1     
Representative Jacob L. Anderegg proposes the following substitute bill:


2     
IMMUNIZATION OF STUDENTS AMENDMENTS

3     
2016 GENERAL SESSION

4     
STATE OF UTAH

5     
Chief Sponsor: Carol Spackman Moss

6     
Senate Sponsor: ____________

7     

8     LONG TITLE
9     General Description:
10          This bill amends provisions related to immunization requirements for students.
11     Highlighted Provisions:
12          This bill:
13          ▸     defines terms;
14          ▸     amends requirements for an exemption from required immunizations;
15          ▸     requires the Department of Health to:
16               •     develop an immunization exemption form;
17               •     provide an immunization exemption form, free of charge, online and at local
18     health departments;
19               •     develop an education module; and
20               •     make rules;
21           ▸     requires an individual to receive educational information as a condition for
22     receiving an immunization exemption form online;
23          ▸     enacts renewal requirements for an exemption from required immunizations;
24          ▸     requires a school to maintain a list of students who have not received required
25     immunizations;
26          ▸     amends provisions related to a conditional enrollment; and

27          ▸     makes technical and conforming changes.
28     Money Appropriated in this Bill:
29          None
30     Other Special Clauses:
31          This bill provides a special effective date.
32     Utah Code Sections Affected:
33     AMENDS:
34          26-1-17.5, as last amended by Laws of Utah 2008, Chapter 382
35          53A-11-303, as enacted by Laws of Utah 1988, Chapter 2
36          53A-11-304, as enacted by Laws of Utah 1988, Chapter 2
37     ENACTS:
38          53A-11-300.5, Utah Code Annotated 1953
39     REPEALS AND REENACTS:
40          53A-11-301, as last amended by Laws of Utah 1992, Chapter 53
41          53A-11-302, as last amended by Laws of Utah 2010, Chapter 395
42          53A-11-302.5, as enacted by Laws of Utah 1992, Chapter 129
43          53A-11-306, as enacted by Laws of Utah 1988, Chapter 2
44     

45     Be it enacted by the Legislature of the state of Utah:
46          Section 1. Section 26-1-17.5 is amended to read:
47          26-1-17.5. Confidential records.
48          (1) A record classified as confidential under this title shall remain confidential, and be
49     released according to the provisions of this title, notwithstanding Section 63G-2-310.
50          (2) In addition to those persons granted access to [records] a private record described in
51     Subsection 63G-2-302(1)(b), immunization records may be shared among schools, school
52     districts, and local and state health departments and the state Department of Human Services as
53     necessary to [assure] ensure compliance with [Section 53A-11-301] Title 53A, Chapter 11, Part
54     3, Immunization of Students, and to prevent, investigate, and control the causes of epidemic,
55     infectious, communicable, and other diseases affecting the public health.
56          Section 2. Section 53A-11-300.5 is enacted to read:
57          53A-11-300.5. Definitions.

58          As used in this part:
59          (1) "Certificate of immunization" means:
60          (a) a certification stating that a student received each required immunization, including
61     the date each immunization was administered, issued by:
62          (i) a licensed health care provider;
63          (ii) an authorized representative of a local health department; or
64          (iii) an authorized representative of the department; or
65          (b) verification from the department, through a central database, that a student has
66     received each required immunization, including the date each immunization was administered.
67          (2) "Department" means the Department of Health, created in Section 26-1-4.
68          (3) "Immunization exemption form" means a form, described in Section 53A-11-302.5,
69     that exempts a student from one or more required immunizations.
70          (4) "Local education agency" or "LEA" means:
71          (a) a school district;
72          (b) a charter school; or
73          (c) the Utah Schools for the Deaf and the Blind.
74          (5) "Required immunizations" means immunizations against communicable diseases
75     required by department rule described in Section 53A-11-303.
76          (6) "School" means:
77          (a) a public school as defined in Section 26-39-102;
78          (b) center-based child care as defined in Section 26-39-102;
79          (c) residential child care, as defined in Section 26-39-102; or
80          (d) a private school that:
81          (i) is not primarily funded at public expense; and
82          (ii) provides education to students in any grade from kindergarten through grade 12.
83          (7) "Student" means an individual who attends a school.
84          Section 3. Section 53A-11-301 is repealed and reenacted to read:
85          53A-11-301. Certificate of immunization required -- Exceptions-- Weighted pupil
86     unit funding.
87          (1) (a) Except as provided in Subsection (1)(b), a student may not attend a school
88     unless there is presented to the appropriate official of the school a certificate of immunization

89     for the student.
90          (b) A student who does not have a certificate of immunization may attend a school if
91     the student:
92          (i) is exempt as described in Section 53A-11-302;
93          (ii) qualifies for conditional enrollment under Section 53A-11-306; or
94          (iii) meets:
95          (A) the definition of a student under Section 53A-1-1001; and
96          (B) the immunization requirements for military children under Section 53A-1-1001.
97          (2) An LEA may not receive weighted pupil unit money for a student unless the
98     student:
99          (a) has a certificate of immunization; or
100          (b) is allowed to attend the LEA without a certificate of immunization as described in
101     Subsection (1)(b).
102          Section 4. Section 53A-11-302 is repealed and reenacted to read:
103          53A-11-302. Exemption from required immunizations.
104          A student is exempt from receiving required immunizations if the student's parent or
105     legal guardian presents to the appropriate official of the student's school:
106          (1) for an exemption for a medical reason:
107          (a) a certificate from a licensed healthcare provider stating that due to the physical
108     condition of the student, a required immunization would endanger the student's life or health;
109     and
110          (b) an immunization exemption form described in Section 53A-11-302.5; or
111          (2) for an exemption for a personal or religious belief, an immunization exemption
112     form described in Section 53A-11-302.5.
113          Section 5. Section 53A-11-302.5 is repealed and reenacted to read:
114          53A-11-302.5. Immunization exemption form -- Online education module --
115     Renewal requirement.
116          (1) The department shall:
117          (a) with input from local health departments, develop an immunization exemption
118     form that:
119          (i) specifies if an exemption is for a medical reason, a personal belief, or a religious

120     belief;
121          (ii) indicates that for a student to receive an exemption from required immunizations,
122     an individual described in Section (1)(a)(v) shall:
123          (A) present an immunization exemption form the first time an exemption is sought;
124     and
125          (B) renew the student's exemption as described in Subsection (4) when the student
126     enters grade 7, and again when the student enters grade 10;
127          (iii) states the department's position regarding the benefits of immunization;
128          (iv) states policies for a student who has not received required immunizations, in the
129     event of an outbreak of a vaccine preventable illness;
130          (v) includes a statement claiming exemption from one or more required
131     immunizations, signed by:
132          (A) a student's parent or legal guardian;
133          (B) for a student who does not have a parent or legal guardian, the student's sibling of
134     legal age; or
135          (C) for a student 18 years of age or older, the student;
136          (vi) includes the name and address of the individual who signs the form;
137          (vii) includes the name of the student claiming exemption from one or more required
138     immunizations; and
139          (viii) includes the name of the school the student attends at the time the form is signed;
140     and
141          (b) make the immunization exemption form available to the public, free of charge:
142          (i) online, for an individual who completes the online education module described in
143     Subsection (2); and
144          (ii) in hard copy at local health departments.
145          (2) (a) The department shall develop an online education module that:
146          (i) is intended to take 20 minutes or less to complete;
147          (ii) includes:
148          (A) information about vaccine preventable illnesses;
149          (B) recommendations to reduce the likelihood of an unvaccinated individual
150     contracting or transmitting a vaccine preventable illness;

151          (C) information, based on the best available science, about vaccine benefits and side
152     effects;
153          (D) interactive questions or activities; and
154          (E) for an individual who completes the module, an immunization exemption form that
155     the individual can present to a school, as described in Subsection (3), to exempt each student
156     the individual intends to exempt from required immunizations; and
157          (iii) that an individual described in Subsection (1)(a)(v) is required to have completed
158     within the previous 5 years of:
159          (A) the first time an immunization exemption form is presented for a student; and
160          (B) renewing the student's exemption from required immunizations as described in
161     Subsection (4).
162          (b) In developing the online education module, the department shall consult with
163     individuals interested in vaccination requirements, including individuals from organizations for
164     healthcare professionals.
165          (3) In order to exempt a student from required immunizations, a student's parent or
166     legal guardian shall present to the student's school an immunization exemption form, which the
167     parent or legal guardian can obtain by:
168          (a) having completed the online education module described in Subsection (2) within
169     the previous 5 years; or
170          (b) going to a local health department in person.
171          (4) (a) A student's exemption from required immunizations is subject to the renewal
172     requirements described in Subsection (4)(b).
173          (b) In order to renew an exemption from required immunizations, when a student with
174     an exemption from required immunizations enters grade 7, and again when the student enters
175     grade 10, an individual described in Subsection (1)(a)(v) shall present to the student's school an
176     immunization exemption form.
177          (c) An LEA may not charge a fee to renew an exemption from required immunizations.
178          (d) An exemption from required immunizations for a student who transfers to or
179     enrolls in a different school may, subject to the renewal requirements described in Subsection
180     (4)(b), be transferred to the student's new school if the student's previous school confirms that
181     the student has an exemption from required immunizations.

182          (5) For a student who has an immunization exemption for the 2016-2017 school year
183     or earlier, an individual described in Subsection (1)(a)(vi) is not required to obtain a new
184     immunization exemption form; and
185          (b) is subject to the renewal requirements described in Subsection (4)(b).
186          (6) Upon request of a local health department, a school shall provide a copy of a
187     student's immunization form to the local health department.
188          Section 6. Section 53A-11-303 is amended to read:
189          53A-11-303. Department of Health regulations.
190          (1) [The Department of Health] In accordance with Title 63G, Chapter 3, Utah
191     Administrative Rulemaking Act, the department shall [adopt] make rules to establish:
192          (a) which immunizations are required [and] as a condition for attending school;
193          (b) the manner and frequency of [their] the administration[.] of required
194     immunizations;
195          (c) the immunization exemption form described in Section 53A-11-302.5;
196          (d) the online education module described in Section 53A-11-302.5; and
197          (e) the requirements for a conditional enrollment described in Section 53A-11-306.
198          (2) The rules [adopted] made under Subsection (1) shall:
199          (a) conform to recognized standard medical practices[.]; and
200          [(3) The rules shall]
201          (b) require [the reporting of] a school to report statistical information and names of
202     [noncompliers by the schools] students who are not in compliance with Section 53A-11-301 to
203     the department.
204          Section 7. Section 53A-11-304 is amended to read:
205          53A-11-304. Certificate part of student's record -- Forms for certificates --
206     Recording of immunization record as official certificate -- School record of noncertificate
207     holders.
208          (1) [Each] A school shall retain an official [certificates] certificate of immunization for
209     [every] an enrolled student[. The certificate becomes a] that is part of the [individual] student's
210     permanent school record [and follows the student through his or her public or private school
211     career].
212          (2) The [Department of Health shall provide official certificate of immunization forms

213     to public and private] department shall create an immunization form and distribute the
214     immunization form to schools, [physicians] health care providers, and local health departments.
215     [The forms referred to in this subsection shall include a clear statement of the student's rights
216     under Section 53A-11-302.]
217          [(3) Any immunization record provided by a licensed physician, registered nurse, or
218     public health official may be accepted by a school official as a certificate of immunization if
219     the type of immunization given and the dates given are specified and the]
220          (3) (a) A school shall record the information [is transferred to] on a certificate of
221     immunization as an official certificate of immunization [and verified by the school district in
222     which the public or private school is located].
223          (b) A school shall verify the information on a certificate of immunization.
224          (4) (a) At the beginning of each school year, a school shall create a list of students who
225     do not have an official certificate of immunization, noting if a student on the list is allowed to
226     attend school without a certificate of immunization, under Section 53A-11-301.
227          (b) A school shall provide the list of students described in Subsection (4)(a) to the
228     principal or other school director each year.
229          (c) A name appearing on the list described in Subsection (4)(a) is subject to
230     confidentiality requirements described in Section 26-1-17.5 and Section 53A-13-301.
231          Section 8. Section 53A-11-306 is repealed and reenacted to read:
232          53A-11-306. Conditional enrollment -- Suspension for noncompliance --
233     Procedure.
234          (1) (a) A student who has not received one or more required immunizations may attend
235     school on a conditional enrollment:
236          (i) if the student has received a dose of each required vaccine, but is not due for the
237     next dose of the vaccine under department rule described in Section 53A-11-303; or
238          (ii) except as provided in Subsection (1)(b), for up to 21 calendar days after the first
239     day of school.
240          (b) A student who enrolls in a school on or after the twenty-second calendar day after
241     the first day of school may attend school on a conditional enrollment for up to 21 calendar days
242     after the day on which the student enrolls in the school.
243          (2) (a) After the conditional enrollment period, a school shall prohibit further

244     attendance of a student who does not comply with Section 53A-11-301.
245          (b) After five days of a student's conditional enrollment, a school shall mail written
246     notice to the student's parent, legal guardian, or, if the student does not have a parent or legal
247     guardian, the student's legal age sibling that:
248          (i) the student will be suspended at the end of the conditional enrollment if the student
249     is not in compliance with Section 53A-11-301; and
250          (ii) describes the process for obtaining the required immunizations or an exemption
251     from the required immunizations.
252          Section 9. Effective date.
253          This bill takes effect on July 1, 2017.