Senator Margaret Dayton proposes the following substitute bill:


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IMMUNIZATION OF STUDENTS AMENDMENTS

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2016 GENERAL SESSION

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STATE OF UTAH

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Chief Sponsor: Carol Spackman Moss

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Senate Sponsor: Brian E. Shiozawa

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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 who intends to receive an immunization exemption form
22     online to complete an education module;
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, subject to the renewal
105     requirement described in Subsection 53A-11-302.5(4), the student's parent or legal guardian
106     presents to the appropriate official of the student's school:
107          (1) for an exemption for a medical reason:
108          (a) a certificate from a licensed healthcare provider stating that due to the physical
109     condition of the student, a required immunization would endanger the student's life or health;
110     and
111          (b) an immunization exemption form described in Section 53A-11-302.5; or
112          (2) for an exemption for a personal or religious belief, an immunization exemption
113     form described in Section 53A-11-302.5.
114          Section 5. Section 53A-11-302.5 is repealed and reenacted to read:
115          53A-11-302.5. Immunization exemption form -- Online education module --
116     Renewal requirement.
117          (1) The department shall:
118          (a) with input from local health departments, develop an immunization exemption

119     form that:
120          (i) specifies if an exemption is for a medical reason, a personal belief, or a religious
121     belief;
122          (ii) indicates that for a student to receive an exemption from required immunizations,
123     an individual described in Section (1)(a)(v) shall:
124          (A) present an immunization exemption form the first time an exemption is sought;
125     and
126          (B) renew the student's exemption once every five years;
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.
155          (b) An individual who intends to exempt a student from required immunizations by
156     obtaining an immunization exemption form online is required to complete the online education
157     module described in Subsection (2)(a) once every 5 years, regardless of how many students the
158     individual exempts from required immunizations.
159          (c) In developing the online education module, the department shall consult with
160     individuals interested in vaccination requirements, including individuals from organizations for
161     healthcare professionals.
162          (3) (a) In order to exempt a student from required immunizations, an individual
163     described in Subsection (1)(a)(v) shall present to the student's school an immunization
164     exemption form, which the individual can obtain by:
165          (i) completing the online education module described in Subsection (2) within the
166     previous 5 years; or
167          (ii) going to a local health department in person.
168          (b) A local health department may not require an individual to complete the online
169     education module described in Subsection (2) in order to receive an immunization exemption
170     form 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 a student's exemption from required immunizations, an individual
174     described in Subsection (1)(a)(v) shall, once every five years, present to the student's school an
175     immunization exemption form.
176          (c) An LEA may not charge a fee to renew an exemption from required immunizations.
177          (d) An exemption from required immunizations for a student who transfers to or
178     enrolls in a different school may, subject to the renewal requirements described in Subsection
179     (4)(b), be transferred to the student's new school if the student's previous school confirms that
180     the student has an exemption from required immunizations.

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

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

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