‘‘(47) at the option of the State, provide that—
‘‘(A) aid under the State plan shall not be
payable to a family with respect to a child born
to a family member—
‘‘(i) while a recipient of aid under the
State plan; or
‘‘(ii) who received aid under any State
plan approved under this part at any time
during the 10-month period that ends with
the birth of the child; and
‘‘(B) a child with respect to whom aid is
not payable under the State plan under this
part solely by reason of subparagraph (A) shall
be considered to be receiving such aid for pur-
poses of eligibility for medical assistance under
the State plan approved under title XIX.’’.
SEC. 9. STATE OPTION TO DENY AFDC BENEFITS TO PAR-
ENTS WHOSE CHILDREN HAVE NOT RE-
CEIVED REQUIRED IMMUNIZATIONS.
(a) IN GENERAL.—Section 402(a) of the Social Secu-
rity Act (42 U.S.C. 602(a)), as amended by sections 7
and 8 of this Act, is amended—
(1) by striking ‘‘and’’ at the end of paragraph
(47);
(2) by striking the period at the end of para-
graph (48) and inserting ‘‘; and’’; and
(3) by inserting after paragraph (48) the fol-
lowing:
‘‘(49) at the option of the State, provide that—
‘‘(A) the State will deduct and withhold
from the amount of aid otherwise payable under
the State plan to a family that is not in compli-
ance with this paragraph an amount equal to—
‘‘(i) the amount of such aid otherwise
payable to the family; minus
‘‘(ii) the amount of such aid that
would be payable to the family if, in mak-
ing the determination under paragraph (7)
with respect to a family, the needs of the
caretaker relative (and the spouse of such
relative, if section 407 applies) were not
taken into account;
‘‘(B) the State will apply subparagraph (A)
to a noncompliant family for each month for
which such noncompliance continues;
‘‘(C) the State will place into escrow all
amounts deducted and withheld from a family
pursuant to subparagraph (A);
‘‘(D) the State will pay in a lump sum to
a family eligible for aid under the State plan
that has ceased to be a noncompliant family an
amount equal to—
‘‘(i) the total amount deducted and
withheld from the family pursuant to sub-
paragraph (A); divided by
‘‘(ii) the number of months for which
amounts have been so withheld and de-
ducted;
‘‘(E) the State shall consider a family to
be not in compliance with this paragraph if the
family includes a dependent child who has not
attained 6 years of age, and the State agency
has not received from 1 or more physicians
written verification (on a form prescribed by the
State) that the child has been immunized in ac-
cordance with recommendations issued by the
Surgeon General of the Public Health Service,
unless the child has not been so immunized for
good cause (as determined by the State in ac-
cordance with regulations prescribed by the
Secretary), including—
‘‘(i) medical contraindication, as evi-
denced by written notice from a physician
(on a form prescribed by the State);
‘‘(ii) an excessive distance between the
residence of the child and the nearest loca-
tion at which the child could be so immu-
nized;
‘‘(iii) the lack of reasonable access to
transportation to any location at which the
child could be so immunized;
‘‘(iv) an excessive waiting period at
any such location before the child could be
so immunized;
‘‘(v) religious objection to the child
being so immunized; and
‘‘(vi) an illness of a member of the
family that has prevented the child from
being accompanied by a responsible adult
to any such location; and
‘‘(F) the State will conduct appropriate
education and outreach activities designed to—
‘‘(i) increase public awareness of the
importance of preventive health care and
immunizations for preschool children; and
‘‘(ii) inform the public about—
‘‘(I) the availability of preventive
health care and immunization services
for preschool children;
‘‘(II) any transportation, child
care, or other support services that
may be available to assist parents in
obtaining such services for their chil-
dren; and
‘‘(III) the clinics at which any
child may receive immunizations free
or at a reduced charge.’’.
(b) ISSUANCE
OF IMMUNIZATION RECOMMENDA-
TIONS
BY
THE SURGEON GENERAL
OF
THE PUBLIC
HEALTH SERVICE.—After taking into consideration the
then most recent report of the Committee on Infectious
Diseases of the American Academy of Pediatrics, the Sur-
geon General of the Public Health Service shall issue, and
revise from time to time, recommendations for the immu-
nization of children under 6 years of age. With respect
to each recommended immunization, such recommenda-
tion shall include—
(1) contraindications (if any) that should be
identified to exempt a child from receiving such im-
munization, and