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 estab-
lished 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.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘School-Based Child-
hood Immunizations Program Amendments Act’’.
SEC. 2. ESTABLISHMENT OF PROGRAM FOR PROVISION OF
CHILDHOOD IMMUNIZATIONS THROUGH ELE-
MENTARY SCHOOLS.
Part B of title III of the Public Health Service Act
(42 U.S.C. 243 et seq.), as amended by section 308 of
Public Law 102–531 (106 Stat. 3495), is amended by in-
serting after section 317D the following section:
‘‘SCHOOL-BASED PROGRAM OF IMMUNIZATIONS FOR
CHILDREN
‘‘SEC. 317E. (a) IN GENERAL.—The Secretary, act-
ing through the Director of the Centers for Disease Con-
trol and Prevention and after consultation with the Sec-
retary of Education, may make grants to local educational
agencies for the purpose of providing to children immuni-
zations for vaccine-preventable diseases.
‘‘(b) ELIGIBLE GEOGRAPHIC AREAS.—The Secretary
may make a grant under subsection (a) only if the local
educational agency involved administers 1 or more elemen-
tary schools located in communities—
‘‘(1) with substantial numbers of cases of vac-
cine-preventable diseases; or
‘‘(2) with substantial numbers of children who
have not received the number and variety of im-
munizations commonly recommended by medical
authorities.
‘‘(c) CERTAIN PROGRAM REQUIREMENTS.—The Sec-
retary may make a grant under subsection (a) only if the
local educational agency involved makes agreements as fol-
lows for the program operated with the grant:
‘‘(1) The principal locations for providing im-
munizations will be the premises of schools described
in subsection (b).
‘‘(2) To the extent practicable, the individual
with the principal responsibility for carrying out
such program for a participating school will be a
registered nurse—
‘‘(A) who is licensed by the State involved
to practice as a nurse; and
‘‘(B)(i) to whom the State has issued a
credential in school nursing; or
‘‘(ii) in the case of a State that does not
issue such credentials, who has other docu-
mentation or experience appropriate for serving
as a nurse at an elementary school.
‘‘(3)(A) Each participating school will, on the
premises of the school, make available to each stu-
dent, and to each of the siblings of the student
whose age is below the official age of school entry,
the number and variety of vaccines recommended by
the American Academy of Pediatrics.
‘‘(B) To the extent practicable, each participat-
ing school will, on the premises of the school, make
available to children in family child care homes or
child care centers the number and variety of vac-
cines so recommended.
‘‘(4) To the extent practicable, the immuniza-
tions will be administered only by the school nurse
or by other registered nurses licensed by the State
involved.
‘‘(5) A charge will not be imposed for the provi-
sion of the immunizations.
‘‘(6) Each participating school will notify the
families of the students of the school that the school
is providing the immunizations and of the impor-
tance of early immunization, and will answer paren-
tal inquiries about immunization.
‘‘(7)(A) In the case of the community in which
a participating school is located and the commu-
nities in which the students of the school reside, the
school will, subject to subparagraphs (B) and (C),
carry out in each such community a program to edu-
cate the residents of the community on—
‘‘(i) the availability from the school of im-
munizations;
‘‘(ii) the importance of children receiving
the number and variety of immunizations
recommended by the American Academy of
Pediatrics;
‘‘(iii) the fact that no significant adverse
health consequences result from administering
immunizations to children during periods in
which the children have common illnesses; and
‘‘(iv) the availability of other health, edu-
cational, or social services from public and non-
profit entities in the geographic area involved.
‘‘(B) In educating residents for purposes of
subparagraph (A), each participating school will
carry out the program of education for individuals
caring for children in child care homes and child
care centers, and will carry out the program for all
parents of newborn infants.
‘‘(C) Such program of education will be coordi-
nated among each participating school (and such
schools will not carry out duplicative activities in a
community) and will be coordinated with local health
departments, hospitals and maternity wards, birth
registries, and community health centers.
‘‘(8) In the case of the purposes for which a
grant under subsection (a) may be expended, the
local educational agency will maintain expenditures
of non-Federal amounts for such purposes at a level
that is not less than the level of such expenditures
maintained by the agency for the fiscal year preced-
ing the first fiscal year for which the agency receives
such a grant.
‘‘(d) REQUIRED PRIOR ARRANGEMENTS FOR PRO-
GRAMS.—
‘‘(1) PROVISION BY STATE OF SUPPLY OF VAC-
CINES.—The Secretary may make a grant under
subsection (a) to a local educational agency only if
the agency has entered into an agreement with the
State involved under which the State will, for pur-
poses of the program operated by the agency with
the grant, provide to the agency a supply of vaccines
that is satisfactory to the Secretary in terms of the
quantity of vaccines supplied and the charge im-
posed for the vaccines.
‘‘(2) PARTICIPANTS
IN
PROGRAM
OF
PUBLIC
EDUCATION.—With respect to the program of edu-
cation described in subsection (c)(7), the Secretary
may make a grant under subsection (a) only if the
local educational agency involved has entered into
such agreements as may be necessary to ensure that,
for purposes of educating a substantial number of
individuals, an appropriate number and variety of
public and private entities participate in the pro-
gram and that the activities of the program are co-
ordinated among such entities.
‘‘(e) REQUIREMENT
OF APPLICATION.—The Sec-
retary may make a grant under subsection (a) only if an
application for the grant is submitted to the Secretary
containing the agreements required in this section, and the
application is in such form, is made in such manner, and
contains such other agreements, and such assurances and
information, as the Secretary determines to be necessary
to carry out this section.
‘‘(f) CERTAIN EXPENDITURES OF GRANT.—
‘‘(1) CERTAIN PERMISSIBLE EXPENDITURES.—
The purposes for which a grant under subsection (a)
may be expended by a local educational agency in-
clude—
‘‘(A) carrying out the program of edu-
cation described in subsection (c)(7); and
‘‘(B) recruiting and retaining a school
nurse, without regard to whether the functions
of the nurse will include functions other than
the functions of the program carried out under
subsection (a).
‘‘(2) GENERAL LIMITATION.—In the case of the
costs of establishing or operating a program under
subsection (a), the Secretary may not authorize a
local educational agency receiving a grant under
such subsection to expend more than 15 percent of
the grant for such costs that are not directly related
to the provision of immunizations at participating
schools.
‘‘(g) DEFINITIONS.—For purposes of this section:
‘‘(1) The term ‘immunizations’ means immuni-
zations against vaccine-preventable diseases.
‘‘(2) The term ‘local educational agency’ has
the meaning given such term in section 1471 of the
Elementary and Secondary Education Act of 1965.
‘‘(3) The term ‘participating school’ means a
school described in subsection (b) at which an agen-
cy is providing immunizations with a grant under
subsection (a).
‘‘(4) The term ‘school nurse’ means a nurse de-
scribed in subsection (c)(2).
‘‘(h) FUNDING.—
‘‘(1) AUTHORIZATION
OF
APPROPRIATIONS.—
For the purpose of carrying out this section, there
are authorized to be appropriated $4,000,000 for
fiscal year 1994, and such sums as may be nec-
essary for each of the fiscal years 1995 and 1996.
‘‘(2) INITIAL
NUMBER
OF
GRANTS.—For the
first fiscal year for which amounts are appropriated
under paragraph (1), the Secretary may not make
more than 10 grants under subsection (a).’’.
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