Florida Senate - 2009                        COMMITTEE AMENDMENT
       Bill No. SB 242
       
       
       
       
       
       
                                Barcode 663500                          
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                   Comm: RE            .                                
                  04/01/2009           .                                
                                       .                                
                                       .                                
                                       .                                
       —————————————————————————————————————————————————————————————————




       —————————————————————————————————————————————————————————————————
       The Committee on Health Regulation (Bennett) recommended the
       following:
       
    1         Senate Amendment to Amendment (637266) (with title
    2  amendment)
    3  
    4         Delete lines 66 - 197
    5  and insert:
    6         (5)In vaccinating his or her child, a parent, legal
    7  guardian, or other authorized person, in consultation with his
    8  or her pediatrician, has the right to choose an alternative
    9  immunization schedule to the immunization schedule recommended
   10  by the Centers for Disease Control and Prevention, as long as
   11  the child is vaccinated before beginning school.
   12         (6)(5) The provisions of this section shall not apply if:
   13         (a) The parent of the child objects in writing that the
   14  administration of immunizing agents conflicts with his or her
   15  religious tenets or practices;
   16         (b) A physician licensed under the provisions of chapter
   17  458 or chapter 459 certifies in writing, on a form approved and
   18  provided by the Department of Health, that the child should be
   19  permanently exempt from the required immunization for medical
   20  reasons stated in writing, based upon valid clinical reasoning
   21  or evidence, demonstrating the need for the permanent exemption;
   22         (c) A physician licensed under the provisions of chapter
   23  458, chapter 459, or chapter 460 certifies in writing, on a form
   24  approved and provided by the Department of Health, that the
   25  child has received as many immunizations as are medically
   26  indicated at the time and is in the process of completing
   27  necessary immunizations;
   28         (d) The Department of Health determines that, according to
   29  recognized standards of medical practice, any required
   30  immunization is unnecessary or hazardous; or
   31         (e) An authorized school official issues a temporary
   32  exemption, for a period not to exceed 30 school days, to permit
   33  a student who transfers into a new county to attend class until
   34  his or her records can be obtained. A homeless child, as defined
   35  in s. 1003.01, shall be given a temporary exemption for 30
   36  school days. The public school health nurse or authorized
   37  private school official is responsible for followup of each such
   38  student until proper documentation or immunizations are
   39  obtained. An exemption for 30 days may be issued for a student
   40  who enters a juvenile justice program to permit the student to
   41  attend class until his or her records can be obtained or until
   42  the immunizations can be obtained. An authorized juvenile
   43  justice official is responsible for followup of each student who
   44  enters a juvenile justice program until proper documentation or
   45  immunizations are obtained.
   46         (7) Before the administration of an immunization required
   47  by this section, a licensed health care provider must:
   48         (a) Provide the child’s parent, legal guardian, or other
   49  authorized person with a copy of the current vaccine information
   50  statement published about the vaccine by the Centers for Disease
   51  Control and Prevention of the United States Department of Health
   52  and Human Services;
   53         (b) Have the child’s parent, legal guardian, or other
   54  authorized person sign a statement in substantially the
   55  following form:
   56  
   57         I have received a copy of the vaccine information
   58         statement published by the Centers for Disease Control
   59         and Prevention. I have read or have had explained to
   60         me information about the vaccine to be administered,
   61         the benefits and risks of the vaccine, how to report
   62         an adverse reaction, the availability of the National
   63         Vaccine Injury Compensation Program, and how to get
   64         more information about childhood diseases and
   65         vaccines. I understand the benefits of the vaccine and
   66         ask that the vaccine be administered to ...(name of
   67         minor child)..., for whom I am authorized to make this
   68         request.
   69  Signature: ...(signature)....
   70  Name: ...(printed name of parent, legal guardian,
   71  or other authorized person)....
   72  Date: ...(date)....
   73  
   74         (c) Keep a copy of the parent’s, legal guardian’s, or
   75  authorized person’s signed statement as part of the minor
   76  child’s permanent medical record; and
   77         (d) Record a notation on the statement of the batch and lot
   78  number for each vaccine administered to the child.
   79  
   80  This subsection applies to each vaccine information statement
   81  published by the Centers for Disease Control and Prevention,
   82  whether or not the statement is covered by the federal National
   83  Childhood Vaccine Injury Act of 1986, 42 U.S.C. s. 300aa-26. If
   84  the Centers for Disease Control and Prevention publish a vaccine
   85  information statement that covers multiple vaccines, the health
   86  care provider may have the child’s parent, legal guardian, or
   87  other authorized person sign a single statement for the vaccines
   88  covered by the vaccine information statement.
   89         (8)(6)(a) No person licensed by this state as a physician
   90  or nurse shall be liable for any injury caused by his or her
   91  action or failure to act in the administration of a vaccine or
   92  other immunizing agent pursuant to the provisions of this
   93  section if the person acts as a reasonably prudent person with
   94  similar professional training would have acted under the same or
   95  similar circumstances.
   96         (b) No member of a district school board, or any of its
   97  employees, or member of a governing board of a private school,
   98  or any of its employees, shall be liable for any injury caused
   99  by the administration of a vaccine to any student who is
  100  required to be so immunized or for a failure to diagnose
  101  scoliosis pursuant to the provisions of this section.
  102         (9)(7) The parents of any child admitted to or in
  103  attendance at a Florida public or private school, grades
  104  prekindergarten through 12, are responsible for assuring that
  105  the child is in compliance with the provisions of this section.
  106         (10)(8) Each public school, including public kindergarten,
  107  and each private school, including private kindergarten, shall
  108  be required to provide to the county health department director
  109  or administrator annual reports of compliance with the
  110  provisions of this section. Reports shall be completed on forms
  111  provided by the Department of Health for each kindergarten, and
  112  other grade as specified; and the reports shall include the
  113  status of children who were admitted at the beginning of the
  114  school year. After consultation with the Department of
  115  Education, the Department of Health shall establish by
  116  administrative rule the dates for submission of these reports,
  117  the grades for which the reports shall be required, and the
  118  forms to be used.
  119         (11)(9) The presence of any of the communicable diseases
  120  for which immunization is required by the Department of Health
  121  in a Florida public or private school shall permit the county
  122  health department director or administrator or the State Health
  123  Officer to declare a communicable disease emergency. The
  124  declaration of such emergency shall mandate that all students in
  125  attendance in the school who are not in compliance with the
  126  provisions of this section be identified by the district school
  127  board or by the governing authority of the private school; and
  128  the school health and immunization records of such children
  129  shall be made available to the county health department director
  130  or administrator. Those children identified as not being
  131  immunized against the disease for which the emergency has been
  132  declared shall be temporarily excluded from school by the
  133  district school board, or the governing authority of the private
  134  school, until such time as is specified by the county health
  135  department director or administrator.
  136         (12)(10) Each district school board and the governing
  137  authority of each private school shall:
  138         (a) Refuse admittance to any child otherwise entitled to
  139  admittance to kindergarten, or any other initial entrance into a
  140  Florida public or private school, who is not in compliance with
  141  the provisions of subsection (4).
  142         (b) Temporarily exclude from attendance any student who is
  143  not in compliance with the provisions of subsection (4).
  144         (13)(11) The provisions of this section do not apply to
  145  those persons admitted to or attending adult education classes
  146  unless the adult students are under 21 years of age.
  147         Section 2. Paragraph (e) of subsection (1) of section
  148  381.003, Florida Statutes, is amended to read:
  149         381.003 Communicable disease and AIDS prevention and
  150  control.—
  151         (1) The department shall conduct a communicable disease
  152  prevention and control program as part of fulfilling its public
  153  health mission. A communicable disease is any disease caused by
  154  transmission of a specific infectious agent, or its toxic
  155  products, from an infected person, an infected animal, or the
  156  environment to a susceptible host, either directly or
  157  indirectly. The communicable disease program must include, but
  158  need not be limited to:
  159         (e) Programs for the prevention and control of vaccine
  160  preventable diseases, including programs to immunize school
  161  children as required by s. 1003.22(3)-(13) s. 1003.22(3)-(11)
  162  and the development of an automated, electronic, and centralized
  163  database or registry of immunizations. The department shall
  164  ensure that all children in this state are immunized against
  165  vaccine-preventable diseases. The immunization registry shall
  166  allow the department to enhance current immunization activities
  167  for the purpose of improving the immunization of all children in
  168  this state.
  169         1. Except as provided in subparagraph 2., the department
  170  shall include all children born in this state in the
  171  immunization registry by using the birth records from the Office
  172  of Vital Statistics. The department shall add other children to
  173  the registry as immunization services are provided.
  174         2. The parent or guardian of a child may refuse to have the
  175  child included in the immunization registry by signing a form
  176  obtained from the department, or from the health care
  177  practitioner or entity that provides the immunization, which
  178  indicates that the parent or guardian does not wish to have the
  179  child included in the immunization registry. The decision to not
  180  participate in the immunization registry must be noted in the
  181  registry.
  182         3. The immunization registry shall allow for immunization
  183  records to be electronically transferred to entities that are
  184  required by law to have such records, including schools,
  185  licensed child care facilities, and any other entity that is
  186  required by law to obtain proof of a child’s immunizations.
  187         4. Any health care practitioner licensed under chapter 458,
  188  chapter 459, or chapter 464 in this state who complies with
  189  rules adopted by the department to access the immunization
  190  registry may, through the immunization registry, directly access
  191  immunization records and update a child’s immunization history
  192  or exchange immunization information with another authorized
  193  practitioner, entity, or agency involved in a child’s care. The
  194  information included in the immunization registry must include
  195  the child’s name, date of birth, address, and any other unique
  196  identifier necessary to correctly identify the child; the
  197  immunization record, including the date, type of administered
  198  vaccine, and vaccine lot number; and the presence or absence of
  199  any adverse reaction or contraindication related to the
  200  immunization. Information received by the department for the
  201  immunization registry retains its status as confidential medical
  202  information and the department must maintain the confidentiality
  203  of that information as otherwise required by law. A health care
  204  practitioner or other agency that obtains information from the
  205  immunization registry must maintain the confidentiality of any
  206  medical records in accordance with s. 456.057 or as otherwise
  207  required by law.
  208         Section 3. Paragraph (b) of subsection (3) of section
  209  1002.20, Florida Statutes, is amended to read:
  210         1002.20 K-12 student and parent rights.—Parents of public
  211  school students must receive accurate and timely information
  212  regarding their child’s academic progress and must be informed
  213  of ways they can help their child to succeed in school. K-12
  214  students and their parents are afforded numerous statutory
  215  rights including, but not limited to, the following:
  216         (3) HEALTH ISSUES.—
  217         (b) Immunizations.—The parent of any child attending a
  218  public or private school shall be exempt from the school
  219  immunization requirements upon meeting any of the exemptions in
  220  accordance with the provisions of s. 1003.22(6) s. 1003.22(5).
  221         Section 4. Paragraph (a) of subsection (6) of section
  222  1002.42, Florida Statutes, is amended to read:
  223         1002.42 Private schools.—
  224         (6) IMMUNIZATIONS.—The governing authority of each private
  225  school shall:
  226         (a) Require students to present a certification of
  227  immunization in accordance with the provisions of s. 1003.22(3)
  228  (13) s. 1003.22(3)-(11).
  229  
  230  ================= T I T L E  A M E N D M E N T ================
  231         And the title is amended as follows:
  232         Delete lines 204 - 215
  233  and insert:
  234         An act relating to childhood vaccinations; amending s.
  235         1003.22, F.S.; authorizing a parent, legal guardian,
  236         or authorized person to choose an alternative
  237         immunization schedule under certain conditions;
  238         requiring health care providers to provide certain
  239         information to parents, guardians, and authorized
  240         persons before administration of certain immunizations
  241         to children; requiring health care providers to obtain
  242         a signed statement from the parents, guardians, and
  243         authorized persons documenting provision of the
  244         information; requiring health care providers to use a
  245         standard form for the signed statement; requiring
  246         health care providers to record the batch and lot
  247         number of each vaccine on the statement; requiring
  248         health care providers to maintain certain records;
  249         providing for a single signed statement for the
  250         administration of multiple vaccines; amending ss.
  251         381.003, 1002.20, and 1002.42, F.S.; conforming cross
  252         references; providing an effective