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6 Cosponsors:
7 Brad M. Daw
Carol Spackman Moss
8
9 LONG TITLE
10 General Description:
11 This bill requires the Department of Health to create an online education module
12 regarding certain preventable diseases.
13 Highlighted Provisions:
14 This bill:
15 ▸ defines terms;
16 ▸ requires the Department of Health to:
17 • create an online education module regarding certain preventable diseases; and
18 • create a new vaccination exemption form;
19 ▸ amends the Utah Health Code regarding student vaccinations and records of student
20 vaccinations;
21 ▸ subject to certain exceptions, continues the requirement that a student receive
22 certain vaccinations in order to attend school;
23 ▸ requires the renewal of a student's vaccination exemption under certain conditions;
24 ▸ allows for the vaccination exemption form to be completed online in conjunction
25 with the education module;
26 ▸ continues the practice of preventing a local education agency from receiving
27 weighted pupil unit money for a student who does not comply with vaccination
28 requirements;
29 ▸ addresses policies and procedures relating to vaccinations, recordkeeping, and
30 disease outbreaks; and
31 ▸ makes technical changes.
32 Money Appropriated in this Bill:
33 None
34 Other Special Clauses:
35 This bill provides a special effective date.
36 This bill provides a coordination clause.
37 Utah Code Sections Affected:
38 AMENDS:
39 26-1-17.5, as last amended by Laws of Utah 2008, Chapter 382
40 26-10-9, as enacted by Laws of Utah 2011, Chapter 147
41 26-39-402, as renumbered and amended by Laws of Utah 2008, Chapter 111
42 ENACTS:
43 26-7-9, Utah Code Annotated 1953
44 53A-11-300.5, Utah Code Annotated 1953
45 53A-11-307, Utah Code Annotated 1953
46 REPEALS AND REENACTS:
47 53A-11-301, as last amended by Laws of Utah 1992, Chapter 53
48 53A-11-302, as last amended by Laws of Utah 2010, Chapter 395
49 53A-11-302.5, as enacted by Laws of Utah 1992, Chapter 129
50 53A-11-303, as enacted by Laws of Utah 1988, Chapter 2
51 53A-11-304, as enacted by Laws of Utah 1988, Chapter 2
52 53A-11-306, as enacted by Laws of Utah 1988, Chapter 2
53 REPEALS:
54 53A-11-305, as last amended by Laws of Utah 1988, Chapter 202
55 Utah Code Sections Affected by Coordination Clause:
56 53A-11-302, as last amended by Laws of Utah 2010, Chapter 395
57 53A-11-302.5, as enacted by Laws of Utah 1992, Chapter 129
58 53A-11-305, as last amended by Laws of Utah 1988, Chapter 202
59
60 Be it enacted by the Legislature of the state of Utah:
61 Section 1. Section 26-1-17.5 is amended to read:
62 26-1-17.5. Confidential records.
63 (1) A record classified as confidential under this title shall remain confidential, and be
64 released according to the provisions of this title, notwithstanding Section 63G-2-310.
65 (2) In addition to those persons granted access to [
66 Subsection 63G-2-302(1)(b), [
67 districts, and local and state health departments and the state Department of Human Services
68 may share an immunization record as defined in Section 53A-11-300.5 or any other record
69 relating to a vaccination or immunization as necessary to [
70 [
71 investigate, and control the causes of epidemic, infectious, communicable, and other diseases
72 affecting the public health.
73 Section 2. Section 26-7-9 is enacted to read:
74 26-7-9. Online public health education module.
75 (1) As used in this section:
76 (a) "Health care provider" means the same as that term is defined in Section
77 78B-3-403.
78 (b) "Nonimmune" means that a child or an individual:
79 (i) has not received each vaccine required in Section 53A-11-303 and has not
80 developed a natural immunity through previous illness to a vaccine-preventable disease, as
81 documented by a health care provider;
82 (ii) cannot receive each vaccine required in Section 53A-11-303; or
83 (iii) is otherwise known to not be immune to a vaccine-preventable disease.
84 (c) "Vaccine-preventable disease" means an infectious disease that can be prevented by
85 a vaccination required in Section 53A-11-303.
86 (2) The department shall develop an online education module regarding
87 vaccine-preventable diseases:
88 (a) to assist a parent of a nonimmune child to:
89 (i) recognize the symptoms of vaccine-preventable diseases;
90 (ii) respond in the case of an outbreak of a vaccine-preventable disease;
91 (iii) protect children who contract a vaccine-preventable disease; and
92 (iv) prevent the spread of vaccine-preventable diseases;
93 (b) that contains only the following:
94 (i) information about vaccine-preventable diseases necessary to achieve the goals
95 stated in Subsection (2)(a), including the best practices to prevent the spread of
96 vaccine-preventable diseases;
97 (ii) recommendations to reduce the likelihood of a nonimmune individual contracting
98 or transmitting a vaccine-preventable disease; and
99 (iii) information about additional available resources related to vaccine-preventable
100 diseases and the availability of low-cost vaccines;
101 (c) that includes interactive questions or activities; and
102 (d) that is expected to take an average user 20 minutes or less to complete, based on
103 user testing.
104 (3) In developing the online education module described in Subsection (2), the
105 department shall consult with individuals interested in vaccination or vaccine-preventable
106 diseases, including:
107 (a) representatives from organizations of health care professionals; and
108 (b) parents of nonimmune children.
109 (4) The department shall make the online education module described in Subsection
110 (2) publicly available to parents through:
111 (a) a link on the department's website;
112 (b) county health departments, as that term is defined in Section 26A-1-102;
113 (c) local health departments, as that term is defined in Section 26A-1-102;
114 (d) local education agencies, as that term is defined in Section 53A-1-401; and
115 (e) other public health programs or organizations.
116 (5) The department shall report to the Health and Human Services Interim Committee
117 before November 30, 2018, regarding compliance with this section.
118 Section 3. Section 26-10-9 is amended to read:
119 26-10-9. Immunizations -- Consent of minor to treatment.
120 (1) This section:
121 (a) is not intended to interfere with the integrity of the family or to minimize the rights
122 of parents or children; and
123 (b) applies to a minor, who at the time care is sought is:
124 (i) married or has been married;
125 (ii) emancipated as provided for in Section 78A-6-805;
126 (iii) a parent with custody of a minor child; or
127 (iv) pregnant.
128 (2) (a) A minor described in Subsections (1)(b)(i) and (ii) may consent to:
129 (i) [
130 diseases as defined in Section 26-6-2; and
131 (ii) examinations and [
132 provided in Title 53A, Chapter 11, Students in Public Schools.
133 (b) A minor described in Subsections (1)(b)(iii) and (iv) may consent to the
134 [
135 human papillomavirus only if:
136 (i) the minor represents to the health care provider that the minor is an abandoned
137 minor as defined in Section 76-5-109; and
138 (ii) the health care provider makes a notation in the minor's chart that the minor
139 represented to the health care provider that the minor is an abandoned minor under Section
140 76-5-109.
141 (c) Nothing in Subsection (2)(a) or (b) requires a health care provider to immunize a
142 minor.
143 (3) The consent of the minor pursuant to this section:
144 (a) is not subject to later disaffirmance because of the minority of the person receiving
145 the medical services;
146 (b) is not voidable because of minority at the time the medical services were provided;
147 (c) has the same legal effect upon the minor and the same legal obligations with regard
148 to the giving of consent as consent given by a person of full age and capacity; and
149 (d) does not require the consent of any other person or persons to authorize the medical
150 services described in Subsections (2)(a) and (b).
151 (4) A health care provider who provides medical services to a minor in accordance
152 with the provisions of this section is not subject to civil or criminal liability for providing the
153 services described in Subsections (2)(a) and (b) without obtaining the consent of another
154 person prior to rendering the medical services.
155 (5) This section does not remove the requirement for parental consent or notice when
156 required by Section 76-7-304 or 76-7-304.5.
157 (6) The parents, parent, or legal guardian of a minor who receives medical services
158 pursuant to Subsections (2)(a) and (b) are not liable for the payment for those services unless
159 the parents, parent, or legal guardian consented to the medical services.
160 Section 4. Section 26-39-402 is amended to read:
161 26-39-402. Residential child care certificate.
162 (1) [
163 obtain a Residential Child Care Certificate from the department, unless Section 26-39-403
164 applies.
165 [
166 [
167 [
168 [
169 Section 26-1-6; and
170 [
171 person and each juvenile age 12 through 17 years of age who resides in the provider's home:
172 [
173 such person has been convicted of a crime;
174 [
175 court; and
176 [
177 described in Section 62A-4a-1006;
178 [
179 sending an intent to inspect notice to:
180 [
181 qualifying child who receives child care in the provider's home;
182 [
183 [
184 [
185 specified by the department by administrative rule, including a current department-approved
186 CPR and first aid course.
187 [
188 inspection conducted pursuant to Subsection [
189 corrective action for the serious hazards found and make an unannounced follow up inspection
190 to determine compliance.
191 [
192 (2)(b), the department may inspect the home of a residential care provider of five to eight
193 qualifying children in response to a complaint of:
194 [
195 [
196 [
197 [
198 (a) a license under Section 26-39-401 is required of a residential child care provider
199 who cares for nine or more qualifying children;
200 (b) a certified residential child care provider may not provide care to more than two
201 qualifying children under the age of two; and
202 (c) an inspection may be required of a residential child care provider in connection
203 with a federal child care program.
204 [
205 enforce rules necessary to implement this section.
206 Section 5. Section 53A-11-300.5 is enacted to read:
207 53A-11-300.5. Definitions.
208 As used in this part:
209 (1) "Department" means the Department of Health, created in Section 26-1-4.
210 (2) "Health official" means an individual designated by a local health department from
211 within the local health department to consult and counsel parents and licensed health care
212 providers, in accordance with Subsection 53A-11-302.5(2)(a).
213 (3) "Health official designee" means a licensed health care provider designated by a
214 local health department, in accordance with Subsection 53A-11-302.5(2)(b), to consult with
215 parents, licensed health care professionals, and school officials.
216 (4) "Immunization" or "immunize" means a process through which an individual
217 develops an immunity to a disease, through vaccination or natural exposure to the disease.
218 (5) "Immunization record" means a record relating to a student that includes:
219 (a) information regarding each required vaccination that the student has received,
220 including the date each vaccine was administered, verified by:
221 (i) a licensed health care provider;
222 (ii) an authorized representative of a local health department;
223 (iii) an authorized representative of the department;
224 (iv) a registered nurse; or
225 (v) a pharmacist;
226 (b) information regarding each disease against which the student has been immunized
227 by previously contracting the disease; and
228 (c) an exemption form identifying each required vaccination from which the student is
229 exempt, including all required supporting documentation described in Section 53A-11-302.
230 (6) "Legally responsible individual" means:
231 (a) a student's parent;
232 (b) the student's legal guardian;
233 (c) an adult brother or sister of a student who has no legal guardian; or
234 (d) the student, if the student:
235 (i) is an adult; or
236 (ii) is a minor who may consent to treatment under Section 26-10-9.
237 (7) "Licensed health care provider" means a health care provider who is licensed under
238 Title 58, Occupations and Professions, as:
239 (a) a medical doctor;
240 (b) an osteopathic doctor;
241 (c) a physician assistant; or
242 (d) an advanced practice registered nurse.
243 (8) "Local education agency" or "LEA" means:
244 (a) a school district;
245 (b) a charter school; or
246 (c) the Utah Schools for the Deaf and the Blind.
247 (9) "Local health department" means the same as that term is defined in Section
248 26A-1-102.
249 (10) "Required vaccines" means vaccines required by department rule described in
250 Section 53A-11-303.
251 (11) "School" means any public or private:
252 (a) elementary or secondary school through grade 12;
253 (b) preschool;
254 (c) child care program, as that term is defined in Section 26-39-102;
255 (d) nursery school; or
256 (e) kindergarten.
257 (12) "Student" means an individual who attends a school.
258 (13) "Vaccinating" or "vaccination" means the administration of a vaccine.
259 (14) "Vaccination exemption form" means a form, described in Section 53A-11-302.5,
260 that documents and verifies that a student is exempt from the requirement to receive one or
261 more required vaccines.
262 (15) "Vaccine" means the substance licensed for use by the United States Food and
263 Drug Administration that is injected into or otherwise administered to an individual to
264 immunize the individual against a communicable disease.
265 Section 6. Section 53A-11-301 is repealed and reenacted to read:
266 53A-11-301. Immunization required -- Exception -- Weighted pupil unit funding.
267 (1) A student may not attend a school unless:
268 (a) the school receives an immunization record from the legally responsible individual
269 of the student, the student's former school, or a statewide registry that shows:
270 (i) that the student has received each vaccination required by the department under
271 Section 53A-11-303; or
272 (ii) for any required vaccination that the student has not received, that the student:
273 (A) has immunity against the disease for which the vaccination is required, because the
274 student previously contracted the disease as documented by a health care provider, as that term
275 is defined in Section 78B-3-103; or
276 (B) is exempt from receiving the vaccination under Section 53A-11-302;
277 (b) the student qualifies for conditional enrollment under Section 53A-11-306; or
278 (c) the student:
279 (i) is a student, as defined in Section 53A-1-1001; and
280 (ii) complies with the immunization requirements for military children under Section
281 53A-1-1001.
282 (2) An LEA may not receive weighted pupil unit money for a student who is not
283 permitted to attend school under Subsection (1).
284 Section 7. Section 53A-11-302 is repealed and reenacted to read:
285 53A-11-302. Grounds for exemption from required vaccines -- Renewal.
286 (1) A student is exempt from the requirement to receive a vaccine required under
287 Section 53A-11-303 if the student qualifies for a medical or personal exemption from the
288 vaccination under Subsection (2) or (3).
289 (2) A student qualifies for a medical exemption from a vaccination required under
290 Section 53A-11-303 if the student's legally responsible individual provides to the student's
291 school:
292 (a) a completed vaccination exemption form; and
293 (b) a written notice signed by a licensed health care provider stating that, due to the
294 physical condition of the student, administration of the vaccine would endanger the student's
295 life or health.
296 (3) A student qualifies for a personal exemption from a vaccination required under
297 Section 53A-11-303 if the student's legally responsible individual provides to the student's
298 school a completed vaccination exemption form, stating that the student is exempt from the
299 vaccination because of a personal or religious belief.
300 (4) (a) A vaccination exemption form submitted under this section is valid for as long
301 as the student remains at the school to which the form first is presented.
302 (b) If the student changes schools before the student is old enough to enroll in
303 kindergarten, the vaccination exemption form accepted as valid at the student's previous school
304 is valid until the earlier of the day on which:
305 (i) the student enrolls in kindergarten; or
306 (ii) the student turns six years old.
307 (c) If the student changes schools after the student is old enough to enroll in
308 kindergarten but before the student is eligible to enroll in grade 7, the vaccination exemption
309 form accepted as valid at the student's previous school is valid until the earlier of the day on
310 which:
311 (i) the student enrolls in grade 7; or
312 (ii) the student turns 12 years old.
313 (d) If the student changes schools after the student is old enough to enroll in grade 7,
314 the vaccination exemption form accepted as valid at the student's previous school is valid until
315 the student completes grade 12.
316 (e) Notwithstanding Subsections (4)(b) and (c), a vaccination exemption form obtained
317 through completion of the online education module created in Section 26-7-9 is valid for at
318 least two years.
319 Section 8. Section 53A-11-302.5 is repealed and reenacted to read:
320 53A-11-302.5. Vaccination exemption form.
321 (1) The department shall:
322 (a) develop a vaccination exemption form that includes only the following information:
323 (i) identifying information regarding:
324 (A) the student to whom an exemption applies; and
325 (B) the legally responsible individual who claims the exemption for the student and
326 signs the vaccination exemption form;
327 (ii) an indication regarding the vaccines to which the exemption relates;
328 (iii) a statement that the claimed exemption is for:
329 (A) a medical reason; or
330 (B) a personal or religious belief; and
331 (iv) an explanation of the requirements, in the event of an outbreak of a disease for
332 which a required vaccine exists, for a student who:
333 (A) has not received the required vaccine; and
334 (B) is not otherwise immune from the disease; and
335 (b) provide the vaccination exemption form created in this Subsection (1) to local
336 health departments.
337 (2) (a) Each local health department shall designate one or more individuals from
338 within the local health department as a health official to consult, regarding the requirements of
339 this part, with:
340 (i) parents, upon the request of parents;
341 (ii) school principals and administrators; and
342 (iii) licensed health care providers.
343 (b) A local health department may designate a licensed health care provider as a health
344 official designee to provide the services described in Subsection (2)(a).
345 (3) (a) To receive a vaccination exemption form described in Subsection (1), a legally
346 responsible individual shall complete the online education module described in Section 26-7-9,
347 permitting an individual to:
348 (i) complete any requirements online; and
349 (ii) download and print the vaccine exemption form immediately upon completion of
350 the requirements.
351 (b) A legally responsible individual may decline to take the online education module
352 and obtain a vaccination exemption form from a local health department if the individual:
353 (i) requests and receives an in-person consultation at a local health department from a
354 health official or a health official designee regarding the requirements of this part; and
355 (ii) pays any fees established under Subsection (4)(b).
356 (4) (a) Neither the department nor any other person may charge a fee for the exemption
357 form offered through the online education module in Subsection (3)(a).
358 (b) A local health department may establish a fee of up to $25 to cover the costs of
359 providing an in-person consultation.
360 Section 9. Section 53A-11-303 is repealed and reenacted to read:
361 53A-11-303. Regulations of department.
362 (1) In accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, the
363 department shall make rules regarding:
364 (a) which vaccines are required as a condition of attending school;
365 (b) the manner and frequency of the vaccinations; and
366 (c) the vaccination exemption form described in Section 53A-11-302.5.
367 (2) The department shall ensure that the rules described in Subsection (1):
368 (a) conform to recognized standard medical practices; and
369 (b) require schools to report to the department statistical information and names of
370 students who are not in compliance with Section 53A-11-301.
371 Section 10. Section 53A-11-304 is repealed and reenacted to read:
372 53A-11-304. Immunization record part of student's record -- School review
373 process at enrollment -- Transfer.
374 (1) Each school:
375 (a) shall request an immunization record for each student at the time the student enrolls
376 in the school;
377 (b) may not charge a fee related to receiving or reviewing an immunization record or a
378 vaccination exemption form; and
379 (c) shall retain an immunization record for each enrolled student as part of the student's
380 permanent school record.
381 (2) (a) Within five business days after the day on which a student enrolls in a school,
382 an individual designated by the school principal or administrator shall:
383 (i) determine whether the school has received an immunization record for the student;
384 (ii) review the student's immunization record to determine whether the record complies
385 with Subsection 53A-11-301(1); and
386 (iii) identify any deficiencies in the student's immunization record.
387 (b) If the school has not received a student's immunization record or there are
388 deficiencies in the immunization record, the school shall:
389 (i) place the student on conditional enrollment, in accordance with Section
390 53A-11-306; and
391 (ii) within five days after the day on which the school places the student on conditional
392 enrollment, provide the written notice described in Subsection 53A-11-306(2).
393 (3) A school from which a student transfers shall provide the student's immunization
394 record to the student's new school upon request of the student's legally responsible individual.
395 Section 11. Section 53A-11-306 is repealed and reenacted to read:
396 53A-11-306. Conditional enrollment -- Suspension for noncompliance --
397 Procedure.
398 (1) A student for whom a school has not received a complete immunization record may
399 attend the school on a conditional enrollment:
400 (a) during the period in which the student's immunization record is under review by the
401 school; or
402 (b) for 21 calendar days after the day on which the school provides the notice described
403 in Subsection (2).
404 (2) (a) Within five days after the day on which a school places a student on conditional
405 enrollment, the school shall provide written notice to the student's legally responsible
406 individual, in person or by mail, that:
407 (i) the school has placed the student on conditional enrollment for failure to
408 comply with the requirements of Subsection 53A-11-301(1);
409 (ii) describes the identified deficiencies in the student's immunization record or states
410 that the school has not received an immunization record for the student;
411 (iii) gives notice that the student will not be allowed to attend school unless the legally
412 responsible individual cures the deficiencies, or provides an immunization record that complies
413 with Subsection 53A-11-301(1), within the conditional enrollment period described in
414 Subsection (1)(b); and
415 (iv) describes the process for obtaining a required vaccination.
416 (b) A school shall remove the conditional enrollment status from a student after the
417 school receives an immunization record for the student that complies with Subsection
418 53A-11-301(1).
419 (c) Except as provided in Subsection (2)(d), at the end of the conditional enrollment
420 period, a school shall prohibit a student who does not comply with Subsection 53A-11-301(1)
421 from attending the school until the student complies with Subsection 53A-11-301(1).
422 (d) A school principal or administrator:
423 (i) shall grant an additional extension of the conditional enrollment period, if the
424 extension is necessary to complete all required vaccination dosages, for a time period medically
425 recommended to complete all required vaccination dosages; and
426 (ii) may grant an additional extension of the conditional enrollment period in cases of
427 extenuating circumstances, if the school principal or administrator and a school nurse, a health
428 official, or a health official designee agree that an additional extension will likely lead to
429 compliance with Subsection 53A-11-301(1) during the additional extension period.
430 Section 12. Section 53A-11-307 is enacted to read:
431 53A-11-307. School record of students' immunization status -- Confidentiality.
432 (1) Each school shall maintain a current list of all enrolled students, noting each
433 student:
434 (a) for whom the school has received a valid and complete immunization record;
435 (b) who is exempt from receiving a required vaccine; and
436 (c) who is allowed to attend school under Section 53A-11-306.
437 (2) Each school shall ensure that the list described in Subsection (1) specifically
438 identifies each disease against which a student is not immunized.
439 (3) Upon the request of an official from a local health department in the case of a
440 disease outbreak, a school principal or administrator shall:
441 (a) notify the legally responsible individual of any student who is not immune to the
442 outbreak disease, providing information regarding steps the legally responsible individual may
443 take to protect students;
444 (b) identify each student who is not immune to the outbreak disease; and
445 (c) for a period determined by the local health department not to exceed the duration of
446 the disease outbreak, do one of the following at the discretion of the school principal or
447 administrator after obtaining approval from the local health department:
448 (i) provide a separate educational environment for the students described in Subsection
449 (3)(b) that ensures the protection of the students described in Subsection (3)(b) as well as the
450 protection of the remainder of the student body; or
451 (ii) prevent each student described in Subsection (3)(b) from attending school.
452 (4) A name appearing on the list described in Subsection (1) is subject to
453 confidentiality requirements described in Section 26-1-17.5 and Section 53A-13-301.
454 Section 13. Repealer.
455 This bill repeals:
456 Section 53A-11-305, Immunization by local health departments -- Fees.
457 Section 14. Effective date.
458 This bill takes effect on July 1, 2018.
459 Section 15. Coordinating H.B. 308 with H.B. 309 -- Superseding substantive and
460 technical amendments.
461 If this H.B. 308 and H.B. 309, Public Health in Schools, both pass and become law, it is
462 the intent of the Legislature that, on July 1, 2018, the amendments to Sections 53A-11-302,
463 53A-11-302.5, and 53A-11-305 in this bill supersede the amendments to Sections 53A-11-302,
464 53A-11-302.5, and 53A-11-305 in H.B. 309 when the Office of Legislative Research and
465 General Counsel prepares the Utah Code database for publication.