101ST GENERAL ASSEMBLY
State of Illinois
2019 and 2020
HB2188

 

Introduced , by Rep. Natalie A. Manley

 

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

    Amends the School Code. With regard to the required health examination, provides that the social and emotional screening must include questions on a child's medical history that pertain to the mental health issues of his or her family and any other matter that could impact the child's future mental health. Effective immediately.


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A BILL FOR

 

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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 (which must include questions on
12the child's medical history that pertain to the mental health
13issues of his or her family and any other matter that could
14impact the child's future mental health), and the collection of
15data relating to asthma and obesity (including at a minimum,
16date of birth, gender, height, weight, blood pressure, and date
17of exam), and a dental examination and may recommend by rule
18that certain additional examinations be performed. The rules
19and regulations of the Department of Public Health shall
20specify that a tuberculosis skin test screening shall be
21included as a required part of each health examination included
22under this Section if the child resides in an area designated
23by the Department of Public Health as having a high incidence
24of tuberculosis. With respect to the developmental screening
25and the social and emotional screening, the Department of
26Public Health must, no later than January 1, 2019, develop

 

 

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1rules and appropriate revisions to the Child Health Examination
2form in conjunction with a statewide organization representing
3school boards; a statewide organization representing
4pediatricians; statewide organizations representing
5individuals holding Illinois educator licenses with school
6support personnel endorsements, including school social
7workers, school psychologists, and school nurses; a statewide
8organization representing children's mental health experts; a
9statewide organization representing school principals; the
10Director of Healthcare and Family Services or his or her
11designee, the State Superintendent of Education or his or her
12designee; and representatives of other appropriate State
13agencies and, at a minimum, must recommend the use of validated
14screening tools appropriate to the child's age or grade, and,
15with regard to the social and emotional screening, require
16recording only whether or not the screening was completed. The
17rules shall take into consideration the screening
18recommendations of the American Academy of Pediatrics and must
19be consistent with the State Board of Education's social and
20emotional learning standards. The Department of Public Health
21shall specify that a diabetes screening as defined by rule
22shall be included as a required part of each health
23examination. Diabetes testing is not 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 by
12subsection (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 report
16forms required by subsection (4) of this Section that pertain
17to the eye examination. For purposes of this Section, an eye
18examination shall at a minimum include history, visual acuity,
19subjective refraction to best visual acuity near and far,
20internal and external examination, and a glaucoma evaluation,
21as well as any other tests or observations that in the
22professional judgment of the doctor are necessary. Vision and
23hearing 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 that
3individuals conducting vision screening tests give a child's
4parent or guardian written notification, before the vision
5screening is conducted, that states, "Vision screening is not a
6substitute for a complete eye and vision evaluation by an eye
7doctor. Your child is not required to undergo this vision
8screening if an optometrist or ophthalmologist has completed
9and signed a report form indicating that an examination has
10been administered within the previous 12 months.".
11    (2.5) With respect to the developmental screening and the
12social and emotional screening portion of the health
13examination, each child may present proof of having been
14screened in accordance with this Section and the rules adopted
15under this Section before October 15th of the school year. With
16regard to the social and emotional screening only, the
17examining health care provider shall only record whether or not
18the screening was completed. If the child fails to present
19proof of the developmental screening or the social and
20emotional screening portions of the health examination by
21October 15th of the school year, qualified school support
22personnel may, with a parent's or guardian's consent, offer the
23developmental screening or the social and emotional screening
24to the child. Each public, private, and parochial school must
25give notice of the developmental screening and social and
26emotional screening requirements to the parents and guardians

 

 

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

 

 

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1of exam), on uniform forms which the Department of Public
2Health and the State Board of Education shall prescribe for
3statewide use. The examiner shall summarize on the report form
4any condition that he or she suspects indicates a need for
5special services, including for a health examination factors
6relating to asthma or obesity. The duty to summarize on the
7report form does not apply to social and emotional screenings.
8The confidentiality of the information and records relating to
9the developmental screening and the social and emotional
10screening shall be determined by the statutes, rules, and
11professional ethics governing the type of provider conducting
12the screening. The individuals confirming the administration
13of required immunizations shall record as indicated on the form
14that the immunizations were administered.
15    (5) If a child does not submit proof of having had either
16the health examination or the immunization as required, then
17the child shall be examined or receive the immunization, as the
18case may be, and present proof by October 15 of the current
19school year, or by an earlier date of the current school year
20established by a school district. To establish a date before
21October 15 of the current school year for the health
22examination or immunization as required, a school district must
23give notice of the requirements of this Section 60 days prior
24to the earlier established date. If for medical reasons one or
25more of the required immunizations must be given after October
2615 of the current school year, or after an earlier established

 

 

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

 

 

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

 

 

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

 

 

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

 

 

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1and to the community of the communicable diseases for which
2immunization is required in this State. However, the health
3care provider's signature on the certificate reflects only that
4education was provided and does not allow a health care
5provider grounds to determine a religious exemption. Those
6receiving immunizations required under this Code shall be
7provided with the relevant vaccine information statements that
8are required to be disseminated by the federal National
9Childhood Vaccine Injury Act of 1986, which may contain
10information on circumstances when a vaccine should not be
11administered, prior to administering a vaccine. A healthcare
12provider may consider including without limitation the
13nationally accepted recommendations from federal agencies such
14as the Advisory Committee on Immunization Practices, the
15information outlined in the relevant vaccine information
16statement, and vaccine package inserts, along with the
17healthcare provider's clinical judgment, to determine whether
18any child may be more susceptible to experiencing an adverse
19vaccine reaction than the general population, and, if so, the
20healthcare provider may exempt the child from an immunization
21or adopt an individualized immunization schedule. The
22Certificate of Religious Exemption shall be created by the
23Department of Public Health and shall be made available and
24used by parents and legal guardians by the beginning of the
252015-2016 school year. Parents or legal guardians must submit
26the Certificate of Religious Exemption to their local school

 

 

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1authority prior to entering kindergarten, sixth grade, and
2ninth grade for each child for which they are requesting an
3exemption. The religious objection stated need not be directed
4by the tenets of an established religious organization.
5However, general philosophical or moral reluctance to allow
6physical examinations, eye examinations, immunizations, vision
7and hearing screenings, or dental examinations does not provide
8a sufficient basis for an exception to statutory requirements.
9The local school authority is responsible for determining if
10the content of the Certificate of Religious Exemption
11constitutes a valid religious objection. The local school
12authority shall inform the parent or legal guardian of
13exclusion procedures, in accordance with the Department's
14rules under Part 690 of Title 77 of the Illinois Administrative
15Code, at the time the objection is presented.
16    If the physical condition of the child is such that any one
17or more of the immunizing agents should not be administered,
18the examining physician, advanced practice registered nurse,
19or physician assistant responsible for the performance of the
20health examination shall endorse that fact upon the health
21examination form.
22    Exempting a child from the health, dental, or eye
23examination does not exempt the child from participation in the
24program of physical education training provided in Sections
2527-5 through 27-7 of this Code.
26    (8.5) The school board of a school district shall include

 

 

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1informational materials regarding influenza and influenza
2vaccinations and meningococcal disease and meningococcal
3vaccinations developed, provided, or approved by the
4Department of Public Health under Section 2310-700 of the
5Department of Public Health Powers and Duties Law of the Civil
6Administrative Code of Illinois when the board provides
7information on immunizations, infectious diseases,
8medications, or other school health issues to the parents or
9guardians of students.
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; 100-829,
17eff. 1-1-19; 100-863, eff. 8-14-18; 100-977, eff. 1-1-19;
18100-1011, eff. 8-21-18; revised 10-5-18.)
 
19    Section 99. Effective date. This Act takes effect upon
20becoming law.