Bill Text: IL SB2541 | 2017-2018 | 100th General Assembly | Engrossed

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: 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.

Spectrum: Slight Partisan Bill (Democrat 3-1)

Status: (Passed) 2018-08-21 - Public Act . . . . . . . . . 100-1011 [SB2541 Detail]

Download: Illinois-2017-SB2541-Engrossed.html

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AN ACT concerning education.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The School Code is amended by changing Section
27-8.1 as follows:
(105 ILCS 5/27-8.1) (from Ch. 122, par. 27-8.1)
Sec. 27-8.1. Health examinations and immunizations.
(1) In compliance with rules and regulations which the
Department of Public Health shall promulgate, and except as
hereinafter provided, all children in Illinois shall have a
health examination as follows: within one year prior to
entering kindergarten or the first grade of any public,
private, or parochial elementary school; upon entering the
sixth and ninth grades of any public, private, or parochial
school; prior to entrance into any public, private, or
parochial nursery school; and, irrespective of grade,
immediately prior to or upon entrance into any public, private,
or parochial school or nursery school, each child shall present
proof of having been examined in accordance with this Section
and the rules and regulations promulgated hereunder. Any child
who received a health examination within one year prior to
entering the fifth grade for the 2007-2008 school year is not
required to receive an additional health examination in order

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to comply with the provisions of Public Act 95-422 when he or
she attends school for the 2008-2009 school year, unless the
child is attending school for the first time as provided in
this paragraph.
A tuberculosis skin test screening shall be included as a
required part of each health examination included under this
Section if the child resides in an area designated by the
Department of Public Health as having a high incidence of
tuberculosis. Additional health examinations of pupils,
including eye examinations, may be required when deemed
necessary by school authorities. Parents are encouraged to have
their children undergo eye examinations at the same points in
time required for health examinations.
(1.5) In compliance with rules adopted by the Department of
Public Health and except as otherwise provided in this Section,
all children in kindergarten and the second and sixth grades of
any public, private, or parochial school shall have a dental
examination. Each of these children shall present proof of
having been examined by a dentist in accordance with this
Section and rules adopted under this Section before May 15th of
the school year. If a child in the second or sixth grade fails
to present proof by May 15th, the school may hold the child's
report card until one of the following occurs: (i) the child
presents proof of a completed dental examination or (ii) the
child presents proof that a dental examination will take place
within 60 days after May 15th. The Department of Public Health

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shall establish, by rule, a waiver for children who show an
undue burden or a lack of access to a dentist. Each public,
private, and parochial school must give notice of this dental
examination requirement to the parents and guardians of
students at least 60 days before May 15th of each school year.
(1.10) Except as otherwise provided in this Section, all
children enrolling in kindergarten in a public, private, or
parochial school on or after January 1, 2008 (the effective
date of Public Act 95-671) this amendatory Act of the 95th
General Assembly and any student enrolling for the first time
in a public, private, or parochial school on or after January
1, 2008 (the effective date of Public Act 95-671) this
amendatory Act of the 95th General Assembly shall have an eye
examination. Each of these children shall present proof of
having been examined by a physician licensed to practice
medicine in all of its branches or a licensed optometrist
within the previous year, in accordance with this Section and
rules adopted under this Section, before October 15th of the
school year. If the child fails to present proof by October
15th, the school may hold the child's report card until one of
the following occurs: (i) the child presents proof of a
completed eye examination or (ii) the child presents proof that
an eye examination will take place within 60 days after October
15th. The Department of Public Health shall establish, by rule,
a waiver for children who show an undue burden or a lack of
access to a physician licensed to practice medicine in all of

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its branches who provides eye examinations or to a licensed
optometrist. Each public, private, and parochial school must
give notice of this eye examination requirement to the parents
and guardians of students in compliance with rules of the
Department of Public Health. Nothing in this Section shall be
construed to allow a school to exclude a child from attending
because of a parent's or guardian's failure to obtain an eye
examination for the child.
(2) The Department of Public Health shall promulgate rules
and regulations specifying the examinations and procedures
that constitute a health examination, which shall include an
age-appropriate developmental screening, an age-appropriate
social and emotional screening, and the collection of data
relating to asthma and obesity (including at a minimum, date of
birth, gender, height, weight, blood pressure, and date of
exam), and a dental examination and may recommend by rule that
certain additional examinations be performed. The rules and
regulations of the Department of Public Health shall specify
that a tuberculosis skin test screening shall be included as a
required part of each health examination included under this
Section if the child resides in an area designated by the
Department of Public Health as having a high incidence of
tuberculosis. With respect to the developmental screening and
the social and emotional screening, the Department of Public
Health must, no later than January 1, 2019, develop rules and
appropriate revisions to the Child Health Examination form in

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conjunction with a statewide organization representing school
boards; a statewide organization representing pediatricians;
statewide organizations representing individuals holding
Illinois educator licenses with school support personnel
endorsements, including school social workers, school
psychologists, and school nurses; a statewide organization
representing children's mental health experts; a statewide
organization representing school principals; the Director of
Healthcare and Family Services or his or her designee, the
State Superintendent of Education or his or her designee; and
representatives of other appropriate State agencies and, at a
minimum, must recommend the use of validated screening tools
appropriate to the child's age or grade, and, with regard to
the social and emotional screening, require recording only
whether or not the screening was completed. The rules shall
take into consideration the screening recommendations of the
American Academy of Pediatrics and must be consistent with the
State Board of Education's social and emotional learning
standards. The Department of Public Health shall specify that a
diabetes screening as defined by rule shall be included as a
required part of each health examination. Diabetes testing is
not required.
Physicians licensed to practice medicine in all of its
branches, licensed advanced practice registered nurses, or
licensed physician assistants shall be responsible for the
performance of the health examinations, other than dental

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examinations, eye examinations, and vision and hearing
screening, and shall sign all report forms required by
subsection (4) of this Section that pertain to those portions
of the health examination for which the physician, advanced
practice registered nurse, or physician assistant is
responsible. If a registered nurse performs any part of a
health examination, then a physician licensed to practice
medicine in all of its branches must review and sign all
required report forms. Licensed dentists shall perform all
dental examinations and shall sign all report forms required by
subsection (4) of this Section that pertain to the dental
examinations. Physicians licensed to practice medicine in all
its branches or licensed optometrists shall perform all eye
examinations required by this Section and shall sign all report
forms required by subsection (4) of this Section that pertain
to the eye examination. For purposes of this Section, an eye
examination shall at a minimum include history, visual acuity,
subjective refraction to best visual acuity near and far,
internal and external examination, and a glaucoma evaluation,
as well as any other tests or observations that in the
professional judgment of the doctor are necessary. Vision and
hearing screening tests, which shall not be considered
examinations as that term is used in this Section, shall be
conducted in accordance with rules and regulations of the
Department of Public Health, and by individuals whom the
Department of Public Health has certified. In these rules and

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regulations, the Department of Public Health shall require that
individuals conducting vision screening tests give a child's
parent or guardian written notification, before the vision
screening is conducted, that states, "Vision screening is not a
substitute for a complete eye and vision evaluation by an eye
doctor. Your child is not required to undergo this vision
screening if an optometrist or ophthalmologist has completed
and signed a report form indicating that an examination has
been administered within the previous 12 months.".
(2.5) With respect to the developmental screening and the
social and emotional screening portion of the health
examination, each child may present proof of having been
screened in accordance with this Section and the rules adopted
under this Section before October 15th of the school year. With
regard to the social and emotional screening only, the
examining health care provider shall only record whether or not
the screening was completed. If the child fails to present
proof of the developmental screening or the social and
emotional screening portions of the health examination by
October 15th of the school year, qualified school support
personnel may, with a parent's or guardian's consent, offer the
developmental screening or the social and emotional screening
to the child. Each public, private, and parochial school must
give notice of the developmental screening and social and
emotional screening requirements to the parents and guardians
of students in compliance with the rules of the Department of

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Public Health. Nothing in this Section shall be construed to
allow a school to exclude a child from attending because of a
parent's or guardian's failure to obtain a developmental
screening or a social and emotional screening for the child.
Once a developmental screening or a social and emotional
screening is completed and proof has been presented to the
school, the school may, with a parent's or guardian's consent,
make available appropriate school personnel to work with the
parent or guardian, the child, and the provider who signed the
screening form to obtain any appropriate evaluations and
services as indicated on the form and in other information and
documentation provided by the parents, guardians, or provider.
(3) Every child shall, at or about the same time as he or
she receives a health examination required by subsection (1) of
this Section, present to the local school proof of having
received such immunizations against preventable communicable
diseases as the Department of Public Health shall require by
rules and regulations promulgated pursuant to this Section and
the Communicable Disease Prevention Act.
(4) The individuals conducting the health examination,
dental examination, or eye examination shall record the fact of
having conducted the examination, and such additional
information as required, including for a health examination
data relating to asthma and obesity (including at a minimum,
date of birth, gender, height, weight, blood pressure, and date
of exam), on uniform forms which the Department of Public

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Health and the State Board of Education shall prescribe for
statewide use. The examiner shall summarize on the report form
any condition that he or she suspects indicates a need for
special services, including for a health examination factors
relating to asthma or obesity. The duty to summarize on the
report form does not apply to social and emotional screenings.
The confidentiality of the information and records relating to
the developmental screening and the social and emotional
screening shall be determined by the statutes, rules, and
professional ethics governing the type of provider conducting
the screening. The individuals confirming the administration
of required immunizations shall record as indicated on the form
that the immunizations were administered.
(5) If a child does not submit proof of having had either
the health examination or the immunization as required, then
the child shall be examined or receive the immunization, as the
case may be, and present proof by October 15 of the current
school year, or by an earlier date of the current school year
established by a school district. To establish a date before
October 15 of the current school year for the health
examination or immunization as required, a school district must
give notice of the requirements of this Section 60 days prior
to the earlier established date. If for medical reasons one or
more of the required immunizations must be given after October
15 of the current school year, or after an earlier established
date of the current school year, then the child shall present,

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by October 15, or by the earlier established date, a schedule
for the administration of the immunizations and a statement of
the medical reasons causing the delay, both the schedule and
the statement being issued by the physician, advanced practice
registered nurse, physician assistant, registered nurse, or
local health department that will be responsible for
administration of the remaining required immunizations. If a
child does not comply by October 15, or by the earlier
established date of the current school year, with the
requirements of this subsection, then the local school
authority shall exclude that child from school until such time
as the child presents proof of having had the health
examination as required and presents proof of having received
those required immunizations which are medically possible to
receive immediately. During a child's exclusion from school for
noncompliance with this subsection, the child's parents or
legal guardian shall be considered in violation of Section 26-1
and subject to any penalty imposed by Section 26-10. This
subsection (5) does not apply to dental examinations, eye
examinations, and the developmental screening and the social
and emotional screening portions of the health examination. If
the student is an out-of-state transfer student and does not
have the proof required under this subsection (5) before
October 15 of the current year or whatever date is set by the
school district, then he or she may only attend classes (i) if
he or she has proof that an appointment for the required

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vaccinations has been scheduled with a party authorized to
submit proof of the required vaccinations. If the proof of
vaccination required under this subsection (5) is not submitted
within 30 days after the student is permitted to attend
classes, then the student is not to be permitted to attend
classes until proof of the vaccinations has been properly
submitted. No school district or employee of a school district
shall be held liable for any injury or illness to another
person that results from admitting an out-of-state transfer
student to class that has an appointment scheduled pursuant to
this subsection (5).
(6) Every school shall report to the State Board of
Education by November 15, in the manner which that agency shall
require, the number of children who have received the necessary
immunizations and the health examination (other than a dental
examination or eye examination) as required, indicating, of
those who have not received the immunizations and examination
as required, the number of children who are exempt from health
examination and immunization requirements on religious or
medical grounds as provided in subsection (8). On or before
December 1 of each year, every public school district and
registered nonpublic school shall make publicly available the
immunization data they are required to submit to the State
Board of Education by November 15. The immunization data made
publicly available must be identical to the data the school
district or school has reported to the State Board of

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Education.
Every school shall report to the State Board of Education
by June 30, in the manner that the State Board requires, the
number of children who have received the required dental
examination, indicating, of those who have not received the
required dental examination, the number of children who are
exempt from the dental examination on religious grounds as
provided in subsection (8) of this Section and the number of
children who have received a waiver under subsection (1.5) of
this Section.
Every school shall report to the State Board of Education
by June 30, in the manner that the State Board requires, the
number of children who have received the required eye
examination, indicating, of those who have not received the
required eye examination, the number of children who are exempt
from the eye examination as provided in subsection (8) of this
Section, the number of children who have received a waiver
under subsection (1.10) of this Section, and the total number
of children in noncompliance with the eye examination
requirement.
The reported information under this subsection (6) shall be
provided to the Department of Public Health by the State Board
of Education.
(7) Upon determining that the number of pupils who are
required to be in compliance with subsection (5) of this
Section is below 90% of the number of pupils enrolled in the

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school district, 10% of each State aid payment made pursuant to
Section 18-8.05 or 18-8.15 to the school district for such year
may be withheld by the State Board of Education until the
number of students in compliance with subsection (5) is the
applicable specified percentage or higher.
(8) Children of parents or legal guardians who object to
health, dental, or eye examinations or any part thereof, to
immunizations, or to vision and hearing screening tests on
religious grounds shall not be required to undergo the
examinations, tests, or immunizations to which they so object
if such parents or legal guardians present to the appropriate
local school authority a signed Certificate of Religious
Exemption detailing the grounds for objection and the specific
immunizations, tests, or examinations to which they object. The
grounds for objection must set forth the specific religious
belief that conflicts with the examination, test,
immunization, or other medical intervention. The signed
certificate shall also reflect the parent's or legal guardian's
understanding of the school's exclusion policies in the case of
a vaccine-preventable disease outbreak or exposure. The
certificate must also be signed by the authorized examining
health care provider responsible for the performance of the
child's health examination confirming that the provider
provided education to the parent or legal guardian on the
benefits of immunization and the health risks to the student
and to the community of the communicable diseases for which

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immunization is required in this State. However, the health
care provider's signature on the certificate reflects only that
education was provided and does not allow a health care
provider grounds to determine a religious exemption. Those
receiving immunizations required under this Code shall be
provided with the relevant vaccine information statements that
are required to be disseminated by the federal National
Childhood Vaccine Injury Act of 1986, which may contain
information on circumstances when a vaccine should not be
administered, prior to administering a vaccine. A healthcare
provider may consider including without limitation the
nationally accepted recommendations from federal agencies such
as the Advisory Committee on Immunization Practices, the
information outlined in the relevant vaccine information
statement, and vaccine package inserts, along with the
healthcare provider's clinical judgment, to determine whether
any child may be more susceptible to experiencing an adverse
vaccine reaction than the general population, and, if so, the
healthcare provider may exempt the child from an immunization
or adopt an individualized immunization schedule. The
Certificate of Religious Exemption shall be created by the
Department of Public Health and shall be made available and
used by parents and legal guardians by the beginning of the
2015-2016 school year. Parents or legal guardians must submit
the Certificate of Religious Exemption to their local school
authority prior to entering kindergarten, sixth grade, and

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ninth grade for each child for which they are requesting an
exemption. The religious objection stated need not be directed
by the tenets of an established religious organization.
However, general philosophical or moral reluctance to allow
physical examinations, eye examinations, immunizations, vision
and hearing screenings, or dental examinations does not provide
a sufficient basis for an exception to statutory requirements.
The local school authority is responsible for determining if
the content of the Certificate of Religious Exemption
constitutes a valid religious objection. The local school
authority shall inform the parent or legal guardian of
exclusion procedures, in accordance with the Department's
rules under Part 690 of Title 77 of the Illinois Administrative
Code, at the time the objection is presented.
If the physical condition of the child is such that any one
or more of the immunizing agents should not be administered,
the examining physician, advanced practice registered nurse,
or physician assistant responsible for the performance of the
health examination shall endorse that fact upon the health
examination form.
Exempting a child from the health, dental, or eye
examination does not exempt the child from participation in the
program of physical education training provided in Sections
27-5 through 27-7 of this Code.
(9) For the purposes of this Section, "nursery schools"
means those nursery schools operated by elementary school

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systems or secondary level school units or institutions of
higher learning.
(Source: P.A. 99-173, eff. 7-29-15; 99-249, eff. 8-3-15;
99-642, eff. 7-28-16; 99-927, eff. 6-1-17; 100-238, eff.
1-1-18; 100-465, eff. 8-31-17; 100-513, eff. 1-1-18; revised
9-22-17.)
Section 99. Effective date. This Act takes effect upon
becoming law.