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Division of Environmental
Health Protection Updates
Conference of Environmental Health Directors
October 14, 2015
2
BCEHFP Updates Brian Miner, Director
March 29, 2016 3
Topics 1. Status of Lead Contracts (LPPP)
2. Update - Amendment to Article 4-A Body
Piercing and Tattooing
3. Proposed Amendment to Subpart 7-2 Children’s Camps
4. Summary – Beach Water Quality web site; Blue Green Algae Beach Closure Events 2009-2015
March 29, 2016 4
Status of Lead Poisoning Prevention Program
(LPPP) Contracts
• In-house department approval was given on the revised funding formula using 2010 Census data (10/1/15)
• B1184 submitted to DOB requesting use of the funds (10/2/15)
• Once the B1184 is approved, the Non-Competitive Grant Award Package (5 yr. contract cycle) will go forward to the Bureau of Contracts and Office of the State Comptroller (OSC) for approval.
• Once OSC approves, we can release the award notices.
• Contracts will be in Grants Gateway for the 10/1/15 cycle. No paper copy will be sent. You will be notified via e-mail of your contract number and award amount but will have to go into the Grants Gateway to complete the contract documents.
March 29, 2016 5
Chapter 230 of the Laws of 2015 Amendment to Article 4-A, Regulation of
Body Piercing and Tattooing
Amendment Effective December 11, 2015.
Requires:
• Only single use needles and inks used for tattoos and piercings
• A Consent form signed by the patron and the licensed tattooist or body piercing specialist – confirming that single use materials were used
• Copy of consent form provided to patron
March 29, 2016 6
• On August 6th the Public Health and Health Planning Council
(PHHPC) chose not to approve another emergency amendment
to Subpart 7-2, which were necessary to implement the Justice
Center legislation.
o Emergency amendments expired on September 8, 2015.
• Department is moving forward with permanent regulation to be
effective prior to next season.
Amendment to Subpart 7-2
Children’s Camps
March 29, 2016 7
Proposed Amendment to Subpart 7-2
Children’s Camps Purpose: To establish minimum standards for the protection of all campers
with developmental or other disabilities.
Summary of proposed amendments: Consideration is being given to
repealing Section 7-2.25 and replacing it with a new section divided into 2
subdivisions.
March 29, 2016 8
1) The first Subdivisions is proposed to include requirements that apply
to all camps enrolling a child with a developmental or other disability.
These requirements are primarily based on current language in
Section 7-2.25 and include item such as:
Personnel and Supervision
1:2 supervision for campers who cannot independently manipulate a
wheelchair or adaptive equipment.
Staff that have direct care responsibilities of campers with disabilities
must receive training relevant to the specific needs of the campers in
their charge.
March 29, 2016 9
Medical Requirements: Camps must obtain and follow care and treatment
plans for campers that have such plans as well as obtain other available
information relevant to the care and specific needs of a camper with disabilities
including pre-existing medical conditions, allergies, modified diets, and activity
restrictions.
Sleeping Quarters: Non-ambulatory campers shall not have their sleeping
accommodations above the ground floor.
Accessibility: Current requirements for adaptive equipment, ramps and
accessible design are proposed to be replaced with a general provision for
compliance with Americans with Disabilities Act (ADA), which is enforced by the
Department of justice.
March 29, 2016 10
Recreational Safety 1:1 supervision during swimming activities for non-ambulatory
campers or campers with a handicapping condition that might
result in unusual emergencies in the water;
1:5 supervision during swimming activities for campers with
developmental disabilities;
Parent/guardian’s written permission to allow campers with
developmentally disabilities to participate in swimming activities;
Camps must develop procedures and training on procedures for
handling seizures or aspiration of water by campers with
developmental disabilities that may occur during swimming
activities.
March 29, 2016 11
2) The second Subsection would contain additional requirements for
camps with 20% or more developmentally disabled campers enrolled.
There are no additional requirements being proposed from what is
currently in Section 7-2.25 and required by the Justice Center
legislation/regulations. However, since the emergency amendments
were first adopted, minor revisions are necessary based on recent
Justice Center regulations and guidance or to clarify requirements.
Additionally, we are considering a definition for “Children’s Camps for
Children with Developmental Disabilities” to clarify that the Justice Center
requirements only apply to camps with an enrollment of 20% or more
enrollment of developmental disabled campers.
March 29, 2016 12
Beach Water Quality Website & Data System
Website- “live” in July +/-1,700 Visits
July 2015
March 29, 2016 13
March 29, 2016 14
2
10
19
35
39
74
0
10
20
30
40
50
60
70
80
2009 2010 2011 2012 2013 2014 2015
Even
ts (
N)
Year
Total BGA Beach Closure Events by Year 2009-2015
No
Clo
sure
s
March 29, 2016 15
0
5
10
15
20
25
30
35
2009 2010 2011 2012 2013 2014 2015
Even
ts (
N)
Year
Total BGA Beach Closure Events by Region 2009-2015 Capital Central MARO Western
No
Clo
sure
s
March 29, 2016 16 Questions?
March 29, 2016 17
Thank You!
3/29/2016 17
18
BWSP Updates Roger Sokol, Ph.D. Director
March 29, 2016 19
Update Topics
• Harmful Algal Blooms
• Regulatory Update
• Revised Total Coliform Rule
• Infrastructure Funding Updates
• DOH/DEC Initiatives/Partnerships
• Sanitary Survey Training
March 29, 2016 20
29th Annual Tap Water Taste Contest Results
The winners from the five regional contests
competed in the final round at the State Fair: • Capital Region – City of Schenectady WW • Central Region – City of Ithaca • Western Region – Village of Lyndonville • Northern Region – Blue Mountain Lake WD • Metropolitan Region – City of Mount Vernon WD
The Winner
Blue Mountain Lake WD !
March 29, 2016 21
• Interagency communication/coordination • DOH / DEC communication regarding HAB occurrence in water bodies with
PWS and regulated beaches
• Drinking water system sampling
• Since 2010 nearly 100 samples have been collected and analyzed for
microcystin
• In 2015 6 water systems sampled to date
• Several detections of microcystin in raw water;
• No finished water detections
• Pilot Disease Surveillance Program
• Council of State & Territorial Epidemiologist (CSTE) fellow
• Active disease surveillance
Harmful Algal Blooms (HABs)
March 29, 2016 22
Pilot HAB Disease Surveillance Program
• Council of State & Territorial Epidemiologist (CSTE) fellow
• Voluntary participation of local health departments (LHDs) across the state
• 15 total participating counties, others participating throughout summer
• Enhanced One Health surveillance
• Human and animal Illnesses reported by LHDs, other agencies, physicians, veterinarians
• DOH actively collected illness reports through hospital data & poison control center data
• Each report was investigated and classified per CDC’s case definition
• Frequencies of key variables were calculated (i.e. demographics,
symptoms, environmental information, etc.) using SAS 9.3
March 29, 2016 23
Results Characteristics of HAB-associated human and animal cases reported in 2015.
Human N=27 Animal N=2
n(%) n(%)
Female 16 (59) 1 (50)
Mean age 26 6
Exposure type*
Recreational 27 (100) 2 (100)
Treated drinking water 0 (0) 0 (0)
Untreated drinking water 0 (0) 2 (100)
Reported health complaints*
Respiratory irritation (i.e. sore throat, cough) 14 (52) 0 (0)
Dermal reaction (i.e. rash, eye irritation) 13 (48) 0 (0)
Diarrhea 12 (44) 2 (100)
Fatigue 10 (37) 2 (100)
Nausea 7 (26) n/a
Headache 6 (22) n/a
Vomiting 4 (15) 2 (100)
Other** 10 (37) 1 (50)
From 6/1-9/15/2015,
there were:
• 45 illness reports
• 29 cases
*Categories not mutually exclusive
**Other complaints include:
Human – chills (3), dark urine (3), fever (2), neurological (2)
Animal – seizures (1)
March 29, 2016 24
Discussion
• Surveillance in 2015 resulted in more human illnesses
than previously reported
• All reported illnesses associated with recreational water
exposure
• Limitations
• Surveillance conducted in only subset of NYS
• Underreporting
• Strengths
• Enhanced surveillance
• Physician & veterinarian outreach
• Additional surveillance will help to describe the
incidence of HAB-associated illnesses
Source: Centers for Disease Control and Prevention
March 29, 2016 25
Revised Total Coliform Rule
• Effective Date – April 1, 2016
• Affects ALL Public Water Systems
• Monitoring Provisions remain the same
• New Assessment Process – must be completed in 30 days, requires any
defects to be fixed
• Level 1 – replaces TC MCL, self assessment by PWS
• Level 2 – E. coli MCL or 2 Level 1 assessments in rolling 12 month
period, completed by LHD
March 29, 2016 26
What we have been working on:
• Stakeholder Outreach
• Level 1 Assessment Form
• Level 2 Assessment Form
• Total Coliform Sample Siting Plan Template
• Start-up procedures for seasonal systems
March 29, 2016 27
Level 1 Assessment
• Replaces TC MCL
• Self assessment by the PWS
• Triggered when: • Systems collecting ≥ 40 samples per month, > 5.0% are total coliform
positive
• Systems collecting < 40 samples per month, two or more are total coliform
positive
• System fails to take every required repeat sample after any single total
coliform positive sample
• Must be completed and submitted to LHD within 30 days
March 29, 2016 28
March 29, 2016 29
Level 2 Assessment
• Completed by the State/LHD
• More in depth review than Level 1 – similar to sanitary
survey
• Triggered by: • E. coli MCL violation
• Failure to collect repeat samples following an E. coli positive routine sample
• Second Level 1 trigger within a rolling 12-month period
• Must be completed within 30 days of trigger
• Any sanitary defects identified must be addressed
March 29, 2016 30
DOH/DEC Initiatives/Partnership • Karst Related Aquifer Contamination Event Survey
• DEC Surveying carbonate formations, including Karst areas, of NYS
• Information on past water well / aquifer contamination events
• Possible contamination incidents: where, when, etc.
• DEC looking for Lat/Long, or street addresses
• To protect privacy, DOH and DEC can “de-identify” locations
Study area:
- 38 counties
- Karst formation runs approx. along I-
90 and I-87
- Remaining carbonate formation rings
Adirondacks
March 29, 2016 31
Karst Contamination Event Project
• The Department assisting DEC on survey and as needed
• DEC also surveying Soil and Water Districts
• The Department will transmit to LHDs, including survey
monkey weblink, this or next week
• Reply by 12/31/15 to DEC
• Possible DEC/USGS presentation to CEHD spring 2016 (?)
March 29, 2016 32
Since Program Inception:
• Received a total of $1.41 billion to fund the program
• Executed $4.67 billion in financings for 682 projects
• Consisting of $4.34 billion in loans & refinancings; and
• $331 million in grants to disadvantaged communities
• Assisted 383 PWSs with regulatory compliance
For FFY 2015
• Executed $433 million in Financings for 58 projects
• Consisting of $424 million in loans & refinancings; and
• $9 million in grants to disadvantaged communities
• Assisted 46 PWSs with regulatory compliance
Drinking Water State Revolving Fund
March 29, 2016 33
FFY 2016 Intended Use Plan Finalized
• Estimated Source Funds Available are $268 million
• W/ Leveraging, Estimated available resources are $434 million
• Hardship Eligibility Line at 130 Points
• Expanded Subsidized Funding Line at 80 Points
• Anticipate Final IUP Will be Posted Shortly
Drinking Water State Revolving Fund Updates
March 29, 2016 34
Changes for FFY 2016
Method for Determining Hardship Eligibility
• Hardship eligibility determinations will be based on published Census Data
• The limit on grant is changed to $2 million/60% of total project cost
• Project serving area with median household income (MHI) below the statewide MHI will
automatically be evaluated
• Projects serving area with median household income with MHI of 100%-125% of the
statewide MHI will be required to submit a hardship application and may qualify for
hardship loan only
• Section 7 of the IUP provides details related to this change
Drinking Water State Revolving Fund Updates
March 29, 2016 35
• $200 million will be appropriated over three state fiscal years to fund both drinking
water and waste water infrastructure projects as follows:
• $50 million in the current (2015-2016) State Fiscal Year (SFY) with $20 million being
provided for drinking water projects
• $75 million in SFYs 2016-2017 & 2017-2018 with the amount to be allocated for drinking
water projects yet to be determined
• NYS Water Grant Funds are not DWSRF Funds
• Call for Projects for Current Round (2015-2016) SFY is Closed
• 80 projects expressed interest totaling $282 million (not all will qualify)
• Vetting applications and anticipate all commitments will be made by 12/31
• More info at www.efc.ny.gov/NYSwatergrants
New York Water Infrastructure Improvement Act (NY Water Grants)
March 29, 2016 36
Sanitary Survey Training
• Needs survey results identified MARO region
• Two training courses scheduled for end of October
– Groundwater Course October 27-28th
– Surface water Course October 29-30th
• Registration through DOH Learning Management
System open
• Additional Groundwater course in Spring
– TBD Central NY Region
March 29, 2016 37
Thank You
Questions ?
38
Division of
Environmental
Health Protection
Field Coordination Updates
Claudine Jones Rafferty
March 29, 2016 40
BEHP & Advisory Committee Updates
• 2015 Course Delivery Updates – Confined Space Webinar
• Advisory Committee Updates – Next Meeting Date is 12/04/15
• 2016-2017 Course Planning – Review Course Participant Feedback
– SPH Electronic Training Needs Survey
– Evaluate Committee Recommendations
March 29, 2016 41
eForms Implementation Update
• Ipad/Tablet Distribution for 2014 Interested LHDs – Completed July 2015
• Statewide Participation by All ‘Full Service’ LHDs – September 2015
• Fall 2015 Regional Implementation Webinars – LHD eForms Contact Information Due 10/16/15
• Article 6 Year 3 Incentive Period – New Start Date: December 01, 2015
March 29, 2016 42
Article 6 Year 3 Incentive for LHDs
• Program Focus: Environmental Health
• Objective: Improve Inspection Data Quality &
Reporting
• Goal: Increase eForms Submittals to eHIPS
• Incentive Period: December 2015 – June 2016
• Incentive Focus: Inspections of Regulated Entities
Division Director Remarks
Michael Cambridge
March 29, 2016 45
There are many ongoing and
new initiatives in New York State
Environmental Health Protection!
March 29, 2016 46
March 29, 2016 47
Center for Environmental
Health
Division of Environmental Health
Protection
Regional, District & Local
Health Departments
LEAN Initiatives
Executive Orders
Strategic Map
Environmental
Public Health Tracker
March 29, 2016 48
• On-line Restaurant Inspection Data
LEAN Initiatives
• Restaurant Inspections • Universal Permit Application
Executive Orders
• Streamlined Enforcement Hearings
Regulatory Programs –Quality
Improvements Special Initiatives
Regional, District and Local Health Departments
Division of Environmental
Health Protection
Reinvent Core Functions & Improve Efficiency
Become a Model Based Performance Organization
• Adopt technologies to increase program efficiency • Monitor, measure and quantify outcomes
• Implement program-level performance measures • Use performance-based decision-making
• Electronic Inspections
• Implement Program Improvements
Performance Measures
• Achieve Required Inspection Frequencies
Ensure that inspections of Food Service Establishments (FSEs) are conducted by properly trained staff
Improve data quality by focusing on submission method of inspection data
• Increase the percentage of NYS High-risk FSE inspections conducted by a standardized Food Service Inspection Officer (FSIO) to ≥ 85%
• Decrease manual entry of inspection data by 20% • Increase inspectors using eForms to 198 users • Increase electronic inspection data submittals to
50%
March 29, 2016 49
Environmental Health Protection Initiatives
• Lean Management
• Legionella Regulations
• Integrated Food Safety Center for Excellence
March 29, 2016 50
CDC Integrated Food Safety Centers of Excellence
• Six (6) States Selected
– Colorado, Florida, Minnesota, New York,
Oregon, and Tennessee
• CDC Concept
– Shared Knowledge = Decreased Foodborne Illness
March 29, 2016 51
CDC Integrated Food Safety Centers of Excellence
March 29, 2016 52
CDC Integrated Food Safety Centers of Excellence
• CDC IFSCE Objectives – Provide technical help and training in epidemiological,
laboratory, and environmental investigations
– Decrease the burden of foodborne illness using improved techniques in detection, investigation, control, and reporting
– Use information gathered during outbreak investigations to prevent future illnesses and outbreaks
– Develop and share best practices through their six main activity areas
March 29, 2016 53
CDC Integrated Food Safety Centers of Excellence
• Six Main Activity Areas Strengthen surveillance and outbreak investigations.
Analyze timeliness and effectiveness of responses.
Train public health staff in proven investigative techniques.
Educate future food safety workforce.
Improve capacity of information systems.
Evaluate and communicate best practices.
March 29, 2016 54
New York State IFSCE
• Partners
– Centers for Disease Control and Prevention
– New York State Department of Health
– Cornell University Department of Food Science
• Establishes a dynamic, academic-government
“Learning Collaborative”
March 29, 2016 55
New York State IFSCE Objectives • Strengthen foodborne illness surveillance systems and outbreak investigations.
• Improve timeliness, completeness and effectiveness of FBI surveillance and outbreak response activities.
• Ensure effective, competency-based training of local and state public health personnel in food safety science, the coordination and standardization of FBI investigations, and the interpretation, application and current limitations of data derived from CIDT, WGS and AMR data.
• Recruit the next generation of epidemiology, environmental health and food safety leaders; exposing them to best-practices in foodborne disease surveillance and outbreak investigation.
• Actively participate as a State partner and engage Local Health Departments (LHDs) in novel approaches to and uses of surveillance and environmental assessment information systems.
• Conduct meaningful food safety-based quality improvement, performance management and program evaluation activities, and proactively communicating results to stakeholders internal and external to the public health system.
