STATE OF NEW YORK ________________________________________________________________________ 4021 2023-2024 Regular Sessions IN SENATE 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: 1 Section 1. Legislative findings. Antibiotics are rightfully considered 2 one of the medical miracles of the last century because of their power- 3 ful ability to fight illness and disease caused by bacteria. But the 4 effectiveness of medically important antibiotics is now at great risk 5 due to their misuse and overuse in medicine and agriculture. Many 6 strains of bacteria have evolved resistance to antibiotics, meaning 7 instead of being killed by the drugs, they survive, multiply, and 8 spread. In fact, the more antibiotics are used, the faster antibiotic- 9 resistant bacteria (aka "superbugs") emerge, increasing the risk of 10 contracting an antibiotic-resistant infection. If effective policy meas- 11 ures are not soon adopted, some experts predict that by 2050, antibiot- 12 ic-resistant infections will be responsible for more annual deaths than 13 cancer. 14 In recognition of the serious public health threat posed by antibiot- 15 ic-resistant infections, the United Nations General Assembly in 2016 16 committed to taking action. The World Health Organization (WHO) consid- 17 ers it to be one of the biggest threats to global health, food security, 18 and international development today. The United States Centers for 19 Disease Control and Prevention (CDC) has stated that fighting this 20 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. LBD05817-01-3S. 4021 2 1 otic-resistant bacteria are responsible for at least 2.8 million 2 infections in the United States and at least 35,000 deaths. A study 3 commissioned by the United Kingdom government predicts that if action is 4 not taken now to combat antibiotic resistance, by 2050 the annual death 5 toll will have risen to 10 million globally. Most major medical and 6 health groups in the United States, including the American Medical Asso- 7 ciation, American Academy of Pediatrics, and Infectious Diseases Society 8 of America, have recognized the urgency of the antibiotic-resistance 9 crisis. New York State, in its Prevention Agenda 2019-2024, established 10 Antibiotic Resistance and Healthcare-Associated Infections as one of 11 five major focus areas. 12 Antibiotic-resistant bacteria are bacteria that are immune to the 13 effect of antibiotics. These so-called "superbugs" can infect humans and 14 animals, and the infections they cause are harder and sometimes impossi- 15 ble to treat. Antibiotic resistance is a naturally occurring phenomenon, 16 but the speed at which superbugs are emerging and spreading is acceler- 17 ating due to overuse and misuse of antibiotics in humans and animals. 18 Antibiotic-resistant bacteria are most prevalent in environments associ- 19 ated with high antibiotic use: healthcare settings and animal agricul- 20 ture. Two-thirds of all medically important antibiotics are sold for use 21 in animals. Bacteria that are resistant can spread from person to 22 person, and from animal to person--via the natural environment or 23 contaminated food--and resistance genes can transfer from bacteria to 24 bacteria. Some bacteria have developed resistance to multiple antibiot- 25 ics, making common infectious diseases such as tuberculosis, pneumonia, 26 food poisoning, urinary tract infections (UTIs), and gonorrhea harder 27 and sometimes impossible to treat. Everyone is at risk of exposure to 28 antibiotic-resistant bacteria, but those who work in hospitals and nurs- 29 ing homes, patients in such facilities, and those who work in livestock 30 farming, slaughterhouses, and large animal veterinarian practices have a 31 greater risk of getting antibiotic-resistant infections. 32 Given the current and growing threat posed by antibiotic resistance, 33 the state of New York must organize itself to adequately respond. The 34 WHO and the CDC recommend taking a "One Health" approach, which recog- 35 nizes the interconnectedness of humans and animals in achieving optimal 36 health outcomes. 37 § 2. Article 2 of the public health law is amended by adding a new 38 title 9 to read as follows: 39 TITLE 9 40 ANTIBIOTIC-RESISTANCE CONTROL 41 Section 269-a. Statement of policy and purposes. 42 269-b. Definitions. 43 269-c. Office of antibiotic-resistance control. 44 269-d. Antibiotic-resistance control board. 45 269-e. Organization of antibiotic-resistance control board. 46 269-f. Meetings. 47 269-g. Functions, powers and duties. 48 269-h. Cooperation with other departments. 49 269-i. Evaluation requirements. 50 269-j. Antibiotic-resistance data collection. 51 269-k. Antibiotic stewardship implementation. 52 269-l. Antibiotic-resistance control in agriculture. 53 269-m. Reporting requirements. 54 269-n. Violations. 55 § 269-a. Statement of policy and purposes. The purpose of this title 56 is to codify the establishment of an office to organize the state'sS. 4021 3 1 efforts to control the spread of antibiotic resistance, coordinate all 2 agencies' responses, and rely on best practices to comprehensively 3 address the public health threat posed by antibiotic resistance. 4 § 269-b. Definitions. As used in this section: 5 1. "Antibiotic" means a drug used to treat infections caused by bacte- 6 ria. Antibiotics may either kill or inhibit the growth of bacteria. 7 2. "Antibiotic class" means antibiotic agents with related molecular 8 structures, often with a similar mode of action because of interaction 9 with a similar target and thus subject to a similar mechanism of resist- 10 ance. 11 3. "Antibiotic resistance" means the ability of a bacterium to multi- 12 ply or persist in the presence of an increased level of an antibiotic 13 relative to the susceptible counterpart of the same species. 14 4. "Antibiotic stewardship" means using the optimal selection, dosage, 15 and duration of antibiotic treatment that results in the best clinical 16 outcome for the treatment of infection, with minimal toxicity to the 17 patient and minimal impact on subsequent resistance. Antibiotic steward- 18 ship may also include measures to prevent spread of infection in hospi- 19 tals and animal husbandry practices that prevent spread of infections on 20 farms. 21 5. "Board" means the antibiotic-resistance control board created 22 pursuant to section two hundred sixty-nine-d of this title. 23 6. "Disease control" means administration of antibiotics to a group of 24 animals once a proportion of the animals in the group have been diag- 25 nosed (based on clinical signs or other appropriate diagnostic methods) 26 with an indicated disease. 27 7. "Disease prevention" means administration of antibiotics to a group 28 of animals, none of which have been diagnosed with an indicated disease, 29 when transmission of existing undiagnosed infections, or the introduc- 30 tion of pathogens, is anticipated based on history, clinical judgment, 31 or epidemiological knowledge. 32 8. (a) "Disease treatment" means administration of an antibiotic only 33 to animals diagnosed (based on clinical signs or other appropriate diag- 34 nostic methods) with an indicated disease. 35 (b) Disease treatment includes but is not limited to selective dry cow 36 therapy, whereby individual dairy cows within a herd are determined, 37 when entering a dry cycle, to be likely infected with mastitis based on 38 key indicators including their previous history of disease, somatic cell 39 counts and/or cell cultures, and are administered antibiotics as 40 prescribed by a licensed veterinarian. 41 9. "Foodborne disease" (also referred to as foodborne illness or food 42 poisoning): means any illness that results from the consumption of food, 43 contaminated with pathogenic bacteria, viruses, or parasites. 44 10. "Food-producing animal" means: 45 (a) All cattle, swine, or poultry, regardless of whether the specific 46 animal is raised for the purpose of producing food for human consump- 47 tion; or 48 (b) Any animal of a type that the department of agriculture and 49 markets identifies by rule as livestock typically used to produce food 50 for human consumption, including aquatic and amphibian species. 51 11. "Livestock producer" means a person raising a food-producing 52 animal for commercial purposes. 53 12. "Medically important antibiotic" means a drug that is composed in 54 whole or in part of:S. 4021 4 1 (a) A form of the antibiotic classes of penicillin, tetracycline, 2 macrolide, lincosamide, streptogramin, aminoglycoside, sulfonamide, 3 fluoroquinolones, amphenicols, polymyxins, or cephalosporin; or 4 (b) A drug from an antibiotic class that is categorized as critically 5 important, highly important, or important in the World Health Organiza- 6 tion list of critically important antimicrobials for human medicine (6th 7 revision, 2019), or a subsequent revision or successor document issued 8 by the World Health Organization that is recognized by rule by the 9 department. 10 13. "Office" means the office of antibiotic-resistance control created 11 pursuant to section two hundred sixty-nine-c of this title. 12 14. "One Health" means taking a collaborative, multisectoral, and 13 transdisciplinary approach to controlling antibiotic resistance, recog- 14 nizing the interconnection between people, animals, plants, and their 15 shared environment. 16 15. "Veterinary feed directive" has the same definition as in section 17 558.3 of title 21 of the code of federal regulations. 18 § 269-c. Office of antibiotic-resistance control. There is hereby 19 created within the department an office of antibiotic-resistance 20 control. Such office shall: 21 1. Integrate and coordinate selected state health antibiotic-resis- 22 tance monitoring, oversight, and education programs based on the centers 23 for disease control's One Health approach to combating antibiotic 24 resistance. As part of this function, the office shall develop a coor- 25 dinated, comprehensive strategy and plan to end the misuse and reduce 26 the overuse of antibiotics in medicine and agriculture in the state. In 27 line with the National Action Plan 2020-2025 created by the Federal Task 28 Force on Combating Antibiotic-Resistant Bacteria, the office shall have 29 a goal for the state of reducing health care-associated antibiotic-re- 30 sistant infections by twenty percent by two thousand twenty-five and 31 community-acquired antibiotic-resistant infections by ten percent by two 32 thousand twenty-five. It shall have a further goal, consistent with the 33 existing goal of the European Union, of reducing use of medically impor- 34 tant antibiotics in food animal production by fifty percent within five 35 years after the effective date of this title, using a baseline estab- 36 lished two years after the effective date of this title. 37 2. Apply for grants, and accept gifts from private and public sources, 38 for research to improve the appropriate use of antibiotics. 39 3. Together with the antibiotic-resistance control board, serve as 40 liaison and advocate on matters relating to the judicious use, unneces- 41 sary use, and misuse of antibiotics. This function shall include the 42 provision of staff support to the antibiotic-resistance control board 43 and the establishment of appropriate program linkages with related 44 federal, state, and local agencies and programs. 45 4. Assist medical schools, veterinarian schools, agricultural schools, 46 and state agencies in the development of antibiotic-resistance control 47 training programs for doctors, veterinarians, medical and veterinary 48 support staff, and farmers, and in the development of educational 49 coursework for medical, veterinary, and agricultural students. 50 5. Promote community strategic planning and new or improved health 51 care delivery systems to reduce the use of antibiotics in health care 52 settings and agricultural settings. 53 6. Review the impact of antibiotic-resistance control programs and 54 regulations on levels of antibiotic-resistant bacteria found in health 55 care settings and agricultural settings, and that are foodborne.S. 4021 5 1 § 269-d. Antibiotic-resistance control board. 1. An antibiotic-resis- 2 tance control board is hereby created. Such board shall have five voting 3 members, who shall be the commissioners of health, agriculture and 4 markets, environmental conservation, education, and a public member. In 5 addition, as advisory members, there shall be a dean of a New York state 6 medical college, a dean of a New York state veterinary college, two 7 epidemiologists with expertise in antibiotic resistance, and, six 8 members, to be appointed by the governor, however, two shall be upon the 9 recommendation of the speaker of the assembly and two shall be upon the 10 recommendation of the temporary president of the senate. At least one of 11 the six members shall be a representative of the pharmaceutical indus- 12 try, one a representative of the farming community, and four represen- 13 tatives of the public with relevant expertise in, but not limited to, 14 the fields of public health, patient experience, or antibiotic resist- 15 ance. To the extent practicable, these public members shall be represen- 16 tative of the diversity of the state. 17 2. Advisory members appointed by the governor shall serve for terms of 18 three years, such terms to commence on July first and to expire on June 19 thirtieth; provided, however, that of the advisory members first 20 appointed, two shall be appointed for a one-year term expiring one year 21 after the effective date of this title, two shall be appointed for a 22 two-year term expiring two years after the effective date of this title, 23 and the remaining two shall be appointed for full three-year terms. Each 24 such advisory member shall hold office until a successor shall have been 25 appointed and qualified. 26 3. Each voting member and each advisory member of such board may, by 27 official order filed in the office of the board, designate a deputy or 28 other representative in their department to perform their duties under 29 this article. 30 4. The members of the board or their respective designees shall 31 receive no additional compensation for their services as members of the 32 board, but shall be allowed their actual and necessary expenses incurred 33 in the performance of their duties under this title. 34 § 269-e. Organization of antibiotic-resistance control board. 1. The 35 chair of the board shall be the commissioner. 36 2. The board shall appoint an executive secretary who shall act as the 37 administrative agent of the board, keep a record of all meetings of the 38 board and perform such other functions and duties as the board may 39 direct. 40 3. The board may make and adopt by-laws to regulate its proceedings. 41 § 269-f. Meetings. 1. The board shall meet at least once every three 42 months. Special meetings shall be called by the chair on their own 43 initiative or upon the written request of two voting members. Notice of 44 the time, place, and purpose of each meeting shall be transmitted to all 45 members of the board at least ten days prior to any meeting. 46 2. Three voting members of the board shall constitute a quorum to 47 transact the business of the board. A majority vote of members present 48 at the meeting shall be necessary for any action taken by the board. 49 Meetings shall be open to public observers, and meeting records shall be 50 publicly available. 51 § 269-g. Functions, powers and duties. 1. The board (a) may prepare 52 and recommend rules and regulations, or amendment or repeal thereof, for 53 controlling the use of antibiotics in health care and agricultural 54 settings consistent with the declared purpose of this title and (b) 55 shall designate the department or departments by whom such rules or 56 regulations shall be promulgated, administered, and enforced in accord-S. 4021 6 1 ance with the functions, powers, and duties of such department or 2 departments prescribed by law. Such rules and regulations shall not be 3 effective until filed in the office of the department of state. Any such 4 action shall be taken only at a meeting upon the affirmative vote in 5 person, electronically or by mail of at least four voting members of the 6 board, exclusive of any deputy or other representative, after a meeting 7 with the advisory members of the board and consideration of available 8 scientific evidence. 9 2. To further the declared purpose of this title, the board shall have 10 the following functions, powers, and duties: 11 (a) To prepare and recommend rules and regulations regarding the use 12 of antibiotics in health care and agricultural settings in order to 13 prevent their misuse and overuse and control, and prevent antibiotic 14 resistance. 15 (b) To coordinate the activities and programs of members' departments 16 concerned with the use of antibiotics and the development and spread of 17 antibiotic resistance. 18 (c) To promote and encourage training programs and practices, includ- 19 ing innovative concepts, that can reduce antibiotic use in health care 20 and agricultural settings. 21 (d) To cause such studies, research, and investigations to be made as 22 it may deem advisable and necessary. 23 (e) To hold and appear at public hearings. 24 (f) To collect and compile information and data relating to the use, 25 overuse, and misuse of antibiotics and development and spread of antibi- 26 otic resistance. 27 (g) To advise and assist state departments and agencies upon request. 28 (h) To inform the public concerning the state's efforts to regulate 29 the use of antibiotics and to provide information concerning antibiot- 30 ics, including those used in agriculture. 31 (i) To recommend, where appropriate, that the use of specific antibi- 32 otics be prohibited under specified conditions. 33 (j) To consult and cooperate with the appropriate agencies of the 34 federal government or of other states or local governments to more 35 effectively carry out its functions, powers, and duties under this 36 title. 37 (k) To do all things necessary or reasonable to carry out the forego- 38 ing functions, powers, and duties. 39 § 269-h. Cooperation with other departments. The board may request 40 from any department, division, board, bureau, commission, or other agen- 41 cy of the state, and the same are authorized to provide, without addi- 42 tional compensation, such assistance, services and data as may be neces- 43 sary to carry out the purpose of this title. The board may, within 44 appropriations available therefore, employ such other personnel as may 45 be necessary to carry out its responsibilities under this title. 46 § 269-i. Evaluation requirements. 1. The commissioner shall evaluate 47 the effectiveness of the efforts by the state government to reduce the 48 overuse and misuse of antibiotics. 49 2. The commissioner shall ensure that, to the extent practicable, the 50 most current research findings regarding mechanisms to reduce and change 51 attitudes toward the use of antibiotics are incorporated into the educa- 52 tion and training programs administered by the department. 53 3. To diminish the overuse and misuse of antibiotics and to ensure 54 that the state's programs are effective, the office shall conduct an 55 independent evaluation of the statewide antibiotic-resistance programs. 56 The purpose of this evaluation is to direct the most efficient allo-S. 4021 7 1 cation of state resources devoted to controlling antibiotic-resistance 2 within health care settings and agricultural settings. Such evaluation 3 shall be made publicly available on the department's website and 4 provided annually to the governor, the temporary president of the 5 senate, and the speaker of the assembly on or before October first of 6 each calendar year. The comprehensive evaluation design shall be guided 7 by the following: 8 (a) Sound evaluation principles including, to the extent feasible, 9 elements of controlled experiments; 10 (b) An evaluation of the comparative effectiveness of individual 11 program designs that shall be used in funding decisions and program 12 modifications; and 13 (c) An evaluation of other programs identified by state agencies, 14 local lead agencies, and federal agencies. 15 § 269-j. Antibiotic-resistance data collection. 1. Notwithstanding any 16 other law, all antibiotic-resistance and infection data collected by the 17 department, and documents pertaining to antibiotic-resistance steward- 18 ship programs, veterinary reports required by federal or state laws, and 19 any other related information as determined by the commissioner, shall 20 be made available to the office. 21 2. The department has the authority to request and receive copies of 22 all veterinary feed directives issued in the state, from veterinarians, 23 livestock owners, feed mills, or distributors to fully implement the 24 provisions of this title. 25 3. The state board of veterinary medicine, the department, and the 26 department of agriculture and markets shall coordinate with the United 27 States department of agriculture, the United States food and drug admin- 28 istration, and the United States centers for disease control and 29 prevention to implement the expanded antibiotic resistance surveillance 30 efforts included in the National Action Plan for Combating Antibiotic- 31 Resistant Bacteria, to obtain a better understanding of the links 32 between antibiotic use patterns in livestock and the development of 33 antibiotic-resistant bacterial infections. 34 4. (a) The department, the state board of veterinary medicine, the 35 department of agriculture and markets, veterinarians, and livestock 36 producers shall gather information on medically important antibiotic 37 sales and usage as well as antibiotic-resistant bacteria and livestock 38 management practice data. Monitoring efforts shall not be duplicative of 39 the National Animal Health Monitoring System or the National Antimicro- 40 bial Resistance Monitoring System, and, to the extent feasible, will 41 coordinate with the United States department of agriculture, the centers 42 for disease control and prevention, and the United States food and drug 43 administration in the development of these efforts. 44 (b) In coordinating with the National Animal Health Monitoring System 45 and the National Antimicrobial Resistance Monitoring System, the depart- 46 ment, the state board of veterinary medicine, and the department of 47 agriculture and markets shall gather representative samples of biolog- 48 ical isolates from all of the following: 49 (i) New York state's major livestock segments; 50 (ii) regions with considerable livestock production; and 51 (iii) representative segments of the food production chain. 52 (c) The department, the state board of veterinary medicine, and the 53 department of agriculture and markets shall report to the legislature 54 three years from the effective date of this title the results of their 55 outreach activities and monitoring efforts.S. 4021 8 1 § 269-k. Antibiotic stewardship implementation. 1. Notwithstanding any 2 law to the contrary, the office may request and shall receive reports on 3 hospitals' and nursing homes' antibiotic-resistance and infection 4 stewardship programs. 5 2. The department, in consultation with the state board of veterinary 6 medicine, the department of agriculture and markets, universities, and 7 cooperative extensions, shall develop antibiotic stewardship guidelines 8 and best management practices for veterinarians, livestock owners, and 9 their employees who are involved with the administering of medically 10 important antibiotics on the proper use of medically important antibiot- 11 ics for disease treatment and control in food animals. The guidelines 12 shall include scientifically validated practical alternatives to the use 13 of medically important antibiotics, including, but not limited to, good 14 hygiene and management practices. The guidelines shall be reviewed and 15 updated periodically, as necessary. 16 3. The department, in consultation with the state board of veterinary 17 medicine and the department of agriculture and markets, shall consult 18 with livestock producers, licensed veterinarians, and other relevant 19 stakeholders on ensuring that livestock grown in rural areas with limit- 20 ed access to veterinary care have timely access to treatment. 21 4. For the purposes of this section, "antibiotic stewardship" for 22 food-producing animals is a commitment to do all of the following: 23 (a) to use medically important antibiotics only when necessary to 24 treat or control disease; 25 (b) to select the appropriate medically important antibiotic and the 26 appropriate dose, duration, and route of administration; 27 (c) to use medically important antibiotics for the shortest duration 28 necessary and allowable, and to administer them to the fewest animals 29 necessary; and 30 (d) to raise animals under conditions that minimize the need for 31 medically important antibiotics by using vaccines, providing healthy 32 diets, maintaining sanitary housing and other appropriate good husbandry 33 practices. 34 § 269-l. Antibiotic-resistance control in agriculture. 1. Beginning 35 one year from the effective date of this title, medically important 36 antibiotics shall not be administered to a food-producing animal unless 37 ordered by a licensed veterinarian who has visited the farm operation 38 within the previous six months, through a prescription or veterinary 39 feed directive, pursuant to a veterinarian-client-patient relationship 40 that meets the requirements as defined by the state office of 41 professions. 42 2. (a) Beginning two years from the effective date of this title, a 43 livestock producer may administer a medically important antibiotic to a 44 food-producing animal only if a licensed veterinarian, in the exercise 45 of professional judgment, determines that the administration of the 46 medically important antibiotic to the animal is necessary: 47 (i) to control the ongoing spread of a diagnosed disease or infection; 48 (ii) to treat a diagnosed disease or infection; or 49 (iii) in relation to surgical or other medical procedures. 50 (b)(i) Medically important antibiotics shall not be administered by 51 any person to food-producing animals solely for the purposes of promot- 52 ing weight gain, improving feed efficiency, or disease prevention. 53 (ii) Blanket dry cow therapy, whereby all dairy cows in a herd enter- 54 ing a dry cycle are routinely administered an antibiotic to prevent 55 clinical mastitis, is considered a method of disease prevention, and is 56 not authorized.S. 4021 9 1 3. A veterinarian who determines that the provision of a medically 2 important antibiotic to a food-producing animal is necessary for a 3 purpose described in this section shall specify an end date for the 4 provision of the antibiotic to the animal. 5 4. A livestock producer may administer a medically important antibiot- 6 ic to a food-producing animal only for the purpose as determined by a 7 licensed veterinarian under this title. The livestock producer may 8 provide the antibiotic only for the duration specified by the veterina- 9 rian. 10 § 269-m. Reporting requirements. 1. Veterinarians licensed to practice 11 in New York state, or who are licensed in a bordering state and practice 12 in the state, and who prescribe medically important antibiotics or write 13 a veterinary feed directive (VFD) for one or more sets of food-producing 14 animals located in New York state, shall file an annual report under 15 this section in a form and manner required by the department by rule. 16 This report shall be submitted to the office. If medically important 17 antibiotics were provided under VFDs, then copies of those VFDs issued 18 during the year, prepared in the format recommended by the American 19 Veterinary Medical Association, may constitute the annual report. 20 Medically important antibiotics prescribed to, provided to, or adminis- 21 tered to food-producing animals during the reporting period that are not 22 covered by VFDs, shall also be included in the annual report and shall 23 contain the following information for each such prescription or adminis- 24 tration: 25 (a) Name and address of the livestock producer, and the location of 26 the treated animal or animals; 27 (b) The number of food-producing animals provided with medically 28 important antibiotics; 29 (c) The name of the medically important antibiotic provided; 30 (d) The species of food-producing animals that were provided the 31 medically important antibiotic; 32 (e) The number of days that the medically important antibiotic was 33 intended to be provided to a food-producing animal; 34 (f) The dosage of the medically important antibiotic that was intended 35 to be provided to a food-producing animal; 36 (g) The method of administration of the medically important antibiotic 37 to a food-producing animal; 38 (h) The purpose for providing the medically important antibiotic to a 39 food-producing animal; and 40 (i) The disease or infection, if any, that was intended to be 41 controlled due to the provision of each medically important antibiotic. 42 2. For the purposes of paragraph (h) of subdivision one of this 43 section, the purpose for providing a medically important antibiotic to a 44 food-producing animal shall be reported as: 45 (a) disease control; or 46 (b) disease treatment; or 47 (c) necessary for surgical or other medical procedures. 48 3. Information reported under this section shall be made publicly 49 available by the department annually in an online searchable database of 50 aggregated data. Such database shall protect the identity of a licensed 51 veterinarian, an individual farm, or business. 52 4. The department, state board of veterinary medicine, and the depart- 53 ment of agriculture and markets shall consult as necessary to fulfill 54 the requirements of this section.S. 4021 10 1 § 269-n. Violations. 1. A person or entity who violates this title 2 shall be liable for a civil penalty of not more than two hundred fifty 3 dollars per farm operation for each day a violation occurs. 4 2. (a) For a second or subsequent violation, a person or entity who 5 violates this title shall be punishable by an administrative fine in the 6 amount of five hundred dollars per farm operation for each day a 7 violation occurs. 8 (b) In addition to the administrative fine, the violator shall attend 9 an educational program to be jointly developed by the department, the 10 department of agriculture and markets, and the state board of veterinary 11 medicine on the judicious use of medically important antibiotics. The 12 violator shall successfully complete the program and provide proof to 13 the board within ninety days from the occurrence of the violation. 14 3. Subdivisions one and two of this section shall not apply to 15 licensed veterinarians. A veterinarian who violates this section is 16 subject to discipline as defined in subarticle three of article one 17 hundred thirty of title eight of the education law. 18 4. The moneys collected pursuant to this title shall be deposited into 19 the antibiotics education fund established pursuant to section ninety- 20 seven-aaaa of the state finance law and be available for expenditure 21 upon appropriation by the legislature. 22 § 3. The state finance law is amended by adding a new section 97-aaaa 23 to read as follows: 24 § 97-aaaa. Antibiotics education fund. 1. There is hereby established 25 in the custody of the state comptroller a special fund to be known as 26 the "antibiotics education fund". 27 2. Such fund shall consist of all monies recovered from the assessment 28 of any penalty authorized by title nine of the public health law. 29 3. Moneys of the fund shall be deposited to the credit of the fund and 30 shall, in addition to any other moneys made available for such purpose, 31 be available to the department of health for the purpose of antibiotics 32 educational programs. All payments from the antibiotics education fund 33 shall be made on the audit and warrant of the state comptroller on 34 vouchers certified and submitted by the commissioner of health. 35 § 4. Paragraph (e) of subdivision 1 of section 218-b of the labor law, 36 as amended by chapter 142 of the laws of 2021, is amended to read as 37 follows: 38 (e) "Airborne infectious disease" shall mean any infectious viral, 39 bacterial or fungal disease that is transmissible through the air in the 40 form of aerosol particles or droplets and is designated by the commis- 41 sioner of health a highly contagious communicable disease that presents 42 a serious risk of harm to the public health. Such diseases shall include 43 methicillin-resistant staphylococcus aureus (MRSA) and other antibiot- 44 ic-resistant infections as established by the commissioner of health. 45 § 5. This act shall take effect one year after it shall have become a 46 law.