California's Sb276: A New Law For Vaccinations

The SB276 bill, also known as the 'Immunizations: medical exemptions' bill, was approved by the Governor of California on September 9, 2019, and filed with the Secretary of State on the same day. The bill amends Sections 120370, 120375, and 120440 of the Health and Safety Code, relating to public health. It requires the State Department of Public Health to develop and make available a standardised medical exemption request form for licensed physicians and surgeons, which would be the only accepted documentation of a medical exemption by a governing authority. The bill also specifies the information to be included in the medical exemption form and imposes requirements on parents or guardians, physicians and surgeons, and the department.

SB276 amends Sections 120370, 120375, and 120440 of the Health and Safety Code

Section 120370

This section outlines the requirements for medical exemptions from immunizations. Prior to January 1, 2021, a child could be exempt from immunizations if their parent or guardian provided a written statement from a licensed physician stating that immunization was not considered safe due to the child's medical condition or circumstances. This exemption had to include specific details, such as the nature and probable duration of the condition.

From January 1, 2021 onwards, an exemption issued before this date is only valid if the parent or guardian complies with Section 120372, which requires the use of a standardized medical exemption form. This section also allows for temporary exclusion of a child from school if there is good cause to believe they have been exposed to a disease and are not immunized against it.

Section 120375

This section focuses on the governing authority's responsibilities regarding immunization records and reporting. The governing authority of each school or institution must require documentary proof of each entrant's immunization status and record it in the entrant's permanent enrollment and scholarship record. They must also prohibit from further attendance any pupil who fails to obtain the required immunizations within the specified time limits, unless the pupil is exempted under Sections 120370 or 120372.

Additionally, the governing authority must file an annual written report on the immunization status of new entrants to the school or institution with the State Department of Public Health and the local health department. This report must be submitted using forms prescribed by the department. The local health department will have access to complete health information related to immunizations for each student to determine immunization deficiencies.

Section 120440

Section 120440 defines various terms used in the Health and Safety Code, including "health care provider," "schools, child care facilities, and family child care homes," "WIC service provider," "health care plan," "county welfare department," "foster care agency," and "tuberculosis screening."

It also outlines the procedures for operating immunization information systems by local health officers and the State Department of Public Health. These systems can be operated separately within their individual jurisdictions or jointly among multiple jurisdictions. Information from these systems can be shared with other health officers and relevant agencies, such as schools, child care facilities, and health care providers.

The section also addresses confidentiality and privacy concerns. It states that information shared within these systems must be treated as confidential medical information and used only for specified purposes, such as providing immunization services, facilitating third-party payer payments, and compiling statistical data. It also provides individuals with the right to refuse to allow information sharing and to correct any errors in their immunization records.

It requires the State Department of Public Health to develop a standardised medical exemption request form

SB276, also known as the Immunizations: Medical Exemptions bill, was approved by the Governor of California on September 9, 2019, and filed with the Secretary of State on the same day. The bill amends Sections 120370, 120375, and 120440 of, and adds Sections 120372 and 120372.05 to, the Health and Safety Code, relating to public health.

The bill requires the State Department of Public Health to develop and make available an electronic, standardized, statewide medical exemption request form for use by licensed physicians and surgeons. This form must be transmitted using the California Immunization Registry (CAIR) and, commencing January 1, 2021, will be the only documentation of a medical exemption that a governing authority may accept. The bill specifies the information to be included in the medical exemption form, including a certification under penalty of perjury that the statements and information contained in the form are true, accurate, and complete.

The bill requires physicians and surgeons to inform parents or guardians of the bill's requirements, examine the child, and submit a completed medical exemption request form to the department. It also expands the crime of perjury and imposes a state-mandated local program.

Parents or guardians must submit a copy of a medical exemption granted prior to January 1, 2021, to the department for inclusion in a state database for the exemption to remain valid. The bill also requires the department to annually review immunization reports from schools and institutions, identifying those with an overall immunization rate of less than 95%, physicians who have submitted five or more medical exemption forms in a calendar year, and schools that do not report immunization rates.

A clinically trained department staff member, either a physician or a registered nurse, is required to review all medical exemption forms submitted under these conditions. The State Public Health Officer or a designated physician may review and revoke medical exemptions deemed inappropriate or invalid. Parents or guardians can appeal a medical exemption denial or revocation to the Secretary of California Health and Human Services, which will be conducted by an independent expert review panel of licensed physicians. The final decision of the secretary is not subject to further administrative review.

The bill expands the crime of perjury

The SB-276 bill, approved by the Governor and filed with the Secretary of State on September 9, 2019, expands the crime of perjury by requiring a certification under penalty of perjury that the statements and information contained in the medical exemption form are true, accurate, and complete. The bill imposes a state-mandated local program by expanding the crime of perjury.

The bill requires the State Department of Public Health to develop and make available an electronic, standardized, statewide medical exemption request form that must be transmitted using the California Immunization Registry (CAIR). This form will be the only documentation of a medical exemption accepted by governing authorities starting January 1, 2021. The bill specifies the information to be included in the medical exemption form, including a certification under penalty of perjury that the statements and information are true, accurate, and complete.

The bill requires physicians and surgeons to inform parents or guardians of the bill's requirements, examine the child, and submit a completed medical exemption request form to the department. It also mandates that parents or guardians submit a copy of any previously granted medical exemption to the department by January 1, 2021, for inclusion in a state database to maintain the validity of the exemption.

The bill further requires the department to annually review immunization reports from schools and institutions, identifying those with immunization rates below 95%, physicians who submitted five or more medical exemption forms in a year, and schools that do not report immunization rates. A clinically trained department staff member, either a physician or a registered nurse, will review all medical exemption forms submitted under these conditions. The bill authorizes the State Public Health Officer or a designated physician to review and revoke inappropriate or invalid medical exemptions.

The bill allows parents or guardians to appeal a medical exemption denial or revocation to the Secretary of California Health and Human Services, who will establish an independent expert review panel of licensed physicians and surgeons to evaluate appeals and issue a final decision. The bill emphasizes the need for the department and the independent expert review panel to comply with state and federal privacy and confidentiality laws and authorizes the disclosure of information submitted in the medical exemption form as per the bill's requirements.

It requires the department to annually review immunisation reports from schools

The SB276 bill, also known as the Immunizations: Medical Exemptions bill, was passed into law in California on September 9, 2019. The bill requires the State Department of Public Health to develop and make available an electronic, standardized, statewide medical exemption request form for licensed physicians and surgeons to use by January 1, 2021. This form will be the only documentation of a medical exemption accepted by a governing authority.

The bill also requires the department to annually review immunization reports from schools and institutions to identify:

• Schools with an overall immunization rate of less than 95%
• Physicians and surgeons who submitted 5 or more medical exemption forms in a calendar year
• Schools and institutions that do not report immunization rates to the department

The bill further requires that a clinically trained department staff member, who is either a physician, surgeon, or registered nurse, review all medical exemption forms submitted under the conditions outlined above. If the staff member deems a medical exemption inappropriate or otherwise invalid, it will be reviewed by the State Public Health Officer or a designated physician and surgeon, who may revoke the exemption under prescribed circumstances.

The bill authorises a parent or guardian to appeal a medical exemption denial or revocation

The SB-276 bill, also known as the Immunizations: Medical Exemptions bill, was approved by the Governor of California on September 9, 2019, and filed with the Secretary of State on the same day. The bill amends Sections 120370, 120375, and 120440 of, and adds Sections 120372 and 120372.05 to, the Health and Safety Code, relating to public health.

The bill authorizes a parent or guardian to appeal a medical exemption denial or revocation to the Secretary of California Health and Human Services. The appeal is conducted by an independent expert review panel of licensed physicians and surgeons established by the secretary. The bill requires the independent expert review panel to evaluate appeals in accordance with specified guidelines and to submit its decision to the secretary.

The bill requires the secretary to adopt the determination of the independent expert review panel and promptly issue a written decision to the child's parent or guardian. The final decision of the secretary is not subject to further administrative review. The bill allows a child whose medical exemption revocation is appealed to continue attending school or an institution without being required to commence the immunization schedule required for conditional admittance, provided that the appeal is filed within 30 calendar days of the revocation of the medical exemption.

The independent expert review panel is required to evaluate appeals in accordance with federal Centers for Disease Control and Prevention, federal Advisory Committee on Immunization Practices, or American Academy of Pediatrics guidelines, or the relevant standard of care, as applicable. The panel must consist of three licensed physicians and surgeons with relevant knowledge, training, and experience relating to primary care or immunization.

The bill also requires the department and the independent expert review panel to comply with all applicable state and federal privacy and confidentiality laws and authorizes the disclosure of information submitted in the medical exemption form in accordance with the requirements set forth in the bill.

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