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Adopt Public Health Order #1 of 2024
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INTRODUCED BY THE HEALTH & HUMAN SERVICES COMMITTEE FOR THE SULLIVAN COUNTY LEGISLATURE TO ACT AS LOCAL BOARD OF HEALTH TO ADOPT PUBLIC HEALTH ORDER NO.1 - 2024
TO SUMMER CAMP OPERATORS, SULLIVAN COUNTY, NEW YORK, 2024
WHEREAS, The Metropolitan region of New York State, including Sullivan County, has seen a historic detection and resurgence of poliomyelitis; and
WHEREAS, Sullivan County has a positive detection of the polio virus via PCR testing as well as strain identifying sequencing with 13 samples identified in Sullivan County in 2022, 2 were collected in July, 5 were collected in August, 5 were collected in September and 1 was collected in October; and
WHEREAS, the Metropolitan region of New York State, including Sullivan County has seen a significant rise in Pertussis; and
WHEREAS, Sullivan County Department of Public Health has investigated the largest Pertussis outbreak in recent county history this past summer, fall and into winter of 2023; and
WHEREAS, New York State experienced the largest outbreak of measles since 1989 during the summer of 2019, and at least 19 confirmed cases were located in Sullivan County, 426 cases were within New York State and 1,282 cases were confirmed in the U.S.; and
WHEREAS, Measles cases and clusters are becoming prevalent in neighboring states as well as states with high traffic travel to New York; and
WHEREAS, outbreaks of vaccine preventable diseases frequently occur in areas where people are unvaccinated or under-vaccinated; and
WHEREAS according to the NYS Immunization Information Services, Sullivan County has historically low vaccination rates with only 64.4% of children having one MMR vaccine by the age of 2 years old; and
WHEREAS, Measles is a highly infectious disease that may cause seizures, pneumonia, blindness, and death; and
WHEREAS, Polio is a life altering, deadly infectious disease which is extremely contagious and can lead to long term disability; and
WHEREAS, Pertussis is highly contagious, and can lead to pneumonia, seizures, sepsis and respiratory failure in small children; and
WHEREAS, Measles, Pertussis and Polio are all vaccine preventable diseases, and
WHEREAS, the Centers for Disease Control and Prevention have been actively investigating the current resurgence in previously well-known controlled diseases in the United States as well as globally. Vaccine preventable diseases kill an estimated 1.5 million people world-wide each year; and
WHEREAS, there are over 170 permitted summer camps for children which operate in Sullivan County which increases the risk of infectious disease outbreaks significantly; and
WHEREAS, summer camps are congregate settings where communicable disease such as Measles, Pertussis and Polio and other vaccine preventable diseases can rapidly spread; and
WHEREAS, in accordance with the New York State Public Health Law, the County Board of Health is authorized to adopt Public Health Order No. 1-2024, which Order shall regulate attendance at summer camps for campers based on evidence of all vaccines listed by the CDC’s Advisory
Committee on Immunization Practices recommended Vaccine Schedule or a valid medical exemption pursuant to the State Sanitary Code; and
WHEREAS, required vaccinations include
• Diphtheria and tetanus toxoid-containing vaccine
• Pertussis vaccine (DTaP or Tdap)
• Hepatitis B vaccine
• Measles, Mumps and Rubella Vaccine (MMR)
• Polio vaccine
• Meningitis vaccine and Varicella (chickenpox) vaccine; and
WHEREAS, an exclusion list of under and unvaccinated campers must be kept on record for inspection by Public Health Staff in the event of an exposure to an infectious individual; and
WHEREAS, after soliciting input from children’s camp operators, the Sullivan County Department of Public Health has determined that it is willing and capable of providing vaccinations to children’s camp staff either by connecting staff with a Federally Qualified Health Center (FQHC) or pharmacy, or for those who qualify, to receive vaccinations funded by the NYS Department of Health Vaccine for Adults (VFA) program in order to enhance public health and safety and to alleviate much of the compliance burden placed on camps by said Order. Opportunities to receive vaccinations will be coordinated with camps and announced to occur at a date to be determined, prior to the beginning of the summer camp season; and
WHEREAS, upon advice form the County Public Health Director, said Order is necessary and proper for the preservation of life and health, to reduce morbidity and mortality from preventable communicable disease, and to properly execute and enforce the New York State Health Law, including 2100, as well as other associated Rules and Regulations, including but not limited to those related to communicable diseases and outbreaks of
diseases as defined in 10 NYCRR 2.2.
NOW, THEREFORE, BE IT RESOLVED, the Legislature, acting in its capacity as the Sullivan County
Board of Health, hereby adopts Public Health Order No.1 - 2024 to secure the safety, health and welfare of Sullivan County residents and visitors; and
BE IT FURTHER RESOLVED, that Public Health Order No.1 - 2024 shall be effective immediately upon adoption by the Legislature and shall continue in effect through December 31, 2024; and
BE IT FURTHER RESOLVED, the Board of Health designates, at its discretion, four hearing officers; and
BE IT FURTHER RESOLVED, Nadia Rajsz, a member of the Board of Health, is hereby authorized to sign and issue subpoenas in accordance with Public Health Law Section 309.
Local Board of Health Public Health Order No. 1 - 2024 Children’s Camps
1. This Order shall apply to all camps operated within Sullivan County, in accordance with the New York State Public Health Law and Sanitary Code, 10 NYCRR 7-2.2, including summer day camps and children’s overnight camps.
2. The camp health director shall verify all campers have evidence of required vaccines or a valid medical exemption. This order excludes children that are five years old and younger.
Upon arrival to camp, the camp operator, health director or designee shall screen children as part of the initial health screening pursuant to the camp’s safety plan, for signs or symptoms of any potentially infectious disease, including vaccine preventable diseases. illness.
Additionally, the camp operator or health director shall request parents or guardians of campers to notify the camp operator or health director if such camper has had any possible exposures to the measles illness twenty-one days prior to attending camp and/or during the camp season.
All campers must have documentation of the following vaccinations administered prior to the beginning of camp:
• Diphtheria and Tetanus toxoid-containing vaccine and Pertussis vaccine (Dtap/DTP/Tdap)
• Hepatitis B vaccine or proof of immunity
• Measles, Mumps and Rubella vaccine (MMR) or proof of immunity (positive titer)
• Polio vaccine (IPV/OPV)
• Varicella (Chickenpox) vaccine or proof of immunity
• Meningococcal conjugate vaccine (MenACWY)
• Haemophilus influenzae type b conjugate vaccine (HiB)
• Pneumococcal Conjugate vaccine (PCV)
3. No camp operator shall permit any camper to attend camp unless such camper has provided evidence of all required immunizations. In regards to measles specifically, a titer proving immunity will also suffice.
Evidence of immunity includes:
a) Written documentation from a health care provider of one or more doses of a measles
containing vaccine (MMR);
b) Laboratory evidence of immunity;
c) Laboratory confirmation of measles; or
d) Birth before 1957
4. Notwithstanding, a camp operator may permit a camper who is in the process of receiving the required vaccine to attend camp. A camper who is “in the process of receiving the required vaccine” or “in-process” if the camper or has received at least the first dose of the required vaccine, has an appointment to complete a second dose of the required vaccine, based upon the current vaccination timelines. If a camper in attendance at a camp when the second dose of a required vaccine is scheduled, such camper or shall receive the second dose, or the camper or shall be excluded from camp after the expiration of the vaccination dose interval, based upon the specific vaccine.
5. All camp operators shall maintain records of camper screening for signs or symptoms of illness or recent exposure to the above-mentioned vaccine preventable diseases. Any immune camper or who was exposed to a vaccine preventable disease within the twenty-one days prior to attending camp or during the camp season shall be monitored for signs and symptoms of disease while at camp, and the camp operator or health director shall immediately report any such known exposures to Sullivan County Department of Public Health and the New York Department of Health.
6. Failure to comply with this Commissioner's Order may result in legal action, including, but limited to, requiring your attendance at an administrative hearing, and may further result in the imposition of penalties in an amount not exceeding $2,000 for a single violation or failure to adhere to any of the provisions of this Order authorized by Public Health Law Section 309(1) (f).
7. The County Public Health Director is directed to undertake the actions necessary to enforce this Order.
8. This Order shall be effective upon its adoption.
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