Florida Senate - 2009                        COMMITTEE AMENDMENT
       Bill No. SB 242
       
       
       
       
       
       
                                Barcode 209710                          
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: FAV            .                                
                  04/01/2009           .                                
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       The Committee on Health Regulation (Bennett) recommended the
       following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Delete everything after the enacting clause
    4  and insert:
    5         Section 1. Paragraph (e) of subsection (1) of section
    6  381.003, Florida Statutes, is amended to read:
    7         381.003 Communicable disease and AIDS prevention and
    8  control.—
    9         (1) The department shall conduct a communicable disease
   10  prevention and control program as part of fulfilling its public
   11  health mission. A communicable disease is any disease caused by
   12  transmission of a specific infectious agent, or its toxic
   13  products, from an infected person, an infected animal, or the
   14  environment to a susceptible host, either directly or
   15  indirectly. The communicable disease program must include, but
   16  need not be limited to:
   17         (e) Programs for the prevention and control of vaccine
   18  preventable diseases, including programs to immunize school
   19  children as required by s. 1003.22(3)-(13) s. 1003.22(3)-(11)
   20  and the development of an automated, electronic, and centralized
   21  database or registry of immunizations. The department shall
   22  ensure that all children in this state are immunized against
   23  vaccine-preventable diseases. The immunization registry shall
   24  allow the department to enhance current immunization activities
   25  for the purpose of improving the immunization of all children in
   26  this state.
   27         1. Except as provided in subparagraph 2., the department
   28  shall include all children born in this state in the
   29  immunization registry by using the birth records from the Office
   30  of Vital Statistics. The department shall add other children to
   31  the registry as immunization services are provided.
   32         2. The parent or guardian of a child may refuse to have the
   33  child included in the immunization registry by signing a form
   34  obtained from the department, or from the health care
   35  practitioner or entity that provides the immunization, which
   36  indicates that the parent or guardian does not wish to have the
   37  child included in the immunization registry. The decision to not
   38  participate in the immunization registry must be noted in the
   39  registry.
   40         3. The immunization registry shall allow for immunization
   41  records to be electronically transferred to entities that are
   42  required by law to have such records, including schools,
   43  licensed child care facilities, and any other entity that is
   44  required by law to obtain proof of a child’s immunizations.
   45         4. Any health care practitioner licensed under chapter 458,
   46  chapter 459, or chapter 464 in this state who complies with
   47  rules adopted by the department to access the immunization
   48  registry may, through the immunization registry, directly access
   49  immunization records and update a child’s immunization history
   50  or exchange immunization information with another authorized
   51  practitioner, entity, or agency involved in a child’s care. The
   52  information included in the immunization registry must include
   53  the child’s name, date of birth, address, and any other unique
   54  identifier necessary to correctly identify the child; the
   55  immunization record, including the date, type of administered
   56  vaccine, and vaccine lot number; and the presence or absence of
   57  any adverse reaction or contraindication related to the
   58  immunization. Information received by the department for the
   59  immunization registry retains its status as confidential medical
   60  information and the department must maintain the confidentiality
   61  of that information as otherwise required by law. A health care
   62  practitioner or other agency that obtains information from the
   63  immunization registry must maintain the confidentiality of any
   64  medical records in accordance with s. 456.057 or as otherwise
   65  required by law.
   66         Section 2. Subsection (30) is added to section 499.005,
   67  Florida Statutes, to read:
   68         499.005 Prohibited acts.—It is unlawful for a person to
   69  perform or cause the performance of any of the following acts in
   70  this state:
   71         (30)The sale, purchase, manufacture, delivery,
   72  importation, administration, or distribution of any vaccine that
   73  contains any organic or inorganic mercury compound in excess of
   74  0.1 microgram per milliliter.
   75         Section 3. Paragraph (b) of subsection (3) of section
   76  1002.20, Florida Statutes, is amended to read:
   77         1002.20 K-12 student and parent rights.—Parents of public
   78  school students must receive accurate and timely information
   79  regarding their child’s academic progress and must be informed
   80  of ways they can help their child to succeed in school. K-12
   81  students and their parents are afforded numerous statutory
   82  rights including, but not limited to, the following:
   83         (3) HEALTH ISSUES.—
   84         (b) Immunizations.—The parent of any child attending a
   85  public or private school shall be exempt from the school
   86  immunization requirements upon meeting any of the exemptions in
   87  accordance with the provisions of s. 1003.22(6) s. 1003.22(5).
   88         Section 4. Paragraph (a) of subsection (6) of section
   89  1002.42, Florida Statutes, is amended to read:
   90         1002.42 Private schools.—
   91         (6) IMMUNIZATIONS.—The governing authority of each private
   92  school shall:
   93         (a) Require students to present a certification of
   94  immunization in accordance with the provisions of s. 1003.22(3)
   95  (13) s. 1003.22(3)-(11).
   96         Section 5. Section 1003.22, Florida Statutes, is amended to
   97  read:
   98         1003.22 School-entry health examinations; immunization
   99  against communicable diseases; exemptions; duties of Department
  100  of Health.—
  101         (1) Each district school board and the governing authority
  102  of each private school shall require that each child who is
  103  entitled to admittance to kindergarten, or is entitled to any
  104  other initial entrance into a public or private school in this
  105  state, present a certification of a school-entry health
  106  examination performed within 1 year prior to enrollment in
  107  school. Each district school board, and the governing authority
  108  of each private school, may establish a policy that permits a
  109  student up to 30 school days to present a certification of a
  110  school-entry health examination. A homeless child, as defined in
  111  s. 1003.01, shall be given a temporary exemption for 30 school
  112  days. Any district school board that establishes such a policy
  113  shall include provisions in its local school health services
  114  plan to assist students in obtaining the health examinations.
  115  However, any child shall be exempt from the requirement of a
  116  health examination upon written request of the parent of the
  117  child stating objections to the examination on religious
  118  grounds.
  119         (2) The State Board of Education, subject to the
  120  concurrence of the Department of Health, shall adopt rules to
  121  govern medical examinations and immunizations performed under
  122  this section.
  123         (3) The Department of Health may adopt rules necessary to
  124  administer and enforce this section. The Department of Health,
  125  after consultation with the Department of Education, shall adopt
  126  rules governing the immunization of children against, the
  127  testing for, and the control of preventable communicable
  128  diseases. The rules must include procedures for exempting a
  129  child from immunization requirements. Immunizations shall be
  130  required for poliomyelitis, diphtheria, rubeola, rubella,
  131  pertussis, mumps, tetanus, and other communicable diseases as
  132  determined by rules of the Department of Health. The manner and
  133  frequency of administration of the immunization or testing shall
  134  conform to recognized standards of medical practice. The
  135  Department of Health shall supervise and secure the enforcement
  136  of the required immunization. Immunizations required by this
  137  section shall be available at no cost from the county health
  138  departments.
  139         (4) Each district school board and the governing authority
  140  of each private school shall establish and enforce as policy
  141  that, prior to admittance to or attendance in a public or
  142  private school, grades kindergarten through 12, or any other
  143  initial entrance into a Florida public or private school, each
  144  child present or have on file with the school a certification of
  145  immunization for the prevention of those communicable diseases
  146  for which immunization is required by the Department of Health
  147  and further shall provide for appropriate screening of its
  148  students for scoliosis at the proper age. Such certification
  149  shall be made on forms approved and provided by the Department
  150  of Health and shall become a part of each student’s permanent
  151  record, to be transferred when the student transfers, is
  152  promoted, or changes schools. The transfer of such immunization
  153  certification by Florida public schools shall be accomplished
  154  using the Florida Automated System for Transferring Education
  155  Records and shall be deemed to meet the requirements of this
  156  section.
  157         (5)In vaccinating his or her child, a parent, legal
  158  guardian, or other authorized person, in consultation with his
  159  or her pediatrician, has the right to choose an alternative
  160  immunization schedule to the immunization schedule recommended
  161  by the Centers for Disease Control and Prevention, as long as
  162  the child is vaccinated before beginning school.
  163         (6)(5) The provisions of this section shall not apply if:
  164         (a) The parent of the child objects in writing that the
  165  administration of immunizing agents conflicts with his or her
  166  religious tenets or practices;
  167         (b) A physician licensed under the provisions of chapter
  168  458 or chapter 459 certifies in writing, on a form approved and
  169  provided by the Department of Health, that the child should be
  170  permanently exempt from the required immunization for medical
  171  reasons stated in writing, based upon valid clinical reasoning
  172  or evidence, demonstrating the need for the permanent exemption;
  173         (c) A physician licensed under the provisions of chapter
  174  458, chapter 459, or chapter 460 certifies in writing, on a form
  175  approved and provided by the Department of Health, that the
  176  child has received as many immunizations as are medically
  177  indicated at the time and is in the process of completing
  178  necessary immunizations;
  179         (d) The Department of Health determines that, according to
  180  recognized standards of medical practice, any required
  181  immunization is unnecessary or hazardous; or
  182         (e) An authorized school official issues a temporary
  183  exemption, for a period not to exceed 30 school days, to permit
  184  a student who transfers into a new county to attend class until
  185  his or her records can be obtained. A homeless child, as defined
  186  in s. 1003.01, shall be given a temporary exemption for 30
  187  school days. The public school health nurse or authorized
  188  private school official is responsible for followup of each such
  189  student until proper documentation or immunizations are
  190  obtained. An exemption for 30 days may be issued for a student
  191  who enters a juvenile justice program to permit the student to
  192  attend class until his or her records can be obtained or until
  193  the immunizations can be obtained. An authorized juvenile
  194  justice official is responsible for followup of each student who
  195  enters a juvenile justice program until proper documentation or
  196  immunizations are obtained.
  197         (7) Before the administration of an immunization required
  198  by this section, a licensed health care provider must:
  199         (a) Provide the child’s parent, legal guardian, or other
  200  authorized person with a copy of the current vaccine information
  201  statement published about the vaccine by the Centers for Disease
  202  Control and Prevention of the United States Department of Health
  203  and Human Services;
  204         (b) Have the child’s parent, legal guardian, or other
  205  authorized person sign a statement in substantially the
  206  following form:
  207  
  208         I have received a copy of the vaccine information
  209         statement published by the Centers for Disease Control
  210         and Prevention. I have read or have had explained to
  211         me information about the vaccine to be administered,
  212         the benefits and risks of the vaccine, how to report
  213         an adverse reaction, the availability of the National
  214         Vaccine Injury Compensation Program, and how to get
  215         more information about childhood diseases and
  216         vaccines. I understand the benefits of the vaccine and
  217         ask that the vaccine be administered to ...(name of
  218         minor child)..., for whom I am authorized to make this
  219         request.
  220  Signature: ...(signature)....
  221  Name: ...(printed name of parent, legal guardian,
  222  or other authorized person)....
  223  Date: ...(date)....
  224  
  225         (c) Keep a copy of the parent’s, legal guardian’s, or
  226  authorized person’s signed statement as part of the minor
  227  child’s permanent medical record; and
  228         (d) Record a notation on the statement of the batch and lot
  229  number for each vaccine administered to the child.
  230  
  231  This subsection applies to each vaccine information statement
  232  published by the Centers for Disease Control and Prevention,
  233  whether or not the statement is covered by the federal National
  234  Childhood Vaccine Injury Act of 1986, 42 U.S.C. s. 300aa-26. If
  235  the Centers for Disease Control and Prevention publish a vaccine
  236  information statement that covers multiple vaccines, the health
  237  care provider may have the child’s parent, legal guardian, or
  238  other authorized person sign a single statement for the vaccines
  239  covered by the vaccine information statement.
  240         (8)(6)(a) No person licensed by this state as a physician
  241  or nurse shall be liable for any injury caused by his or her
  242  action or failure to act in the administration of a vaccine or
  243  other immunizing agent pursuant to the provisions of this
  244  section if the person acts as a reasonably prudent person with
  245  similar professional training would have acted under the same or
  246  similar circumstances.
  247         (b) No member of a district school board, or any of its
  248  employees, or member of a governing board of a private school,
  249  or any of its employees, shall be liable for any injury caused
  250  by the administration of a vaccine to any student who is
  251  required to be so immunized or for a failure to diagnose
  252  scoliosis pursuant to the provisions of this section.
  253         (9)(7) The parents of any child admitted to or in
  254  attendance at a Florida public or private school, grades
  255  prekindergarten through 12, are responsible for assuring that
  256  the child is in compliance with the provisions of this section.
  257         (10)(8) Each public school, including public kindergarten,
  258  and each private school, including private kindergarten, shall
  259  be required to provide to the county health department director
  260  or administrator annual reports of compliance with the
  261  provisions of this section. Reports shall be completed on forms
  262  provided by the Department of Health for each kindergarten, and
  263  other grade as specified; and the reports shall include the
  264  status of children who were admitted at the beginning of the
  265  school year. After consultation with the Department of
  266  Education, the Department of Health shall establish by
  267  administrative rule the dates for submission of these reports,
  268  the grades for which the reports shall be required, and the
  269  forms to be used.
  270         (11)(9) The presence of any of the communicable diseases
  271  for which immunization is required by the Department of Health
  272  in a Florida public or private school shall permit the county
  273  health department director or administrator or the State Health
  274  Officer to declare a communicable disease emergency. The
  275  declaration of such emergency shall mandate that all students in
  276  attendance in the school who are not in compliance with the
  277  provisions of this section be identified by the district school
  278  board or by the governing authority of the private school; and
  279  the school health and immunization records of such children
  280  shall be made available to the county health department director
  281  or administrator. Those children identified as not being
  282  immunized against the disease for which the emergency has been
  283  declared shall be temporarily excluded from school by the
  284  district school board, or the governing authority of the private
  285  school, until such time as is specified by the county health
  286  department director or administrator.
  287         (12)(10) Each district school board and the governing
  288  authority of each private school shall:
  289         (a) Refuse admittance to any child otherwise entitled to
  290  admittance to kindergarten, or any other initial entrance into a
  291  Florida public or private school, who is not in compliance with
  292  the provisions of subsection (4).
  293         (b) Temporarily exclude from attendance any student who is
  294  not in compliance with the provisions of subsection (4).
  295         (13)(11) The provisions of this section do not apply to
  296  those persons admitted to or attending adult education classes
  297  unless the adult students are under 21 years of age.
  298         Section 6. This act shall take effect July 1, 2009.
  299  
  300  
  301  ================= T I T L E  A M E N D M E N T ================
  302         And the title is amended as follows:
  303         Delete everything before the enacting clause
  304  and insert:
  305                        A bill to be entitled                      
  306         An act relating to vaccinations; amending s. 381.003,
  307         F.S.; conforming a cross-reference; amending s.
  308         499.005, F.S.; prohibiting the sale, purchase,
  309         manufacture, delivery, importation, administration,
  310         and distribution of vaccines containing organic or
  311         inorganic mercury compounds in excess of a certain
  312         amount; amending ss. 1002.20 and 1002.42, F.S.;
  313         conforming cross-references; amending s. 1003.22,
  314         F.S.; authorizing a parent, legal guardian, or
  315         authorized person to choose an alternative
  316         immunization schedule under certain conditions;
  317         requiring health care providers to provide certain
  318         information to parents, legal guardians, and
  319         authorized persons before administration of certain
  320         immunizations to children; requiring health care
  321         providers to obtain a signed statement from the
  322         parents, legal guardians, and authorized persons
  323         documenting provision of the information; requiring
  324         health care providers to use a standard form for the
  325         signed statement; requiring health care providers to
  326         record the batch and lot number of each vaccine on the
  327         statement; requiring health care providers to maintain
  328         certain records; providing for a single, signed
  329         statement for the administration of multiple vaccines;
  330         providing an effective date.