HB4908 EngrossedLRB100 20485 AXK 35846 b

1    AN ACT concerning education.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The School Code is amended by changing Section
527-8.1 as follows:
 
6    (105 ILCS 5/27-8.1)  (from Ch. 122, par. 27-8.1)
7    Sec. 27-8.1. Health examinations and immunizations.
8    (1) In compliance with rules and regulations which the
9Department of Public Health shall promulgate, and except as
10hereinafter provided, all children in Illinois shall have a
11health examination as follows: within one year prior to
12entering kindergarten or the first grade of any public,
13private, or parochial elementary school; upon entering the
14sixth and ninth grades of any public, private, or parochial
15school; prior to entrance into any public, private, or
16parochial nursery school; and, irrespective of grade,
17immediately prior to or upon entrance into any public, private,
18or parochial school or nursery school, each child shall present
19proof of having been examined in accordance with this Section
20and the rules and regulations promulgated hereunder. Any child
21who received a health examination within one year prior to
22entering the fifth grade for the 2007-2008 school year is not
23required to receive an additional health examination in order

 

 

HB4908 Engrossed- 2 -LRB100 20485 AXK 35846 b

1to comply with the provisions of Public Act 95-422 when he or
2she attends school for the 2008-2009 school year, unless the
3child is attending school for the first time as provided in
4this paragraph.
5    A tuberculosis skin test screening shall be included as a
6required part of each health examination included under this
7Section if the child resides in an area designated by the
8Department of Public Health as having a high incidence of
9tuberculosis. Additional health examinations of pupils,
10including eye examinations, may be required when deemed
11necessary by school authorities. Parents are encouraged to have
12their children undergo eye examinations at the same points in
13time required for health examinations.
14    (1.5) In compliance with rules adopted by the Department of
15Public Health and except as otherwise provided in this Section,
16all children in kindergarten and the second, and sixth, and
17ninth grades of any public, private, or parochial school shall
18have a dental examination. Each of these children shall present
19proof of having been examined by a dentist in accordance with
20this Section and rules adopted under this Section before May
2115th of the school year. If a child in the second, or sixth, or
22ninth grade fails to present proof by May 15th, the school may
23hold the child's report card until one of the following occurs:
24(i) the child presents proof of a completed dental examination
25or (ii) the child presents proof that a dental examination will
26take place within 60 days after May 15th. The Department of

 

 

HB4908 Engrossed- 3 -LRB100 20485 AXK 35846 b

1Public Health shall establish, by rule, a waiver for children
2who show an undue burden or a lack of access to a dentist. Each
3public, private, and parochial school must give notice of this
4dental examination requirement to the parents and guardians of
5students at least 60 days before May 15th of each school year.
6    (1.10) Except as otherwise provided in this Section, all
7children enrolling in kindergarten in a public, private, or
8parochial school on or after January 1, 2008 (the effective
9date of Public Act 95-671) this amendatory Act of the 95th
10General Assembly and any student enrolling for the first time
11in a public, private, or parochial school on or after January
121, 2008 (the effective date of Public Act 95-671) this
13amendatory Act of the 95th General Assembly shall have an eye
14examination. Each of these children shall present proof of
15having been examined by a physician licensed to practice
16medicine in all of its branches or a licensed optometrist
17within the previous year, in accordance with this Section and
18rules adopted under this Section, before October 15th of the
19school year. If the child fails to present proof by October
2015th, the school may hold the child's report card until one of
21the following occurs: (i) the child presents proof of a
22completed eye examination or (ii) the child presents proof that
23an eye examination will take place within 60 days after October
2415th. The Department of Public Health shall establish, by rule,
25a waiver for children who show an undue burden or a lack of
26access to a physician licensed to practice medicine in all of

 

 

HB4908 Engrossed- 4 -LRB100 20485 AXK 35846 b

1its branches who provides eye examinations or to a licensed
2optometrist. Each public, private, and parochial school must
3give notice of this eye examination requirement to the parents
4and guardians of students in compliance with rules of the
5Department of Public Health. Nothing in this Section shall be
6construed to allow a school to exclude a child from attending
7because of a parent's or guardian's failure to obtain an eye
8examination for the child.
9    (2) The Department of Public Health shall promulgate rules
10and regulations specifying the examinations and procedures
11that constitute a health examination, which shall include an
12age-appropriate developmental screening, an age-appropriate
13social and emotional screening, and the collection of data
14relating to asthma and obesity (including at a minimum, date of
15birth, gender, height, weight, blood pressure, and date of
16exam), and a dental examination and may recommend by rule that
17certain additional examinations be performed. The rules and
18regulations of the Department of Public Health shall specify
19that a tuberculosis skin test screening shall be included as a
20required part of each health examination included under this
21Section if the child resides in an area designated by the
22Department of Public Health as having a high incidence of
23tuberculosis. With respect to the developmental screening and
24the social and emotional screening, the Department of Public
25Health must develop rules and appropriate revisions to the
26Child Health Examination form in conjunction with a statewide

 

 

HB4908 Engrossed- 5 -LRB100 20485 AXK 35846 b

1organization representing school boards; a statewide
2organization representing pediatricians; statewide
3organizations representing individuals holding Illinois
4educator licenses with school support personnel endorsements,
5including school social workers, school psychologists, and
6school nurses; a statewide organization representing
7children's mental health experts; a statewide organization
8representing school principals; the Director of Healthcare and
9Family Services or his or her designee, the State
10Superintendent of Education or his or her designee; and
11representatives of other appropriate State agencies and, at a
12minimum, must recommend the use of validated screening tools
13appropriate to the child's age or grade, and, with regard to
14the social and emotional screening, require recording only
15whether or not the screening was completed. The rules shall
16take into consideration the screening recommendations of the
17American Academy of Pediatrics and must be consistent with the
18State Board of Education's social and emotional learning
19standards. The Department of Public Health shall specify that a
20diabetes screening as defined by rule shall be included as a
21required part of each health examination. Diabetes testing is
22not required.
23    Physicians licensed to practice medicine in all of its
24branches, licensed advanced practice registered nurses, or
25licensed physician assistants shall be responsible for the
26performance of the health examinations, other than dental

 

 

HB4908 Engrossed- 6 -LRB100 20485 AXK 35846 b

1examinations, eye examinations, and vision and hearing
2screening, and shall sign all report forms required by
3subsection (4) of this Section that pertain to those portions
4of the health examination for which the physician, advanced
5practice registered nurse, or physician assistant is
6responsible. If a registered nurse performs any part of a
7health examination, then a physician licensed to practice
8medicine in all of its branches must review and sign all
9required report forms. Licensed dentists shall perform all
10dental examinations and shall sign all report forms required by
11subsection (4) of this Section that pertain to the dental
12examinations. Physicians licensed to practice medicine in all
13its branches or licensed optometrists shall perform all eye
14examinations required by this Section and shall sign all report
15forms required by subsection (4) of this Section that pertain
16to the eye examination. For purposes of this Section, an eye
17examination shall at a minimum include history, visual acuity,
18subjective refraction to best visual acuity near and far,
19internal and external examination, and a glaucoma evaluation,
20as well as any other tests or observations that in the
21professional judgment of the doctor are necessary. Vision and
22hearing screening tests, which shall not be considered
23examinations as that term is used in this Section, shall be
24conducted in accordance with rules and regulations of the
25Department of Public Health, and by individuals whom the
26Department of Public Health has certified. In these rules and

 

 

HB4908 Engrossed- 7 -LRB100 20485 AXK 35846 b

1regulations, the Department of Public Health shall require that
2individuals conducting vision screening tests give a child's
3parent or guardian written notification, before the vision
4screening is conducted, that states, "Vision screening is not a
5substitute for a complete eye and vision evaluation by an eye
6doctor. Your child is not required to undergo this vision
7screening if an optometrist or ophthalmologist has completed
8and signed a report form indicating that an examination has
9been administered within the previous 12 months.".
10    (2.5) With respect to the developmental screening and the
11social and emotional screening portion of the health
12examination, each child may present proof of having been
13screened in accordance with this Section and the rules adopted
14under this Section before October 15th of the school year. With
15regard to the social and emotional screening only, the
16examining health care provider shall only record whether or not
17the screening was completed. If the child fails to present
18proof of the developmental screening or the social and
19emotional screening portions of the health examination by
20October 15th of the school year, qualified school support
21personnel may, with a parent's or guardian's consent, offer the
22developmental screening or the social and emotional screening
23to the child. Each public, private, and parochial school must
24give notice of the developmental screening and social and
25emotional screening requirements to the parents and guardians
26of students in compliance with the rules of the Department of

 

 

HB4908 Engrossed- 8 -LRB100 20485 AXK 35846 b

1Public Health. Nothing in this Section shall be construed to
2allow a school to exclude a child from attending because of a
3parent's or guardian's failure to obtain a developmental
4screening or a social and emotional screening for the child.
5Once a developmental screening or a social and emotional
6screening is completed and proof has been presented to the
7school, the school may, with a parent's or guardian's consent,
8make available appropriate school personnel to work with the
9parent or guardian, the child, and the provider who signed the
10screening form to obtain any appropriate evaluations and
11services as indicated on the form and in other information and
12documentation provided by the parents, guardians, or provider.
13    (3) Every child shall, at or about the same time as he or
14she receives a health examination required by subsection (1) of
15this Section, present to the local school proof of having
16received such immunizations against preventable communicable
17diseases as the Department of Public Health shall require by
18rules and regulations promulgated pursuant to this Section and
19the Communicable Disease Prevention Act.
20    (4) The individuals conducting the health examination,
21dental examination, or eye examination shall record the fact of
22having conducted the examination, and such additional
23information as required, including for a health examination
24data relating to asthma and obesity (including at a minimum,
25date of birth, gender, height, weight, blood pressure, and date
26of exam), on uniform forms which the Department of Public

 

 

HB4908 Engrossed- 9 -LRB100 20485 AXK 35846 b

1Health and the State Board of Education shall prescribe for
2statewide use. The examiner shall summarize on the report form
3any condition that he or she suspects indicates a need for
4special services, including for a health examination factors
5relating to asthma or obesity. The duty to summarize on the
6report form does not apply to social and emotional screenings.
7The confidentiality of the information and records relating to
8the developmental screening and the social and emotional
9screening shall be determined by the statutes, rules, and
10professional ethics governing the type of provider conducting
11the screening. The individuals confirming the administration
12of required immunizations shall record as indicated on the form
13that the immunizations were administered.
14    (5) If a child does not submit proof of having had either
15the health examination or the immunization as required, then
16the child shall be examined or receive the immunization, as the
17case may be, and present proof by October 15 of the current
18school year, or by an earlier date of the current school year
19established by a school district. To establish a date before
20October 15 of the current school year for the health
21examination or immunization as required, a school district must
22give notice of the requirements of this Section 60 days prior
23to the earlier established date. If for medical reasons one or
24more of the required immunizations must be given after October
2515 of the current school year, or after an earlier established
26date of the current school year, then the child shall present,

 

 

HB4908 Engrossed- 10 -LRB100 20485 AXK 35846 b

1by October 15, or by the earlier established date, a schedule
2for the administration of the immunizations and a statement of
3the medical reasons causing the delay, both the schedule and
4the statement being issued by the physician, advanced practice
5registered nurse, physician assistant, registered nurse, or
6local health department that will be responsible for
7administration of the remaining required immunizations. If a
8child does not comply by October 15, or by the earlier
9established date of the current school year, with the
10requirements of this subsection, then the local school
11authority shall exclude that child from school until such time
12as the child presents proof of having had the health
13examination as required and presents proof of having received
14those required immunizations which are medically possible to
15receive immediately. During a child's exclusion from school for
16noncompliance with this subsection, the child's parents or
17legal guardian shall be considered in violation of Section 26-1
18and subject to any penalty imposed by Section 26-10. This
19subsection (5) does not apply to dental examinations, eye
20examinations, and the developmental screening and the social
21and emotional screening portions of the health examination. If
22the student is an out-of-state transfer student and does not
23have the proof required under this subsection (5) before
24October 15 of the current year or whatever date is set by the
25school district, then he or she may only attend classes (i) if
26he or she has proof that an appointment for the required

 

 

HB4908 Engrossed- 11 -LRB100 20485 AXK 35846 b

1vaccinations has been scheduled with a party authorized to
2submit proof of the required vaccinations. If the proof of
3vaccination required under this subsection (5) is not submitted
4within 30 days after the student is permitted to attend
5classes, then the student is not to be permitted to attend
6classes until proof of the vaccinations has been properly
7submitted. No school district or employee of a school district
8shall be held liable for any injury or illness to another
9person that results from admitting an out-of-state transfer
10student to class that has an appointment scheduled pursuant to
11this subsection (5).
12    (6) Every school shall report to the State Board of
13Education by November 15, in the manner which that agency shall
14require, the number of children who have received the necessary
15immunizations and the health examination (other than a dental
16examination or eye examination) as required, indicating, of
17those who have not received the immunizations and examination
18as required, the number of children who are exempt from health
19examination and immunization requirements on religious or
20medical grounds as provided in subsection (8). On or before
21December 1 of each year, every public school district and
22registered nonpublic school shall make publicly available the
23immunization data they are required to submit to the State
24Board of Education by November 15. The immunization data made
25publicly available must be identical to the data the school
26district or school has reported to the State Board of

 

 

HB4908 Engrossed- 12 -LRB100 20485 AXK 35846 b

1Education.
2    Every school shall report to the State Board of Education
3by June 30, in the manner that the State Board requires, the
4number of children who have received the required dental
5examination, indicating, of those who have not received the
6required dental examination, the number of children who are
7exempt from the dental examination on religious grounds as
8provided in subsection (8) of this Section and the number of
9children who have received a waiver under subsection (1.5) of
10this Section.
11    Every school shall report to the State Board of Education
12by June 30, in the manner that the State Board requires, the
13number of children who have received the required eye
14examination, indicating, of those who have not received the
15required eye examination, the number of children who are exempt
16from the eye examination as provided in subsection (8) of this
17Section, the number of children who have received a waiver
18under subsection (1.10) of this Section, and the total number
19of children in noncompliance with the eye examination
20requirement.
21    The reported information under this subsection (6) shall be
22provided to the Department of Public Health by the State Board
23of Education.
24    (7) Upon determining that the number of pupils who are
25required to be in compliance with subsection (5) of this
26Section is below 90% of the number of pupils enrolled in the

 

 

HB4908 Engrossed- 13 -LRB100 20485 AXK 35846 b

1school district, 10% of each State aid payment made pursuant to
2Section 18-8.05 or 18-8.15 to the school district for such year
3may be withheld by the State Board of Education until the
4number of students in compliance with subsection (5) is the
5applicable specified percentage or higher.
6    (8) Children of parents or legal guardians who object to
7health, dental, or eye examinations or any part thereof, to
8immunizations, or to vision and hearing screening tests on
9religious grounds shall not be required to undergo the
10examinations, tests, or immunizations to which they so object
11if such parents or legal guardians present to the appropriate
12local school authority a signed Certificate of Religious
13Exemption detailing the grounds for objection and the specific
14immunizations, tests, or examinations to which they object. The
15grounds for objection must set forth the specific religious
16belief that conflicts with the examination, test,
17immunization, or other medical intervention. The signed
18certificate shall also reflect the parent's or legal guardian's
19understanding of the school's exclusion policies in the case of
20a vaccine-preventable disease outbreak or exposure. The
21certificate must also be signed by the authorized examining
22health care provider responsible for the performance of the
23child's health examination confirming that the provider
24provided education to the parent or legal guardian on the
25benefits of immunization and the health risks to the student
26and to the community of the communicable diseases for which

 

 

HB4908 Engrossed- 14 -LRB100 20485 AXK 35846 b

1immunization is required in this State. However, the health
2care provider's signature on the certificate reflects only that
3education was provided and does not allow a health care
4provider grounds to determine a religious exemption. Those
5receiving immunizations required under this Code shall be
6provided with the relevant vaccine information statements that
7are required to be disseminated by the federal National
8Childhood Vaccine Injury Act of 1986, which may contain
9information on circumstances when a vaccine should not be
10administered, prior to administering a vaccine. A healthcare
11provider may consider including without limitation the
12nationally accepted recommendations from federal agencies such
13as the Advisory Committee on Immunization Practices, the
14information outlined in the relevant vaccine information
15statement, and vaccine package inserts, along with the
16healthcare provider's clinical judgment, to determine whether
17any child may be more susceptible to experiencing an adverse
18vaccine reaction than the general population, and, if so, the
19healthcare provider may exempt the child from an immunization
20or adopt an individualized immunization schedule. The
21Certificate of Religious Exemption shall be created by the
22Department of Public Health and shall be made available and
23used by parents and legal guardians by the beginning of the
242015-2016 school year. Parents or legal guardians must submit
25the Certificate of Religious Exemption to their local school
26authority prior to entering kindergarten, sixth grade, and

 

 

HB4908 Engrossed- 15 -LRB100 20485 AXK 35846 b

1ninth grade for each child for which they are requesting an
2exemption. The religious objection stated need not be directed
3by the tenets of an established religious organization.
4However, general philosophical or moral reluctance to allow
5physical examinations, eye examinations, immunizations, vision
6and hearing screenings, or dental examinations does not provide
7a sufficient basis for an exception to statutory requirements.
8The local school authority is responsible for determining if
9the content of the Certificate of Religious Exemption
10constitutes a valid religious objection. The local school
11authority shall inform the parent or legal guardian of
12exclusion procedures, in accordance with the Department's
13rules under Part 690 of Title 77 of the Illinois Administrative
14Code, at the time the objection is presented.
15    If the physical condition of the child is such that any one
16or more of the immunizing agents should not be administered,
17the examining physician, advanced practice registered nurse,
18or physician assistant responsible for the performance of the
19health examination shall endorse that fact upon the health
20examination form.
21    Exempting a child from the health, dental, or eye
22examination does not exempt the child from participation in the
23program of physical education training provided in Sections
2427-5 through 27-7 of this Code.
25    (9) For the purposes of this Section, "nursery schools"
26means those nursery schools operated by elementary school

 

 

HB4908 Engrossed- 16 -LRB100 20485 AXK 35846 b

1systems or secondary level school units or institutions of
2higher learning.
3(Source: P.A. 99-173, eff. 7-29-15; 99-249, eff. 8-3-15;
499-642, eff. 7-28-16; 99-927, eff. 6-1-17; 100-238, eff.
51-1-18; 100-465, eff. 8-31-17; 100-513, eff. 1-1-18; revised
69-22-17.)