Illinois-2017-SB2541-Introduced

100TH GENERAL ASSEMBLY State of Illinois 2017 and 2018 SB2541

Introduced 2/6/2018, by Sen. Kimberly A. Lightford

SYNOPSIS AS INTRODUCED:

105 ILCS 5/27-8.1 from Ch. 122, par. 27-8.1

Amends the School Code. With respect to age-appropriate developmental screening and age-appropriate social and emotional screening, provides that the Department of Public Health must, no later than January 1, 2019, develop rules and appropriate revisions to the Child Health Examination form in conjunction with various organizations. 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,

3 represented in the General Assembly:

4 Section 5. The School Code is amended by changing Section

5 27-8.1 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

9 Department of Public Health shall promulgate, and except as

10 hereinafter provided, all children in Illinois shall have a

11 health examination as follows: within one year prior to

12 entering kindergarten or the first grade of any public,

13 private, or parochial elementary school; upon entering the

14 sixth and ninth grades of any public, private, or parochial

15 school; prior to entrance into any public, private, or

16 parochial nursery school; and, irrespective of grade,

17 immediately prior to or upon entrance into any public, private,

18 or parochial school or nursery school, each child shall present

19 proof of having been examined in accordance with this Section

20 and the rules and regulations promulgated hereunder. Any child

21 who received a health examination within one year prior to

22 entering the fifth grade for the 2007-2008 school year is not

23 required to receive an additional health examination in order

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1 to comply with the provisions of Public Act 95-422 when he or

2 she attends school for the 2008-2009 school year, unless the

3 child is attending school for the first time as provided in

4 this paragraph.

5 A tuberculosis skin test screening shall be included as a

6 required part of each health examination included under this

7 Section if the child resides in an area designated by the

8 Department of Public Health as having a high incidence of

9 tuberculosis. Additional health examinations of pupils,

10 including eye examinations, may be required when deemed

11 necessary by school authorities. Parents are encouraged to have

12 their children undergo eye examinations at the same points in

13 time required for health examinations.

14 (1.5) In compliance with rules adopted by the Department of

15 Public Health and except as otherwise provided in this Section,

16 all children in kindergarten and the second and sixth grades of

17 any public, private, or parochial school shall have a dental

18 examination. Each of these children shall present proof of

19 having been examined by a dentist in accordance with this

20 Section and rules adopted under this Section before May 15th of

21 the school year. If a child in the second or sixth grade fails

22 to present proof by May 15th, the school may hold the child's

23 report card until one of the following occurs: (i) the child

24 presents proof of a completed dental examination or (ii) the

25 child presents proof that a dental examination will take place

26 within 60 days after May 15th. The Department of Public Health

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1 shall establish, by rule, a waiver for children who show an

2 undue burden or a lack of access to a dentist. Each public,

3 private, and parochial school must give notice of this dental

4 examination requirement to the parents and guardians of

5 students at least 60 days before May 15th of each school year.

6 (1.10) Except as otherwise provided in this Section, all

7 children enrolling in kindergarten in a public, private, or

8 parochial school on or after January 1, 2008 (the effective

9 date of Public Act 95-671) ~~this amendatory Act of the 95th~~

10 ~~General Assembly~~ and any student enrolling for the first time

11 in a public, private, or parochial school on or after January

12 1, 2008 (the effective date of Public Act 95-671) ~~this~~

13 ~~amendatory Act of the 95th General Assembly~~ shall have an eye

14 examination. Each of these children shall present proof of

15 having been examined by a physician licensed to practice

16 medicine in all of its branches or a licensed optometrist

17 within the previous year, in accordance with this Section and

18 rules adopted under this Section, before October 15th of the

19 school year. If the child fails to present proof by October

20 15th, the school may hold the child's report card until one of

21 the following occurs: (i) the child presents proof of a

22 completed eye examination or (ii) the child presents proof that

23 an eye examination will take place within 60 days after October

24 15th. The Department of Public Health shall establish, by rule,

25 a waiver for children who show an undue burden or a lack of

26 access to a physician licensed to practice medicine in all of

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1 its branches who provides eye examinations or to a licensed

2 optometrist. Each public, private, and parochial school must

3 give notice of this eye examination requirement to the parents

4 and guardians of students in compliance with rules of the

5 Department of Public Health. Nothing in this Section shall be

6 construed to allow a school to exclude a child from attending

7 because of a parent's or guardian's failure to obtain an eye

8 examination for the child.

9 (2) The Department of Public Health shall promulgate rules

10 and regulations specifying the examinations and procedures

11 that constitute a health examination, which shall include an

12 age-appropriate developmental screening, an age-appropriate

13 social and emotional screening, and the collection of data

14 relating to asthma and obesity (including at a minimum, date of

15 birth, gender, height, weight, blood pressure, and date of

16 exam), and a dental examination and may recommend by rule that

17 certain additional examinations be performed. The rules and

18 regulations of the Department of Public Health shall specify

19 that a tuberculosis skin test screening shall be included as a

20 required part of each health examination included under this

21 Section if the child resides in an area designated by the

22 Department of Public Health as having a high incidence of

23 tuberculosis. With respect to the developmental screening and

24 the social and emotional screening, the Department of Public

25 Health must, no later than January 1, 2019, develop rules and

26 appropriate revisions to the Child Health Examination form in

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1 conjunction with a statewide organization representing school

2 boards; a statewide organization representing pediatricians;

3 statewide organizations representing individuals holding

4 Illinois educator licenses with school support personnel

5 endorsements, including school social workers, school

6 psychologists, and school nurses; a statewide organization

7 representing children's mental health experts; a statewide

8 organization representing school principals; the Director of

9 Healthcare and Family Services or his or her designee, the

10 State Superintendent of Education or his or her designee; and

11 representatives of other appropriate State agencies and, at a

12 minimum, must recommend the use of validated screening tools

13 appropriate to the child's age or grade, and, with regard to

14 the social and emotional screening, require recording only

15 whether or not the screening was completed. The rules shall

16 take into consideration the screening recommendations of the

17 American Academy of Pediatrics and must be consistent with the

18 State Board of Education's social and emotional learning

19 standards. The Department of Public Health shall specify that a

20 diabetes screening as defined by rule shall be included as a

21 required part of each health examination. Diabetes testing is

22 not required.

23 Physicians licensed to practice medicine in all of its

24 branches, licensed advanced practice registered nurses, or

25 licensed physician assistants shall be responsible for the

26 performance of the health examinations, other than dental

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1 examinations, eye examinations, and vision and hearing

2 screening, and shall sign all report forms required by

3 subsection (4) of this Section that pertain to those portions

4 of the health examination for which the physician, advanced

5 practice registered nurse, or physician assistant is

6 responsible. If a registered nurse performs any part of a

7 health examination, then a physician licensed to practice

8 medicine in all of its branches must review and sign all

9 required report forms. Licensed dentists shall perform all

10 dental examinations and shall sign all report forms required by

11 subsection (4) of this Section that pertain to the dental

12 examinations. Physicians licensed to practice medicine in all

13 its branches or licensed optometrists shall perform all eye

14 examinations required by this Section and shall sign all report

15 forms required by subsection (4) of this Section that pertain

16 to the eye examination. For purposes of this Section, an eye

17 examination shall at a minimum include history, visual acuity,

18 subjective refraction to best visual acuity near and far,

19 internal and external examination, and a glaucoma evaluation,

20 as well as any other tests or observations that in the

21 professional judgment of the doctor are necessary. Vision and

22 hearing screening tests, which shall not be considered

23 examinations as that term is used in this Section, shall be

24 conducted in accordance with rules and regulations of the

25 Department of Public Health, and by individuals whom the

26 Department of Public Health has certified. In these rules and

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1 regulations, the Department of Public Health shall require that

2 individuals conducting vision screening tests give a child's

3 parent or guardian written notification, before the vision

4 screening is conducted, that states, "Vision screening is not a

5 substitute for a complete eye and vision evaluation by an eye

6 doctor. Your child is not required to undergo this vision

7 screening if an optometrist or ophthalmologist has completed

8 and signed a report form indicating that an examination has

9 been administered within the previous 12 months.".

10 (2.5) With respect to the developmental screening and the

11 social and emotional screening portion of the health

12 examination, each child may present proof of having been

13 screened in accordance with this Section and the rules adopted

14 under this Section before October 15th of the school year. With

15 regard to the social and emotional screening only, the

16 examining health care provider shall only record whether or not

17 the screening was completed. If the child fails to present

18 proof of the developmental screening or the social and

19 emotional screening portions of the health examination by

20 October 15th of the school year, qualified school support

21 personnel may, with a parent's or guardian's consent, offer the

22 developmental screening or the social and emotional screening

23 to the child. Each public, private, and parochial school must

24 give notice of the developmental screening and social and

25 emotional screening requirements to the parents and guardians

26 of students in compliance with the rules of the Department of

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1 Public Health. Nothing in this Section shall be construed to

2 allow a school to exclude a child from attending because of a

3 parent's or guardian's failure to obtain a developmental

4 screening or a social and emotional screening for the child.

5 Once a developmental screening or a social and emotional

6 screening is completed and proof has been presented to the

7 school, the school may, with a parent's or guardian's consent,

8 make available appropriate school personnel to work with the

9 parent or guardian, the child, and the provider who signed the

10 screening form to obtain any appropriate evaluations and

11 services as indicated on the form and in other information and

12 documentation provided by the parents, guardians, or provider.

13 (3) Every child shall, at or about the same time as he or

14 she receives a health examination required by subsection (1) of

15 this Section, present to the local school proof of having

16 received such immunizations against preventable communicable

17 diseases as the Department of Public Health shall require by

18 rules and regulations promulgated pursuant to this Section and

19 the Communicable Disease Prevention Act.

20 (4) The individuals conducting the health examination,

21 dental examination, or eye examination shall record the fact of

22 having conducted the examination, and such additional

23 information as required, including for a health examination

24 data relating to asthma and obesity (including at a minimum,

25 date of birth, gender, height, weight, blood pressure, and date

26 of exam), on uniform forms which the Department of Public

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1 Health and the State Board of Education shall prescribe for

2 statewide use. The examiner shall summarize on the report form

3 any condition that he or she suspects indicates a need for

4 special services, including for a health examination factors

5 relating to asthma or obesity. The duty to summarize on the

6 report form does not apply to social and emotional screenings.

7 The confidentiality of the information and records relating to

8 the developmental screening and the social and emotional

9 screening shall be determined by the statutes, rules, and

10 professional ethics governing the type of provider conducting

11 the screening. The individuals confirming the administration

12 of required immunizations shall record as indicated on the form

13 that the immunizations were administered.

14 (5) If a child does not submit proof of having had either

15 the health examination or the immunization as required, then

16 the child shall be examined or receive the immunization, as the

17 case may be, and present proof by October 15 of the current

18 school year, or by an earlier date of the current school year

19 established by a school district. To establish a date before

20 October 15 of the current school year for the health

21 examination or immunization as required, a school district must

22 give notice of the requirements of this Section 60 days prior

23 to the earlier established date. If for medical reasons one or

24 more of the required immunizations must be given after October

25 15 of the current school year, or after an earlier established

26 date of the current school year, then the child shall present,

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1 by October 15, or by the earlier established date, a schedule

2 for the administration of the immunizations and a statement of

3 the medical reasons causing the delay, both the schedule and

4 the statement being issued by the physician, advanced practice

5 registered nurse, physician assistant, registered nurse, or

6 local health department that will be responsible for

7 administration of the remaining required immunizations. If a

8 child does not comply by October 15, or by the earlier

9 established date of the current school year, with the

10 requirements of this subsection, then the local school

11 authority shall exclude that child from school until such time

12 as the child presents proof of having had the health

13 examination as required and presents proof of having received

14 those required immunizations which are medically possible to

15 receive immediately. During a child's exclusion from school for

16 noncompliance with this subsection, the child's parents or

17 legal guardian shall be considered in violation of Section 26-1

18 and subject to any penalty imposed by Section 26-10. This

19 subsection (5) does not apply to dental examinations, eye

20 examinations, and the developmental screening and the social

21 and emotional screening portions of the health examination. If

22 the student is an out-of-state transfer student and does not

23 have the proof required under this subsection (5) before

24 October 15 of the current year or whatever date is set by the

25 school district, then he or she may only attend classes (i) if

26 he or she has proof that an appointment for the required

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1 vaccinations has been scheduled with a party authorized to

2 submit proof of the required vaccinations. If the proof of

3 vaccination required under this subsection (5) is not submitted

4 within 30 days after the student is permitted to attend

5 classes, then the student is not to be permitted to attend

6 classes until proof of the vaccinations has been properly

7 submitted. No school district or employee of a school district

8 shall be held liable for any injury or illness to another

9 person that results from admitting an out-of-state transfer

10 student to class that has an appointment scheduled pursuant to

11 this subsection (5).

12 (6) Every school shall report to the State Board of

13 Education by November 15, in the manner which that agency shall

14 require, the number of children who have received the necessary

15 immunizations and the health examination (other than a dental

16 examination or eye examination) as required, indicating, of

17 those who have not received the immunizations and examination

18 as required, the number of children who are exempt from health

19 examination and immunization requirements on religious or

20 medical grounds as provided in subsection (8). On or before

21 December 1 of each year, every public school district and

22 registered nonpublic school shall make publicly available the

23 immunization data they are required to submit to the State

24 Board of Education by November 15. The immunization data made

25 publicly available must be identical to the data the school

26 district or school has reported to the State Board of

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1 Education.

2 Every school shall report to the State Board of Education

3 by June 30, in the manner that the State Board requires, the

4 number of children who have received the required dental

5 examination, indicating, of those who have not received the

6 required dental examination, the number of children who are

7 exempt from the dental examination on religious grounds as

8 provided in subsection (8) of this Section and the number of

9 children who have received a waiver under subsection (1.5) of

10 this Section.

11 Every school shall report to the State Board of Education

12 by June 30, in the manner that the State Board requires, the

13 number of children who have received the required eye

14 examination, indicating, of those who have not received the

15 required eye examination, the number of children who are exempt

16 from the eye examination as provided in subsection (8) of this

17 Section, the number of children who have received a waiver

18 under subsection (1.10) of this Section, and the total number

19 of children in noncompliance with the eye examination

20 requirement.

21 The reported information under this subsection (6) shall be

22 provided to the Department of Public Health by the State Board

23 of Education.

24 (7) Upon determining that the number of pupils who are

25 required to be in compliance with subsection (5) of this

26 Section is below 90% of the number of pupils enrolled in the

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1 school district, 10% of each State aid payment made pursuant to

2 Section 18-8.05 or 18-8.15 to the school district for such year

3 may be withheld by the State Board of Education until the

4 number of students in compliance with subsection (5) is the

5 applicable specified percentage or higher.

6 (8) Children of parents or legal guardians who object to

7 health, dental, or eye examinations or any part thereof, to

8 immunizations, or to vision and hearing screening tests on

9 religious grounds shall not be required to undergo the

10 examinations, tests, or immunizations to which they so object

11 if such parents or legal guardians present to the appropriate

12 local school authority a signed Certificate of Religious

13 Exemption detailing the grounds for objection and the specific

14 immunizations, tests, or examinations to which they object. The

15 grounds for objection must set forth the specific religious

16 belief that conflicts with the examination, test,

17 immunization, or other medical intervention. The signed

18 certificate shall also reflect the parent's or legal guardian's

19 understanding of the school's exclusion policies in the case of

20 a vaccine-preventable disease outbreak or exposure. The

21 certificate must also be signed by the authorized examining

22 health care provider responsible for the performance of the

23 child's health examination confirming that the provider

24 provided education to the parent or legal guardian on the

25 benefits of immunization and the health risks to the student

26 and to the community of the communicable diseases for which

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1 immunization is required in this State. However, the health

2 care provider's signature on the certificate reflects only that

3 education was provided and does not allow a health care

4 provider grounds to determine a religious exemption. Those

5 receiving immunizations required under this Code shall be

6 provided with the relevant vaccine information statements that

7 are required to be disseminated by the federal National

8 Childhood Vaccine Injury Act of 1986, which may contain

9 information on circumstances when a vaccine should not be

10 administered, prior to administering a vaccine. A healthcare

11 provider may consider including without limitation the

12 nationally accepted recommendations from federal agencies such

13 as the Advisory Committee on Immunization Practices, the

14 information outlined in the relevant vaccine information

15 statement, and vaccine package inserts, along with the

16 healthcare provider's clinical judgment, to determine whether

17 any child may be more susceptible to experiencing an adverse

18 vaccine reaction than the general population, and, if so, the

19 healthcare provider may exempt the child from an immunization

20 or adopt an individualized immunization schedule. The

21 Certificate of Religious Exemption shall be created by the

22 Department of Public Health and shall be made available and

23 used by parents and legal guardians by the beginning of the

24 2015-2016 school year. Parents or legal guardians must submit

25 the Certificate of Religious Exemption to their local school

26 authority prior to entering kindergarten, sixth grade, and

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1 ninth grade for each child for which they are requesting an

2 exemption. The religious objection stated need not be directed

3 by the tenets of an established religious organization.

4 However, general philosophical or moral reluctance to allow

5 physical examinations, eye examinations, immunizations, vision

6 and hearing screenings, or dental examinations does not provide

7 a sufficient basis for an exception to statutory requirements.

8 The local school authority is responsible for determining if

9 the content of the Certificate of Religious Exemption

10 constitutes a valid religious objection. The local school

11 authority shall inform the parent or legal guardian of

12 exclusion procedures, in accordance with the Department's

13 rules under Part 690 of Title 77 of the Illinois Administrative

14 Code, at the time the objection is presented.

15 If the physical condition of the child is such that any one

16 or more of the immunizing agents should not be administered,

17 the examining physician, advanced practice registered nurse,

18 or physician assistant responsible for the performance of the

19 health examination shall endorse that fact upon the health

20 examination form.

21 Exempting a child from the health, dental, or eye

22 examination does not exempt the child from participation in the

23 program of physical education training provided in Sections

24 27-5 through 27-7 of this Code.

25 (9) For the purposes of this Section, "nursery schools"

26 means those nursery schools operated by elementary school

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1 systems or secondary level school units or institutions of

2 higher learning.

3 (Source: P.A. 99-173, eff. 7-29-15; 99-249, eff. 8-3-15;

4 99-642, eff. 7-28-16; 99-927, eff. 6-1-17; 100-238, eff.

5 1-1-18; 100-465, eff. 8-31-17; 100-513, eff. 1-1-18; revised

6 9-22-17.)

7 Section 99. Effective date. This Act takes effect upon

8 becoming law.