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1    AN ACT concerning education.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The School Code is amended by changing Section
527-8.1 as follows:
 
6    (105 ILCS 5/27-8.1)  (from Ch. 122, par. 27-8.1)
7    Sec. 27-8.1. Health examinations and immunizations.
8    (1) In compliance with rules and regulations which the
9Department of Public Health shall promulgate, and except as
10hereinafter provided, all children in Illinois shall have a
11health examination as follows: within one year prior to
12entering kindergarten or the first grade of any public,
13private, or parochial elementary school; upon entering the
14sixth and ninth grades of any public, private, or parochial
15school; prior to entrance into any public, private, or
16parochial nursery school; and, irrespective of grade,
17immediately prior to or upon entrance into any public, private,
18or parochial school or nursery school, each child shall present
19proof of having been examined in accordance with this Section
20and the rules and regulations promulgated hereunder. Any child
21who received a health examination within one year prior to
22entering the fifth grade for the 2007-2008 school year is not
23required to receive an additional health examination in order

 

 

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1to comply with the provisions of Public Act 95-422 when he or
2she attends school for the 2008-2009 school year, unless the
3child is attending school for the first time as provided in
4this paragraph.
5    A tuberculosis skin test screening shall be included as a
6required part of each health examination included under this
7Section if the child resides in an area designated by the
8Department of Public Health as having a high incidence of
9tuberculosis. Additional health examinations of pupils,
10including eye examinations, may be required when deemed
11necessary by school authorities. Parents are encouraged to have
12their children undergo eye examinations at the same points in
13time required for health examinations.
14    (1.5) In compliance with rules adopted by the Department of
15Public Health and except as otherwise provided in this Section,
16all children in kindergarten and the second, sixth, and ninth
17grades of any public, private, or parochial school shall have a
18dental examination. Each of these children shall present proof
19of having been examined by a dentist in accordance with this
20Section and rules adopted under this Section before May 15th of
21the school year. If a child in the second, sixth, or ninth
22grade fails to present proof by May 15th, the school may hold
23the child's report card until one of the following occurs: (i)
24the child presents proof of a completed dental examination or
25(ii) the child presents proof that a dental examination will
26take place within 60 days after May 15th. The Department of

 

 

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1Public Health shall establish, by rule, a waiver for children
2who show an undue burden or a lack of access to a dentist. Each
3public, private, and parochial school must give notice of this
4dental examination requirement to the parents and guardians of
5students at least 60 days before May 15th of each school year.
6    (1.10) Except as otherwise provided in this Section, all
7children enrolling in kindergarten in a public, private, or
8parochial school on or after January 1, 2008 (the effective
9date of Public Act 95-671) and any student enrolling for the
10first time in a public, private, or parochial school on or
11after January 1, 2008 (the effective date of Public Act 95-671)
12shall have an eye examination. Each of these children shall
13present proof of having been examined by a physician licensed
14to practice medicine in all of its branches or a licensed
15optometrist within the previous year, in accordance with this
16Section and rules adopted under this Section, before October
1715th of the school year. If the child fails to present proof by
18October 15th, the school may hold the child's report card until
19one of the following occurs: (i) the child presents proof of a
20completed eye examination or (ii) the child presents proof that
21an eye examination will take place within 60 days after October
2215th. The Department of Public Health shall establish, by rule,
23a waiver for children who show an undue burden or a lack of
24access to a physician licensed to practice medicine in all of
25its branches who provides eye examinations or to a licensed
26optometrist. Each public, private, and parochial school must

 

 

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1give notice of this eye examination requirement to the parents
2and guardians of students in compliance with rules of the
3Department of Public Health. Nothing in this Section shall be
4construed to allow a school to exclude a child from attending
5because of a parent's or guardian's failure to obtain an eye
6examination for the child.
7    (2) The Department of Public Health shall promulgate rules
8and regulations specifying the examinations and procedures
9that constitute a health examination, which shall include an
10age-appropriate developmental screening, an age-appropriate
11social and emotional screening, and the collection of data
12relating to asthma and obesity (including at a minimum, date of
13birth, gender, height, weight, blood pressure, and date of
14exam), and a dental examination and may recommend by rule that
15certain additional examinations be performed. The rules and
16regulations of the Department of Public Health shall specify
17that a tuberculosis skin test screening shall be included as a
18required part of each health examination included under this
19Section if the child resides in an area designated by the
20Department of Public Health as having a high incidence of
21tuberculosis. With respect to the developmental screening and
22the social and emotional screening, the Department of Public
23Health must, no later than January 1, 2019, develop rules and
24appropriate revisions to the Child Health Examination form in
25conjunction with a statewide organization representing school
26boards; a statewide organization representing pediatricians;

 

 

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1statewide organizations representing individuals holding
2Illinois educator licenses with school support personnel
3endorsements, including school social workers, school
4psychologists, and school nurses; a statewide organization
5representing children's mental health experts; a statewide
6organization representing school principals; the Director of
7Healthcare and Family Services or his or her designee, the
8State Superintendent of Education or his or her designee; and
9representatives of other appropriate State agencies and, at a
10minimum, must recommend the use of validated screening tools
11appropriate to the child's age or grade, and, with regard to
12the social and emotional screening, require recording only
13whether or not the screening was completed. The rules shall
14take into consideration the screening recommendations of the
15American Academy of Pediatrics and must be consistent with the
16State Board of Education's social and emotional learning
17standards. The Department of Public Health shall specify that a
18diabetes screening as defined by rule shall be included as a
19required part of each health examination. Diabetes testing is
20not required.
21    Physicians licensed to practice medicine in all of its
22branches, licensed advanced practice registered nurses, or
23licensed physician assistants shall be responsible for the
24performance of the health examinations, other than dental
25examinations, eye examinations, and vision and hearing
26screening, and shall sign all report forms required by

 

 

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1subsection (4) of this Section that pertain to those portions
2of the health examination for which the physician, advanced
3practice registered nurse, or physician assistant is
4responsible. If a registered nurse performs any part of a
5health examination, then a physician licensed to practice
6medicine in all of its branches must review and sign all
7required report forms. Licensed dentists shall perform all
8dental examinations and shall sign all report forms required by
9subsection (4) of this Section that pertain to the dental
10examinations. Physicians licensed to practice medicine in all
11its branches or licensed optometrists shall perform all eye
12examinations required by this Section and shall sign all report
13forms required by subsection (4) of this Section that pertain
14to the eye examination. For purposes of this Section, an eye
15examination shall at a minimum include history, visual acuity,
16subjective refraction to best visual acuity near and far,
17internal and external examination, and a glaucoma evaluation,
18as well as any other tests or observations that in the
19professional judgment of the doctor are necessary. Vision and
20hearing screening tests, which shall not be considered
21examinations as that term is used in this Section, shall be
22conducted in accordance with rules and regulations of the
23Department of Public Health, and by individuals whom the
24Department of Public Health has certified. In these rules and
25regulations, the Department of Public Health shall require that
26individuals conducting vision screening tests give a child's

 

 

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1parent or guardian written notification, before the vision
2screening is conducted, that states, "Vision screening is not a
3substitute for a complete eye and vision evaluation by an eye
4doctor. Your child is not required to undergo this vision
5screening if an optometrist or ophthalmologist has completed
6and signed a report form indicating that an examination has
7been administered within the previous 12 months.".
8    (2.5) With respect to the developmental screening and the
9social and emotional screening portion of the health
10examination, each child may present proof of having been
11screened in accordance with this Section and the rules adopted
12under this Section before October 15th of the school year. With
13regard to the social and emotional screening only, the
14examining health care provider shall only record whether or not
15the screening was completed. If the child fails to present
16proof of the developmental screening or the social and
17emotional screening portions of the health examination by
18October 15th of the school year, qualified school support
19personnel may, with a parent's or guardian's consent, offer the
20developmental screening or the social and emotional screening
21to the child. Each public, private, and parochial school must
22give notice of the developmental screening and social and
23emotional screening requirements to the parents and guardians
24of students in compliance with the rules of the Department of
25Public Health. Nothing in this Section shall be construed to
26allow a school to exclude a child from attending because of a

 

 

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1parent's or guardian's failure to obtain a developmental
2screening or a social and emotional screening for the child.
3Once a developmental screening or a social and emotional
4screening is completed and proof has been presented to the
5school, the school may, with a parent's or guardian's consent,
6make available appropriate school personnel to work with the
7parent or guardian, the child, and the provider who signed the
8screening form to obtain any appropriate evaluations and
9services as indicated on the form and in other information and
10documentation provided by the parents, guardians, or provider.
11    (3) Every child shall, at or about the same time as he or
12she receives a health examination required by subsection (1) of
13this Section, present to the local school proof of having
14received such immunizations against preventable communicable
15diseases as the Department of Public Health shall require by
16rules and regulations promulgated pursuant to this Section and
17the Communicable Disease Prevention Act.
18    (4) The individuals conducting the health examination,
19dental examination, or eye examination shall record the fact of
20having conducted the examination, and such additional
21information as required, including for a health examination
22data relating to asthma and obesity (including at a minimum,
23date of birth, gender, height, weight, blood pressure, and date
24of exam), on uniform forms which the Department of Public
25Health and the State Board of Education shall prescribe for
26statewide use. The examiner shall summarize on the report form

 

 

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1any condition that he or she suspects indicates a need for
2special services, including for a health examination factors
3relating to asthma or obesity. The duty to summarize on the
4report form does not apply to social and emotional screenings.
5The confidentiality of the information and records relating to
6the developmental screening and the social and emotional
7screening shall be determined by the statutes, rules, and
8professional ethics governing the type of provider conducting
9the screening. The individuals confirming the administration
10of required immunizations shall record as indicated on the form
11that the immunizations were administered.
12    (5) If a child does not submit proof of having had either
13the health examination or the immunization as required, then
14the child shall be examined or receive the immunization, as the
15case may be, and present proof by October 15 of the current
16school year, or by an earlier date of the current school year
17established by a school district. To establish a date before
18October 15 of the current school year for the health
19examination or immunization as required, a school district must
20give notice of the requirements of this Section 60 days prior
21to the earlier established date. If for medical reasons one or
22more of the required immunizations must be given after October
2315 of the current school year, or after an earlier established
24date of the current school year, then the child shall present,
25by October 15, or by the earlier established date, a schedule
26for the administration of the immunizations and a statement of

 

 

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1the medical reasons causing the delay, both the schedule and
2the statement being issued by the physician, advanced practice
3registered nurse, physician assistant, registered nurse, or
4local health department that will be responsible for
5administration of the remaining required immunizations. If a
6child does not comply by October 15, or by the earlier
7established date of the current school year, with the
8requirements of this subsection, then the local school
9authority shall exclude that child from school until such time
10as the child presents proof of having had the health
11examination as required and presents proof of having received
12those required immunizations which are medically possible to
13receive immediately. During a child's exclusion from school for
14noncompliance with this subsection, the child's parents or
15legal guardian shall be considered in violation of Section 26-1
16and subject to any penalty imposed by Section 26-10. This
17subsection (5) does not apply to dental examinations, eye
18examinations, and the developmental screening and the social
19and emotional screening portions of the health examination. If
20the student is an out-of-state transfer student and does not
21have the proof required under this subsection (5) before
22October 15 of the current year or whatever date is set by the
23school district, then he or she may only attend classes (i) if
24he or she has proof that an appointment for the required
25vaccinations has been scheduled with a party authorized to
26submit proof of the required vaccinations. If the proof of

 

 

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1vaccination required under this subsection (5) is not submitted
2within 30 days after the student is permitted to attend
3classes, then the student is not to be permitted to attend
4classes until proof of the vaccinations has been properly
5submitted. No school district or employee of a school district
6shall be held liable for any injury or illness to another
7person that results from admitting an out-of-state transfer
8student to class that has an appointment scheduled pursuant to
9this subsection (5).
10    (6) Every school shall report to the State Board of
11Education by November 15, in the manner which that agency shall
12require, the number of children who have received the necessary
13immunizations and the health examination (other than a dental
14examination or eye examination) as required, indicating, of
15those who have not received the immunizations and examination
16as required, the number of children who are exempt from health
17examination and immunization requirements on religious or
18medical grounds as provided in subsection (8). On or before
19December 1 of each year, every public school district and
20registered nonpublic school shall make publicly available the
21immunization data they are required to submit to the State
22Board of Education by November 15. The immunization data made
23publicly available must be identical to the data the school
24district or school has reported to the State Board of
25Education.
26    Every school shall report to the State Board of Education

 

 

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1by June 30, in the manner that the State Board requires, the
2number of children who have received the required dental
3examination, indicating, of those who have not received the
4required dental examination, the number of children who are
5exempt from the dental examination on religious grounds as
6provided in subsection (8) of this Section and the number of
7children who have received a waiver under subsection (1.5) of
8this Section.
9    Every school shall report to the State Board of Education
10by June 30, in the manner that the State Board requires, the
11number of children who have received the required eye
12examination, indicating, of those who have not received the
13required eye examination, the number of children who are exempt
14from the eye examination as provided in subsection (8) of this
15Section, the number of children who have received a waiver
16under subsection (1.10) of this Section, and the total number
17of children in noncompliance with the eye examination
18requirement.
19    The reported information under this subsection (6) shall be
20provided to the Department of Public Health by the State Board
21of Education.
22    (7) Upon determining that the number of pupils who are
23required to be in compliance with subsection (5) of this
24Section is below 90% of the number of pupils enrolled in the
25school district, 10% of each State aid payment made pursuant to
26Section 18-8.05 or 18-8.15 to the school district for such year

 

 

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1may be withheld by the State Board of Education until the
2number of students in compliance with subsection (5) is the
3applicable specified percentage or higher.
4    (8) Children of parents or legal guardians who object to
5health, dental, or eye examinations or any part thereof, to
6immunizations, or to vision and hearing screening tests on
7religious grounds shall not be required to undergo the
8examinations, tests, or immunizations to which they so object
9if such parents or legal guardians present to the appropriate
10local school authority a signed Certificate of Religious
11Exemption detailing the grounds for objection and the specific
12immunizations, tests, or examinations to which they object. The
13grounds for objection must set forth the specific religious
14belief that conflicts with the examination, test,
15immunization, or other medical intervention. The signed
16certificate shall also reflect the parent's or legal guardian's
17understanding of the school's exclusion policies in the case of
18a vaccine-preventable disease outbreak or exposure. The
19certificate must also be signed by the authorized examining
20health care provider responsible for the performance of the
21child's health examination confirming that the provider
22provided education to the parent or legal guardian on the
23benefits of immunization and the health risks to the student
24and to the community of the communicable diseases for which
25immunization is required in this State. However, the health
26care provider's signature on the certificate reflects only that

 

 

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1education was provided and does not allow a health care
2provider grounds to determine a religious exemption. Those
3receiving immunizations required under this Code shall be
4provided with the relevant vaccine information statements that
5are required to be disseminated by the federal National
6Childhood Vaccine Injury Act of 1986, which may contain
7information on circumstances when a vaccine should not be
8administered, prior to administering a vaccine. A healthcare
9provider may consider including without limitation the
10nationally accepted recommendations from federal agencies such
11as the Advisory Committee on Immunization Practices, the
12information outlined in the relevant vaccine information
13statement, and vaccine package inserts, along with the
14healthcare provider's clinical judgment, to determine whether
15any child may be more susceptible to experiencing an adverse
16vaccine reaction than the general population, and, if so, the
17healthcare provider may exempt the child from an immunization
18or adopt an individualized immunization schedule. The
19Certificate of Religious Exemption shall be created by the
20Department of Public Health and shall be made available and
21used by parents and legal guardians by the beginning of the
222015-2016 school year. Parents or legal guardians must submit
23the Certificate of Religious Exemption to their local school
24authority prior to entering kindergarten, sixth grade, and
25ninth grade for each child for which they are requesting an
26exemption. The religious objection stated need not be directed

 

 

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1by the tenets of an established religious organization.
2However, general philosophical or moral reluctance to allow
3physical examinations, eye examinations, immunizations, vision
4and hearing screenings, or dental examinations does not provide
5a sufficient basis for an exception to statutory requirements.
6The local school authority is responsible for determining if
7the content of the Certificate of Religious Exemption
8constitutes a valid religious objection. The local school
9authority shall inform the parent or legal guardian of
10exclusion procedures, in accordance with the Department's
11rules under Part 690 of Title 77 of the Illinois Administrative
12Code, at the time the objection is presented. Beginning with
13the 2020-2021 school year, a parent or legal guardian who
14objects to immunizations on religious grounds must submit with
15the Certificate of Religious Exemption a certificate of
16completion of an online immunization seminar issued by the
17Department of Public Health under Section 2.5 of the
18Communicable Disease Prevention Act.
19    If the physical condition of the child is such that any one
20or more of the immunizing agents should not be administered,
21the examining physician, advanced practice registered nurse,
22or physician assistant responsible for the performance of the
23health examination shall endorse that fact upon the health
24examination form.
25    Exempting a child from the health, dental, or eye
26examination does not exempt the child from participation in the

 

 

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1program of physical education training provided in Sections
227-5 through 27-7 of this Code.
3    (8.5) The school board of a school district shall include
4informational materials regarding influenza and influenza
5vaccinations and meningococcal disease and meningococcal
6vaccinations developed, provided, or approved by the
7Department of Public Health under Section 2310-700 of the
8Department of Public Health Powers and Duties Law of the Civil
9Administrative Code of Illinois when the board provides
10information on immunizations, infectious diseases,
11medications, or other school health issues to the parents or
12guardians of students.
13    (9) For the purposes of this Section, "nursery schools"
14means those nursery schools operated by elementary school
15systems or secondary level school units or institutions of
16higher learning.
17(Source: P.A. 99-173, eff. 7-29-15; 99-249, eff. 8-3-15;
1899-642, eff. 7-28-16; 99-927, eff. 6-1-17; 100-238, eff.
191-1-18; 100-465, eff. 8-31-17; 100-513, eff. 1-1-18; 100-829,
20eff. 1-1-19; 100-863, eff. 8-14-18; 100-977, eff. 1-1-19;
21100-1011, eff. 8-21-18; revised 10-5-18.)
 
22    Section 10. The Communicable Disease Prevention Act is
23amended by adding Section 2.5 as follows:
 
24    (410 ILCS 315/2.5 new)

 

 

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1    Sec. 2.5. Online immunization seminar. The Department of
2Public Health shall develop and implement an online seminar
3that contains information on the risks and benefits of
4immunizing children against preventable communicable diseases.
5The Department shall issue a certificate of completion to those
6parents or legal guardians completing the seminar who must
7submit a certificate of completion under subsection (8) of
8Section 27-8.1 of the School Code.