1.1                          A bill for an act
  1.2             relating to health; requiring the commissioner of 
  1.3             health to annually establish an immunization schedule 
  1.4             for persons enrolled in an elementary or secondary 
  1.5             school, child care facility, or public or private 
  1.6             post-secondary educational institutions; establishing 
  1.7             a task force; amending Minnesota Statutes 2000, 
  1.8             sections 121A.15, subdivisions 1, 2, 3, 4, 8, 9, and 
  1.9             by adding subdivisions; and 135A.14, subdivisions 2 
  1.10            and 3; repealing Minnesota Statutes 2000, section 
  1.11            121A.15, subdivisions 6 and 10. 
  1.12  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.13     Section 1.  Minnesota Statutes 2000, section 121A.15, 
  1.14  subdivision 1, is amended to read: 
  1.15     Subdivision 1.  Except as provided in subdivisions 3~~,~~ and 
  1.16  4, ~~and 10,~~ no person over two months old may be allowed to 
  1.17  enroll or remain enrolled in any elementary or secondary school 
  1.18  or child care facility in this state until the person has 
  1.19  submitted to the administrator or other person having general 
  1.20  control and supervision of the school or child care 
  1.21  facility, ~~one of the following statements:~~ 
  1.22     ~~(1)~~ a statement from a physician or a public clinic which 
  1.23  provides immunizations stating that the person ~~has received~~ 
  1.24  ~~immunization, consistent with medically acceptable standards,~~ 
  1.25  ~~against measles after having attained the age of 12 months,~~ 
  1.26  ~~rubella, diphtheria, tetanus, pertussis, polio, mumps,~~ 
  1.27  ~~haemophilus influenza type b, and hepatitis B; or~~ 
  1.28     ~~(2) a statement from a physician or a public clinic which~~ 
  2.1   ~~provides immunizations stating that the person has received~~ 
  2.2   ~~immunizations, consistent with medically acceptable standards,~~ 
  2.3   ~~against measles after having attained the age of 12 months,~~ 
  2.4   ~~rubella, mumps, and haemophilus influenza type b and that the~~ 
  2.5   ~~person has commenced a schedule of immunizations for diphtheria,~~ 
  2.6   ~~tetanus, pertussis, polio, and hepatitis B and which indicates~~ 
  2.7   ~~the month and year of each immunization received~~ is 
  2.8   age-appropriately immunized or is in the process of being 
  2.9   age-appropriately immunized against diseases in compliance with 
  2.10  the immunization schedule established by the commissioner of 
  2.11  health according to subdivision 1a.  
  2.12     Sec. 2.  Minnesota Statutes 2000, section 121A.15, is 
  2.13  amended by adding a subdivision to read: 
  2.14     Subd. 1a.  [IMMUNIZATIONS REQUIRED; ANNUAL 
  2.15  DETERMINATION.] (a) The commissioner of health shall annually 
  2.16  determine the immunizations required and the manner and 
  2.17  frequency of their administration to the persons specified in 
  2.18  subdivision 1 and to the persons specified in section 135A.14, 
  2.19  subdivision 2.  The commissioner shall not include an 
  2.20  immunization on the immunization schedule unless the 
  2.21  immunization is part of the current immunization recommendations 
  2.22  of each of the following organizations:  the United States 
  2.23  Public Health Service's Advisory Committee on Immunization 
  2.24  Practices, the American Academy of Family Physicians, and the 
  2.25  American Academy of Pediatrics.  In annually determining the 
  2.26  immunization schedule, the commissioner shall: 
  2.27     (1) consult with the immunization practices task force; the 
  2.28  commissioner of children, families, and learning; and the 
  2.29  commissioner of human services; and 
  2.30     (2) consider the following criteria:  the epidemiology of 
  2.31  the disease, the burden of the disease, the safety and efficacy 
  2.32  of the vaccine, the cost of a vaccination program, a 
  2.33  cost-benefit analysis of vaccination, and the long-term 
  2.34  consequences of the disease. 
  2.35     (b) The commissioner of health shall inform all 
  2.36  immunization providers of any changes in the immunization 
  3.1   schedule in a timely manner. 
  3.2      Sec. 3.  Minnesota Statutes 2000, section 121A.15, 
  3.3   subdivision 2, is amended to read: 
  3.4      Subd. 2.  [SCHEDULE OF IMMUNIZATIONS.] No person who has 
  3.5   commenced a treatment schedule of ~~immunization~~ immunizations 
  3.6   pursuant to subdivision 1, ~~clause (2),~~ may remain enrolled in 
  3.7   any child care facility, elementary, or secondary school in this 
  3.8   state after 18 months of enrollment unless there is submitted to 
  3.9   the administrator, or other person having general control and 
  3.10  supervision of the school or child care facility, a statement 
  3.11  from a physician or a public clinic which provides immunizations 
  3.12  that the person has completed or is actively engaged in the 
  3.13  process of completing the ~~primary~~ schedule of immunizations ~~for~~ 
  3.14  ~~diphtheria, tetanus, pertussis, polio, and hepatitis~~ 
  3.15  ~~B~~ established by the commissioner of health under subdivision 
  3.16  1a.  The statement must include the month and year, and for 
  3.17  immunizations administered after January 1, 1990, the day of 
  3.18  each ~~additional~~ immunization received.  ~~For a child less than~~ 
  3.19  ~~seven years of age, a primary schedule of immunizations shall~~ 
  3.20  ~~consist of four doses of vaccine for diphtheria, tetanus, and~~ 
  3.21  ~~pertussis and three doses of vaccine for poliomyelitis and~~ 
  3.22  ~~hepatitis B.  For a child seven years of age or older, a primary~~ 
  3.23  ~~schedule of immunizations shall consist of three doses of~~ 
  3.24  ~~vaccine for diphtheria, tetanus, polio, and hepatitis B.~~ 
  3.25     Sec. 4.  Minnesota Statutes 2000, section 121A.15, 
  3.26  subdivision 3, is amended to read: 
  3.27     Subd. 3.  [EXEMPTIONS FROM IMMUNIZATIONS.] (a) ~~If a person~~ 
  3.28  ~~is at least seven years old and has not been immunized against~~ 
  3.29  ~~pertussis, the person must not be required to be immunized~~ 
  3.30  ~~against pertussis.~~ 
  3.31     ~~(b) If a person is at least 18 years old and has not~~ 
  3.32  ~~completed a series of immunizations against poliomyelitis, the~~ 
  3.33  ~~person must not be required to be immunized against~~ 
  3.34  ~~poliomyelitis.~~  
  3.35     ~~(c)~~ If a statement, signed by a physician, is submitted to 
  3.36  the administrator or other person having general control and 
  4.1   supervision of the school or child care facility stating that an 
  4.2   immunization is contraindicated for medical reasons or that 
  4.3   laboratory confirmation of the presence of adequate immunity 
  4.4   exists, the immunization specified in the statement need not be 
  4.5   required.  
  4.6      ~~(d)~~ (b) If a notarized statement signed by the minor 
  4.7   child's parent or guardian, or by the emancipated person who 
  4.8   meets the requirements in section 144.341, is submitted to the 
  4.9   administrator or other person having general control and 
  4.10  supervision of the school or child care facility stating that 
  4.11  the person has not been immunized as prescribed in subdivision 1 
  4.12  because of the conscientiously held beliefs of the parent or 
  4.13  guardian of the minor child or of the emancipated person, the 
  4.14  immunizations specified in the statement shall not be required.  
  4.15  This statement must also be forwarded to the commissioner of ~~the~~ 
  4.16  ~~department of~~ health.  
  4.17     ~~(e) If the person is under 15 months, the person is not~~ 
  4.18  ~~required to be immunized against measles, rubella, or mumps.~~ 
  4.19     ~~(f) If a person is at least five years old and has not been~~ 
  4.20  ~~immunized against haemophilus influenza type b, the person is~~ 
  4.21  ~~not required to be immunized against haemophilus influenza type~~ 
  4.22  ~~b.~~ 
  4.23     Sec. 5.  Minnesota Statutes 2000, section 121A.15, 
  4.24  subdivision 4, is amended to read: 
  4.25     Subd. 4.  [SUBSTITUTE IMMUNIZATION STATEMENT.] ~~(a)~~ A person 
  4.26  who is enrolling or enrolled in an elementary or secondary 
  4.27  school or child care facility may substitute a statement from 
  4.28  the emancipated person who meets the requirements in section 
  4.29  144.341 or a parent or guardian if the person is a minor child 
  4.30  in lieu of the statement from a physician or public clinic which 
  4.31  provides immunizations.  If the statement is from a parent or 
  4.32  guardian or emancipated person, the statement must indicate the 
  4.33  month and year and, for immunizations administered after January 
  4.34  1, 1990, the day of each immunization given. 
  4.35     ~~(b) In order for the statement to be acceptable for a~~ 
  4.36  ~~person who is enrolling in an elementary school and who is six~~ 
  5.1   ~~years of age or younger, it must indicate that the following was~~ 
  5.2   ~~given:  no less than one dose of vaccine each for measles,~~ 
  5.3   ~~mumps, and rubella given separately or in combination; no less~~ 
  5.4   ~~than four doses of vaccine for poliomyelitis, unless the third~~ 
  5.5   ~~dose was given after the fourth birthday, then three doses are~~ 
  5.6   ~~minimum; no less than five doses of vaccine for diphtheria,~~ 
  5.7   ~~tetanus, and pertussis, unless the fourth dose was given after~~ 
  5.8   ~~the fourth birthday, then four doses are minimum; and no less~~ 
  5.9   ~~than three doses of vaccine for hepatitis B.~~  
  5.10     ~~(c) In order for the statement to be consistent with~~ 
  5.11  ~~subdivision 10 and acceptable for a person who is enrolling in~~ 
  5.12  ~~an elementary or secondary school and is age seven through age~~ 
  5.13  ~~19, the statement must indicate that the person has received no~~ 
  5.14  ~~less than one dose of vaccine each for measles, mumps, and~~ 
  5.15  ~~rubella given separately or in combination, and no less than~~ 
  5.16  ~~three doses of vaccine for poliomyelitis, diphtheria, tetanus,~~ 
  5.17  ~~and hepatitis B.~~  
  5.18     ~~(d) In order for the statement to be acceptable for a~~ 
  5.19  ~~person who is enrolling in a secondary school, and who was born~~ 
  5.20  ~~after 1956 and is 20 years of age or older, the statement must~~ 
  5.21  ~~indicate that the person has received no less than one dose of~~ 
  5.22  ~~vaccine each for measles, mumps, and rubella given separately or~~ 
  5.23  ~~in combination, and no less than one dose of vaccine for~~ 
  5.24  ~~diphtheria and tetanus within the preceding ten years.~~ 
  5.25     ~~(e) In order for the statement to be acceptable for a~~ 
  5.26  ~~person who is enrolling in a child care facility and who is at~~ 
  5.27  ~~least 15 months old but who has not reached five years of age,~~ 
  5.28  ~~it must indicate that the following were given:  no less than~~ 
  5.29  ~~one dose of vaccine each for measles, mumps, and rubella given~~ 
  5.30  ~~separately or in combination; no less than one dose of vaccine~~ 
  5.31  ~~for haemophilus influenza type b; no less than four doses of~~ 
  5.32  ~~vaccine for diphtheria, tetanus, and pertussis; and no less than~~ 
  5.33  ~~three doses of vaccine for poliomyelitis.~~ 
  5.34     ~~(f) In order for the statement to be acceptable for a~~ 
  5.35  ~~person who is enrolling in a child care facility and who is five~~ 
  5.36  ~~or six years of age, it must indicate that the following was~~ 
  6.1   ~~given:  no less than one dose of vaccine each for measles,~~ 
  6.2   ~~mumps, and rubella given separately or in combination; no less~~ 
  6.3   ~~than four doses of vaccine for diphtheria, tetanus, and~~ 
  6.4   ~~pertussis; and no less than three doses of vaccine for~~ 
  6.5   ~~poliomyelitis.~~ 
  6.6      ~~(g) In order for the statement to be acceptable for a~~ 
  6.7   ~~person who is enrolling in a child care facility and who is~~ 
  6.8   ~~seven years of age or older, the statement must indicate that~~ 
  6.9   ~~the person has received no less than one dose of vaccine each~~ 
  6.10  ~~for measles, mumps, and rubella given separately or in~~ 
  6.11  ~~combination and consistent with subdivision 10, and no less than~~ 
  6.12  ~~three doses of vaccine for poliomyelitis, diphtheria, and~~ 
  6.13  ~~tetanus.~~  
  6.14     ~~(h) The commissioner of health, on finding that any of the~~ 
  6.15  ~~above requirements are not necessary to protect the public's~~ 
  6.16  ~~health, may suspend for one year that requirement.~~  
  6.17     Sec. 6.  Minnesota Statutes 2000, section 121A.15, 
  6.18  subdivision 8, is amended to read: 
  6.19     Subd. 8.  [REPORT.] (a) The administrator or other person 
  6.20  having general control and supervision of the elementary or 
  6.21  secondary school shall file a report with the commissioner on 
  6.22  all persons enrolled in the school.  The superintendent of each 
  6.23  district shall file a report with the commissioner for all 
  6.24  persons within the district receiving instruction in a home 
  6.25  school in compliance with sections 120A.22 and 120A.24.  The 
  6.26  parent of persons receiving instruction in a home school shall 
  6.27  submit the statements as required by subdivisions 1, 2, 3, and 4 
  6.28  to the superintendent of the district in which the person 
  6.29  resides by October 1 of each school year.  The school report 
  6.30  must be prepared on forms developed jointly by the commissioner 
  6.31  of health and the commissioner of children, families, and 
  6.32  learning and be distributed to the local districts by the 
  6.33  commissioner of health.  The school report must state the number 
  6.34  of persons attending the school, the number of persons who have 
  6.35  not been immunized according to subdivision 1 or 2, and the 
  6.36  number of persons who received an exemption under subdivision 3, 
  7.1   ~~clause (c) or (d)~~ paragraph (a) or (b).  The school report must 
  7.2   be filed with the commissioner of children, families, and 
  7.3   learning within 60 days of the commencement of each new school 
  7.4   term.  Upon request, a district must be given a 60-day extension 
  7.5   for filing the school report.  The commissioner of children, 
  7.6   families, and learning shall forward the report, or a copy 
  7.7   thereof, to the commissioner of health who shall provide summary 
  7.8   reports to boards of health as defined in section 145A.02, 
  7.9   subdivision 2.  
  7.10     (b) The administrator or other person having general 
  7.11  control and supervision of the child care facility shall file a 
  7.12  report with the commissioner of human services on all persons 
  7.13  enrolled in the child care facility.  The child care facility 
  7.14  report must be prepared on forms developed jointly by the 
  7.15  commissioner of health and the commissioner of human services 
  7.16  and be distributed to child care facilities by the commissioner 
  7.17  of health.  The child care facility report must state the number 
  7.18  of persons enrolled in the facility, the number of persons with 
  7.19  no immunizations, the number of persons who received an 
  7.20  exemption under subdivision 3, ~~clause (c) or (d)~~ paragraph (a) 
  7.21  or (b), and the number of persons with partial or full 
  7.22  immunization histories.  The child care facility report must be 
  7.23  filed with the commissioner of human services by November 1 of 
  7.24  each year.  The commissioner of human services shall forward the 
  7.25  report, or a copy thereof, to the commissioner of health who 
  7.26  shall provide summary reports to boards of health as defined in 
  7.27  section 145A.02, subdivision 2.  
  7.28     (c) The report required by this subdivision is not required 
  7.29  of a family child care or group family child care facility, for 
  7.30  prekindergarten children enrolled in any elementary or secondary 
  7.31  school provided services according to sections 125A.05 and 
  7.32  125A.06, nor for child care facilities in which at least 75 
  7.33  percent of children in the facility participate on a one-time 
  7.34  only or occasional basis to a maximum of 45 hours per child, per 
  7.35  month.  
  7.36     Sec. 7.  Minnesota Statutes 2000, section 121A.15, 
  8.1   subdivision 9, is amended to read: 
  8.2      Subd. 9.  [DEFINITIONS.] As used in this section the 
  8.3   following terms have the meanings given them. 
  8.4      (a) "Elementary or secondary school" includes any public 
  8.5   school as defined in section 120A.05, subdivisions 9, 11, 13, 
  8.6   and 17, or nonpublic school, church, or religious organization, 
  8.7   or home school in which a child is provided instruction in 
  8.8   compliance with sections 120A.22 and 120A.24. 
  8.9      (b) "Person enrolled in any elementary or secondary school" 
  8.10  means a person born after 1956 and enrolled in grades 
  8.11  kindergarten through 12, and a child with a disability receiving 
  8.12  special instruction and services as required in sections 125A.03 
  8.13  to 125A.24 and 125A.65, excluding a child being provided 
  8.14  services according to section 125A.05, paragraph (c), or 
  8.15  125A.06, paragraph (d).  
  8.16     (c) "Child care facility" includes those child care 
  8.17  programs subject to licensure under chapter 245A, and Minnesota 
  8.18  Rules, chapters 9502 and 9503. 
  8.19     (d) "Family child care" means child care for no more than 
  8.20  ten children at one time of which no more than six are under 
  8.21  school age.  The licensed capacity must include all children of 
  8.22  any caregiver when the children are present in the residence. 
  8.23     (e) "Group family child care" means child care for no more 
  8.24  than 14 children at any one time.  The total number of children 
  8.25  includes all children of any caregiver when the children are 
  8.26  present in the residence. 
  8.27     (f) "Immunization practices task force" means the task 
  8.28  force created according to subdivision 12. 
  8.29     Sec. 8.  Minnesota Statutes 2000, section 121A.15, is 
  8.30  amended by adding a subdivision to read: 
  8.31     Subd. 12.  [IMMUNIZATION PRACTICES TASK FORCE.] The 
  8.32  commissioner of health shall appoint a nine-member immunization 
  8.33  practices task force to advise the commissioner on the 
  8.34  immunizations required for persons over two months of age who 
  8.35  are enrolled in an elementary or secondary school, child care 
  8.36  facility, or public or private post-secondary educational 
  9.1   institution and the manner and frequency of their 
  9.2   administration.  Membership on the task force shall consist of 
  9.3   one member recommended by the Minnesota chapter of the American 
  9.4   Academy of Pediatrics; one member recommended by the Minnesota 
  9.5   medical association; one member recommended by the Minnesota 
  9.6   academy of family physicians; one member recommended by the 
  9.7   school nurses association of Minnesota; one member chosen by the 
  9.8   commissioner of health who serves on a community health board, 
  9.9   as defined in section 145A.09, subdivision 2; one member 
  9.10  recommended by the Minnesota council of health plans; one member 
  9.11  recommended by the Minnesota coalition of adult immunization; 
  9.12  one member recommended by the Minnesota nurses association; and 
  9.13  one public member chosen by the commissioner of health who 
  9.14  represents at-risk communities.  Terms, compensation, and 
  9.15  removal of members are governed by section 15.059, subdivision 6.
  9.16  Notwithstanding section 15.059, subdivision 6, the task force 
  9.17  does not expire. 
  9.18     Sec. 9.  Minnesota Statutes 2000, section 135A.14, 
  9.19  subdivision 2, is amended to read: 
  9.20     Subd. 2.  [STATEMENT OF IMMUNIZATION REQUIRED.] Except as 
  9.21  provided in subdivision 3, no student may remain enrolled in a 
  9.22  public or private post-secondary educational institution unless 
  9.23  the student has submitted to the administrator a statement that 
  9.24  the student ~~has received appropriate immunization against~~ 
  9.25  ~~measles, rubella, and mumps after having attained the age of 12~~ 
  9.26  ~~months, and against diphtheria and tetanus within ten years of~~ 
  9.27  ~~first registration at the institution~~ is age-appropriately 
  9.28  immunized against diseases in compliance with the immunization 
  9.29  schedule established by the commissioner of health according to 
  9.30  section 121A.15, subdivision 1a.  This statement must indicate 
  9.31  the month and year of each immunization given.  Instead of 
  9.32  submitting a statement, a student may provide an immunization 
  9.33  record maintained by a school according to section 121A.15, 
  9.34  subdivision 7, or a school in another state if the required 
  9.35  information is contained in the record.  A student who has 
  9.36  submitted a statement as provided in this subdivision may 
 10.1   transfer to a different Minnesota institution without submitting 
 10.2   another statement if the student's transcript or other official 
 10.3   documentation indicates that the statement was submitted. 
 10.4      Sec. 10.  Minnesota Statutes 2000, section 135A.14, 
 10.5   subdivision 3, is amended to read: 
 10.6      Subd. 3.  [EXEMPTIONS FROM IMMUNIZATION.] (a) An 
 10.7   immunization ~~listed in subdivision 2~~ specified in the 
 10.8   immunization schedule established according to section 121A.15, 
 10.9   subdivision 1a, is not required if the student submits to the 
 10.10  administrator a statement signed by a physician that shows:  
 10.11     (1) that, for medical reasons, the student did not receive 
 10.12  an immunization; 
 10.13     (2) that the student has experienced the natural disease 
 10.14  against which the immunization protects; or 
 10.15     (3) that a laboratory has confirmed the presence of 
 10.16  adequate immunity. 
 10.17     (b) If the student submits a notarized statement that the 
 10.18  student has not been immunized as required in subdivision 2 
 10.19  because of the student's conscientiously held beliefs, the 
 10.20  immunizations ~~described in subdivision 2~~ specified in the 
 10.21  immunization schedule are not required.  The institution shall 
 10.22  forward this statement to the commissioner of health.  
 10.23     Sec. 11.  [REPEALER.] 
 10.24     Minnesota Statutes 2000, section 121A.15, subdivisions 6 
 10.25  and 10, are repealed. 
 10.26     Sec. 12.  [EFFECTIVE DATE.] 
 10.27     Sections 1 to 11 are effective August 1, 2002, and apply to 
 10.28  school terms beginning on or after that date.