Rep. Sue Scherer

Filed: 3/19/2019

 

 


 

 


 
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1
AMENDMENT TO HOUSE BILL 422

2    AMENDMENT NO. ______. Amend House Bill 422 by replacing
3everything after the enacting clause with the following:
 
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,

 

 

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1immediately prior to or upon entrance into any public, private,
2or parochial school or nursery school, each child shall present
3proof of having been examined in accordance with this Section
4and the rules and regulations promulgated hereunder. Any child
5who received a health examination within one year prior to
6entering the fifth grade for the 2007-2008 school year is not
7required to receive an additional health examination in order
8to comply with the provisions of Public Act 95-422 when he or
9she attends school for the 2008-2009 school year, unless the
10child is attending school for the first time as provided in
11this paragraph.
12    A tuberculosis skin test screening shall be included as a
13required part of each health examination included under this
14Section if the child resides in an area designated by the
15Department of Public Health as having a high incidence of
16tuberculosis. Additional health examinations of pupils,
17including eye examinations, may be required when deemed
18necessary by school authorities. Parents are encouraged to have
19their children undergo eye examinations at the same points in
20time required for health examinations.
21    (1.5) In compliance with rules adopted by the Department of
22Public Health and except as otherwise provided in this Section,
23all children in kindergarten and the second, sixth, and ninth
24grades of any public, private, or parochial school shall have a
25dental examination. Each of these children shall present proof
26of having been examined by a dentist in accordance with this

 

 

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1Section and rules adopted under this Section before May 15th of
2the school year. If a child in the second, sixth, or ninth
3grade fails to present proof by May 15th, the school may hold
4the child's report card until one of the following occurs: (i)
5the child presents proof of a completed dental examination or
6(ii) the child presents proof that a dental examination will
7take place within 60 days after May 15th. The Department of
8Public Health shall establish, by rule, a waiver for children
9who show an undue burden or a lack of access to a dentist. Each
10public, private, and parochial school must give notice of this
11dental examination requirement to the parents and guardians of
12students at least 60 days before May 15th of each school year.
13    (1.10) Except as otherwise provided in this Section, all
14children enrolling in kindergarten in a public, private, or
15parochial school on or after January 1, 2008 (the effective
16date of Public Act 95-671) and any student enrolling for the
17first time in a public, private, or parochial school on or
18after January 1, 2008 (the effective date of Public Act 95-671)
19shall have an eye examination. Each of these children shall
20present proof of having been examined by a physician licensed
21to practice medicine in all of its branches or a licensed
22optometrist within the previous year, in accordance with this
23Section and rules adopted under this Section, before October
2415th of the school year. If the child fails to present proof by
25October 15th, the school may hold the child's report card until
26one of the following occurs: (i) the child presents proof of a

 

 

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1completed eye examination or (ii) the child presents proof that
2an eye examination will take place within 60 days after October
315th. The Department of Public Health shall establish, by rule,
4a waiver for children who show an undue burden or a lack of
5access to a physician licensed to practice medicine in all of
6its branches who provides eye examinations or to a licensed
7optometrist. Each public, private, and parochial school must
8give notice of this eye examination requirement to the parents
9and guardians of students in compliance with rules of the
10Department of Public Health. Nothing in this Section shall be
11construed to allow a school to exclude a child from attending
12because of a parent's or guardian's failure to obtain an eye
13examination for the child.
14    (2) The Department of Public Health shall promulgate rules
15and regulations specifying the examinations and procedures
16that constitute a health examination, which shall include an
17age-appropriate developmental screening, an age-appropriate
18social and emotional screening, and the collection of data
19relating to asthma and obesity (including at a minimum, date of
20birth, gender, height, weight, blood pressure, and date of
21exam), and a dental examination and may recommend by rule that
22certain additional examinations be performed. The rules and
23regulations of the Department of Public Health shall specify
24that a tuberculosis skin test screening shall be included as a
25required part of each health examination included under this
26Section if the child resides in an area designated by the

 

 

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1Department of Public Health as having a high incidence of
2tuberculosis. With respect to the developmental screening and
3the social and emotional screening, the Department of Public
4Health must, no later than January 1, 2019, develop rules and
5appropriate revisions to the Child Health Examination form in
6conjunction with a statewide organization representing school
7boards; a statewide organization representing pediatricians;
8statewide organizations representing individuals holding
9Illinois educator licenses with school support personnel
10endorsements, including school social workers, school
11psychologists, and school nurses; a statewide organization
12representing children's mental health experts; a statewide
13organization representing school principals; the Director of
14Healthcare and Family Services or his or her designee, the
15State Superintendent of Education or his or her designee; and
16representatives of other appropriate State agencies and, at a
17minimum, must recommend the use of validated screening tools
18appropriate to the child's age or grade, and, with regard to
19the social and emotional screening, require recording only
20whether or not the screening was completed. The rules shall
21take into consideration the screening recommendations of the
22American Academy of Pediatrics and must be consistent with the
23State Board of Education's social and emotional learning
24standards. The Department of Public Health shall specify that a
25diabetes screening as defined by rule shall be included as a
26required part of each health examination. Diabetes testing is

 

 

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

 

 

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1hearing screening tests, which shall not be considered
2examinations as that term is used in this Section, shall be
3conducted in accordance with rules and regulations of the
4Department of Public Health, and by individuals whom the
5Department of Public Health has certified. In these rules and
6regulations, the Department of Public Health shall require that
7individuals conducting vision screening tests give a child's
8parent or guardian written notification, before the vision
9screening is conducted, that states, "Vision screening is not a
10substitute for a complete eye and vision evaluation by an eye
11doctor. Your child is not required to undergo this vision
12screening if an optometrist or ophthalmologist has completed
13and signed a report form indicating that an examination has
14been administered within the previous 12 months.".
15    (2.5) With respect to the developmental screening and the
16social and emotional screening portion of the health
17examination, each child may present proof of having been
18screened in accordance with this Section and the rules adopted
19under this Section before October 15th of the school year. With
20regard to the social and emotional screening only, the
21examining health care provider shall only record whether or not
22the screening was completed. If the child fails to present
23proof of the developmental screening or the social and
24emotional screening portions of the health examination by
25October 15th of the school year, qualified school support
26personnel may, with a parent's or guardian's consent, offer the

 

 

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1developmental screening or the social and emotional screening
2to the child. Each public, private, and parochial school must
3give notice of the developmental screening and social and
4emotional screening requirements to the parents and guardians
5of students in compliance with the rules of the Department of
6Public Health. Nothing in this Section shall be construed to
7allow a school to exclude a child from attending because of a
8parent's or guardian's failure to obtain a developmental
9screening or a social and emotional screening for the child.
10Once a developmental screening or a social and emotional
11screening is completed and proof has been presented to the
12school, the school may, with a parent's or guardian's consent,
13make available appropriate school personnel to work with the
14parent or guardian, the child, and the provider who signed the
15screening form to obtain any appropriate evaluations and
16services as indicated on the form and in other information and
17documentation provided by the parents, guardians, or provider.
18    (3) Every child shall, at or about the same time as he or
19she receives a health examination required by subsection (1) of
20this Section, present to the local school proof of having
21received such immunizations against preventable communicable
22diseases as the Department of Public Health shall require by
23rules and regulations promulgated pursuant to this Section and
24the Communicable Disease Prevention Act.
25    (4) The individuals conducting the health examination,
26dental examination, or eye examination shall record the fact of

 

 

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1having conducted the examination, and such additional
2information as required, including for a health examination
3data relating to asthma and obesity (including at a minimum,
4date of birth, gender, height, weight, blood pressure, and date
5of exam), on uniform forms which the Department of Public
6Health and the State Board of Education shall prescribe for
7statewide use. The examiner shall summarize on the report form
8any condition that he or she suspects indicates a need for
9special services, including for a health examination factors
10relating to asthma or obesity. The duty to summarize on the
11report form does not apply to social and emotional screenings.
12The confidentiality of the information and records relating to
13the developmental screening and the social and emotional
14screening shall be determined by the statutes, rules, and
15professional ethics governing the type of provider conducting
16the screening. The individuals confirming the administration
17of required immunizations shall record as indicated on the form
18that the immunizations were administered.
19    (5) If a child does not submit proof of having had either
20the health examination or the immunization as required, then
21the child shall be examined or receive the immunization, as the
22case may be, and present proof by October 15 of the current
23school year, or by an earlier date of the current school year
24established by a school district. To establish a date before
25October 15 of the current school year for the health
26examination or immunization as required, a school district must

 

 

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1give notice of the requirements of this Section 60 days prior
2to the earlier established date. If for medical reasons one or
3more of the required immunizations must be given after October
415 of the current school year, or after an earlier established
5date of the current school year, then the child shall present,
6by October 15, or by the earlier established date, a schedule
7for the administration of the immunizations and a statement of
8the medical reasons causing the delay, both the schedule and
9the statement being issued by the physician, advanced practice
10registered nurse, physician assistant, registered nurse, or
11local health department that will be responsible for
12administration of the remaining required immunizations. If a
13child does not comply by October 15, or by the earlier
14established date of the current school year, with the
15requirements of this subsection, then the local school
16authority shall exclude that child from school until such time
17as the child presents proof of having had the health
18examination as required and presents proof of having received
19those required immunizations which are medically possible to
20receive immediately. During a child's exclusion from school for
21noncompliance with this subsection, the child's parents or
22legal guardian shall be considered in violation of Section 26-1
23and subject to any penalty imposed by Section 26-10. This
24subsection (5) does not apply to dental examinations, eye
25examinations, and the developmental screening and the social
26and emotional screening portions of the health examination. If

 

 

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

 

 

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1registered nonpublic school shall make publicly available the
2immunization data they are required to submit to the State
3Board of Education by November 15. The immunization data made
4publicly available must be identical to the data the school
5district or school has reported to the State Board of
6Education.
7    Every school shall report to the State Board of Education
8by June 30, in the manner that the State Board requires, the
9number of children who have received the required dental
10examination, indicating, of those who have not received the
11required dental examination, the number of children who are
12exempt from the dental examination on religious grounds as
13provided in subsection (8) of this Section and the number of
14children who have received a waiver under subsection (1.5) of
15this Section.
16    Every school shall report to the State Board of Education
17by June 30, in the manner that the State Board requires, the
18number of children who have received the required eye
19examination, indicating, of those who have not received the
20required eye examination, the number of children who are exempt
21from the eye examination as provided in subsection (8) of this
22Section, the number of children who have received a waiver
23under subsection (1.10) of this Section, and the total number
24of children in noncompliance with the eye examination
25requirement.
26    The reported information under this subsection (6) shall be

 

 

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1provided to the Department of Public Health by the State Board
2of Education.
3    (7) Upon determining that the number of pupils who are
4required to be in compliance with subsection (5) of this
5Section is below 90% of the number of pupils enrolled in the
6school district, 10% of each State aid payment made pursuant to
7Section 18-8.05 or 18-8.15 to the school district for such year
8may be withheld by the State Board of Education until the
9number of students in compliance with subsection (5) is the
10applicable specified percentage or higher.
11    (8) Children of parents or legal guardians who object to
12health, dental, or eye examinations or any part thereof, to
13immunizations, or to vision and hearing screening tests on
14religious grounds shall not be required to undergo the
15examinations, tests, or immunizations to which they so object
16if such parents or legal guardians present to the appropriate
17local school authority a signed Certificate of Religious
18Exemption detailing the grounds for objection and the specific
19immunizations, tests, or examinations to which they object. The
20grounds for objection must set forth the specific religious
21belief that conflicts with the examination, test,
22immunization, or other medical intervention. The signed
23certificate shall also reflect the parent's or legal guardian's
24understanding of the school's exclusion policies in the case of
25a vaccine-preventable disease outbreak or exposure. The
26certificate must also be signed by the authorized examining

 

 

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1health care provider responsible for the performance of the
2child's health examination confirming that the provider
3provided education to the parent or legal guardian on the
4benefits of immunization and the health risks to the student
5and to the community of the communicable diseases for which
6immunization is required in this State. However, the health
7care provider's signature on the certificate reflects only that
8education was provided and does not allow a health care
9provider grounds to determine a religious exemption. Those
10receiving immunizations required under this Code shall be
11provided with the relevant vaccine information statements that
12are required to be disseminated by the federal National
13Childhood Vaccine Injury Act of 1986, which may contain
14information on circumstances when a vaccine should not be
15administered, prior to administering a vaccine. A healthcare
16provider may consider including without limitation the
17nationally accepted recommendations from federal agencies such
18as the Advisory Committee on Immunization Practices, the
19information outlined in the relevant vaccine information
20statement, and vaccine package inserts, along with the
21healthcare provider's clinical judgment, to determine whether
22any child may be more susceptible to experiencing an adverse
23vaccine reaction than the general population, and, if so, the
24healthcare provider may exempt the child from an immunization
25or adopt an individualized immunization schedule. The
26Certificate of Religious Exemption shall be created by the

 

 

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1Department of Public Health and shall be made available and
2used by parents and legal guardians by the beginning of the
32015-2016 school year. Parents or legal guardians must submit
4the Certificate of Religious Exemption to their local school
5authority prior to entering kindergarten, sixth grade, and
6ninth grade for each child for which they are requesting an
7exemption. The religious objection stated need not be directed
8by the tenets of an established religious organization.
9However, general philosophical or moral reluctance to allow
10physical examinations, eye examinations, immunizations, vision
11and hearing screenings, or dental examinations does not provide
12a sufficient basis for an exception to statutory requirements.
13The local school authority is responsible for determining if
14the content of the Certificate of Religious Exemption
15constitutes a valid religious objection. The local school
16authority shall inform the parent or legal guardian of
17exclusion procedures, in accordance with the Department's
18rules under Part 690 of Title 77 of the Illinois Administrative
19Code, at the time the objection is presented. Beginning with
20the 2020-2021 school year, a parent or legal guardian who
21objects to immunizations on religious grounds must submit with
22the Certificate of Religious Exemption a certificate of
23completion of an online immunization seminar issued by the
24Department of Public Health under Section 2.5 of the
25Communicable Disease Prevention Act.
26    If the physical condition of the child is such that any one

 

 

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1or more of the immunizing agents should not be administered,
2the examining physician, advanced practice registered nurse,
3or physician assistant responsible for the performance of the
4health examination shall endorse that fact upon the health
5examination form.
6    Exempting a child from the health, dental, or eye
7examination does not exempt the child from participation in the
8program of physical education training provided in Sections
927-5 through 27-7 of this Code.
10    (8.5) The school board of a school district shall include
11informational materials regarding influenza and influenza
12vaccinations and meningococcal disease and meningococcal
13vaccinations developed, provided, or approved by the
14Department of Public Health under Section 2310-700 of the
15Department of Public Health Powers and Duties Law of the Civil
16Administrative Code of Illinois when the board provides
17information on immunizations, infectious diseases,
18medications, or other school health issues to the parents or
19guardians of students.
20    (9) For the purposes of this Section, "nursery schools"
21means those nursery schools operated by elementary school
22systems or secondary level school units or institutions of
23higher learning.
24(Source: P.A. 99-173, eff. 7-29-15; 99-249, eff. 8-3-15;
2599-642, eff. 7-28-16; 99-927, eff. 6-1-17; 100-238, eff.
261-1-18; 100-465, eff. 8-31-17; 100-513, eff. 1-1-18; 100-829,

 

 

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1eff. 1-1-19; 100-863, eff. 8-14-18; 100-977, eff. 1-1-19;
2100-1011, eff. 8-21-18; revised 10-5-18.)
 
3    Section 10. The Communicable Disease Prevention Act is
4amended by adding Section 2.5 as follows:
 
5    (410 ILCS 315/2.5 new)
6    Sec. 2.5. Online immunization seminar. The Department of
7Public Health shall develop and implement an online seminar
8that contains information on the risks and benefits of
9immunizing children against preventable communicable diseases.
10The Department shall issue a certificate of completion to those
11parents or legal guardians completing the seminar who must
12submit a certificate of completion under subsection (8) of
13Section 27-8.1 of the School Code.".