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SB-676 Health: immunizations.(2007-2008)

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SB676:v93#DOCUMENT

Amended  IN  Assembly  August 20, 2007
Amended  IN  Assembly  July 18, 2007
Amended  IN  Assembly  July 09, 2007
Amended  IN  Assembly  June 21, 2007
Amended  IN  Senate  April 26, 2007
Amended  IN  Senate  April 11, 2007

CALIFORNIA LEGISLATURE— 2007–2008 REGULAR SESSION

Senate Bill
No. 676

Introduced  by  Senator Ridley-Thomas

February 23, 2007

An act to amend Section 120325 of, and to amend, add, and repeal Section 120335 of, the Health and Safety Code, relating to vaccinations. An act to amend Sections 120325 and 120335 of the Health and Safety Code, relating to vaccinations.


LEGISLATIVE COUNSEL'S DIGEST


SB 676, as amended, Ridley-Thomas. Health: immunizations.
Existing law prohibits the governing authority of a school or other institution from unconditionally admitting any person as a pupil of any private or public elementary or secondary school, child care center, day nursery, nursery school, family day care home, or development center, unless prior to his or her first admission to that institution he or she has been fully immunized against various diseases.
This bill would until July 1, 2010, recast those provisions to, in part, remove certain of the age and date restrictions and add pneumococcus to the list of diseases, on and after July 1, 2008, would prohibit the governing authority from admitting or advancing any pupil to the 7th grade unless immunized against pertussis.

The bill would, commencing July 1, 2010, revise the list of institutions that are subject to the prohibition, and would require the State Public Health Officer to create and maintain a list of immunizations and doses that shall be required prior to conditional and unconditional entry into the above-described institutions.

The bill would also, commencing July 1, 2010, require the State Department of Public Health to annually publish on its Web site the list of immunizations that are required under these provisions, and to adopt regulations as necessary to administer the immunization requirements by July 1, 2011.

Because the bill would add to the duties of certain local agencies it would impose a state-mandated local program.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to these statutory provisions.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: YES  

The people of the State of California do enact as follows:


SECTION 1.

 The Legislature finds and declares that it does not intend to relinquish its responsibilities relating to immunization requirements as it will continue oversight of this process through legislative and budgetary mechanisms, as necessary.

SEC. 2.

 Section 120325 of the Health and Safety Code is amended to read:

120325.
 In enacting this chapter, but excluding Section 120380, and in enacting Sections 120400, 120405, 120410, and 120415, it is the intent of the Legislature to provide:
(a) A means for the eventual achievement of total immunization of appropriate age groups against the following childhood diseases:
(1) Diphtheria.
(2) Hepatitis B.
(3) Haemophilus influenzae type b.
(4) Measles.
(5) Mumps.
(6) Pertussis (whooping cough).
(7) Poliomyelitis.
(8) Rubella.
(9) Tetanus.
(10) Varicella (chickenpox). This paragraph shall be operative only to the extent that funds for this purpose are appropriated in the annual Budget Act.
(11) Any other disease that is consistent with the most current recommendations of the Advisory Committee on Immunization Practices (ACIP) of the United States Department of Health and Human Services, the American Academy of Pediatrics (AAP), and the American Academy of Family Physicians (AAFP), and deemed appropriate by the State Public Health Officer pursuant to subdivision (c) of Section 120335. appropriate by the department.
(b) That the persons required to be immunized be allowed to obtain immunizations from whatever medical source they so desire, subject only to the condition that the immunization be performed in accordance with the regulations of the department and that a record of the immunization is made in accordance with the regulations.
(c) Exemptions from immunization for medical reasons or because of personal beliefs.
(d) For the keeping of adequate records of immunization so that health departments, schools, and other institutions, parents or guardians, and the persons immunized will be able to ascertain that a child is fully or only partially immunized, and so that appropriate public agencies will be able to ascertain the immunization needs of groups of children in schools or other institutions.
(e) Incentives to public health authorities to design innovative and creative programs that will promote and achieve full and timely immunization of children.

SEC. 3.

 Section 120335 of the Health and Safety Code is amended to read:

120335.
 (a) As used in this chapter, but excluding Section 120380, and as used in Sections 120400, 120405, 120410, and 120415, the term “governing authority” means the governing board of each school district or the authority of each other private or public institution responsible for the operation and control of the institution or the principal or administrator of each school or institution.
(b) The governing authority shall not unconditionally admit any person as a pupil of any private or public elementary or secondary school, child care center, day nursery, nursery school, family day care home, or development center, unless prior to his or her first admission to that institution he or she has been fully immunized. The following are the diseases for which immunizations shall be documented:
(1) Diphtheria.
(2) Haemophilus influenzae type b.
(3) Measles.
(4) Mumps.
(5) Pertussis (whooping cough).

(6)On and after July 1, 2008, pneumococcus, except for children who are 24 months of age and older in which case the governing authority shall not be required to verify documentation for this immunization.

(7)

(6) Poliomyelitis.

(8)

(7) Rubella.

(9)

(8) Tetanus.

(10)

(9) Hepatitis B.

(11)

(10)  Varicella (chickenpox), effective July 1, 2001. This paragraph shall be operative only to the extent that funds for this purpose are appropriated in the annual Budget Act.
The department may adopt emergency regulations to implement this paragraph including, but not limited to, requirements for documentation and immunization status reports, in accordance with the rulemaking provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code). The initial adoption of emergency regulations shall be deemed to be an emergency and considered by the Office of Administrative Law as necessary for the immediate preservation of the public peace, health and safety, or general welfare. Emergency regulations adopted pursuant to this paragraph shall remain in effect for no more than 180 days.

(12)

(11) Any other disease deemed appropriate by the department, taking into consideration the recommendations of the federal Centers for Disease Control and Prevention Advisory Committee on Immunization Practices (ACIP) and the American Academy of Pediatrics.
(c) On and after July 1, 2008, in addition to the initial vaccination against pertussis, the governing authority shall not unconditionally admit any pupil to the 7th grade level, nor unconditionally advance any pupil to the 7th grade level, of any of the institutions listed in subdivision (b) unless the pupil has been fully immunized against pertussis, including, but not limited to, any necessary adolescent booster immunization.
(d) The department may specify the immunizing agents which may be utilized and the manner in which immunizations are administered.

(e)This section shall become inoperative on July 1, 2010, and as of January 1, 2011, is repealed, unless a later enacted statute that is enacted before January 1, 2011, deletes or extends the dates on which it becomes inoperative and is repealed.

SEC. 4.Section 120335 is added to the Health and Safety Code, to read:
120335.

(a)The governing authority of a private or public elementary or secondary school, child day care center, as defined in Section 1596.750, day care center, as defined in Section 1596.76, or child care and development center, as defined in Section 8208 of the Education Code, shall not unconditionally admit a pupil unless, prior to his or her first admission to that institution, he or she has been fully immunized with the immunizations and dosages identified on the list developed pursuant to subdivision (b).

(b)The State Public Health Officer, in consultation with the California Conference of Local Health Officers, shall create and maintain a list of immunizations and doses required prior to unconditional and conditional entry into the institutions identified in subdivision (a).

(c)When creating the list of requirements pursuant to subdivision (b), the State Public Health Officer shall consider all of the following:

(1)Vaccines consistent with the most current recommendations of the Advisory Committee on Immunization Practices (ACIP) of the federal Centers for Disease Control and Prevention, the American Academy of Pediatrics, and the American Academy of Family Physicians.

(2)Criteria necessary for implementation of immunization requirements, including, but not limited to:

(A)Scientific data regarding disease and vaccines.

(B)Supply and availability of vaccines.

(C)Vaccine financing and reimbursement.

(D)Health care provider and public acceptance of a vaccine.

(3)The rationale for the decision to accept or decline a recommendation including, but not limited to, documentation of all considerations set forth in paragraph (2), and modified versions of the list shall be publicly posted on the department’s Web site within 30 days of the final decision by the State Public Health Officer.

(4)Upon the addition of an immunization to, or the deletion of an immunization from, the list of required vaccinations, the department, 30 days prior to adoption of new regulations, shall notify the Governor, the Senate Committees on Health and Education, and the Assembly Committees on Health and Education.

(5)If, by January 1, 2014, a recommendation by an organization described in paragraph (1) has not been included in the list of required immunizations, the department shall post its rational stating why it chose to not include the recommendation, including, but not limited to, documentation of the considerations described in paragraph (2), on its Web site.

(d)Except in cases of emergency in which the State Public Health Officer must act immediately to protect the public health, the State Public Health Officer shall delay the prohibition described in subdivision (a) until the cost of the vaccine for Medi-Cal beneficiaries and uninsured individuals is covered by the federal Vaccines for Children program, by other federal funds, or by an appropriation by the Legislature for that specific purpose.

(e)The department shall publish and post on the department’s Web site by July 1 of every year a list of the immunizations that are required under this section, and shall include links to other Web sites that provide information about the required vaccines, including, but not limited to, ACIP’s recommended childhood and adolescent immunization schedule.

(f)(1)The State Public Health Officer may waive the prohibition described in subdivision (a) for a specific immunization if the State Public Health Officer, after consulting with the American Academy of Pediatrics, the American Academy of Family Physicians, and the California Conference of Local Health Officers, finds any of the following:

(A)There is a shortage of the recommended vaccine.

(B)Public or private funding or insurance coverage for the vaccine is not sufficient.

(C)A waiver is necessary to protect the public health.

(2)If the State Public Health Officer waives an immunization requirement pursuant to paragraph (1) for a vaccine on the list established pursuant to subdivision (b), he or she shall publish a public statement that shall be posted on the department’s Web site and sent to the Governor, the Senate Committees on Health and Education, and the Assembly Committees on Health and Education stating why he or she chose to waive the requirement.

(g)(1)The department shall adopt regulations necessary to administer this section by July 1, 2011. Until the adoption of these regulations, the list of immunizations and doses required prior to unconditional and conditional entry pursuant to subdivision (b) shall consist of the immunizations against the diseases listed in subdivision (b) of this section as it read on June 30, 2010.

(2)Notwithstanding paragraph (1), after the adoption of regulations to administer this section, which includes the list required in subdivision (b), the department may revise the list in a manner that is consistent with the administrative rulemaking requirements of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code. The State Public Health Officer may revise the list in a manner that is exempt from the administrative rulemaking requirements of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code in order to add a booster vaccination to the list, to change the required dosage, or, with respect to a particular immunization that has been on the ACIP’s recommended immunization schedule for at least five years, to revise the list for any reason.

(h)For the purposes of this section, the term “governing authority” means the governing board of each school district or the authority of each private or public institution responsible for the operation and control of the institution or the principal or administrator of each school or institution listed in subdivision (a).

(g)This section shall become operative on July 1, 2010.

SEC. 5. SEC. 4.

 If the Commission on State Mandates determines that this act contains costs mandated by the state, reimbursement to local agencies and school districts for those costs shall be made pursuant to Part 7 (commencing with Section 17500) of Division 4 of Title 2 of the Government Code.