II

103D CONGRESS

1ST SESSION S. 1041

To amend the Public Health Service Act to promote the immunization of

children, and for other purposes.

IN THE SENATE OF THE UNITED STATES

MAY 27 (legislative day, APRIL 19), 1993

Mr. GREGG introduced the following bill; which was read twice and referred

to the Committee on Labor and Human Resources

A BILL

To amend the Public Health Service Act to promote the

immunization of children, and for other purposes.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. IMMUNIZATION OF CHILDREN.

4 Subtitle 1 of title XXI of the Public Health Service

5 Act is amended—

6 (1) by redesignating section 2106 (42 U.S.C.

7 300aa–6) as section 2107; and

8 (2) by inserting after section 2105 (42 U.S.C.

9 300aa–5) the following new section:
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1 ‘‘SEC. 2106. IMMUNIZATION OF CHILDREN.

2 ‘‘(a) IN GENERAL.—Subject to the other provisions

3 of this section and notwithstanding section 17 of Public

4 Law 89–462, in the case of infants and children who are

5 enrolled in the program established under such section (re6 ferred to in this section as the ‘program’) and who have

7 not received all vaccinations that are appropriate for the

8 age of the infants and children, a State agency (as defined

9 in subsection (b)(13) of such section 17) may take action

10 to—

11 ‘‘(1) identify the infants and children whose

12 health is at increased risk because the infants and

13 children have not received the vaccinations that are

14 appropriate for the age of the infants and children;

15 and

16 ‘‘(2) ensure that the infants and children are

17 properly vaccinated.

18 ‘‘(b) VERIFICATION.—To carry out this section, the

19 State agency may require that the parent or legal guard20 ian of an infant or child enrolled in the program submit

21 to the State or local agency, at intervals determined by

22 the State agency—

23 ‘‘(1) a copy of the immunization record of the

24 infant or child; or

25 ‘‘(2) a statement from a licensed health care

26 provider certifying that the infant or child has re-
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1 ceived all vaccinations that are appropriate for the

2 age of the infant or child.

3 ‘‘(c) STATE OPTIONS.—To carry out this section, in

4 the case of an infant or child who is enrolled in the pro5 gram and who has not received all vaccinations that are

6 appropriate for the age of the infant or child, the State

7 agency may—

8 ‘‘(1) adjust or delay the delivery schedule of

9 benefits made available under the program, except

10 that the benefits may not be discontinued pursuant

11 to this paragraph; or

12 ‘‘(2) require more frequent evaluative clinic vis13 its for an infant or child who has been identified as

14 being at higher medical risk because the infant or

15 child has not received all vaccinations that are ap16 propriate for the age of the infant or child.

17 ‘‘(d) PREREQUISITES.—A State agency may not take

18 an action under subsection (c) unless the State agency

19 has—

20 ‘‘(1) notified the parent or legal guardian of the

21 enrolled infant or child, in writing, of the require22 ments of this section not later than 90 days, and

23 again 30 days, before the action is taken;
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1 ‘‘(2) informed the parent or legal guardian of

2 the need and importance of childhood vaccinations,

3 in a manner determined by the State agency;

4 ‘‘(3) provided the parent or legal guardian with

5 information concerning the availability of public and

6 private providers of vaccination services; and

7 ‘‘(4) provided the parent or legal guardian with

8 a copy of the appropriate vaccination schedule deter9 mined pursuant to subsection (e).

10 ‘‘(e) APPROPRIATE VACCINATIONS.—To carry out

11 this section, a State shall determine the vaccinations that

12 are appropriate for the age of an infant or child after re13 viewing standards established by—

14 ‘‘(1) the Secretary; 

15 ‘‘(2) the Advisory Committee on Immunization

16 Practices of the Centers for Disease Control and

17 Prevention; or

18 ‘‘(3) the American Academy of Pediatrics.

19 ‘‘(f) EXEMPTIONS.—An infant or child residing in a

20 State shall be exempt from any requirement imposed

21 under this section to the extent that the law of the State

22 would exempt the infant or child from immunization re23 quirements if the infant or child were entering or attend24 ing school.
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1 ‘‘(g) FUNDING.—The State agency may use amounts

2 made available under section 17 of Public Law 89–462

3 for the costs of nutrition services and administration (as

4 defined in subsection (b)(4) of such section) to carry out

5 this section (other than subsection (h)).

6 ‘‘(h) GRANTS.—

7 ‘‘(1) IN GENERAL.—The Secretary may make

8 grants to States for the purpose of assisting in the

9 vaccination of children enrolled in the program at

10 local program offices where no health care providers

11 are available.

12 ‘‘(2) APPLICATIONS.—To receive a grant under

13 this subsection, a State shall submit an application

14 to the Secretary at such time, and containing or ac15 companied by such information, as the Secretary

16 may reasonably require.

17 ‘‘(3) NEED.—The Secretary shall award grants

18 under this subsection based on need, as dem19 onstrated in the application of a State.

20 ‘‘(4) AUTHORIZATION OF APPROPRIATIONS.—

21 There are authorized to be appropriated to carry out

22 this subsection $6,000,000 for each of fiscal years

23 1993 and 1994.’’.

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