Bill Text: IL HB5043 | 2023-2024 | 103rd General Assembly | Engrossed

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Bill Title: Amends the Department of Public Health Powers and Duties Law of the Civil Administrative Code of Illinois. Repeals a requirement for the Department of Public Health to provide to school districts educational materials on meningococcal disease and meningococcal vaccines. Amends the School Code to make conforming changes.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced) 2024-04-19 - Rule 19(a) / Re-referred to Rules Committee [HB5043 Detail]

Download: Illinois-2023-HB5043-Engrossed.html

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AN ACT concerning health.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Department of Public Health Powers and
Duties Law of the Civil Administrative Code of Illinois is
amended by changing Section 2310-700 as follows:
(20 ILCS 2310/2310-700)
Sec. 2310-700. Influenza and meningococcal disease and
vaccine information; school districts. The Department shall
develop, provide, or approve and shall publish informational
materials for school districts in this State regarding
influenza and influenza vaccinations and meningococcal disease
and meningococcal vaccinations in accordance with the latest
information provided by the Advisory Committee on Immunization
Practices of the Centers for Disease Control and Prevention.
(Source: P.A. 100-977, eff. 1-1-19.)
(20 ILCS 2310/2310-391 rep.)
Section 10. The Department of Public Health Powers and
Duties Law of the Civil Administrative Code of Illinois is
amended by repealing Section 2310-391.
Section 15. The School Code is amended by changing Section

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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

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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, sixth,
and ninth 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, sixth, or ninth 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. A school may not withhold a child's report card
during a school year in which the Governor has declared a
disaster due to a public health emergency pursuant to Section
7 of the Illinois Emergency Management Agency Act. 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

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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) 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) 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. A school may not withhold a child's
report card during a school year in which the Governor has
declared a disaster due to a public health emergency pursuant
to Section 7 of the Illinois Emergency Management Agency Act.
The Department of Public Health shall establish, by rule, a
waiver for children who show an undue burden or a lack of

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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

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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

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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

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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

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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

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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

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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

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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

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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.

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(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

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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

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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

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