To authorize the Secretary of Health and Human Services to carry out a demonstration program to test the feasibility of using the Nation's elementary and secondary schools as influenza vaccination centers.

Summary: No Child Left Unimmunized Against Influenza Act of 2009 - Directs the Secretary of Health and Human Services (HHS) to carry out a multistate demonstration program designed to test the feasibility of using the nation's elementary and secondary schools as influenza vaccination centers in coordination with school nurses, school health care programs, local health departments, community health care providers, state insurance agencies, and private insurers.

Prohibits the Secretary from using such program for children who are eligible under other federally funded programs for payment of the costs of purchasing and administering the influenza vaccine. Requires the Secretary to work with the Secretary of Labor, state insurance agencies, and private insurers to ensure that children who have private insurance have coverage for all reasonable and customary expenses, including the costs of purchasing and administering the vaccine, incurred when influenza vaccine is administered outside of the physician's office in a school or other related setting. Authorizes the Secretary to pay the cost of purchasing and administering the influenza vaccine for children to the extent such cost is not covered through other federally funded programs or through private insurance.

Requires the program to be designed to administer vaccines consistent with recommendations of the Advisory Committee on Immunization Practices for the annual vaccination of all children aged 5 years through 19 years.

Sets forth selection criteria for schools. Makes participation by a school or an individual voluntary. Requires the program to be conducted for the 2010-2011 and 2011-2012 influenza seasons.

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``No Child Left Unimmunized Against 
Influenza Act of 2009''.

SEC. 2. FINDINGS.

    The Congress finds as follows:
            (1) The influenza is a contagious respiratory illness 
        caused by influenza viruses. The best way to prevent the 
        influenza is by getting a influenza vaccination each year.
            (2) Every year in the United States, on average, more than 
        200,000 people are hospitalized from influenza-related 
        complications, and about 36,000 people die from influenza-
        related causes.
            (3) The Centers for Disease Control and Prevention (CDC) 
        Advisory Committee on Immunization Practices recommends routine 
        influenza vaccination for all children aged 6 months through 18 
        years with influenza vaccine, effective July 1, 2008.
            (4) Children 2 to 17 years of age are twice as likely to 
        get influenza as adults, including the elderly.
            (5) School-aged children are the population group most 
        responsible for transmission of contagious respiratory viruses, 
        including influenza.
            (6) The elderly and young children are the most vulnerable 
        population to severe illness from influenza due to weaker 
        immune response to vaccination. Experts have recognized that 
        the best way to protect the elderly from influenza may be to 
        vaccinate children.
            (7) School-based vaccination programs are effective and 
        cost-saving ways to vaccinate children while reducing 
        transmission and infection rates to the larger community and at 
        the same time reducing rates of school absenteeism due to 
        influenza.
            (8) Increased focus on providing influenza vaccine to 
        children targeted for immunization will also help efforts to 
        build a sound foundation for future vaccination efforts.
            (9) School-based vaccination programs also potentially 
        represent the most feasible mechanism for community-based 
        pandemic vaccination.
            (10) Increased participation in annual influenza 
        vaccination programs builds the infrastructure necessary for 
        pandemic vaccination.
            (11) School-based programs will investigate the feasibility 
        of conducting mass immunization clinics and build partnerships 
        with local public health teams, in the event of a public health 
        emergency.

SEC. 3. DEMONSTRATION PROGRAM USING ELEMENTARY AND SECONDARY SCHOOLS AS 
              INFLUENZA VACCINATION CENTERS.

    (a) In General.--The Secretary of Health and Human Services, in 
consultation with the Secretary of Education and the Secretary of 
Labor, shall carry out a multistate demonstration program designed to 
test the feasibility of using the Nation's elementary schools and 
secondary schools as influenza vaccination centers in coordination with 
school nurses, school health care programs, local health departments, 
community health care providers, State insurance agencies, and private 
insurers.
    (b) Program Description.--
            (1) Vaccination.--
                    (A) Children covered by other federal programs.--
                For children who are eligible under other federally 
                funded programs for payment of the costs of purchasing 
                and administering the influenza vaccine, the Secretary 
                shall not use the demonstration program under this 
                section to supplant payment of such costs.
                    (B) Children covered by private health insurance.--
                For children who have private insurance, the Secretary 
                shall work with the Secretary of Labor, State insurance 
                agencies, and private insurers to ensure that such 
                children have coverage for all reasonable and customary 
                expenses, including the costs of purchasing and 
                administering the vaccine, incurred when influenza 
                vaccine is administered outside of the physician's 
                office in a school or other related setting.
                    (C) Other children.--To the extent to which payment 
                of the costs of purchasing and administering the 
                influenza vaccine for children is not covered through 
                other federally funded programs or through private 
                insurance, the Secretary may pay such costs through the 
                demonstration program under this section.
            (2) ACIP recommendations.--The demonstration program shall 
        be designed to administer vaccines consistent with the 
        recommendations of the Advisory Committee on Immunization 
        Practices for the annual vaccination of all children aged 5 
        years through 19 years.
            (3) Locations.--
                    (A) Selection.--The Secretary, in consultation with 
                the Secretary of Education, shall select the elementary 
                schools and secondary schools to participate in the 
                demonstration program.
                    (B) Selection criteria.--The schools selected under 
                subparagraph (A) shall include elementary schools and 
                secondary schools--
                            (i) located in at least 10 metropolitan 
                        regions in at least 10 States and serving 
                        primarily low-income public school student 
                        populations; and
                            (ii) located in at least 5 major areas in 
                        at least 5 States served by rural school 
                        districts.
            (4) Voluntary participation.--Participation in the 
        demonstration program by a school or an individual shall be 
        voluntary.
            (5) Duration.--The demonstration program shall be conducted 
        for the 2010-2011 and 2011-2012 influenza seasons.
            (6) Choice of vaccine.--The demonstration program shall not 
        restrict the discretion of a health care provider to administer 
        any influenza vaccine approved by the Food and Drug 
        Administration for use in pediatric populations.
    (c) Report.--Not later than 90 days following the completion of the 
demonstration program under this section, the Secretary shall submit to 
the Committees on Education and Labor, Energy and Commerce, and 
Appropriations of the House of Representatives and to the Committees on 
Health, Education, Labor, and Pensions and Appropriations of the Senate 
a report on the results of the program. The report shall include--
            (1) an assessment of the influenza vaccination rates of 
        school-aged children in localities where the demonstration 
        program is implemented, compared to the national average 
        influenza vaccination rates for school-aged children, including 
        whether school-based vaccination assists in achieving the 
        recommendations of the Advisory Committee on Immunization 
        Practices for annual influenza vaccination of all children aged 
        6 months to 18 years;
            (2) an assessment of the utility of employing elementary 
        schools and secondary schools as a part of a multi-state, 
        community-based pandemic response program that is consistent 
        with existing Federal and State pandemic response plans;
            (3) an assessment of the feasibility of using existing 
        Federal and private insurance funding in establishing a multi-
        state, school-based vaccination program for seasonal influenza 
        vaccination;
            (4) an assessment of the number of education days gained by 
        students as a result of seasonal vaccinations based on 
        absenteeism rates;
            (5) a determination of whether the demonstration program 
        under this section--
                    (A) was successful; and
                    (B) was implemented for sufficient time for 
                gathering enough valid data; and
            (6) a recommendation on whether the demonstration program 
        under this section should be continued, expanded, or 
        terminated.
    (d) Definitions.--In this section:
            (1) The terms ``elementary school'' and ``secondary 
        school'' have the meanings given such terms in section 9101 of 
        the Elementary and Secondary Education Act of 1965 (20 U.S.C. 
        7801).
            (2) The term ``low-income'' means at or below 200 percent 
        of the income level specified in the most recent applicable 
        version of the Department of Health and Human Services Poverty 
        Guidelines per person in a family unit.
            (3) Except as otherwise specified, the term ``Secretary'' 
        means the Secretary of Health and Human Services.
    (e) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated $5,000,000 for each of fiscal 
years 2010 through 2012.