I

103D CONGRESS

1ST SESSION H. R. 2468

To amend the Public Health Service Act to provide for grants to immunize

children against vaccine-preventable diseases through programs established in elementary schools.

IN THE HOUSE OF REPRESENTATIVES

JUNE 18, 1993

Mrs. SCHROEDER introduced the following bill; which was referred to the

Committee on Energy and Commerce

A BILL

To amend the Public Health Service Act to provide for

grants to immunize children against vaccine-preventable

diseases through programs established in elementary

schools.

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

2 This Act may be cited as the ‘‘School-Based Child3 hood Immunizations Program Amendments Act’’.

4 SEC. 2. ESTABLISHMENT OF PROGRAM FOR PROVISION OF

5 CHILDHOOD IMMUNIZATIONS THROUGH ELE6 MENTARY SCHOOLS.

7 Part B of title III of the Public Health Service Act

8 (42 U.S.C. 243 et seq.), as amended by section 308 of

9 Public Law 102–531 (106 Stat. 3495), is amended by in10 serting after section 317D the following section:

11 ‘‘SCHOOL-BASED PROGRAM OF IMMUNIZATIONS FOR

12 CHILDREN

13 ‘‘SEC. 317E. (a) IN GENERAL.—The Secretary, act14 ing through the Director of the Centers for Disease Con15 trol and Prevention and after consultation with the Sec16 retary of Education, may make grants to local educational

17 agencies for the purpose of providing to children immuni18 zations for vaccine-preventable diseases.

19 ‘‘(b) ELIGIBLE GEOGRAPHIC AREAS.—The Secretary

20 may make a grant under subsection (a) only if the local

21 educational agency involved administers 1 or more elemen22 tary schools located in communities—

23 ‘‘(1) with substantial numbers of cases of vac24 cine-preventable diseases; or

25 ‘‘(2) with substantial numbers of children who

26 have not received the number and variety of im-
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1 munizations commonly recommended by medical

2 authorities.

3 ‘‘(c) CERTAIN PROGRAM REQUIREMENTS.—The Sec4 retary may make a grant under subsection (a) only if the

5 local educational agency involved makes agreements as fol6 lows for the program operated with the grant:

7 ‘‘(1) The principal locations for providing im8 munizations will be the premises of schools described

9 in subsection (b).

10 ‘‘(2) To the extent practicable, the individual

11 with the principal responsibility for carrying out

12 such program for a participating school will be a

13 registered nurse—

14 ‘‘(A) who is licensed by the State involved

15 to practice as a nurse; and

16 ‘‘(B)(i) to whom the State has issued a

17 credential in school nursing; or

18 ‘‘(ii) in the case of a State that does not

19 issue such credentials, who has other docu20 mentation or experience appropriate for serving

21 as a nurse at an elementary school.

22 ‘‘(3)(A) Each participating school will, on the

23 premises of the school, make available to each stu24 dent, and to each of the siblings of the student

25 whose age is below the official age of school entry,
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1 the number and variety of vaccines recommended by

2 the American Academy of Pediatrics.

3 ‘‘(B) To the extent practicable, each participat4 ing school will, on the premises of the school, make

5 available to children in family child care homes or

6 child care centers the number and variety of vac7 cines so recommended.

8 ‘‘(4) To the extent practicable, the immuniza9 tions will be administered only by the school nurse

10 or by other registered nurses licensed by the State

11 involved.

12 ‘‘(5) A charge will not be imposed for the provi13 sion of the immunizations.

14 ‘‘(6) Each participating school will notify the

15 families of the students of the school that the school

16 is providing the immunizations and of the impor17 tance of early immunization, and will answer paren18 tal inquiries about immunization.

19 ‘‘(7)(A) In the case of the community in which

20 a participating school is located and the commu21 nities in which the students of the school reside, the

22 school will, subject to subparagraphs (B) and (C),

23 carry out in each such community a program to edu24 cate the residents of the community on—
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1 ‘‘(i) the availability from the school of im2 munizations;

3 ‘‘(ii) the importance of children receiving

4 the number and variety of immunizations

5 recommended by the American Academy of

6 Pediatrics;

7 ‘‘(iii) the fact that no significant adverse

8 health consequences result from administering

9 immunizations to children during periods in

10 which the children have common illnesses; and

11 ‘‘(iv) the availability of other health, edu12 cational, or social services from public and non13 profit entities in the geographic area involved.

14 ‘‘(B) In educating residents for purposes of

15 subparagraph (A), each participating school will

16 carry out the program of education for individuals

17 caring for children in child care homes and child

18 care centers, and will carry out the program for all

19 parents of newborn infants.

20 ‘‘(C) Such program of education will be coordi21 nated among each participating school (and such

22 schools will not carry out duplicative activities in a

23 community) and will be coordinated with local health

24 departments, hospitals and maternity wards, birth

25 registries, and community health centers.
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1 ‘‘(8) In the case of the purposes for which a

2 grant under subsection (a) may be expended, the

3 local educational agency will maintain expenditures

4 of non-Federal amounts for such purposes at a level

5 that is not less than the level of such expenditures

6 maintained by the agency for the fiscal year preced7 ing the first fiscal year for which the agency receives

8 such a grant.

9 ‘‘(d) REQUIRED PRIOR ARRANGEMENTS FOR PRO10 GRAMS.—

11 ‘‘(1) PROVISION BY STATE OF SUPPLY OF VAC12 CINES.—The Secretary may make a grant under

13 subsection (a) to a local educational agency only if

14 the agency has entered into an agreement with the

15 State involved under which the State will, for pur16 poses of the program operated by the agency with

17 the grant, provide to the agency a supply of vaccines

18 that is satisfactory to the Secretary in terms of the

19 quantity of vaccines supplied and the charge im20 posed for the vaccines.

21 ‘‘(2) PARTICIPANTS IN PROGRAM OF PUBLIC

22 EDUCATION.—With respect to the program of edu23 cation described in subsection (c)(7), the Secretary

24 may make a grant under subsection (a) only if the

25 local educational agency involved has entered into
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1 such agreements as may be necessary to ensure that,

2 for purposes of educating a substantial number of

3 individuals, an appropriate number and variety of

4 public and private entities participate in the pro5 gram and that the activities of the program are co6 ordinated among such entities.

7 ‘‘(e) REQUIREMENT OF APPLICATION.—The Sec8 retary may make a grant under subsection (a) only if an

9 application for the grant is submitted to the Secretary

10 containing the agreements required in this section, and the

11 application is in such form, is made in such manner, and

12 contains such other agreements, and such assurances and

13 information, as the Secretary determines to be necessary

14 to carry out this section.

15 ‘‘(f) CERTAIN EXPENDITURES OF GRANT.—

16 ‘‘(1) CERTAIN PERMISSIBLE EXPENDITURES.—

17 The purposes for which a grant under subsection (a)

18 may be expended by a local educational agency in19 clude—

20 ‘‘(A) carrying out the program of edu21 cation described in subsection (c)(7); and

22 ‘‘(B) recruiting and retaining a school

23 nurse, without regard to whether the functions

24 of the nurse will include functions other than
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1 the functions of the program carried out under

2 subsection (a).

3 ‘‘(2) GENERAL LIMITATION.—In the case of the

4 costs of establishing or operating a program under

5 subsection (a), the Secretary may not authorize a

6 local educational agency receiving a grant under

7 such subsection to expend more than 15 percent of

8 the grant for such costs that are not directly related

9 to the provision of immunizations at participating

10 schools.

11 ‘‘(g) DEFINITIONS.—For purposes of this section:

12 ‘‘(1) The term ‘immunizations’ means immuni13 zations against vaccine-preventable diseases.

14 ‘‘(2) The term ‘local educational agency’ has

15 the meaning given such term in section 1471 of the

16 Elementary and Secondary Education Act of 1965.

17 ‘‘(3) The term ‘participating school’ means a

18 school described in subsection (b) at which an agen19 cy is providing immunizations with a grant under

20 subsection (a).

21 ‘‘(4) The term ‘school nurse’ means a nurse de22 scribed in subsection (c)(2).

23 ‘‘(h) FUNDING.—

24 ‘‘(1) AUTHORIZATION OF APPROPRIATIONS.—

25 For the purpose of carrying out this section, there
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1 are authorized to be appropriated $4,000,000 for

2 fiscal year 1994, and such sums as may be nec3 essary for each of the fiscal years 1995 and 1996.

4 ‘‘(2) INITIAL NUMBER OF GRANTS.—For the

5 first fiscal year for which amounts are appropriated

6 under paragraph (1), the Secretary may not make

7 more than 10 grants under subsection (a).’’.

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