100TH GENERAL ASSEMBLY
State of Illinois
2017 and 2018
HB4704

 

Introduced , by Rep. Michael Halpin

 

SYNOPSIS AS INTRODUCED:
 
105 ILCS 5/27-8.1  from Ch. 122, par. 27-8.1

    Amends the School Code. With respect to the requirement that children in certain grades receive a health examination, provides that the Department of Public Health shall, by rule, extend to November 15 the date by which proof of having the health examination must be presented for children who show an undue burden or a lack of access to a physician licensed to practice medicine in all of its branches, a licensed advanced practice registered nurse, or a licensed physician assistant. Makes related changes. Effective immediately.


LRB100 16468 NHT 31597 b

 

 

A BILL FOR

 

HB4704LRB100 16468 NHT 31597 b

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 and sixth grades of
17any public, private, or parochial school shall have a dental
18examination. Each of these children shall present proof of
19having 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 or sixth grade fails
22to present proof by May 15th, the school may hold the child's
23report card until one of the following occurs: (i) the child
24presents proof of a completed dental examination or (ii) the
25child presents proof that a dental examination will take place
26within 60 days after May 15th. The Department of Public Health

 

 

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1shall establish, by rule, a waiver for children who show an
2undue burden or a lack of access to a dentist. Each public,
3private, and parochial school must give notice of this dental
4examination 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) this amendatory Act of the 95th
10General Assembly and any student enrolling for the first time
11in a public, private, or parochial school on or after January
121, 2008 (the effective date of Public Act 95-671) this
13amendatory Act of the 95th General Assembly shall have an eye
14examination. Each of these children shall present proof of
15having been examined by a physician licensed to practice
16medicine in all of its branches or a licensed optometrist
17within the previous year, in accordance with this Section and
18rules adopted under this Section, before October 15th of the
19school year. If the child fails to present proof by October
2015th, the school may hold the child's report card until one of
21the following occurs: (i) the child presents proof of a
22completed eye examination or (ii) the child presents proof that
23an eye examination will take place within 60 days after October
2415th. The Department of Public Health shall establish, by rule,
25a waiver for children who show an undue burden or a lack of
26access to a physician licensed to practice medicine in all of

 

 

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1its branches who provides eye examinations or to a licensed
2optometrist. Each public, private, and parochial school must
3give notice of this eye examination requirement to the parents
4and guardians of students in compliance with rules of the
5Department of Public Health. Nothing in this Section shall be
6construed to allow a school to exclude a child from attending
7because of a parent's or guardian's failure to obtain an eye
8examination for the child.
9    (2) The Department of Public Health shall promulgate rules
10and regulations specifying the examinations and procedures
11that constitute a health examination, which shall include an
12age-appropriate developmental screening, an age-appropriate
13social and emotional screening, and the collection of data
14relating to asthma and obesity (including at a minimum, date of
15birth, gender, height, weight, blood pressure, and date of
16exam), and a dental examination and may recommend by rule that
17certain additional examinations be performed. The rules and
18regulations of the Department of Public Health shall specify
19that a tuberculosis skin test screening shall be included as a
20required part of each health examination included under this
21Section if the child resides in an area designated by the
22Department of Public Health as having a high incidence of
23tuberculosis. With respect to the developmental screening and
24the social and emotional screening, the Department of Public
25Health must develop rules and appropriate revisions to the
26Child Health Examination form in conjunction with a statewide

 

 

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

 

 

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

 

 

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

 

 

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

 

 

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1Health and the State Board of Education shall prescribe for
2statewide use. The examiner shall summarize on the report form
3any condition that he or she suspects indicates a need for
4special services, including for a health examination factors
5relating to asthma or obesity. The duty to summarize on the
6report form does not apply to social and emotional screenings.
7The confidentiality of the information and records relating to
8the developmental screening and the social and emotional
9screening shall be determined by the statutes, rules, and
10professional ethics governing the type of provider conducting
11the screening. The individuals confirming the administration
12of required immunizations shall record as indicated on the form
13that the immunizations were administered.
14    (5) If a child does not submit proof of having had either
15the health examination or the immunization as required, then
16the child shall be examined or receive the immunization, as the
17case may be, and present proof by October 15 of the current
18school year, or by an earlier date of the current school year
19established by a school district. However, the Department of
20Public Health shall, by rule, extend to November 15 the date by
21which proof of having the health examination must be presented
22for children who show an undue burden or a lack of access to a
23physician licensed to practice medicine in all of its branches,
24a licensed advanced practice registered nurse, or a licensed
25physician assistant. To establish a date before October 15 of
26the current school year for the health examination or

 

 

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1immunization as required, a school district must give notice of
2the requirements of this Section 60 days prior to the earlier
3established date. If for medical reasons one or more of the
4required immunizations must be given after October 15 of the
5current school year, or after an earlier established date of
6the current school year, then the child shall present, by
7October 15, or by the earlier established date, a schedule for
8the administration of the immunizations and a statement of the
9medical reasons causing the delay, both the schedule and the
10statement being issued by the physician, advanced practice
11registered nurse, physician assistant, registered nurse, or
12local health department that will be responsible for
13administration of the remaining required immunizations. If a
14child does not comply with the requirements of this subsection
15(5) by October 15, or by the earlier established date of the
16current school year, or by November 15 if extended pursuant to
17the Department of Public Health's rules with the requirements
18of this subsection, then the local school authority shall
19exclude that child from school until such time as the child
20presents proof of having had the health examination as required
21and presents proof of having received those required
22immunizations which are medically possible to receive
23immediately. During a child's exclusion from school for
24noncompliance with this subsection, the child's parents or
25legal guardian shall be considered in violation of Section 26-1
26and subject to any penalty imposed by Section 26-10. This

 

 

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

 

 

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1examination and immunization requirements on religious or
2medical grounds as provided in subsection (8) and the number of
3children who have not yet presented proof of having received
4the health examination because the date of presentment was
5extended pursuant to the Department of Public Health's rules
6under subsection (5). On or before December 1 of each year,
7every public school district and registered nonpublic school
8shall make publicly available the immunization data they are
9required to submit to the State Board of Education by November
1015. The immunization data made publicly available must be
11identical to the data the school district or school has
12reported to the State Board of Education.
13    Every school shall report to the State Board of Education
14by June 30, in the manner that the State Board requires, the
15number of children who have received the required dental
16examination, indicating, of those who have not received the
17required dental examination, the number of children who are
18exempt from the dental examination on religious grounds as
19provided in subsection (8) of this Section and the number of
20children who have received a waiver under subsection (1.5) of
21this Section.
22    Every school shall report to the State Board of Education
23by June 30, in the manner that the State Board requires, the
24number of children who have received the required eye
25examination, indicating, of those who have not received the
26required eye examination, the number of children who are exempt

 

 

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1from the eye examination as provided in subsection (8) of this
2Section, the number of children who have received a waiver
3under subsection (1.10) of this Section, and the total number
4of children in noncompliance with the eye examination
5requirement.
6    The reported information under this subsection (6) shall be
7provided to the Department of Public Health by the State Board
8of Education.
9    (7) Upon determining that the number of pupils who are
10required to be in compliance with subsection (5) of this
11Section is below 90% of the number of pupils enrolled in the
12school district, 10% of each State aid payment made pursuant to
13Section 18-8.05 or 18-8.15 to the school district for such year
14may be withheld by the State Board of Education until the
15number of students in compliance with subsection (5) is the
16applicable specified percentage or higher.
17    (8) Children of parents or legal guardians who object to
18health, dental, or eye examinations or any part thereof, to
19immunizations, or to vision and hearing screening tests on
20religious grounds shall not be required to undergo the
21examinations, tests, or immunizations to which they so object
22if such parents or legal guardians present to the appropriate
23local school authority a signed Certificate of Religious
24Exemption detailing the grounds for objection and the specific
25immunizations, tests, or examinations to which they object. The
26grounds for objection must set forth the specific religious

 

 

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1belief that conflicts with the examination, test,
2immunization, or other medical intervention. The signed
3certificate shall also reflect the parent's or legal guardian's
4understanding of the school's exclusion policies in the case of
5a vaccine-preventable disease outbreak or exposure. The
6certificate must also be signed by the authorized examining
7health care provider responsible for the performance of the
8child's health examination confirming that the provider
9provided education to the parent or legal guardian on the
10benefits of immunization and the health risks to the student
11and to the community of the communicable diseases for which
12immunization is required in this State. However, the health
13care provider's signature on the certificate reflects only that
14education was provided and does not allow a health care
15provider grounds to determine a religious exemption. Those
16receiving immunizations required under this Code shall be
17provided with the relevant vaccine information statements that
18are required to be disseminated by the federal National
19Childhood Vaccine Injury Act of 1986, which may contain
20information on circumstances when a vaccine should not be
21administered, prior to administering a vaccine. A healthcare
22provider may consider including without limitation the
23nationally accepted recommendations from federal agencies such
24as the Advisory Committee on Immunization Practices, the
25information outlined in the relevant vaccine information
26statement, and vaccine package inserts, along with the

 

 

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1healthcare provider's clinical judgment, to determine whether
2any child may be more susceptible to experiencing an adverse
3vaccine reaction than the general population, and, if so, the
4healthcare provider may exempt the child from an immunization
5or adopt an individualized immunization schedule. The
6Certificate of Religious Exemption shall be created by the
7Department of Public Health and shall be made available and
8used by parents and legal guardians by the beginning of the
92015-2016 school year. Parents or legal guardians must submit
10the Certificate of Religious Exemption to their local school
11authority prior to entering kindergarten, sixth grade, and
12ninth grade for each child for which they are requesting an
13exemption. The religious objection stated need not be directed
14by the tenets of an established religious organization.
15However, general philosophical or moral reluctance to allow
16physical examinations, eye examinations, immunizations, vision
17and hearing screenings, or dental examinations does not provide
18a sufficient basis for an exception to statutory requirements.
19The local school authority is responsible for determining if
20the content of the Certificate of Religious Exemption
21constitutes a valid religious objection. The local school
22authority shall inform the parent or legal guardian of
23exclusion procedures, in accordance with the Department's
24rules under Part 690 of Title 77 of the Illinois Administrative
25Code, at the time the objection is presented.
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    (9) For the purposes of this Section, "nursery schools"
11means those nursery schools operated by elementary school
12systems or secondary level school units or institutions of
13higher learning.
14(Source: P.A. 99-173, eff. 7-29-15; 99-249, eff. 8-3-15;
1599-642, eff. 7-28-16; 99-927, eff. 6-1-17; 100-238, eff.
161-1-18; 100-465, eff. 8-31-17; 100-513, eff. 1-1-18; revised
179-22-17.)
 
18    Section 99. Effective date. This Act takes effect upon
19becoming law.