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1    AN ACT concerning health.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Department of Public Health Powers and
5Duties Law of the Civil Administrative Code of Illinois is
6amended by changing Section 2310-700 as follows:
 
7    (20 ILCS 2310/2310-700)
8    Sec. 2310-700. Influenza and meningococcal disease and
9vaccine information; school districts. The Department shall
10develop, provide, or approve and shall publish informational
11materials for school districts in this State regarding
12influenza and influenza vaccinations and meningococcal disease
13and meningococcal vaccinations in accordance with the latest
14information provided by the Advisory Committee on Immunization
15Practices of the Centers for Disease Control and Prevention.
16(Source: P.A. 100-977, eff. 1-1-19.)
 
17    (20 ILCS 2310/2310-391 rep.)
18    Section 10. The Department of Public Health Powers and
19Duties Law of the Civil Administrative Code of Illinois is
20amended by repealing Section 2310-391.
 
21    Section 15. The School Code is amended by changing Section

 

 

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127-8.1 as follows:
 
2    (105 ILCS 5/27-8.1)  (from Ch. 122, par. 27-8.1)
3    Sec. 27-8.1. Health examinations and immunizations.
4    (1) In compliance with rules and regulations which the
5Department of Public Health shall promulgate, and except as
6hereinafter provided, all children in Illinois shall have a
7health examination as follows: within one year prior to
8entering kindergarten or the first grade of any public,
9private, or parochial elementary school; upon entering the
10sixth and ninth grades of any public, private, or parochial
11school; prior to entrance into any public, private, or
12parochial nursery school; and, irrespective of grade,
13immediately prior to or upon entrance into any public,
14private, or parochial school or nursery school, each child
15shall present proof of having been examined in accordance with
16this Section and the rules and regulations promulgated
17hereunder. Any child who received a health examination within
18one year prior to entering the fifth grade for the 2007-2008
19school year is not required to receive an additional health
20examination in order to comply with the provisions of Public
21Act 95-422 when he or she attends school for the 2008-2009
22school year, unless the child is attending school for the
23first time as provided in this paragraph.
24    A tuberculosis skin test screening shall be included as a
25required part of each health examination included under this

 

 

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1Section if the child resides in an area designated by the
2Department of Public Health as having a high incidence of
3tuberculosis. Additional health examinations of pupils,
4including eye examinations, may be required when deemed
5necessary by school authorities. Parents are encouraged to
6have their children undergo eye examinations at the same
7points in time required for health examinations.
8    (1.5) In compliance with rules adopted by the Department
9of Public Health and except as otherwise provided in this
10Section, all children in kindergarten and the second, sixth,
11and ninth grades of any public, private, or parochial school
12shall have a dental examination. Each of these children shall
13present proof of having been examined by a dentist in
14accordance with this Section and rules adopted under this
15Section before May 15th of the school year. If a child in the
16second, sixth, or ninth grade fails to present proof by May
1715th, the school may hold the child's report card until one of
18the following occurs: (i) the child presents proof of a
19completed dental examination or (ii) the child presents proof
20that a dental examination will take place within 60 days after
21May 15th. A school may not withhold a child's report card
22during a school year in which the Governor has declared a
23disaster due to a public health emergency pursuant to Section
247 of the Illinois Emergency Management Agency Act. The
25Department of Public Health shall establish, by rule, a waiver
26for children who show an undue burden or a lack of access to a

 

 

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1dentist. Each public, private, and parochial school must give
2notice of this dental examination requirement to the parents
3and guardians of students at least 60 days before May 15th of
4each school year.
5    (1.10) Except as otherwise provided in this Section, all
6children enrolling in kindergarten in a public, private, or
7parochial school on or after January 1, 2008 (the effective
8date of Public Act 95-671) and any student enrolling for the
9first time in a public, private, or parochial school on or
10after January 1, 2008 (the effective date of Public Act
1195-671) shall have an eye examination. Each of these children
12shall present proof of having been examined by a physician
13licensed to practice medicine in all of its branches or a
14licensed optometrist within the previous year, in accordance
15with this Section and rules adopted under this Section, before
16October 15th of the school year. If the child fails to present
17proof by October 15th, the school may hold the child's report
18card until one of the following occurs: (i) the child presents
19proof of a completed eye examination or (ii) the child
20presents proof that an eye examination will take place within
2160 days after October 15th. A school may not withhold a child's
22report card during a school year in which the Governor has
23declared a disaster due to a public health emergency pursuant
24to Section 7 of the Illinois Emergency Management Agency Act.
25The Department of Public Health shall establish, by rule, a
26waiver for children who show an undue burden or a lack of

 

 

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

 

 

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

 

 

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

 

 

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

 

 

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

 

 

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1data relating to asthma and obesity (including at a minimum,
2date of birth, gender, height, weight, blood pressure, and
3date of exam), on uniform forms which the Department of Public
4Health and the State Board of Education shall prescribe for
5statewide use. The examiner shall summarize on the report form
6any condition that he or she suspects indicates a need for
7special services, including for a health examination factors
8relating to asthma or obesity. The duty to summarize on the
9report form does not apply to social and emotional screenings.
10The confidentiality of the information and records relating to
11the developmental screening and the social and emotional
12screening shall be determined by the statutes, rules, and
13professional ethics governing the type of provider conducting
14the screening. The individuals confirming the administration
15of required immunizations shall record as indicated on the
16form that the immunizations were administered.
17    (5) If a child does not submit proof of having had either
18the health examination or the immunization as required, then
19the child shall be examined or receive the immunization, as
20the case may be, and present proof by October 15 of the current
21school year, or by an earlier date of the current school year
22established by a school district. To establish a date before
23October 15 of the current school year for the health
24examination or immunization as required, a school district
25must give notice of the requirements of this Section 60 days
26prior to the earlier established date. If for medical reasons

 

 

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1one or more of the required immunizations must be given after
2October 15 of the current school year, or after an earlier
3established date of the current school year, then the child
4shall present, by October 15, or by the earlier established
5date, a schedule for the administration of the immunizations
6and a statement of the medical reasons causing the delay, both
7the schedule and the statement being issued by the physician,
8advanced practice registered nurse, physician assistant,
9registered nurse, or local health department that will be
10responsible for administration of the remaining required
11immunizations. If a child does not comply by October 15, or by
12the earlier established date of the current school year, with
13the requirements of this subsection, then the local school
14authority shall exclude that child from school until such time
15as the child presents proof of having had the health
16examination as required and presents proof of having received
17those required immunizations which are medically possible to
18receive immediately. During a child's exclusion from school
19for noncompliance with this subsection, the child's parents or
20legal guardian shall be considered in violation of Section
2126-1 and subject to any penalty imposed by Section 26-10. This
22subsection (5) does not apply to dental examinations, eye
23examinations, and the developmental screening and the social
24and emotional screening portions of the health examination. If
25the student is an out-of-state transfer student and does not
26have the proof required under this subsection (5) before

 

 

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

 

 

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

 

 

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

 

 

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

 

 

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1and legal guardians by the beginning of the 2015-2016 school
2year. Parents or legal guardians must submit the Certificate
3of Religious Exemption to their local school authority prior
4to entering kindergarten, sixth grade, and ninth grade for
5each child for which they are requesting an exemption. The
6religious objection stated need not be directed by the tenets
7of an established religious organization. However, general
8philosophical or moral reluctance to allow physical
9examinations, eye examinations, immunizations, vision and
10hearing screenings, or dental examinations does not provide a
11sufficient basis for an exception to statutory requirements.
12The local school authority is responsible for determining if
13the content of the Certificate of Religious Exemption
14constitutes a valid religious objection. The local school
15authority shall inform the parent or legal guardian of
16exclusion procedures, in accordance with the Department's
17rules under Part 690 of Title 77 of the Illinois
18Administrative Code, at the time the objection is presented.
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

 

 

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1the program of physical education training provided in
2Sections 27-5 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. 100-238, eff. 1-1-18; 100-465, eff. 8-31-17;
18100-513, eff. 1-1-18; 100-829, eff. 1-1-19; 100-863, eff.
198-14-18; 100-977, eff. 1-1-19; 100-1011, eff. 8-21-18; 101-81,
20eff. 7-12-19; 101-643, eff. 6-18-20.)