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1    AN ACT concerning State government.
 
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

 

 

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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 grades of
17any public, private, or parochial school shall have a dental
18examination. Each of these children shall present proof of
19having been examined by a dentist in accordance with this
20Section and rules adopted under this Section before May 15th of
21the school year. If a child in the second or sixth grade fails
22to present proof by May 15th, the school may hold the child's
23report card until one of the following occurs: (i) the child
24presents proof of a completed dental examination or (ii) the
25child presents proof that a dental examination will take place
26within 60 days after May 15th. The Department of Public Health

 

 

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1shall establish, by rule, a waiver for children who show an
2undue burden or a lack of access to a dentist. Each public,
3private, and parochial school must give notice of this dental
4examination 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 the effective date of this
9amendatory Act of the 95th General Assembly and any student
10enrolling for the first time in a public, private, or parochial
11school on or after the effective date of this amendatory Act of
12the 95th General Assembly shall have an eye examination. Each
13of these children shall present proof of having been examined
14by a physician licensed to practice medicine in all of its
15branches or a licensed optometrist within the previous year, in
16accordance with this Section and rules adopted under this
17Section, before October 15th of the school year. If the child
18fails to present proof by October 15th, the school may hold the
19child's report card until one of the following occurs: (i) the
20child presents proof of a completed eye examination or (ii) the
21child presents proof that an eye examination will take place
22within 60 days after October 15th. The Department of Public
23Health shall establish, by rule, a waiver for children who show
24an undue burden or a lack of access to a physician licensed to
25practice medicine in all of its branches who provides eye
26examinations or to a licensed optometrist. Each public,

 

 

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

 

 

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1validated screening tool. The rules shall provide that social
2and emotional screenings are not intended to replace or
3duplicate health care systems conducting screening and
4anticipatory guidance consistent with recommendations of the
5American Academy of Pediatrics and must be consistent with the
6State Board of Education's social and emotional learning
7standards. The Department of Public Health shall specify that a
8diabetes screening as defined by rule shall be included as a
9required part of each health examination. Diabetes testing is
10not required.
11    Physicians licensed to practice medicine in all of its
12branches, licensed advanced practice nurses, or licensed
13physician assistants shall be responsible for the performance
14of the health examinations, other than dental examinations, eye
15examinations, and vision and hearing screening, and shall sign
16all report forms required by subsection (4) of this Section
17that pertain to those portions of the health examination for
18which the physician, advanced practice nurse, or physician
19assistant is responsible. If a registered nurse performs any
20part of a health examination, then a physician licensed to
21practice medicine in all of its branches must review and sign
22all required report forms. Licensed dentists shall perform all
23dental examinations and shall sign all report forms required by
24subsection (4) of this Section that pertain to the dental
25examinations. Physicians licensed to practice medicine in all
26its branches or licensed optometrists shall perform all eye

 

 

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1examinations required by this Section and shall sign all report
2forms required by subsection (4) of this Section that pertain
3to the eye examination. For purposes of this Section, an eye
4examination shall at a minimum include history, visual acuity,
5subjective refraction to best visual acuity near and far,
6internal and external examination, and a glaucoma evaluation,
7as well as any other tests or observations that in the
8professional judgment of the doctor are necessary. Vision and
9hearing screening tests, which shall not be considered
10examinations as that term is used in this Section, shall be
11conducted in accordance with rules and regulations of the
12Department of Public Health, and by individuals whom the
13Department of Public Health has certified. In these rules and
14regulations, the Department of Public Health shall require that
15individuals conducting vision screening tests give a child's
16parent or guardian written notification, before the vision
17screening is conducted, that states, "Vision screening is not a
18substitute for a complete eye and vision evaluation by an eye
19doctor. Your child is not required to undergo this vision
20screening if an optometrist or ophthalmologist has completed
21and signed a report form indicating that an examination has
22been administered within the previous 12 months."
23    (2.5) With respect to the social and emotional screening
24portion of the health examination, each child shall present
25proof of having been examined by a physician licensed to
26practice medicine in all of its branches within the previous

 

 

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1year, in accordance with this Section and rules adopted under
2this Section, before October 15th of the school year. If the
3child fails to present proof of the social and emotional
4screening portion of the health examination by October 15th,
5the school may hold the child's report card until one of the
6following occurs: (i) the child presents proof of a completed
7social and emotional screening or (ii) the child presents proof
8that a social and emotional screening will take place within 60
9days after October 15th. The Department of Public Health shall
10establish, by rule, a waiver for children who show an undue
11burden or a lack of access to a physician licensed to practice
12medicine in all of its branches who provides social and
13emotional screenings. Each public, private, and parochial
14school must give notice of this social and emotional screening
15requirement to the parents and guardians of students in
16compliance with rules of the Department of Public Health.
17Nothing in this Section shall be construed to allow a school to
18exclude a child from attending because of a parent's or
19guardian's failure to obtain a social and emotional screening
20for the child.
21    (3) Every child shall, at or about the same time as he or
22she receives a health examination required by subsection (1) of
23this Section, present to the local school proof of having
24received such immunizations against preventable communicable
25diseases as the Department of Public Health shall require by
26rules and regulations promulgated pursuant to this Section and

 

 

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1the Communicable Disease Prevention Act.
2    (4) The individuals conducting the health examination,
3dental examination, or eye examination shall record the fact of
4having conducted the examination, and such additional
5information as required, including for a health examination
6data relating to obesity (including at a minimum, date of
7birth, gender, height, weight, blood pressure, and date of
8exam), on uniform forms which the Department of Public Health
9and the State Board of Education shall prescribe for statewide
10use. The examiner shall summarize on the report form any
11condition that he or she suspects indicates a need for special
12services, including for a health examination factors relating
13to obesity. Regarding social and emotional functioning,
14information must be shared in a manner consistent with laws and
15policies governing health care confidentiality. The
16individuals confirming the administration of required
17immunizations shall record as indicated on the form that the
18immunizations were administered.
19    (5) If a child does not submit proof of having had either
20the health examination or the immunization as required, then
21the child shall be examined or receive the immunization, as the
22case may be, and present proof by October 15 of the current
23school year, or by an earlier date of the current school year
24established by a school district. To establish a date before
25October 15 of the current school year for the health
26examination or immunization as required, a school district must

 

 

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1give notice of the requirements of this Section 60 days prior
2to the earlier established date. If for medical reasons one or
3more of the required immunizations must be given after October
415 of the current school year, or after an earlier established
5date of the current school year, then the child shall present,
6by October 15, or by the earlier established date, a schedule
7for the administration of the immunizations and a statement of
8the medical reasons causing the delay, both the schedule and
9the statement being issued by the physician, advanced practice
10nurse, physician assistant, registered nurse, or local health
11department that will be responsible for administration of the
12remaining required immunizations. If a child does not comply by
13October 15, or by the earlier established date of the current
14school year, with the requirements of this subsection, then the
15local school authority shall exclude that child from school
16until such time as the child presents proof of having had the
17health examination as required and presents proof of having
18received those required immunizations which are medically
19possible to receive immediately. During a child's exclusion
20from school for noncompliance with this subsection, the child's
21parents or legal guardian shall be considered in violation of
22Section 26-1 and subject to any penalty imposed by Section
2326-10. This subsection (5) does not apply to dental
24examinations, and eye examinations, or the social and emotional
25screening portion of the health examination. If the student is
26an out-of-state transfer student and does not have the proof

 

 

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

 

 

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

 

 

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1    (7) Upon determining that the number of pupils who are
2required to be in compliance with subsection (5) of this
3Section is below 90% of the number of pupils enrolled in the
4school district, 10% of each State aid payment made pursuant to
5Section 18-8.05 to the school district for such year may be
6withheld by the State Board of Education until the number of
7students in compliance with subsection (5) is the applicable
8specified percentage or higher.
9    (8) Children of parents or legal guardians who object to
10health, dental, or eye examinations or any part thereof, to
11immunizations, or to vision and hearing screening tests on
12religious grounds shall not be required to undergo the
13examinations, tests, or immunizations to which they so object
14if such parents or legal guardians present to the appropriate
15local school authority a signed Certificate of Religious
16Exemption detailing the grounds for objection and the specific
17immunizations, tests, or examinations to which they object. The
18grounds for objection must set forth the specific religious
19belief that conflicts with the examination, test,
20immunization, or other medical intervention. The signed
21certificate shall also reflect the parent's or legal guardian's
22understanding of the school's exclusion policies in the case of
23a vaccine-preventable disease outbreak or exposure. The
24certificate must also be signed by the authorized examining
25health care provider responsible for the performance of the
26child's health examination confirming that the provider

 

 

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1provided education to the parent or legal guardian on the
2benefits of immunization and the health risks to the student
3and to the community of the communicable diseases for which
4immunization is required in this State. However, the health
5care provider's signature on the certificate reflects only that
6education was provided and does not allow a health care
7provider grounds to determine a religious exemption. Those
8receiving immunizations required under this Code shall be
9provided with the relevant vaccine information statements that
10are required to be disseminated by the federal National
11Childhood Vaccine Injury Act of 1986, which may contain
12information on circumstances when a vaccine should not be
13administered, prior to administering a vaccine. A healthcare
14provider may consider including without limitation the
15nationally accepted recommendations from federal agencies such
16as the Advisory Committee on Immunization Practices, the
17information outlined in the relevant vaccine information
18statement, and vaccine package inserts, along with the
19healthcare provider's clinical judgment, to determine whether
20any child may be more susceptible to experiencing an adverse
21vaccine reaction than the general population, and, if so, the
22healthcare provider may exempt the child from an immunization
23or adopt an individualized immunization schedule. The
24Certificate of Religious Exemption shall be created by the
25Department of Public Health and shall be made available and
26used by parents and legal guardians by the beginning of the

 

 

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12015-2016 school year. Parents or legal guardians must submit
2the Certificate of Religious Exemption to their local school
3authority prior to entering kindergarten, sixth grade, and
4ninth grade for each child for which they are requesting an
5exemption. The religious objection stated need not be directed
6by the tenets of an established religious organization.
7However, general philosophical or moral reluctance to allow
8physical examinations, eye examinations, immunizations, vision
9and hearing screenings, or dental examinations does not provide
10a sufficient basis for an exception to statutory requirements.
11The local school authority is responsible for determining if
12the content of the Certificate of Religious Exemption
13constitutes a valid religious objection. The local school
14authority shall inform the parent or legal guardian of
15exclusion procedures, in accordance with the Department's
16rules under Part 690 of Title 77 of the Illinois Administrative
17Code, at the time the objection is presented.
18    If the physical condition of the child is such that any one
19or more of the immunizing agents should not be administered,
20the examining physician, advanced practice nurse, or physician
21assistant responsible for the performance of the health
22examination shall endorse that fact upon the health examination
23form.
24    Exempting a child from the health, dental, or eye
25examination does not exempt the child from participation in the
26program of physical education training provided in Sections

 

 

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127-5 through 27-7 of this Code.
2    (9) For the purposes of this Section, "nursery schools"
3means those nursery schools operated by elementary school
4systems or secondary level school units or institutions of
5higher learning.
6(Source: P.A. 98-673, eff. 6-30-14; 99-173, eff. 7-29-15;
799-249, eff. 8-3-15; revised 10-21-15.)