THE EFFECTIVE DATE OF  THIS  TITLE,  A
 LIVESTOCK  PRODUCER MAY ADMINISTER A MEDICALLY IMPORTANT ANTIBIOTIC TO A
 FOOD-PRODUCING ANIMAL ONLY IF A LICENSED VETERINARIAN, IN  THE  EXERCISE
 OF  PROFESSIONAL  JUDGMENT,  DETERMINES  THAT  THE ADMINISTRATION OF THE
 MEDICALLY IMPORTANT ANTIBIOTIC TO THE ANIMAL IS NECESSARY:
   (I) TO CONTROL THE ONGOING SPREAD OF A DIAGNOSED DISEASE OR INFECTION;
   (II) TO TREAT A DIAGNOSED DISEASE OR INFECTION; OR
   (III) IN RELATION TO SURGICAL OR OTHER MEDICAL PROCEDURES.
   (B)(I) MEDICALLY IMPORTANT ANTIBIOTICS SHALL NOT  BE  ADMINISTERED  BY
 ANY  PERSON TO FOOD-PRODUCING ANIMALS SOLELY FOR THE PURPOSES OF PROMOT-
 ING WEIGHT GAIN, IMPROVING FEED EFFICIENCY, OR DISEASE PREVENTION.
   (II) BLANKET DRY COW THERAPY, WHEREBY ALL DAIRY COWS IN A HERD  ENTER-
 ING  A  DRY  CYCLE  ARE  ROUTINELY ADMINISTERED AN ANTIBIOTIC TO PREVENT
 CLINICAL MASTITIS, IS CONSIDERED A METHOD OF DISEASE PREVENTION, AND  IS
 NOT AUTHORIZED.
 S. 4021                             9
 
   3.  A  VETERINARIAN  WHO  DETERMINES THAT THE PROVISION OF A MEDICALLY
 IMPORTANT ANTIBIOTIC TO A  FOOD-PRODUCING  ANIMAL  IS  NECESSARY  FOR  A
 PURPOSE  DESCRIBED  IN  THIS  SECTION  SHALL SPECIFY AN END DATE FOR THE
 PROVISION OF THE ANTIBIOTIC TO THE ANIMAL.
   4. A LIVESTOCK PRODUCER MAY ADMINISTER A MEDICALLY IMPORTANT ANTIBIOT-
 IC  TO  A  FOOD-PRODUCING ANIMAL ONLY FOR THE PURPOSE AS DETERMINED BY A
 LICENSED VETERINARIAN UNDER  THIS  TITLE.  THE  LIVESTOCK  PRODUCER  MAY
 PROVIDE  THE ANTIBIOTIC ONLY FOR THE DURATION SPECIFIED BY THE VETERINA-
 RIAN.
   § 269-M. REPORTING REQUIREMENTS. 1. VETERINARIANS LICENSED TO PRACTICE
 IN NEW YORK STATE, OR WHO ARE LICENSED IN A BORDERING STATE AND PRACTICE
 IN THE STATE, AND WHO PRESCRIBE MEDICALLY IMPORTANT ANTIBIOTICS OR WRITE
 A VETERINARY FEED DIRECTIVE (VFD) FOR ONE OR MORE SETS OF FOOD-PRODUCING
 ANIMALS LOCATED IN NEW YORK STATE, SHALL FILE  AN  ANNUAL  REPORT  UNDER
 THIS  SECTION  IN  A FORM AND MANNER REQUIRED BY THE DEPARTMENT BY RULE.
 THIS REPORT SHALL BE SUBMITTED TO THE  OFFICE.  IF  MEDICALLY  IMPORTANT
 ANTIBIOTICS  WERE  PROVIDED UNDER VFDS, THEN COPIES OF THOSE VFDS ISSUED
 DURING THE YEAR, PREPARED IN THE  FORMAT  RECOMMENDED  BY  THE  AMERICAN
 VETERINARY  MEDICAL  ASSOCIATION,  MAY  CONSTITUTE  THE  ANNUAL  REPORT.
 MEDICALLY IMPORTANT ANTIBIOTICS PRESCRIBED TO, PROVIDED TO, OR  ADMINIS-
 TERED TO FOOD-PRODUCING ANIMALS DURING THE REPORTING PERIOD THAT ARE NOT
 COVERED  BY  VFDS, SHALL ALSO BE INCLUDED IN THE ANNUAL REPORT AND SHALL
 CONTAIN THE FOLLOWING INFORMATION FOR EACH SUCH PRESCRIPTION OR ADMINIS-
 TRATION:
   (A) NAME AND ADDRESS OF THE LIVESTOCK PRODUCER, AND  THE  LOCATION  OF
 THE TREATED ANIMAL OR ANIMALS;
   (B)  THE  NUMBER  OF  FOOD-PRODUCING  ANIMALS  PROVIDED WITH MEDICALLY
 IMPORTANT ANTIBIOTICS;
   (C) THE NAME OF THE MEDICALLY IMPORTANT ANTIBIOTIC PROVIDED;
   (D) THE SPECIES OF  FOOD-PRODUCING  ANIMALS  THAT  WERE  PROVIDED  THE
 MEDICALLY IMPORTANT ANTIBIOTIC;
   (E)  THE  NUMBER  OF  DAYS THAT THE MEDICALLY IMPORTANT ANTIBIOTIC WAS
 INTENDED TO BE PROVIDED TO A FOOD-PRODUCING ANIMAL;
   (F) THE DOSAGE OF THE MEDICALLY IMPORTANT ANTIBIOTIC THAT WAS INTENDED
 TO BE PROVIDED TO A FOOD-PRODUCING ANIMAL;
   (G) THE METHOD OF ADMINISTRATION OF THE MEDICALLY IMPORTANT ANTIBIOTIC
 TO A FOOD-PRODUCING ANIMAL;
   (H) THE PURPOSE FOR PROVIDING THE MEDICALLY IMPORTANT ANTIBIOTIC TO  A
 FOOD-PRODUCING ANIMAL; AND
   (I)  THE  DISEASE  OR  INFECTION,  IF  ANY,  THAT  WAS  INTENDED TO BE
 CONTROLLED DUE TO THE PROVISION OF EACH MEDICALLY IMPORTANT ANTIBIOTIC.
   2. FOR THE PURPOSES OF  PARAGRAPH  (H)  OF  SUBDIVISION  ONE  OF  THIS
 SECTION, THE PURPOSE FOR PROVIDING A MEDICALLY IMPORTANT ANTIBIOTIC TO A
 FOOD-PRODUCING ANIMAL SHALL BE REPORTED AS:
   (A) DISEASE CONTROL; OR
   (B) DISEASE TREATMENT; OR
   (C) NECESSARY FOR SURGICAL OR OTHER MEDICAL PROCEDURES.
   3.  INFORMATION  REPORTED  UNDER  THIS  SECTION SHALL BE MADE PUBLICLY
 AVAILABLE BY THE DEPARTMENT ANNUALLY IN AN ONLINE SEARCHABLE DATABASE OF
 AGGREGATED DATA. SUCH DATABASE SHALL PROTECT THE IDENTITY OF A  LICENSED
 VETERINARIAN, AN INDIVIDUAL FARM, OR BUSINESS.
   4. THE DEPARTMENT, STATE BOARD OF VETERINARY MEDICINE, AND THE DEPART-
 MENT  OF  AGRICULTURE  AND MARKETS SHALL CONSULT AS NECESSARY TO FULFILL
 THE REQUIREMENTS OF THIS SECTION.
 S. 4021                            10
 
   § 269-N. VIOLATIONS. 1. A PERSON OR ENTITY  WHO  VIOLATES  THIS  TITLE
 SHALL  BE  LIABLE FOR A CIVIL PENALTY OF NOT MORE THAN TWO HUNDRED FIFTY
 DOLLARS PER FARM OPERATION FOR EACH DAY A VIOLATION OCCURS.
   2.  (A)  FOR  A SECOND OR SUBSEQUENT VIOLATION, A PERSON OR ENTITY WHO
 VIOLATES THIS TITLE SHALL BE PUNISHABLE BY AN ADMINISTRATIVE FINE IN THE
 AMOUNT OF FIVE HUNDRED  DOLLARS  PER  FARM  OPERATION  FOR  EACH  DAY  A
 VIOLATION OCCURS.
   (B)  IN ADDITION TO THE ADMINISTRATIVE FINE, THE VIOLATOR SHALL ATTEND
 AN EDUCATIONAL PROGRAM TO BE JOINTLY DEVELOPED BY  THE  DEPARTMENT,  THE
 DEPARTMENT OF AGRICULTURE AND MARKETS, AND THE STATE BOARD OF VETERINARY
 MEDICINE  ON  THE  JUDICIOUS USE OF MEDICALLY IMPORTANT ANTIBIOTICS. THE
 VIOLATOR SHALL SUCCESSFULLY COMPLETE THE PROGRAM AND  PROVIDE  PROOF  TO
 THE BOARD WITHIN NINETY DAYS FROM THE OCCURRENCE OF THE VIOLATION.
   3.  SUBDIVISIONS  ONE  AND  TWO  OF  THIS  SECTION  SHALL NOT APPLY TO
 LICENSED VETERINARIANS. A VETERINARIAN  WHO  VIOLATES  THIS  SECTION  IS
 SUBJECT  TO  DISCIPLINE  AS  DEFINED  IN SUBARTICLE THREE OF ARTICLE ONE
 HUNDRED THIRTY OF TITLE EIGHT OF THE EDUCATION LAW.
   4. THE MONEYS COLLECTED PURSUANT TO THIS TITLE SHALL BE DEPOSITED INTO
 THE ANTIBIOTICS EDUCATION FUND ESTABLISHED PURSUANT TO  SECTION  NINETY-
 SEVEN-AAAA  OF  THE  STATE  FINANCE LAW AND BE AVAILABLE FOR EXPENDITURE
 UPON APPROPRIATION BY THE LEGISLATURE.
   § 3. The state finance law is amended by adding a new section  97-aaaa
 to read as follows:
   §  97-AAAA. ANTIBIOTICS EDUCATION FUND. 1. THERE IS HEREBY ESTABLISHED
 IN THE CUSTODY OF THE STATE COMPTROLLER A SPECIAL FUND TO  BE  KNOWN  AS
 THE "ANTIBIOTICS EDUCATION FUND".
   2. SUCH FUND SHALL CONSIST OF ALL MONIES RECOVERED FROM THE ASSESSMENT
 OF ANY PENALTY AUTHORIZED BY TITLE NINE OF THE PUBLIC HEALTH LAW.
   3. MONEYS OF THE FUND SHALL BE DEPOSITED TO THE CREDIT OF THE FUND AND
 SHALL,  IN ADDITION TO ANY OTHER MONEYS MADE AVAILABLE FOR SUCH PURPOSE,
 BE AVAILABLE TO THE DEPARTMENT OF HEALTH FOR THE PURPOSE OF  ANTIBIOTICS
 EDUCATIONAL  PROGRAMS.  ALL PAYMENTS FROM THE ANTIBIOTICS EDUCATION FUND
 SHALL BE MADE ON THE AUDIT AND  WARRANT  OF  THE  STATE  COMPTROLLER  ON
 VOUCHERS CERTIFIED AND SUBMITTED BY THE COMMISSIONER OF HEALTH.
   § 4. Paragraph (e) of subdivision 1 of section 218-b of the labor law,
 as  amended  by  chapter  142 of the laws of 2021, is amended to read as
 follows:
   (e) "Airborne infectious disease" shall  mean  any  infectious  viral,
 bacterial or fungal disease that is transmissible through the air in the
 form  of  aerosol particles or droplets and is designated by the commis-
 sioner of health a highly contagious communicable disease that  presents
 a serious risk of harm to the public health. SUCH DISEASES SHALL INCLUDE
 METHICILLIN-RESISTANT  STAPHYLOCOCCUS  AUREUS (MRSA) AND OTHER ANTIBIOT-
 IC-RESISTANT INFECTIONS AS ESTABLISHED BY THE COMMISSIONER OF HEALTH.
   § 5. This act shall take effect one year after it shall have become  a
 law.