Introduced Version
Senate Bill 1 History
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Key: Green = existing Code. Red = new code to be enacted
Senate Bill No. 1
(By Senators Foster and Yost)
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[Introduced February 11, 2009; referred to the Committee on
Health and Human Resources; and then to the Committee on
Finance.]
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A BILL to amend and reenact §16-3-4 and §16-3-5 of the Code of West
Virginia, 1931, as amended, all relating to providing medical
and nonmedical exemptions from mandatory immunizations for
school children; requiring parental or guardian affidavit of
conscientious or religious belief; requiring parents and
guardians to assert their beliefs in an affidavit and to
present an affidavit affirming that they have completed an
educational course regarding the risks and benefits of
immunizations; providing that the affidavit be provided before
the exemption may apply; requiring submission of affidavit to
magistrate; requiring notification by magistrates; requiring
the development of certain rules governing the magistrate
review procedure; allowing the removal of students who are not
immunized from school in times of emergency or epidemic;
and providing that the Commissioner of the Bureau for Public
Health may, by rule, add or delete diseases for which vaccines
are required for school attendance and provide for the
membership of the Immunization Advisory Committee.
Be it enacted by the Legislature of West Virginia:
That §16-3-4 and §16-3-5 of the Code of West Virginia, 1931,
as amended, be amended and reenacted, all to read as follows:
ARTICLE 3. PREVENTION AND CONTROL OF COMMUNICABLE AND OTHER
INFECTIOUS DISEASES.
§16-3-4. Compulsory immunization of school children; required
vaccinations; exemptions; magistrate review; health
emergencies; appeals.
(a) When a resident birth occurs, the Commissioner of the
Bureau for Public Health shall promptly provide parents of the
newborn child with information on immunizations, including those
mandated by this state for admission to a school in this state.
(b) With vaccines widely available to reduce or prevent the
incidence of disease, the Legislature has determined that assuring
enrolled school children have been vaccinated against diseases is
a beneficial method of protecting public health.
(c) All children entering school in this state must be age
appropriately immunized against chickenpox, hepatitis-b, polio,
rubeola, rubella, tetanus, whooping cough and any other disease
requiring vaccination as established by rule by the Commissioner of the Bureau for Public Health. Any person who cannot give
satisfactory proof of having been immunized previously or who does
not have a current certificate of exemption shall be immunized for
chickenpox, hepatitis-b, diphtheria, polio, rubeola, rubella,
tetanus, whooping cough and any other disease requiring vaccination
as established by rule by the Commissioner of the Bureau for Public
Health prior to being admitted to the schools of this state.
Satisfactory proof of immunization shall be provided to the school
in the form of the certificate of immunization. The certificate of
immunization shall be developed by the Commissioner of the Bureau
for Public Health's immunization program. Beginning July 1, 2009,
the certificate of immunization shall be made available to health
care providers and school systems to document the immunization
records of school children. Beginning July 1, 2009, the
certificate of immunization is the only form used for this purpose.
A parent or guardian may apply for an exemption as follows:
(1) Medical exemption. -- A parent or guardian of a child
entering the schools of this state for the first time may request
a medical exemption from a required vaccination for his or her
minor child as follows:
(A) The parent or guardian of the child or ward presents a
certificate signed by a physician who is duly registered and
licensed to practice medicine in the United States which sets forth
the opinion and the basis of the opinion of the physician examining the child or ward that immunization of the child or ward is
medically impossible or improper for any or all of the following
diseases including chickenpox, hepatitis-b, diphtheria, polio,
rubeola, rubella, tetanus, whooping cough and any other disease
requiring vaccination as established by rule by the Commissioner of
the Bureau for Public Health; or, because of another compelling
medical reason immunization of the child or ward for any or all of
the following diseases including chickenpox, hepatitis-b,
diphtheria, polio, rubeola, rubella, tetanus, whooping cough and
any other disease requiring vaccination as established by rule by
the Commissioner of the Bureau for Public Health should not be
required for public school attendance; and
(B) The parent or guardian presents an affidavit affirming
that he or she has completed and understood an educational course
approved by the Commissioner of the Bureau for Public Health to
include the nature of the risks of the failure to vaccinate a child
and the benefits of each vaccine for which a child is to be exempt
under the provisions of this section. The educational course may
be provided by an instructor in a classroom, by videotape, or by
any means approved by the Commissioner of the Bureau for Public
Health. A nominal charge may be imposed by the Commissioner of the
Bureau for Public Health for the educational course, unless it is
determined that the cost would be a hardship for a parent or
guardian then no fee may be charged for attendance.
(2) Nonmedical exemption. -- A parent or guardian with a
strongly held conscientious or religious belief that his or her
minor child or ward should not be subject to a required
immunization as provided in this section, may seek an exemption
from any or all required vaccinations for his or her minor child
entering the schools of this state for the first time as follows:
(A) The parent or guardian executes an affidavit on a form
provided by the Commissioner of the Bureau for Public Health which
includes a list of required immunizations to allow a parent or
guardian to request an exemption for his or her child from any or
all of the required immunizations. In the affidavit, the parent or
guardian shall state the conscientious or religious belief and
shall indicate the specific vaccines for which an exemption is
being requested;
(B) The parent or guardian presents an affidavit affirming
that he or she has completed and understood an educational course
approved by the Commissioner of the Bureau for Public Health to
include the nature of the risks of the failure to vaccinate a child
and the benefits of each vaccine for which a child is to be exempt
under the provisions of this section. The educational course may
be provided by an instructor in a classroom, by videotape, or by
any means approved by the Commissioner of the Bureau for Public
Health. A nominal charge may be imposed by the Commissioner of the
Bureau for Public Health for the educational course, unless it is determined that the cost would be a hardship for a parent or
guardian, then no fee may be charged for attendance;
(C) General requirement for exemptions. -- A parent or
guardian shall provide a copy of the required affidavits to a
public health officer, designated for that purpose by the
Commissioner of the Bureau for Public Health
who shall certify in
writing within ten working days of receiving the request for an
exemption that the granting of an exemption for each specific
vaccination will not present an imminent health threat to the
general public.
(D) Magistrate court review. -- The parent or guardian seeking
an exemption shall file the affidavits and certificate with the
magistrate court with jurisdiction in the county in which the
school in which the parent or guardian is seeking an exemption for
a child to be enrolled is located. The magistrate shall review the
affidavits and certificate presented by the parent or guardian to
determine whether the affidavits and certificate are complete and
whether they meet the requirements of this section. If the
magistrate determines that the affidavits and certificate meet the
requirements of this section, he or she shall notify the parent or
guardian, the public health officer for the county and the
principal of the school in which the minor intends to enroll that
the affidavits and certificate are complete and meet the
requirements of this section. The magistrate shall make the determination required by this section within ten working days of
receiving the certified request from the public health officer.
Upon notification to the principal of the school by the magistrate,
the child is exempt from each required vaccination for which a
certification has been completed and shall be admitted to school
unless under the specific circumstances and based upon verifiable
data as determined by the Commissioner of the Bureau for Public
Health or the designated public health officer, the child's
attendance would pose an unreasonable risk to the community.
(E) The Commissioner of the Bureau for Public Health may
require the parent or guardian of any child enrolled in schools who
is exempt from the required immunizations as provided in this
section or under an earlier statute to reapply for an exemption if
the commissioner determines that because of advances in medical
knowledge, public health knowledge or change in public health risk,
it is appropriate to require a review of all applicable exemptions.
The review shall include both medical and nonmedical exemptions.
(3) The Commissioner of the Bureau for Public Health in
cooperation with the State Supreme Court of Appeals shall develop
rules and procedures for carrying out the provisions of this
section relating to the responsibilities of magistrates in carrying
out the provisions of this section.
(4) The Commissioner of
the Bureau for Public Health or his or
her designated public health officer may temporarily suspend an exemption for a student who is not immunized and exclude the
student from attending school during an outbreak or health
emergency. The student may not return or be admitted to school
until the outbreak or health emergency has been resolved and the
Commissioner of the Bureau for Public Health or his or her designee
approves the return or admittance to school. When a public health
emergency has been declared relating to a communicable disease,
citizens identified as being infected with the declared disease may
be subjected to humane quarantine using the least restrictive means
possible, in order to prevent the spreading of disease.
Additionally, quarantine and isolation must be by the least
restrictive means necessary to prevent the spread of a communicable
disease to others and may include, but is not limited to,
confinement to private homes.
No child or person may be admitted
or received in any of the schools of the state, except as otherwise
provided in this section, until he or she has been immunized.
Any teacher, school nurse or other school official having
information concerning any person who attempts to enter school
without having been immunized against
chickenpox, hepatitis-b,
diphtheria, polio, rubeola, rubella, tetanus and whooping cough or
other disease requiring vaccination as established by rule by the
Commissioner of the Bureau for Public Health shall report the name
of the person to the designated public health officer. It is the
duty of the Commissioner of the Bureau for Public Health or his or her designated public health officer to see that persons are
immunized before entering school.
(d) Health officers and health care providers providing
immunizations shall give to all persons and children a certificate
free of charge showing that they have been immunized against
chickenpox, hepatitis-b, diphtheria, polio, rubeola, rubella,
tetanus and whooping cough or other disease requiring vaccination
as established by rule by the Commissioner of the Bureau for Public
Health, or he or she may give the certificate to any person or
child whom he or she knows to have been immunized against
chickenpox, hepatitis-b, diphtheria, polio, rubeola, rubella,
tetanus and whooping cough or other disease requiring vaccination
as established by rule by the Commissioner of the Bureau for Public
Health.
(e) The Commissioner of the Bureau for Public Health shall
propose rules for legislative approval in accordance with the
provisions of article three, chapter twenty-nine-a of this code, to
implement the provisions of this section, to add or remove diseases
requiring vaccination for school attendance, addressing the issue
of school transfers, reporting requirements for each county related
to the exemptions and the membership of the immunization advisory
committee as provided in section five of this article.
(f) Any person adversely affected by a decision of the
designee of the Commissioner of the Bureau for Public Health may appeal the decision to the commissioner within 30 days of the
decision. The appeal shall be in writing and shall include the
reason or reasons the designee's decision should be changed.
Within ten days of receipt of the written appeal, the Commissioner
of the Bureau for Public Health shall either uphold the decision of
the designee or overturn it. In either case, he or she shall
notify the appellant in writing of his or her decision. The
decision of the commissioner is the final administrative procedure
available to an adversely affected party. Any person adversely
affected by a decision of the Commissioner of the Bureau for Public
Health may appeal the decision to the circuit court with
jurisdiction for the county in which the school of attendance is
located.
§16-3-5. Distribution of free vaccine preventives of disease.
(a) Declaration of legislative findings and purpose. -- The
Legislature finds and declares that early immunization for
preventable diseases represents one of the most cost-effective
means of disease prevention. The savings which can be realized
from immunization, compared to the cost of health care necessary to
treat the illness and lost productivity, are substantial.
Immunization of children at an early age serves as a preventative
preventive measure both in time and money and is essential to
maintain our children's health and well-being. The costs of
childhood immunizations should not be allowed to preclude the benefits available from a comprehensive, medically supervised child
immunization service. Furthermore, the federal government has
established goals that require 90% of all children to be immunized
by age two and provided funding to allow uninsured children to meet
this goal.
(b) The State Director Commissioner of the Bureau for Public
Health shall acquire vaccine for the prevention of polio, measles,
mumps, rubella, chickenpox, diphtheria, pertussis, tetanus,
hepatitis-b, haemophilus influenzae-b and other vaccine preventives
of disease preventable diseases as may be deemed considered
necessary or required by law, and shall distribute the same, free
of charge, in such quantities as he or she may deem consider
necessary, to county and municipal health officers public and
private providers, to be used by them for the benefit of and
without expense to the citizens within their respective
jurisdictions, to check contagions and control epidemics.
(c) The county and municipal health officers shall have
Commissioner of the Bureau for Public Health through the
immunization program, has the responsibility to properly store and
distribute, free of charge, vaccines to public and private
providers medical or osteopathic physicians within their
jurisdictions to be utilized to check contagions and control
epidemics: Provided, That the public and private providers medical
or osteopathic physicians shall may not make a charge for the vaccine itself when administering it to a patient. The county and
municipal health officers shall provide a receipt to the State
Director of Health for Commissioner of the Bureau for Public Health
through the immunization program shall keep an accurate record of
any vaccine delivered as herein provided in this section.
(d) The Director of the Division Commissioner of the Bureau
for Public Health is charged with establishing a childhood an
Immunization Advisory Committee, to plan for universal access, make
recommendations on the distribution of vaccines acquired pursuant
to this section, advise the commissioner and the state health
officer on the changing needs and opportunities for immunization
from known diseases for all persons across their life span and
tracking of track immunization compliance in accordance with
federal and state laws. The childhood Members of the Immunization
Advisory Committee shall be designated and appointed by the
Secretary of the Department of the Health and Human Resources no
later than the first day of July, one thousand nine hundred ninety-
four July 1, 2009, and the membership of the committee existing
prior to the effective date of the amendments made to this section
made during the regular session of the Legislature in 2009 shall be
comprised of representatives from the following groups: Public
health nursing, public health officers, primary health care
providers, pediatricians, family practice physicians, health care
administrators, state Medicaid program, the health insurance industry, the Public Employees Insurance Agency, the self-insured
industry and consumers continue until established by rule as
provided by the provisions of subsection (f) of section four of
this article. The state epidemiologist shall serve serves as an
advisor to the committee. Members of the advisory committee shall
serve two-year four-year terms.
(e) All health insurance policies and prepaid care policies
issued in this state which provide coverage for the children of the
insured shall provide coverage for child immunization services to
include the cost of the vaccine, if incurred by the health care
provider, and all costs of administration from birth through age 16
years. These services shall be are exempt from any deductible,
per-visit charge and/or copayment provisions which may be in force
in these policies or contracts. This section does not exempt other
health care services provided at the time of immunization from any
deductible and/ or copayment provisions.
(f) Attending physicians, midwives, nurse practitioners,
hospitals, birthing centers, clinics and other appropriate health
care providers shall provide parents of newborns and preschool age
children with information on the following immunizations:
Diphtheria, polio, mumps, measles, rubella, tetanus, hepatitis-b,
hemophilus influenzae-b, chickenpox and whooping cough
and other
diseases requiring vaccination as established by rule by the
Commissioner of the Bureau for Public Health. This information should include the availability of free immunization services for
children.
NOTE: The purpose of this bill is to provide medical and
nonmedical exemptions from mandatory immunizations for school
children. The bill would require parents and guardians to assert
their conscientious or religious beliefs in an affidavit. Parents
or guardians seeking an exemption for a child would be required to
present an affidavit affirming that they have completed and
understood an educational course approved by the Commissioner of
Public Health regarding the risks and benefits of immunizations, to
be provided by the Bureau for Public Health, before the exemption
could apply. Further, the bill would remove students who are not
immunized from school in times of emergency or epidemics. The bill
provides that the Commissioner of the Bureau of Health may by rule
add or delete diseases for which vaccines are required for school
attendance and to reconstitute the Immunization Advisory Committee.
§16-3-4
has been completely rewritten, therefore,
strike-throughs and underscoring have been omitted.
Strike-throughs indicate language that would be stricken from
the present law, and underscoring indicates new language that would
be added.
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