1.1                          A bill for an act 
  1.2             relating to health; modifying child immunization 
  1.3             requirements; providing for rulemaking by the 
  1.4             commissioner of health; amending Minnesota Statutes 
  1.5             2000, section 121A.15, subdivisions 1, 2, 3, 7, 8, 9, 
  1.6             and by adding subdivisions; repealing Minnesota 
  1.7             Statutes 2000, section 121A.15, subdivisions 4, 6, and 
  1.8             10. 
  1.9   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.10     Section 1.  Minnesota Statutes 2000, section 121A.15, 
  1.11  subdivision 1, is amended to read: 
  1.12     Subdivision 1.  [IMMUNIZATION REQUIREMENTS; RULEMAKING.] 
  1.13  Except as provided in subdivisions subdivision 3, 4, and 10, no 
  1.14  person over two months old may be allowed to enroll or remain 
  1.15  enrolled in any elementary or secondary school or child care 
  1.16  facility in this state until the person has submitted to the 
  1.17  administrator or other person having general control and 
  1.18  supervision of the school or child care facility, one of the 
  1.19  following statements: 
  1.20     (1) a statement from a physician or a public clinic which 
  1.21  provides immunizations stating that the person has received 
  1.22  immunization, consistent with medically acceptable standards, 
  1.23  against measles after having attained the age of 12 months, 
  1.24  rubella, diphtheria, tetanus, pertussis, polio, mumps, 
  1.25  haemophilus influenza type b, and hepatitis B; or 
  1.26     (2) a statement from a physician or a public clinic which 
  1.27  provides immunizations stating that the person has received 
  2.1   immunizations, consistent with medically acceptable standards, 
  2.2   against measles after having attained the age of 12 months, 
  2.3   rubella, mumps, and haemophilus influenza type b and that the 
  2.4   person has commenced a schedule of immunizations for diphtheria, 
  2.5   tetanus, pertussis, polio, and hepatitis B and which indicates 
  2.6   the month and year of each immunization received a statement 
  2.7   showing proof of being age-appropriately immunized or in the 
  2.8   process of being age-appropriately immunized against diseases 
  2.9   deemed necessary to protect the public health. 
  2.10     Sec. 2.  Minnesota Statutes 2000, section 121A.15, is 
  2.11  amended by adding a subdivision to read: 
  2.12     Subd. 1a.  [IMMUNIZATION REQUIREMENTS; NOTICE.] The 
  2.13  immunizations required and the manner and frequency of their 
  2.14  administration shall be determined annually by the commissioner 
  2.15  of health according to subdivision 1c.  Before publishing 
  2.16  proposed rules, the commissioner of health shall review the most 
  2.17  current recommendations of the United States Public Health 
  2.18  Service's Advisory Committee on Immunization Practices, the 
  2.19  American Academy of Pediatrics, and the American Academy of 
  2.20  Family Physicians and consult with the immunization practices 
  2.21  task force established under subdivision 1d; the commissioner of 
  2.22  children, families, and learning; and the commissioner of human 
  2.23  services.  The commissioner of health shall consider the 
  2.24  following criteria in determining the immunization 
  2.25  requirements:  epidemiology of disease, morbidity and mortality 
  2.26  rates of disease, safety and efficacy of a vaccine, cost of a 
  2.27  vaccination program, cost-benefit analysis of vaccination, and 
  2.28  costs of enforcement of the law.  In addition to the publication 
  2.29  requirements of subdivision 1c, the commissioner of health shall 
  2.30  inform all immunization providers of changes in the immunization 
  2.31  requirements. 
  2.32     Sec. 3.  Minnesota Statutes 2000, section 121A.15, is 
  2.33  amended by adding a subdivision to read: 
  2.34     Subd. 1b.  [RULEMAKING EXEMPTION.] The commissioner of 
  2.35  health is exempt from chapter 14, including section 14.386, in 
  2.36  implementing this section. 
  3.1      Sec. 4.  Minnesota Statutes 2000, section 121A.15, is 
  3.2   amended by adding a subdivision to read: 
  3.3      Subd 1c.  [RULES PROCEDURE.] (a) The commissioner of health 
  3.4   shall publish proposed immunization rules in the State Register. 
  3.5      (b) Interested parties shall have 30 days to comment in 
  3.6   writing on the proposed rules.  After the commissioner of health 
  3.7   has considered all timely comments, the commissioner of health 
  3.8   shall publish notice in the State Register that the rules have 
  3.9   been adopted.  The rules shall take effect on the 31st day after 
  3.10  publication. 
  3.11     (c) If the adopted rules are the same as the proposed 
  3.12  rules, the notice shall state that the rules have been adopted 
  3.13  as proposed and shall cite the prior publication.  If the 
  3.14  adopted rules differ from the proposed rules, the portions of 
  3.15  the adopted rules that differ from the proposed rules shall be 
  3.16  included in the notice of adoption together with a citation to 
  3.17  the prior State Register that contained the notice of the 
  3.18  proposed rules. 
  3.19     Sec. 5.  Minnesota Statutes 2000, section 121A.15, is 
  3.20  amended by adding a subdivision to read: 
  3.21     Subd. 1d.  [IMMUNIZATION PRACTICES TASK FORCE.] The 
  3.22  commissioner of health shall appoint an advisory task force to 
  3.23  advise the commissioner of health on immunization requirements 
  3.24  and revision of those requirements under this section.  The 
  3.25  terms, compensation, and removal of members are governed by 
  3.26  section 15.059, except that the task force does not expire and 
  3.27  its members do not receive per diem compensation.  Membership on 
  3.28  the task force shall include, but is not limited to, 
  3.29  representatives of the Minnesota chapter of the American Academy 
  3.30  of Pediatrics, the Minnesota medical association, the Minnesota 
  3.31  academy of family physicians, the school nurses organization of 
  3.32  Minnesota, a community health board, the council of health 
  3.33  plans, the Minnesota coalition of adult immunization, the 
  3.34  Minnesota nurses association, and the general public 
  3.35  representing communities at risk. 
  3.36     Sec. 6.  Minnesota Statutes 2000, section 121A.15, is 
  4.1   amended by adding a subdivision to read: 
  4.2      Subd. 1e.  [TRANSITION PROVISION.] During calendar years 
  4.3   2001 and 2002, until the rules under subdivision 1a become 
  4.4   effective, the statement requirement under subdivision 1 is 
  4.5   satisfied by one of the following: 
  4.6      (1) a statement from a physician or a public clinic that 
  4.7   provides immunizations stating that the person has received 
  4.8   immunizations, consistent with medically acceptable standards, 
  4.9   against measles after having attained the age of 12 months, 
  4.10  rubella, diphtheria, tetanus, pertussis, polio, mumps, 
  4.11  haemophilus influenza type b, and hepatitis B; or 
  4.12     (2) a statement from a physician or a public clinic that 
  4.13  provides immunizations stating that the person has received 
  4.14  immunizations, consistent with medically acceptable standards, 
  4.15  against measles after having attained the age of 12 months, 
  4.16  rubella, mumps, and haemophilus influenza type b and that the 
  4.17  person has commenced a schedule of immunizations for diphtheria, 
  4.18  tetanus, pertussis, polio, and hepatitis B.  The statement must 
  4.19  indicate the month and year of each immunization received. 
  4.20     Sec. 7.  Minnesota Statutes 2000, section 121A.15, 
  4.21  subdivision 2, is amended to read: 
  4.22     Subd. 2.  [COMPLETION OF SCHEDULE OF IMMUNIZATIONS.] No 
  4.23  person who has commenced a treatment schedule of immunization 
  4.24  pursuant to subdivision 1, clause (2), may remain enrolled in 
  4.25  any child care facility, in this state after 18 months nor in 
  4.26  any elementary, or secondary school in this state after 18 8 
  4.27  months of enrollment after the first day of attendance unless 
  4.28  there is submitted to the administrator, or other person having 
  4.29  general control and supervision of the school or child care 
  4.30  facility, a statement from a physician or a public clinic which 
  4.31  provides immunizations an immunization provider that the person 
  4.32  has completed the primary schedule of immunizations for 
  4.33  diphtheria, tetanus, pertussis, polio, and hepatitis B.  The 
  4.34  statement must include the month and year of each additional 
  4.35  immunization received.  For a child less than seven years of 
  4.36  age, a primary schedule of immunizations shall consist of four 
  5.1   doses of vaccine for diphtheria, tetanus, and pertussis and 
  5.2   three doses of vaccine for poliomyelitis and hepatitis B.  For a 
  5.3   child seven years of age or older, a primary schedule of 
  5.4   immunizations shall consist of three doses of vaccine for 
  5.5   diphtheria, tetanus, polio, and hepatitis B required by the 
  5.6   commissioner of health. 
  5.7      Sec. 8.  Minnesota Statutes 2000, section 121A.15, 
  5.8   subdivision 3, is amended to read: 
  5.9      Subd. 3.  [EXEMPTIONS FROM IMMUNIZATIONS.] (a) If a person 
  5.10  is at least seven years old and has not been immunized against 
  5.11  pertussis, the person must not be required to be immunized 
  5.12  against pertussis. 
  5.13     (b) If a person is at least 18 years old and has not 
  5.14  completed a series of immunizations against poliomyelitis, the 
  5.15  person must not be required to be immunized against 
  5.16  poliomyelitis.  
  5.17     (c) If a statement, signed by a physician, is submitted to 
  5.18  the administrator or other person having general control and 
  5.19  supervision of the school or child care facility stating that an 
  5.20  immunization is contraindicated for medical reasons or that 
  5.21  laboratory confirmation of the presence of adequate immunity 
  5.22  exists, the immunization specified in the statement need not be 
  5.23  required.  
  5.24     (d) (b) If a notarized statement signed by the minor 
  5.25  child's parent or guardian or by the emancipated person a minor 
  5.26  meeting the requirements of section 144.341 or 144.342 is 
  5.27  submitted to the administrator or other person having general 
  5.28  control and supervision of the school or child care facility 
  5.29  stating that the person has not been immunized as prescribed in 
  5.30  subdivision 1 because of the conscientiously held beliefs of the 
  5.31  parent or guardian of the minor child or of the emancipated 
  5.32  person, the immunizations specified in the statement shall not 
  5.33  be required.  This statement must also be forwarded to the 
  5.34  commissioner of the department of health.  
  5.35     (e) If the person is under 15 months, the person is not 
  5.36  required to be immunized against measles, rubella, or mumps. 
  6.1      (f) If a person is at least five years old and has not been 
  6.2   immunized against haemophilus influenza type b, the person is 
  6.3   not required to be immunized against haemophilus influenza type 
  6.4   b. 
  6.5      Sec. 9.  Minnesota Statutes 2000, section 121A.15, 
  6.6   subdivision 7, is amended to read: 
  6.7      Subd. 7.  [FILE ON IMMUNIZATION RECORDS.] Each school or 
  6.8   child care facility shall maintain on file immunization records 
  6.9   for all persons in attendance that contain the information 
  6.10  required by subdivisions 1, 2, and 3.  The school shall maintain 
  6.11  the records for at least five years after the person attains the 
  6.12  age of majority.  The department of health and the board of 
  6.13  health, as defined in section 145A.02, subdivision 2, in whose 
  6.14  jurisdiction the school or child care facility is located, shall 
  6.15  have access to the files maintained pursuant to this 
  6.16  subdivision.  When a person transfers to another elementary or 
  6.17  secondary school or child care facility, the administrator or 
  6.18  other person having general control and supervision of the 
  6.19  school or child care facility shall assist the person's parent 
  6.20  or guardian in the transfer of the immunization file to the 
  6.21  person's new school or child care facility within 30 days of the 
  6.22  transfer.  Upon the request of a public or private 
  6.23  post-secondary educational institution, as defined in section 
  6.24  135A.14, the administrator or other person having general 
  6.25  control or supervision of a school shall assist in the transfer 
  6.26  of a student's immunization file to the post-secondary 
  6.27  institution. 
  6.28     Sec. 10.  Minnesota Statutes 2000, section 121A.15, 
  6.29  subdivision 8, is amended to read: 
  6.30     Subd. 8.  [REPORT.] The administrator or other person 
  6.31  having general control and supervision of the elementary or 
  6.32  secondary school shall file a report with the commissioner of 
  6.33  children, families, and learning on all persons enrolled in the 
  6.34  school.  The superintendent of each district shall file a report 
  6.35  with the commissioner of children, families, and learning for 
  6.36  all persons within the district receiving instruction in a home 
  7.1   school in compliance with sections 120A.22 and 120A.24.  The 
  7.2   parent of persons receiving instruction in a home school shall 
  7.3   submit the statements as required by subdivisions 1, 2, and 3, 
  7.4   and 4 to the superintendent of the district in which the person 
  7.5   resides by October 1 of each school year.  The school report 
  7.6   must be prepared on forms developed jointly by the commissioner 
  7.7   of health and the commissioner of children, families, and 
  7.8   learning and be distributed to the local districts by the 
  7.9   commissioner of health.  The school report must state the number 
  7.10  of persons attending the school, the number of persons who have 
  7.11  not been immunized according to subdivision 1 or 2, and the 
  7.12  number of persons who received an exemption under subdivision 3, 
  7.13  clause (c) or (d).  The school report must be filed with the 
  7.14  commissioner of children, families, and learning within 60 days 
  7.15  of the commencement of each new school term.  Upon request, a 
  7.16  district must be given a 60-day extension for filing the school 
  7.17  report.  The commissioner of children, families, and learning 
  7.18  shall forward the report, or a copy thereof, to the commissioner 
  7.19  of health who shall provide summary reports to boards of health 
  7.20  as defined in section 145A.02, subdivision 2.  The administrator 
  7.21  or other person having general control and supervision of the 
  7.22  child care facility shall file a report with the commissioner of 
  7.23  human services on all persons enrolled in the child care 
  7.24  facility.  The child care facility report must be prepared on 
  7.25  forms developed jointly by the commissioner of health and the 
  7.26  commissioner of human services and be distributed to child care 
  7.27  facilities by the commissioner of health.  The child care 
  7.28  facility report must state the number of persons enrolled in the 
  7.29  facility, the number of persons with no immunizations, the 
  7.30  number of persons who received an exemption under subdivision 3, 
  7.31  clause (c) or (d), and the number of persons with partial or 
  7.32  full immunization histories.  The child care facility report 
  7.33  must be filed with the commissioner of human services by 
  7.34  November 1 of each year.  The commissioner of human services 
  7.35  shall forward the report, or a copy thereof, to the commissioner 
  7.36  of health who shall provide summary reports to boards of health 
  8.1   as defined in section 145A.02, subdivision 2.  The report 
  8.2   required by this subdivision is not required of a family child 
  8.3   care or group family child care facility, for prekindergarten 
  8.4   children enrolled in any elementary or secondary school provided 
  8.5   services according to sections 125A.05 and 125A.06 section 
  8.6   125A.03, nor for child care facilities in which at least 75 
  8.7   percent of children in the facility participate on a one-time 
  8.8   only or occasional basis to a maximum of 45 hours per child, per 
  8.9   month.  
  8.10     Sec. 11.  Minnesota Statutes 2000, section 121A.15, 
  8.11  subdivision 9, is amended to read: 
  8.12     Subd. 9.  [DEFINITIONS.] As used in this section the 
  8.13  following terms have the meanings given them. 
  8.14     (a) "Elementary or secondary school" includes any public 
  8.15  school as defined in section 120A.05, subdivisions 9, 11, 13, 
  8.16  and 17, or nonpublic school, church, or religious organization, 
  8.17  or home school in which a child is provided instruction in 
  8.18  compliance with sections 120A.22 and 120A.24. 
  8.19     (b) "Person enrolled in any elementary or secondary school" 
  8.20  means a person born after 1956 and enrolled in grades 
  8.21  kindergarten through 12, and a child with a disability receiving 
  8.22  special instruction and services as required in sections section 
  8.23  125A.03 to 125A.24 and 125A.65, excluding a child being provided 
  8.24  services according to section 125A.05, paragraph (c), or 
  8.25  125A.06, paragraph (d) (a), clause 3 or 7.  
  8.26     (c) "Child care facility" includes those child care 
  8.27  programs subject to licensure under chapter 245A, and Minnesota 
  8.28  Rules, chapters 9502 and 9503. 
  8.29     (d) "Family child care" means child care for no more than 
  8.30  ten children at one time of which no more than six are under 
  8.31  school age.  The licensed capacity must include all children of 
  8.32  any caregiver when the children are present in the residence. 
  8.33     (e) "Group family child care" means child care for no more 
  8.34  than 14 children at any one time.  The total number of children 
  8.35  includes all children of any caregiver when the children are 
  8.36  present in the residence. 
  9.1      (f) "Administrator" means the school principal, the 
  9.2   school's designated representative, or the person having general 
  9.3   control and supervision of a school or child care facility. 
  9.4      (g) "Immunization provider" means a physician, health care 
  9.5   provider, or public clinic that provides immunizations. 
  9.6      (h) "In the process of being age-appropriately immunized" 
  9.7   means having documentation of a minimum of one dose of each 
  9.8   required vaccine, including those for which multiple doses must 
  9.9   be given over time to be completely immunized. 
  9.10     Sec. 12.  [REPEALER.] 
  9.11     (a) Minnesota Statutes 2000, section 121A.15, subdivisions 
  9.12  4 and 10, is repealed. 
  9.13     (b) Minnesota Statutes 2000, section 121A.15, subdivision 
  9.14  6, is repealed. 
  9.15     Sec. 13.  [EFFECTIVE DATE.] 
  9.16     Sections 1 to 8 and 12, paragraph (a), are effective 
  9.17  January 1, 2002.  Sections 9 to 11 and 12, paragraph (b), are 
  9.18  effective the day following final enactment.