Bill Text: NY A10139 | 2009-2010 | General Assembly | Introduced


Bill Title: Creates the lupus research enhancement program; creates the lupus research enhancement fund.

Spectrum: Partisan Bill (Democrat 14-0)

Status: (Introduced - Dead) 2010-03-05 - referred to health [A10139 Detail]

Download: New_York-2009-A10139-Introduced.html
                           S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________
                                         10139
                                 I N  A S S E M B L Y
                                     March 5, 2010
                                      ___________
       Introduced by M. of A. GIBSON -- read once and referred to the Committee
         on Health
       AN ACT to amend the public health law, in relation to creating the lupus
         research  enhancement  program; and to amend the state finance law, in
         relation to creating the lupus research enhancement fund
         THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
       BLY, DO ENACT AS FOLLOWS:
    1    Section  1.  Article 2 of the public health law is amended by adding a
    2  new title 4-A to read as follows:
    3                                 TITLE IV-A
    4                       LUPUS RESEARCH ENHANCEMENT ACT
    5  SECTION 256. SHORT TITLE.
    6          256-A. LEGISLATIVE INTENT.
    7          256-B. DEFINITION.
    8          256-C. LUPUS RESEARCH ENHANCEMENT PROGRAM.
    9          256-D. LUPUS RESEARCH ADVISORY COUNCIL.
   10          256-E. LUPUS RESEARCH ENHANCEMENT FUND.
   11    S 256. SHORT TITLE.  THIS TITLE SHALL BE KNOWN AND MAY BE CITED AS THE
   12  "LUPUS RESEARCH ENHANCEMENT ACT".
   13    S 256-A. LEGISLATIVE INTENT. 1.   THE  LEGISLATURE  HEREBY  FINDS  THE
   14  FOLLOWING:
   15    (A)  LUPUS IS A SERIOUS, COMPLEX, DEBILITATING AUTOIMMUNE DISEASE THAT
   16  CAN CAUSE INFLAMMATION AND TISSUE DAMAGE TO VIRTUALLY ANY  ORGAN  SYSTEM
   17  IN  THE BODY, INCLUDING THE SKIN, JOINTS, OTHER CONNECTIVE TISSUE, BLOOD
   18  AND BLOOD VESSELS, HEART, LUNGS, KIDNEY, AND BRAIN.
   19    (B) THE LUPUS FOUNDATION OF AMERICA, INC. ESTIMATES THAT APPROXIMATELY
   20  1.5 TO TWO MILLION AMERICANS LIVE WITH SOME FORM OF LUPUS; LUPUS AFFECTS
   21  WOMEN NINE TIMES MORE OFTEN THAN MEN AND EIGHTY PERCENT OF  NEWLY  DIAG-
   22  NOSED CASES OF LUPUS DEVELOP AMONG WOMEN OF CHILDBEARING AGE.
   23    (C)  LUPUS  DISPROPORTIONATELY  AFFECTS  WOMEN OF COLOR - IT IS TWO TO
   24  THREE TIMES MORE COMMON AMONG AFRICAN-AMERICANS, HISPANICS,  ASIANS  AND
   25  NATIVE AMERICANS AND IS GENERALLY MORE PREVALENT IN MINORITY POPULATIONS
        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD02148-04-9
       A. 10139                            2
    1  -  A HEALTH DISPARITY THAT REMAINS UNEXPLAINED. ACCORDING TO THE CENTERS
    2  FOR DISEASE CONTROL AND PREVENTION  THE  RATE  OF  LUPUS  MORTALITY  HAS
    3  INCREASED  SINCE  THE  LATE NINETEEN SEVENTIES AND IS HIGHER AMONG OLDER
    4  AFRICAN-AMERICAN WOMEN.
    5    (D) NO NEW DRUGS HAVE BEEN APPROVED BY THE U.S. FOOD AND DRUG ADMINIS-
    6  TRATION  SPECIFICALLY FOR LUPUS IN NEARLY FORTY YEARS, AND WHILE CURRENT
    7  TREATMENTS FOR THE DISEASE CAN BE EFFECTIVE, THEY CAN LEAD  TO  DAMAGING
    8  SIDE EFFECTS.
    9    (E)  THE  PAIN AND FATIGUE ASSOCIATED WITH LUPUS CAN THREATEN PEOPLE'S
   10  ABILITY TO LIVE INDEPENDENTLY, MAKE IT DIFFICULT TO MAINTAIN  EMPLOYMENT
   11  AND LEAD NORMAL LIVES, AND ONE IN FIVE  PEOPLE WITH LUPUS IS DISABLED BY
   12  THE DISEASE, AND CONSEQUENTLY RECEIVES SUPPORT FROM GOVERNMENT PROGRAMS,
   13  INCLUDING  MEDICARE,  MEDICAID,  SOCIAL  SECURITY DISABILITY, AND SOCIAL
   14  SECURITY SUPPLEMENTAL INCOME.
   15    (F) THE ESTIMATED AVERAGE ANNUAL COST  OF  MEDICAL  TREATMENT  FOR  AN
   16  INDIVIDUAL  WITH LUPUS CAN RANGE BETWEEN TEN THOUSAND DOLLARS AND THIRTY
   17  THOUSAND DOLLARS; FOR PEOPLE WHO HAVE THE MOST SERIOUS  FORM  OF  LUPUS,
   18  MEDICAL  COSTS  CAN  GREATLY  EXCEED  THIS AMOUNT, CAUSING A SIGNIFICANT
   19  ECONOMIC, EMOTIONAL AND SOCIAL BURDEN TO THE ENTIRE FAMILY AND SOCIETY.
   20    (G) MORE THAN HALF OF THE PEOPLE WITH LUPUS SUFFER FOUR OR MORE  YEARS
   21  AND  VISIT  THREE  OR  MORE  PHYSICIANS  BEFORE OBTAINING A DIAGNOSIS OF
   22  LUPUS; EARLY DIAGNOSIS OF AND COMMENCEMENT OF TREATMENT  FOR  LUPUS  CAN
   23  PREVENT OR REDUCE SERIOUS ORGAN DAMAGE, DISABILITY, AND DEATH.
   24    (H)  DESPITE  THE MAGNITUDE OF LUPUS AND ITS IMPACT ON INDIVIDUALS AND
   25  FAMILIES, HEALTH PROFESSIONAL AND PUBLIC UNDERSTANDING OF LUPUS  REMAINS
   26  LOW; ONLY ONE OF FIVE AMERICANS CAN PROVIDE EVEN BASIC INFORMATION ABOUT
   27  LUPUS,  AND  AWARENESS  OF LUPUS IS LOWEST AMONG ADULTS AGES EIGHTEEN TO
   28  THIRTY-FOUR - THE AGE GROUP MOST LIKELY TO DEVELOP SYMPTOMS OF LUPUS.
   29    (I) LUPUS IS A SIGNIFICANT  NATIONAL  HEALTH  ISSUE  THAT  DESERVES  A
   30  COMPREHENSIVE  AND COORDINATED RESPONSE BY STATE AND FEDERAL GOVERNMENTS
   31  WITH INVOLVEMENT OF THE HEALTH CARE PROVIDER, PATIENT, AND PUBLIC HEALTH
   32  COMMUNITIES.
   33    2. THE PURPOSES OF THIS TITLE ARE:
   34    (A) TO PROMOTE BASIC AND CLINICAL RESEARCH PROGRAMS DESIGNED TO REDUCE
   35  OR PREVENT SUFFERING FROM LUPUS,  BY  PROVIDING  ADDITIONAL  FUNDING  TO
   36  STATE  ACADEMIC MEDICAL INSTITUTIONS WITHIN THE STATE CURRENTLY CONDUCT-
   37  ING OR HAVING AN INTEREST IN  CONDUCTING  BASIC  AND  CLINICAL,  SOCIAL,
   38  TRANSLATIONAL,  TECHNOLOGICAL,  EPIDEMIOLOGICAL, AND BEHAVIORAL RESEARCH
   39  ON LUPUS. SUCH ACTIVITIES MAY INCLUDE:
   40    (I) INVESTIGATING THE PATHOGENESIS AND PHYSIOLOGY OF LUPUS;
   41    (II) IDENTIFYING AND VALIDATING LUPUS BIOMARKERS;
   42    (III) ENHANCING  THE  STATEWIDE  INFRASTRUCTURE  TO  CONDUCT  CLINICAL
   43  TRIALS OF POTENTIAL NEW LUPUS THERAPIES;
   44    (IV)  DEVELOPING  OR IMPROVING DIAGNOSTIC TESTS FOR EARLY DETECTION OF
   45  LUPUS; AND
   46    (V) DEVELOPING NOVEL THERAPIES TO TREAT LUPUS.
   47    (B) TO ESTABLISH A MULTIDISCIPLINARY LUPUS RESEARCH  ADVISORY  COUNCIL
   48  TO MONITOR PROGRESS AND MAKE GRANTING RECOMMENDATIONS TO THE DEPARTMENT.
   49    S  256-B.  DEFINITION. AS USED IN THIS TITLE, "PROGRAM" SHALL MEAN THE
   50  LUPUS RESEARCH ENHANCEMENT  PROGRAM  CREATED  PURSUANT  TO  SECTION  TWO
   51  HUNDRED FIFTY-SIX-C OF THIS TITLE.
   52    S 256-C. LUPUS RESEARCH ENHANCEMENT PROGRAM. 1. THE COMMISSIONER SHALL
   53  ESTABLISH  WITHIN  THE  DEPARTMENT  A LUPUS RESEARCH ENHANCEMENT PROGRAM
   54  THROUGH WHICH THE DEPARTMENT SHALL MAKE GRANTS TO STATE ACADEMIC MEDICAL
   55  INSTITUTIONS WITHIN THE STATE CURRENTLY CONDUCTING OR HAVING AN INTEREST
       A. 10139                            3
    1  IN CONDUCTING BASIC AND CLINICAL, SOCIAL, TRANSLATIONAL,  TECHNOLOGICAL,
    2  EPIDEMIOLOGICAL, AND BEHAVIORAL RESEARCH ON LUPUS.
    3    2.  ALL  RESEARCH  FUNDS SHALL BE AWARDED ON THE BASIS OF THE RESEARCH
    4  PRIORITIES ESTABLISHED FOR THE PROGRAM AND THE SCIENTIFIC MERIT  OF  THE
    5  PROPOSED  RESEARCH,  AS  DETERMINED  BY AN OPEN, COMPETITIVE PEER REVIEW
    6  PROCESS THAT ENSURES OBJECTIVITY, CONSISTENCY,  AND  HIGH  QUALITY.  ALL
    7  INVESTIGATORS,  REGARDLESS  OF  AFFILIATION, SHALL HAVE EQUAL ACCESS AND
    8  OPPORTUNITY TO COMPETE FOR PROGRAM FUNDS.
    9    3. THE PEER REVIEW  PROCESS  FOR  THE  SELECTION  OF  RESEARCH  GRANTS
   10  AWARDED  UNDER  THIS  PROGRAM SHALL BE MODELED GENERALLY ON THAT USED BY
   11  THE NATIONAL INSTITUTES OF HEALTH IN ITS GRANT MAKING PROCESS.
   12    4. AN AWARDEE SHALL BE AWARDED GRANTS FOR THE FULL COST,  BOTH  DIRECT
   13  AND INDIRECT, OF CONDUCTING THE SPONSORED RESEARCH CONSISTENT WITH THOSE
   14  FEDERAL  GUIDELINES GOVERNING ALL FEDERAL RESEARCH GRANTS AND CONTRACTS.
   15  ALL INTELLECTUAL PROPERTY ASSETS DEVELOPED UNDER THIS PROGRAM  SHALL  BE
   16  TREATED IN ACCORDANCE WITH STATE AND FEDERAL LAW.
   17    5.  IN  ESTABLISHING  ITS RESEARCH PRIORITIES, THE STATE SHALL CONSULT
   18  WITH THE LUPUS RESEARCH ADVISORY COUNCIL AND CONSIDER A BROAD  RANGE  OF
   19  CROSS-DISCIPLINARY  LUPUS  RESEARCH,  INCLUDING,  BUT  NOT  LIMITED  TO,
   20  RESEARCH INTO THE CAUSE, CURE, AND DIAGNOSIS OF LUPUS; TRANSLATIONAL AND
   21  TECHNOLOGICAL RESEARCH, INCLUDING RESEARCH TO DEVELOP IMPROVED  DIAGNOS-
   22  TIC TESTS; RESEARCH REGARDING THE CULTURAL, ECONOMIC, AND LEGAL BARRIERS
   23  TO ACCESSING THE HEALTH CARE SYSTEM FOR EARLY DETECTION AND TREATMENT OF
   24  LUPUS;  AND  RESEARCH EXAMINING THE HEALTH DISPARITIES SEEN IN THE INCI-
   25  DENCE AND PREVALENCE OF LUPUS.
   26    S 256-D. LUPUS RESEARCH ADVISORY COUNCIL. 1. OPERATIONS. (A) THE COUN-
   27  CIL SHALL BE COMPRISED OF FIFTEEN MEMBERS REPRESENTING A BROAD RANGE  OF
   28  EXPERTISE AND EXPERIENCE.
   29    (B)  INDIVIDUALS  AND  ORGANIZATIONS  MAY  SUBMIT  NOMINATIONS  TO THE
   30  COMMISSIONER THROUGH THE COUNCIL.
   31    (C) EACH APPOINTED COUNCIL MEMBER SHOULD HAVE FAMILIARITY  WITH  LUPUS
   32  AND  ISSUES  THAT SURROUND LUPUS AND BE ONE OF THE FOLLOWING: HEALTH AND
   33  MEDICAL PROFESSIONAL WITH EXPERTISE IN LUPUS; AN INDIVIDUAL WITH  LUPUS;
   34  A  REPRESENTATIVE  FROM A LOCAL OR COUNTY HEALTH DEPARTMENT; OR A RECOG-
   35  NIZED EXPERT IN  THE  PROVISION  OF  HEALTH  SERVICES  TO  WOMEN,  LUPUS
   36  RESEARCH OR HEALTH DISPARITIES.
   37    (D) THE COUNCIL SHALL BE COMPRISED AS FOLLOWS:
   38    (I) AT LEAST THREE INDIVIDUALS WITH LUPUS;
   39    (II) NO MORE THAN TWO REPRESENTATIVES FROM THE DEPARTMENT;
   40    (III)  AT LEAST FIVE INDIVIDUALS FROM LUPUS NONPROFIT HEALTH ORGANIZA-
   41  TIONS; AND
   42    (IV) AT LEAST FIVE SCIENTISTS OR CLINICIANS WITH EXPERIENCE  IN  LUPUS
   43  AND WHO PARTICIPATE IN VARIOUS FIELDS OF SCIENTIFIC ENDEAVOR, INCLUDING,
   44  BUT  NOT LIMITED TO, THE FIELDS OF BIOMEDICAL RESEARCH, SOCIAL, TRANSLA-
   45  TIONAL, BEHAVIORAL AND EPIDEMIOLOGICAL RESEARCH, AND PUBLIC HEALTH.
   46    (E) ALL MEMBERS OF THE COUNCIL SHALL BE APPOINTED BY THE  COMMISSIONER
   47  AND THE COMMISSIONER SHALL CHOOSE FROM AMONG THE FIFTEEN COUNCIL MEMBERS
   48  ONE MEMBER TO SERVE AS CHAIR.
   49    (F)  ALL  MEMBERS  OF THE COUNCIL SHALL SERVE TERMS OF TWO YEARS EACH.
   50  MEMBERS CAN BE NAMED TO SERVE A TOTAL OF TWO  TERMS  AND  TERMS  CAN  BE
   51  CONSECUTIVE.
   52    (G) MEMBERS SHALL SERVE WITHOUT COMPENSATION, BUT SHALL BE ENTITLED TO
   53  ACTUAL, NECESSARY EXPENSES INCURRED IN THE PERFORMANCE OF THEIR BUSINESS
   54  AS MEMBERS OF THE COUNCIL.
       A. 10139                            4
    1    (H)  A  MAJORITY  OF  THE  MEMBERS  OF  THE COUNCIL SHALL CONSTITUTE A
    2  QUORUM.  A MAJORITY VOTE OF A QUORUM SHALL BE REQUIRED FOR ANY  OFFICIAL
    3  ACTION OF THE COUNCIL.
    4    (I) THE COUNCIL SHALL MEET AT THE CALL OF THE CHAIR, BUT NOT LESS THAN
    5  FOUR TIMES PER YEAR.
    6    2. FUNCTIONS. THE LUPUS RESEARCH ADVISORY COUNCIL SHALL:
    7    (A)  REVIEW  SUBMITTED  GRANT APPLICATIONS AND MAKE RECOMMENDATIONS TO
    8  THE COMMISSIONER, AND THE COMMISSIONER SHALL, AT HIS OR HER  DISCRETION,
    9  GRANT APPROVAL OF APPLICATIONS FOR GRANTS FROM THOSE APPLICATIONS RECOM-
   10  MENDED  BY THE COUNCIL (IF A COUNCIL MEMBER SUBMITS AN APPLICATION FOR A
   11  GRANT FROM THE LUPUS RESEARCH AND EDUCATION FUND,  HE  OR  SHE  WILL  BE
   12  PROHIBITED  FROM  REVIEWING  AND MAKING A RECOMMENDATION ON THE APPLICA-
   13  TION);
   14    (B) CONSULT WITH  THE  NATIONAL  INSTITUTES  OF  HEALTH,  CENTERS  FOR
   15  DISEASE  CONTROL  AND PREVENTION, THE AGENCY FOR HEALTHCARE RESEARCH AND
   16  QUALITY, THE NATIONAL ACADEMY OF SCIENCES (INSTITUTE OF MEDICINE), LUPUS
   17  ADVOCACY GROUPS, AND  OTHER  ORGANIZATIONS  OR  ENTITIES  WHICH  MAY  BE
   18  INVOLVED  IN  LUPUS RESEARCH TO SOLICIT BOTH INFORMATION REGARDING LUPUS
   19  RESEARCH PROJECTS THAT ARE CURRENTLY BEING CONDUCTED AND RECOMMENDATIONS
   20  FOR FUTURE RESEARCH PROJECTS; AND
   21    (C) SHALL TRANSMIT ANNUALLY ON  OR  BEFORE  DECEMBER  THIRTY-FIRST,  A
   22  REPORT  TO  THE  LEGISLATURE ON GRANTS MADE, GRANTS IN PROGRESS, PROGRAM
   23  ACCOMPLISHMENTS,  AND  FUTURE  PROGRAM  DIRECTIONS.  EACH  REPORT  SHALL
   24  INCLUDE, BUT NOT BE LIMITED TO, THE FOLLOWING INFORMATION:
   25    (I)  THE  NUMBER  AND DOLLAR AMOUNTS OF RESEARCH GRANTS, INCLUDING THE
   26  AMOUNT ALLOCATED TO INDIRECT COSTS;
   27    (II) THE SUBJECT OF RESEARCH GRANTS;
   28    (III) THE RELATIONSHIP BETWEEN FEDERAL AND  STATE  FUNDING  FOR  LUPUS
   29  RESEARCH;
   30    (IV) THE RELATIONSHIP BETWEEN EACH PROJECT AND THE OVERALL STRATEGY OF
   31  THE RESEARCH PROGRAM;
   32    (V)  A  SUMMARY OF RESEARCH FINDINGS INCLUDING DISCUSSION OF PROMISING
   33  NEW AREAS;
   34    (VI) THE INSTITUTIONS AND CAMPUSES RECEIVING GRANT AWARDS; AND
   35    (VII) THE FIRST ANNUAL REPORT SHALL INCLUDE AN EVALUATION  AND  RECOM-
   36  MENDATIONS  CONCERNING  THE  DESIRABILITY  AND  FEASIBILITY OF REQUIRING
   37  FOR-PROFIT GRANTEES TO COMPENSATE THE STATE IN THE EVENT  THAT  A  GRANT
   38  RESULTS  IN  THE DEVELOPMENT OF A PROFIT-MAKING PRODUCT. THIS EVALUATION
   39  SHALL INCLUDE, BUT NOT BE LIMITED TO, THE COSTS AND BENEFITS OF  REQUIR-
   40  ING  A  FOR-PROFIT GRANTEE TO REPAY THE GRANT, TO PROVIDE THE PRODUCT AT
   41  COST TO STATE PROGRAMS SERVING LOW-INCOME LUPUS PATIENTS, AND TO PAY THE
   42  STATE A PERCENTAGE OF THE ROYALTIES DERIVED FROM THE PRODUCT.
   43    3. CONTRIBUTIONS. THE SECRETARY OF THE LUPUS RESEARCH ADVISORY COUNCIL
   44  MAY ACCEPT GRANTS, SERVICES, AND PROPERTY FROM THE  FEDERAL  GOVERNMENT,
   45  FOUNDATIONS,  ORGANIZATIONS,  MEDICAL SCHOOLS, AND OTHER ENTITIES AS MAY
   46  BE AVAILABLE FOR THE PURPOSES OF  FULFILLING  THE  OBLIGATIONS  OF  THIS
   47  PROGRAM. ANY SUCH FUNDS SHALL SUPPLEMENT AND NOT SUPPLANT APPROPRIATIONS
   48  PROVIDED FOR THE IMPLEMENTATION OF THIS ARTICLE.
   49    4. WAIVERS. THE SECRETARY OF THE LUPUS RESEARCH ADVISORY COUNCIL SHALL
   50  SEEK  ANY  FEDERAL  WAIVER  OR WAIVERS THAT MAY BE NECESSARY TO MAXIMIZE
   51  FUNDS FROM THE FEDERAL GOVERNMENT TO IMPLEMENT THIS PROGRAM.
   52    S 256-E. LUPUS RESEARCH ENHANCEMENT FUND. ALL MONEYS RECEIVED PURSUANT
   53  TO SECTION TWO HUNDRED FIFTY-SIX-C OF THIS TITLE SHALL  BE  CREDITED  TO
   54  THE  FUND,  AS ESTABLISHED BY SECTION NINETY-FIVE-H OF THE STATE FINANCE
   55  LAW. THE COMMISSIONER  SHALL  USE  THE  FUND  TO  ADMINISTER  THE  LUPUS
       A. 10139                            5
    1  RESEARCH  ENHANCEMENT PROGRAM AND TO MAKE GRANTS TO AWARDEES PURSUANT TO
    2  SECTION TWO HUNDRED FIFTY-SIX-C OF THIS TITLE.
    3    S  2. The state finance law is amended by adding a new section 95-h to
    4  read as follows:
    5    S 95-H. LUPUS RESEARCH ENHANCEMENT FUND. 1.  THERE  IS  HEREBY  ESTAB-
    6  LISHED  IN THE JOINT CUSTODY OF THE COMMISSIONER OF TAXATION AND FINANCE
    7  AND THE COMPTROLLER, A SPECIAL FUND TO BE KNOWN AS THE  "LUPUS  RESEARCH
    8  ENHANCEMENT FUND".
    9    2.  SUCH FUND SHALL CONSIST OF ALL MONIES APPROPRIATED FOR THE PURPOSE
   10  OF SUCH FUND AND ANY GRANT, GIFT OR BEQUEST MADE TO THE  LUPUS  RESEARCH
   11  ENHANCEMENT PROGRAM AS ESTABLISHED BY TITLE FOUR-A OF ARTICLE TWO OF THE
   12  PUBLIC HEALTH LAW.
   13    3.  MONEYS OF THE FUND SHALL BE AVAILABLE FOR GRANTS THROUGH THE LUPUS
   14  RESEARCH ENHANCEMENT PROGRAM ADVISORY COUNCIL AND FOR  THE  EXPENSES  OF
   15  THE  LUPUS  RESEARCH  ENHANCEMENT PROGRAM ADVISORY COUNCIL, AND SHALL BE
   16  EXPENDED ONLY FOR THE PURPOSES  SPELLED  OUT  IN  SECTIONS  TWO  HUNDRED
   17  FIFTY-SIX-C AND TWO HUNDRED FIFTY-SIX-D OF THE PUBLIC HEALTH LAW.
   18    4.  MONEYS  IN THE LUPUS RESEARCH ENHANCEMENT FUND SHALL BE KEPT SEPA-
   19  RATE AND SHALL NOT BE COMMINGLED WITH ANY OTHER MONEYS IN THE CUSTODY OF
   20  THE COMMISSIONER OF TAXATION AND FINANCE AND THE COMPTROLLER.
   21    5. THE MONEYS OF THE FUND SHALL BE PAID OUT ON THE AUDIT  AND  WARRANT
   22  OF THE COMPTROLLER ON VOUCHERS CERTIFIED OR APPROVED BY THE COMMISSIONER
   23  OF  HEALTH,  OR  BY  AN  OFFICER OR EMPLOYEE OF THE DEPARTMENT OF HEALTH
   24  DESIGNATED BY SUCH COMMISSIONER.
   25    S 3. This act shall take effect immediately.
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