Bill Text: NY S05186 | 2013-2014 | General Assembly | Introduced


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

Spectrum: Partisan Bill (Democrat 7-0)

Status: (Introduced - Dead) 2014-01-08 - REFERRED TO HEALTH [S05186 Detail]

Download: New_York-2013-S05186-Introduced.html
                           S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________
                                         5186
                              2013-2014 Regular Sessions
                                   I N  S E N A T E
                                     May 14, 2013
                                      ___________
       Introduced  by  Sen.  SAVINO -- 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 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.
        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD02045-01-3
       S. 5186                             2
    1    (C) LUPUS DISPROPORTIONATELY AFFECTS WOMEN OF COLOR -  IT  IS  TWO  TO
    2  THREE  TIMES  MORE COMMON AMONG AFRICAN-AMERICANS, HISPANICS, ASIANS AND
    3  NATIVE AMERICANS AND IS GENERALLY MORE PREVALENT IN MINORITY POPULATIONS
    4  - A HEALTH DISPARITY THAT REMAINS UNEXPLAINED. ACCORDING TO THE  CENTERS
    5  FOR  DISEASE  CONTROL  AND  PREVENTION  THE  RATE OF LUPUS MORTALITY HAS
    6  INCREASED SINCE THE LATE NINETEEN SEVENTIES AND IS  HIGHER  AMONG  OLDER
    7  AFRICAN-AMERICAN WOMEN.
    8    (D) NO NEW DRUGS HAVE BEEN APPROVED BY THE U.S. FOOD AND DRUG ADMINIS-
    9  TRATION  SPECIFICALLY FOR LUPUS IN NEARLY FORTY YEARS, AND WHILE CURRENT
   10  TREATMENTS FOR THE DISEASE CAN BE EFFECTIVE, THEY CAN LEAD  TO  DAMAGING
   11  SIDE EFFECTS.
   12    (E)  THE  PAIN AND FATIGUE ASSOCIATED WITH LUPUS CAN THREATEN PEOPLE'S
   13  ABILITY TO LIVE INDEPENDENTLY, MAKE IT DIFFICULT TO MAINTAIN  EMPLOYMENT
   14  AND LEAD NORMAL LIVES, AND ONE IN FIVE  PEOPLE WITH LUPUS IS DISABLED BY
   15  THE DISEASE, AND CONSEQUENTLY RECEIVES SUPPORT FROM GOVERNMENT PROGRAMS,
   16  INCLUDING  MEDICARE,  MEDICAID,  SOCIAL  SECURITY DISABILITY, AND SOCIAL
   17  SECURITY SUPPLEMENTAL INCOME.
   18    (F) THE ESTIMATED AVERAGE ANNUAL COST  OF  MEDICAL  TREATMENT  FOR  AN
   19  INDIVIDUAL  WITH LUPUS CAN RANGE BETWEEN TEN THOUSAND DOLLARS AND THIRTY
   20  THOUSAND DOLLARS; FOR PEOPLE WHO HAVE THE MOST SERIOUS  FORM  OF  LUPUS,
   21  MEDICAL  COSTS  CAN  GREATLY  EXCEED  THIS AMOUNT, CAUSING A SIGNIFICANT
   22  ECONOMIC, EMOTIONAL AND SOCIAL BURDEN TO THE ENTIRE FAMILY AND SOCIETY.
   23    (G) MORE THAN HALF OF THE PEOPLE WITH LUPUS SUFFER FOUR OR MORE  YEARS
   24  AND  VISIT  THREE  OR  MORE  PHYSICIANS  BEFORE OBTAINING A DIAGNOSIS OF
   25  LUPUS; EARLY DIAGNOSIS OF AND COMMENCEMENT OF TREATMENT  FOR  LUPUS  CAN
   26  PREVENT OR REDUCE SERIOUS ORGAN DAMAGE, DISABILITY, AND DEATH.
   27    (H)  DESPITE  THE MAGNITUDE OF LUPUS AND ITS IMPACT ON INDIVIDUALS AND
   28  FAMILIES, HEALTH PROFESSIONAL AND PUBLIC UNDERSTANDING OF LUPUS  REMAINS
   29  LOW; ONLY ONE OF FIVE AMERICANS CAN PROVIDE EVEN BASIC INFORMATION ABOUT
   30  LUPUS,  AND  AWARENESS  OF LUPUS IS LOWEST AMONG ADULTS AGES EIGHTEEN TO
   31  THIRTY-FOUR - THE AGE GROUP MOST LIKELY TO DEVELOP SYMPTOMS OF LUPUS.
   32    (I) LUPUS IS A SIGNIFICANT  NATIONAL  HEALTH  ISSUE  THAT  DESERVES  A
   33  COMPREHENSIVE  AND COORDINATED RESPONSE BY STATE AND FEDERAL GOVERNMENTS
   34  WITH INVOLVEMENT OF THE HEALTH CARE PROVIDER, PATIENT, AND PUBLIC HEALTH
   35  COMMUNITIES.
   36    2. THE PURPOSES OF THIS TITLE ARE:
   37    (A) TO PROMOTE BASIC AND CLINICAL RESEARCH PROGRAMS DESIGNED TO REDUCE
   38  OR PREVENT SUFFERING FROM LUPUS,  BY  PROVIDING  ADDITIONAL  FUNDING  TO
   39  STATE  ACADEMIC MEDICAL INSTITUTIONS WITHIN THE STATE CURRENTLY CONDUCT-
   40  ING OR HAVING AN INTEREST IN  CONDUCTING  BASIC  AND  CLINICAL,  SOCIAL,
   41  TRANSLATIONAL,  TECHNOLOGICAL,  EPIDEMIOLOGICAL, AND BEHAVIORAL RESEARCH
   42  ON LUPUS. SUCH ACTIVITIES MAY INCLUDE:
   43    (I) INVESTIGATING THE PATHOGENESIS AND PHYSIOLOGY OF LUPUS;
   44    (II) IDENTIFYING AND VALIDATING LUPUS BIOMARKERS;
   45    (III) ENHANCING  THE  STATEWIDE  INFRASTRUCTURE  TO  CONDUCT  CLINICAL
   46  TRIALS OF POTENTIAL NEW LUPUS THERAPIES;
   47    (IV)  DEVELOPING  OR IMPROVING DIAGNOSTIC TESTS FOR EARLY DETECTION OF
   48  LUPUS; AND
   49    (V) DEVELOPING NOVEL THERAPIES TO TREAT LUPUS.
   50    (B) TO ESTABLISH A MULTIDISCIPLINARY LUPUS RESEARCH  ADVISORY  COUNCIL
   51  TO MONITOR PROGRESS AND MAKE GRANTING RECOMMENDATIONS TO THE DEPARTMENT.
   52    S  256-B.  DEFINITION. AS USED IN THIS TITLE, "PROGRAM" SHALL MEAN THE
   53  LUPUS RESEARCH ENHANCEMENT  PROGRAM  CREATED  PURSUANT  TO  SECTION  TWO
   54  HUNDRED FIFTY-SIX-C OF THIS TITLE.
   55    S 256-C. LUPUS RESEARCH ENHANCEMENT PROGRAM. 1. THE COMMISSIONER SHALL
   56  ESTABLISH  WITHIN  THE  DEPARTMENT  A LUPUS RESEARCH ENHANCEMENT PROGRAM
       S. 5186                             3
    1  THROUGH WHICH THE DEPARTMENT SHALL MAKE GRANTS TO STATE ACADEMIC MEDICAL
    2  INSTITUTIONS WITHIN THE STATE CURRENTLY CONDUCTING OR HAVING AN INTEREST
    3  IN CONDUCTING BASIC AND CLINICAL, SOCIAL, TRANSLATIONAL,  TECHNOLOGICAL,
    4  EPIDEMIOLOGICAL, AND BEHAVIORAL RESEARCH ON LUPUS.
    5    2.  ALL  RESEARCH  FUNDS SHALL BE AWARDED ON THE BASIS OF THE RESEARCH
    6  PRIORITIES ESTABLISHED FOR THE PROGRAM AND THE SCIENTIFIC MERIT  OF  THE
    7  PROPOSED  RESEARCH,  AS  DETERMINED  BY AN OPEN, COMPETITIVE PEER REVIEW
    8  PROCESS THAT ENSURES OBJECTIVITY, CONSISTENCY,  AND  HIGH  QUALITY.  ALL
    9  INVESTIGATORS,  REGARDLESS  OF  AFFILIATION, SHALL HAVE EQUAL ACCESS AND
   10  OPPORTUNITY TO COMPETE FOR PROGRAM FUNDS.
   11    3. THE PEER REVIEW  PROCESS  FOR  THE  SELECTION  OF  RESEARCH  GRANTS
   12  AWARDED  UNDER  THIS  PROGRAM SHALL BE MODELED GENERALLY ON THAT USED BY
   13  THE NATIONAL INSTITUTES OF HEALTH IN ITS GRANT MAKING PROCESS.
   14    4. AN AWARDEE SHALL BE AWARDED GRANTS FOR THE FULL COST,  BOTH  DIRECT
   15  AND INDIRECT, OF CONDUCTING THE SPONSORED RESEARCH CONSISTENT WITH THOSE
   16  FEDERAL  GUIDELINES GOVERNING ALL FEDERAL RESEARCH GRANTS AND CONTRACTS.
   17  ALL INTELLECTUAL PROPERTY ASSETS DEVELOPED UNDER THIS PROGRAM  SHALL  BE
   18  TREATED IN ACCORDANCE WITH STATE AND FEDERAL LAW.
   19    5.  IN  ESTABLISHING  ITS RESEARCH PRIORITIES, THE STATE SHALL CONSULT
   20  WITH THE LUPUS RESEARCH ADVISORY COUNCIL AND CONSIDER A BROAD  RANGE  OF
   21  CROSS-DISCIPLINARY  LUPUS  RESEARCH,  INCLUDING,  BUT  NOT  LIMITED  TO,
   22  RESEARCH INTO THE CAUSE, CURE, AND DIAGNOSIS OF LUPUS; TRANSLATIONAL AND
   23  TECHNOLOGICAL RESEARCH, INCLUDING RESEARCH TO DEVELOP IMPROVED  DIAGNOS-
   24  TIC TESTS; RESEARCH REGARDING THE CULTURAL, ECONOMIC, AND LEGAL BARRIERS
   25  TO ACCESSING THE HEALTH CARE SYSTEM FOR EARLY DETECTION AND TREATMENT OF
   26  LUPUS;  AND  RESEARCH EXAMINING THE HEALTH DISPARITIES SEEN IN THE INCI-
   27  DENCE AND PREVALENCE OF LUPUS.
   28    S 256-D. LUPUS RESEARCH ADVISORY COUNCIL. 1. OPERATIONS. (A) THE COUN-
   29  CIL SHALL BE COMPRISED OF FIFTEEN MEMBERS REPRESENTING A BROAD RANGE  OF
   30  EXPERTISE AND EXPERIENCE.
   31    (B)  INDIVIDUALS  AND  ORGANIZATIONS  MAY  SUBMIT  NOMINATIONS  TO THE
   32  COMMISSIONER THROUGH THE COUNCIL.
   33    (C) EACH APPOINTED COUNCIL MEMBER SHOULD HAVE FAMILIARITY  WITH  LUPUS
   34  AND  ISSUES  THAT SURROUND LUPUS AND BE ONE OF THE FOLLOWING: HEALTH AND
   35  MEDICAL PROFESSIONAL WITH EXPERTISE IN LUPUS; AN INDIVIDUAL WITH  LUPUS;
   36  A  REPRESENTATIVE  FROM A LOCAL OR COUNTY HEALTH DEPARTMENT; OR A RECOG-
   37  NIZED EXPERT IN  THE  PROVISION  OF  HEALTH  SERVICES  TO  WOMEN,  LUPUS
   38  RESEARCH OR HEALTH DISPARITIES.
   39    (D) THE COUNCIL SHALL BE COMPRISED AS FOLLOWS:
   40    (I) AT LEAST THREE INDIVIDUALS WITH LUPUS;
   41    (II) NO MORE THAN TWO REPRESENTATIVES FROM THE DEPARTMENT;
   42    (III)  AT LEAST FIVE INDIVIDUALS FROM LUPUS NONPROFIT HEALTH ORGANIZA-
   43  TIONS; AND
   44    (IV) AT LEAST FIVE SCIENTISTS OR CLINICIANS WITH EXPERIENCE  IN  LUPUS
   45  AND WHO PARTICIPATE IN VARIOUS FIELDS OF SCIENTIFIC ENDEAVOR, INCLUDING,
   46  BUT  NOT LIMITED TO, THE FIELDS OF BIOMEDICAL RESEARCH, SOCIAL, TRANSLA-
   47  TIONAL, BEHAVIORAL AND EPIDEMIOLOGICAL RESEARCH, AND PUBLIC HEALTH.
   48    (E) ALL MEMBERS OF THE COUNCIL SHALL BE APPOINTED BY THE  COMMISSIONER
   49  AND THE COMMISSIONER SHALL CHOOSE FROM AMONG THE FIFTEEN COUNCIL MEMBERS
   50  ONE MEMBER TO SERVE AS CHAIR.
   51    (F)  ALL  MEMBERS  OF THE COUNCIL SHALL SERVE TERMS OF TWO YEARS EACH.
   52  MEMBERS CAN BE NAMED TO SERVE A TOTAL OF TWO  TERMS  AND  TERMS  CAN  BE
   53  CONSECUTIVE.
   54    (G) MEMBERS SHALL SERVE WITHOUT COMPENSATION, BUT SHALL BE ENTITLED TO
   55  ACTUAL, NECESSARY EXPENSES INCURRED IN THE PERFORMANCE OF THEIR BUSINESS
   56  AS MEMBERS OF THE COUNCIL.
       S. 5186                             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
       S. 5186                             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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