Public Act 103-0985
 
SB3378 EnrolledLRB103 39159 RJT 69305 b

    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 
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 
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 
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 
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 
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 
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 
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 
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 
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 
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 
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 
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.
    (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 
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 
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 
the program of physical education training provided in 
Sections 27-5 through 27-7 of this Code.
    (8.5) The school board of a school district shall include 
informational materials regarding influenza and influenza 
vaccinations and meningococcal disease and meningococcal 
vaccinations developed, provided, or approved by the 
Department of Public Health under Section 2310-700 of the 
Department of Public Health Powers and Duties Law of the Civil 
Administrative Code of Illinois when the board provides 
information on immunizations, infectious diseases, 
medications, or other school health issues to the parents or 
guardians of students.
    (9) For the purposes of this Section, "nursery schools" 
means those nursery schools operated by elementary school 
systems or secondary level school units or institutions of 
higher learning.
(Source: P.A. 100-238, eff. 1-1-18; 100-465, eff. 8-31-17; 
100-513, eff. 1-1-18; 100-829, eff. 1-1-19; 100-863, eff. 
8-14-18; 100-977, eff. 1-1-19; 100-1011, eff. 8-21-18; 101-81, 
eff. 7-12-19; 101-643, eff. 6-18-20.)