Public Act 100-1011

SB2541 Enrolled LRB100 16196 AXK 31317 b

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

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

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

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

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

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

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

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

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,

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

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

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

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

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

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

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.