Amendment ID: S3018-44-R1

Redraft Amendment 44

Boosting Businesses, Workers, and Families

Ms. Rausch, Ms. Comerford, Ms. Gobi, Messrs. Eldridge, Keenan, Kennedy and Hinds, Ms. Chang-Diaz, Ms. Jehlen, Ms. Edwards and Ms. Lovely move that the proposed new text be amended by inserting after section 110 the following 2 sections:-

“SECTION 110A. Section 24N of chapter 111 of the General Laws, as appearing in the 2020 Official Edition, is hereby amended by inserting after the word “24M”, in line 32, the following words:- , and to administer chapter 111P.

SECTION 110B. The General Laws are hereby amended by inserting after chapter 111O the following chapter:-

CHAPTER 111P.

COMMUNITY IMMUNITY.

Section 1. As used in this chapter, the following words shall have the following meanings unless the context clearly requires otherwise:-

“Covered program”, (a) a child care center, an early education and care program, a family child care home, a large family child care home, a public preschool program, or a school-aged child care program, as defined in section 1A of chapter 15D; (b) a school, whether public, private or charter, that provides education to students in any combination of grade levels from kindergarten to grade 12, inclusive, and including, but not limited to, any school activity open to children who are otherwise instructed in accordance with section 1 of chapter 76; or (c) an institution of higher education, whether public or private.

“Department”, the department of public health.

“Exemption”, written acknowledgement from the department that a participant is excused from the schedule.

“Immunization”, an inoculation administered for the purpose of making a person resistant to an infectious disease.

“Participant”, a person who engages in 1 or more activities of a covered program through enrollment or other registration process.

“Provider”, a health care provider licensed by an agency, board or division of the commonwealth who, acting within their scope of practice, may lawfully administer an immunization.

“Responsible adult”, a parent or legal guardian of a participant or a participant who is an emancipated minor or who has achieved the age of majority.

“Schedule”, the immunization administration schedule established by the department and consistent with generally accepted medical practice.

Section 2. The department shall prepare and maintain separate standardized declaration of exemption forms for medical and religious exemptions to required immunizations. The department shall make the forms available to covered programs and the public online and, as necessary, in hard copy.

Section 3. The declaration of medical exemption form shall include: (i) a checklist of generally accepted contraindications to immunizations that shall be completed by a provider; (ii) a statement that the provider has an established provider-patient relationship with the participant; (iii) a request for the signature of the provider; (iv) a request for a unique government-issued professional identification number assigned to the provider; (v) a request for the signature of the responsible adult; and (vi) requests for dates for all signatures.

Section 4. The declaration of religious exemption form shall include: (i) a statement that the participant or responsible adult has a sincere religious belief conflicting with immunizations; (ii) a certification that the responsible adult has provided a complete and accurate copy of the religious exemption form to the participant’s primary health care provider, including the provider’s name and contact information; (iii) an acknowledgement of receipt from a provider on the participant’s primary health care team; and (iv) a request for the dated signature of the responsible adult. The form shall include a statement from the department that refusing to immunize is against public health policy and may result in serious illness or death of the participant or others. The department may provide alternative requirements to clauses (ii) and (iii) of this section if a participant does not have a primary health care provider.

Section 5. Covered program participants shall provide: (a) documentation of immunizations in accordance with the schedule; (b) a validly executed and accurately completed declaration of exemption; or (c) other documentation as determined by the department of public health. A private covered program may implement immunization requirements more stringent than those set forth in this chapter; provided, that the program creates and maintains a written immunization policy, which shall be made available to all responsible adults; and provided further, that no private covered program shall refuse to accept medical exemptions.

Section 6. All covered programs shall annually report total numbers of participants who have been immunized and participants who are exempt from immunization requirements, delineated by exemption type, as applicable, to the department, in a method determined by the department, and shall distribute the data from the report to all responsible adults electronically or in hard copy. Distribution shall not be required if it would result in disclosure of personal information as defined in section 1 of chapter 93H or otherwise violate applicable privacy laws.

Section 7. The department shall annually publish immunizations and exemptions data, delineated by exemption type, as applicable, for each covered program and school district on its website and may publish such data in hard copy. The department may also publish data by municipality, county, other geographic designation or by other criteria in its discretion. Publication shall not be required whenever doing so would result in disclosure of personal information as defined in section 1 of chapter 93H or otherwise violate applicable privacy laws.  The department shall directly disseminate electronic copies of any published data to the school physician or nurse assigned to any public covered program pursuant to section 53 of chapter 71.

Section 8. The department shall develop and make available online an informational pamphlet about immunization safety and immunization efficacy. The department shall distribute the informational pamphlet, either electronically or in hard copy, to every responsible adult who submits a declaration of exemption form pursuant to this chapter. All elevated risk programs shall distribute the informational pamphlet, either electronically or in hard copy, to all responsible adults for participants or those seeking enrollment in the program during the period in which the designation is in place.

Section 9. The department shall promulgate regulations to implement this chapter, except that the department of early education and care, department of elementary and secondary education and department of higher education shall promulgate regulations to implement application of this chapter to covered programs falling within each department’s jurisdiction.

Section 10. In conjunction with and as facilitated by the departments listed in section 9 of this chapter, as well as partnerships with trusted community-based organizations and local public health departments, health care providers or clergy, the department shall conduct outreach to support the delivery of medically accurate information about immunizations, including, but not limited to, the availability of programs funded through the Vaccine Purchase Trust Fund established in section 24N of chapter 111. Such outreach shall focus on, but not be limited to, immunization gap populations in under-vaccinated communities.

Section 11. The department shall collect and report data on immunizations against any infectious disease which has given rise to a declared public health state of emergency in the commonwealth. Daily immunization data reports, which the department shall publish on its website, shall include the number of individuals receiving the immunization, delineated by age and geographic location, including municipal, county and statewide counts. The department shall collect infectious disease immunization data by key socioeconomic and demographic indicators, including race, gender, ethnicity, disability, sexual orientation and gender identity, primary language, occupation, household income, residence in elder care facilities and other congregate care settings and housing status, and report such data on its website not less than weekly, except where publication would result in disclosure of personal information as defined in section 1 of chapter 93H or would otherwise violate applicable privacy laws.”.