A bill to amend the Public Health Service Act to promote the immunization of children, and for other purposes.

Summary: Amends the Public Health Service Act to authorize States to identify unimmunized infants and children enrolled in a specified program and ensure that they are immunized.  Requires States to determine the vaccinations that are appropriate for the age of an infant or child.  Allows States to use amounts made available under specified Federal law to carry out this Act. 
Authorizes grants to States to assist in the vaccination of children enrolled in such program at local program offices where no health care providers are available.  Authorizes appropriations.

SECTION 1. IMMUNIZATION OF CHILDREN.

    Subtitle 1 of title XXI of the Public Health Service Act is 
amended--
            (1) by redesignating section 2106 (42 U.S.C. 300aa-6) as 
        section 2107; and
            (2) by inserting after section 2105 (42 U.S.C. 300aa-5) the 
        following new section:

``SEC. 2106. IMMUNIZATION OF CHILDREN.

    ``(a) In General.--Subject to the other provisions of this section 
and notwithstanding section 17 of Public Law 89-462, in the case of 
infants and children who are enrolled in the program established under 
such section (referred to in this section as the `program') and who 
have not received all vaccinations that are appropriate for the age of 
the infants and children, a State agency (as defined in subsection 
(b)(13) of such section 17) may take action to--
            ``(1) identify the infants and children whose health is at 
        increased risk because the infants and children have not 
        received the vaccinations that are appropriate for the age of 
        the infants and children; and
            ``(2) ensure that the infants and children are properly 
        vaccinated.
    ``(b) Verification.--To carry out this section, the State agency 
may require that the parent or legal guardian of an infant or child 
enrolled in the program submit to the State or local agency, at 
intervals determined by the State agency--
            ``(1) a copy of the immunization record of the infant or 
        child; or
            ``(2) a statement from a licensed health care provider 
        certifying that the infant or child has received all 
        vaccinations that are appropriate for the age of the infant or 
        child.
    ``(c) State Options.--To carry out this section, in the case of an 
infant or child who is enrolled in the program and who has not received 
all vaccinations that are appropriate for the age of the infant or 
child, the State agency may--
            ``(1) adjust or delay the delivery schedule of benefits 
        made available under the program, except that the benefits may 
        not be discontinued pursuant to this paragraph; or
            ``(2) require more frequent evaluative clinic visits for an 
        infant or child who has been identified as being at higher 
        medical risk because the infant or child has not received all 
        vaccinations that are appropriate for the age of the infant or 
        child.
    ``(d) Prerequisites.--A State agency may not take an action under 
subsection (c) unless the State agency has--
            ``(1) notified the parent or legal guardian of the enrolled 
        infant or child, in writing, of the requirements of this 
        section not later than 90 days, and again 30 days, before the 
        action is taken;
            ``(2) informed the parent or legal guardian of the need and 
        importance of childhood vaccinations, in a manner determined by 
        the State agency;
            ``(3) provided the parent or legal guardian with 
        information concerning the availability of public and private 
        providers of vaccination services; and
            ``(4) provided the parent or legal guardian with a copy of 
        the appropriate vaccination schedule determined pursuant to 
        subsection (e).
    ``(e) Appropriate Vaccinations.--To carry out this section, a State 
shall determine the vaccinations that are appropriate for the age of an 
infant or child after reviewing standards established by--
            ``(1) the Secretary; 
            ``(2) the Advisory Committee on Immunization Practices of 
        the Centers for Disease Control and Prevention; or
            ``(3) the American Academy of Pediatrics.
    ``(f) Exemptions.--An infant or child residing in a State shall be 
exempt from any requirement imposed under this section to the extent 
that the law of the State would exempt the infant or child from 
immunization requirements if the infant or child were entering or 
attending school.
    ``(g) Funding.--The State agency may use amounts made available 
under section 17 of Public Law 89-462 for the costs of nutrition 
services and administration (as defined in subsection (b)(4) of such 
section) to carry out this section (other than subsection (h)).
    ``(h) Grants.--
            ``(1) In general.--The Secretary may make grants to States 
        for the purpose of assisting in the vaccination of children 
        enrolled in the program at local program offices where no 
        health care providers are available.
            ``(2) Applications.--To receive a grant under this 
        subsection, a State shall submit an application to the 
        Secretary at such time, and containing or accompanied by such 
        information, as the Secretary may reasonably require.
            ``(3) Need.--The Secretary shall award grants under this 
        subsection based on need, as demonstrated in the application of 
        a State.
            ``(4) Authorization of appropriations.--There are 
        authorized to be appropriated to carry out this subsection 
        $6,000,000 for each of fiscal years 1993 and 1994.''.