An Act To O Protect Maine Children and Studentlfi\,m Preventable Diseases by Repealing Certain Exemptions from the Laws Governing Immunization Requirements
Maine Legislature, Session 129, LD 0798
Committee Amendment CA_A_H120 (House)
Amends: 20-A MRSA §6355, 20-A MRSA §6358, 20-A MRSA §6359, 22 MRSA §802

COMMITTEE AMENDMENT "A " to H.P. 586, L.D. 798, Bill, ''.An Act To 
O 
Protect Maine Children and Studentlfi\,m Preventable Diseases by Repealing Certain 
Exemptions from the Laws Governing Immunization Requirements" 
Amend the bill by inserting after the enacting clause and before section 1 the 
following; 
'Sec. 1. 20-A MRSA §6355, sub-§2, as amended by PL 2001, c. 326, §2, is 
further amended to read: 
2. 
Medical exemption. The parent or the child provides a physician's written 
statement from a licensed physician, nurse practitioner or physician assistant that, in the 
licensed physician's, nurse practitioner's or physician assistant's professional judgment, 
immunization against one or more of the diseases may be medically inadvisable.' 
Amend the bill by inserting after section 1 the following: 
'Sec. 2. 20-A MRSA §6355, sub-§4 is enacted to read: 
4. Student covered by individualized education plan. A student covered by an 
individualized education plan on September 1, 2021 who elected a philosophical or 
religious exemption from immunization requirements on or before September 1, 2021 
pursuant to the law in effect prior to that date may continue to attend school under that 
student's existing exemption as long as: 
A. 
The parent or guardian of the student provides a statement from a licensed 
physician, nurse practitioner or physician assistant that the physician, nurse 
practitioner or physician assistant has consulted with that parent or guardian and has 
made that parent or guardian aware of the risks and benefits associated with the 
choice to immunize; or 
B. If the student is 18 years of age or older, the student provides a statement from a 
licensed physician, nurse practitioner or physician assistant that the physician, nurse 
practitioner or physician assistant has consulted with that student and has made that 
student aware of the risks and benefits associated with the choice to immunize. 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT "A" to H.P. 586, L.D._ 798 
Sec. 3. 20-A MRSA §6358, as amended by PL 2001, c. 326, §3 and PL 2003, c. 
689, Pt. B, §6, is further amended to read: 
§6358. Rules; requirements; reports 
1. Rules authorized. The commissioner and the Director of the Bureau of Health, 
Maine Center for Disease Control and Prevention within the Department of Health and 
Human Services, shall jointly issue rules necessary for the effective implementation of 
this subchapter, including, but not limited to, rules specifying those diseases for which 
immunization is required and establishing school record keeping and reporting 
requirements or guidelines and procedures for the exclusion of nonimmunized children 
from school. The rules may not include any provision governing medical exemptions. 
Rules adopted pursuant to this subchapter are routine technical rules as defined in Title 5, 
chapter 375, subchapter 2-A except that rules adopted pursuant to this subchapter 
specifying the diseases for which immunization is required are major substantive rules as 
defined in Title 5, chapter 375, subchapter II-A 2-A. 
2. Local requirements authorized. Immunization requirements more stringent than 
the provisions of this subchapter may be adopted by ordinance enacted by a municipality, 
by regulation of a school board or by policy of a private school's governing board. 
3. Report. By January 1st of each odd-numbered year, the Director of the Maine 
Center for Disease Control and Prevention within the Department of Health and Human 
Services shall submit a report to the joint standing committees of the Legislature having 
jurisdiction over health and human services matters and education matters concerning any 
new developments in the evaluation of vaccine safety and effectiveness. 
The joint 
standing committees of the Legislature having jurisdiction over health and human 
services matters and education matters are each authorized to submit a bill during the 
legislative session in which the report was submitted. 
Sec. 4. 20-A MRSA §6359, sub:-§3, 1A, as amended by PL 1991, c. 146, §3, is 
further amended to read: 
· 
A. The parent or the student provides a physician's written statement or a written 
statement from a sohool health provider from a licensed physician, nurse practitioner 
or physician assistant that, in the physician's, nurse practitioner's or physician 
assistant's professional judgment, immunization against one or more of the diseases 
may be medically inadvisable.' 
· 
Amend the bill by inserting after section 2 the following: 
'Sec. 3. 20-A MRSA §6359, sub-§6, as amended by PL 1991, c. 146, §4, is 
further amended to read: 
6. Rules; requirements; reports. The Director of the Bureau of Health Maine 
Center for Disease Control and Prevention within the Department of Health and Human 
Services shall adopt rules necessary for the effective implementation of this subchapter, 
including, but not limited to, rules establishing immunization requirements and medical 
exceptions to receiving vaccines or toxoids for each disease, school record keeping and 
reporting requirements or guidelines and procedures for the exclusion of nonimmunized 
students from school. 
The rules may not include any provision governing medical 
exemptions. Rules adopted pursuant to this subchapter are routine technical rules as 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT "A" to H.P. 586, L.D. 798 
defined in Title 5, chapter 375, subchapter 2-A except that rules adopted pursuant to this 
subchapter specifying the diseases for which immunization is required are major 
substantive rules as defined in Title 5, chapter 375, subchapter 2-A. 
Immunization requirements more stringent than the provisions of this subchapter may be 
adopted by a school board or by policy of a private school's governing board. 
Sec. 4. 22 MRSA §802, sub-§4-B, ,fA, as enacted by PL 2001, c. 185, §2, is 
amended to read: 
· 
A. A medical exemption is available to an employee who provides a physioian1s 
written statement from a licensed physician, nurse practitioner or physician assistant 
that, in the physician's, nurse practitioner's or physician assistant's professional 
judgment, immunization against one or more diseases may be medically inadvisable.' 
Amend the bill in section 4 in paragraph A in the 6th line (page 1, line 15 in L.D.) by 
inserting after the following: 
11~' the following: 
1, nurse practitioner or physician 
assistant' 
Amend the bill by striking out all of section 5 and inserting the following: 
'Sec. 5. Rules. The Department of Education and the Department of Health and 
Human Services shall amend their rule.s to remove any rules exempting persons from 
immunization requirements because of their religious or philosophical beliefs. 
Rules adopted pursuant to this section are routine technical rules pursuant to the 
Maine Revised Statutes, Title 20-A, section 6358, subsection 1 and section 6359, 
subsection 6. 
Sec. 6. Effective date. Those sections of this Act that amend the Maine Revised 
Statutes, Title 22, section 802, subsection 4-B, paragraph A and Title 22, section 8402, 
subsection 3, paragraph A and that repeal Title 20-A, section 6355, subsection 3 and Title 
20-A, section 6359, subsection 3, paragraph B take effect September 1, 2021. 1 
Amend the bill by relettering or renumbering any nonconsecutive Part letter or 
section number to read consecutively. 
SUMMARY 
Current law allows exemptions from immunization requirements based on religious 
or philosophical beliefs for students in elementary and secondary schools and 
postsecondary schools and employees of nursery schools and health care facilities. This 
amendment, which is the majority report, removes those exemptions effective September 
1, 2021. 
Current law relating to emollment in any public or private elementary or secondary 
school provides that the superintendent may not permit any child to be emolled in or to 
attend school without a certificate of immunization for each disease or other acceptable 
evidence of required immunization or immunity against the disease except when the 
parent or child provides a physician's written statement that immunization against one or 
more of the diseases may be medically inadvisable. Instead, the amendment requires the 
parent or child to provide a written statement from a licensed physician, nurse practitioner 
or physician assistant that, in that physician's, nurse practitioner's or physician assistant's 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT ''-fi" to H.P. 586, L.D. 798 
professional judgment, immunization against one or more of the diseases may be 
medically inadvisable. 
Current law relating to immunization of students enrolled in any public or private 
postsecondary school provides that a chief administrative officer may not permit a student 
to be enrolled in or to attend a school without a certificate of immunization for each 
disease or other acceptable evidence of required immunization or immunity against the 
disease except when the parent or the student provides a physician's written statement or a 
written statement from a school health provider that immunization against one or more of 
the diseases may be medically inadvisable. Instead, the amendment requires that the 
parent or the student provide a written statement from a licensed physician, nurse 
practitioner or physician assistant that, in that physician's, nurse practitioner's or 
physician assistant's professional judgment, immunization against one or more of the 
diseases may be medically inadvisable. 
The amendment keeps the directive in the unallocated section of the bill to the 
Department of Education and the Department of Health and Human Services to remove 
any immunization exemptions based on religious or philosophical beliefs from their rules. 
The amendment places in statute the directive in the unallocated section of the bill 
allowing a student who is covered by an individualized education plan and has elected a 
philosophical or religious exemption from immunization requirements to continue to 
attend school under the existing exemption as long as a licensed physician, nurse 
practitioner or physician assistant provides a statement that the physician, nurse 
practitioner or physician assistant has provided information on the risks and benefits 
associated with the choice to immunize. 
The amendment also requires the Director of the Maine Center for Disease Control 
and Prevention within the Department of Health and Human Services to submit a report, 
by January 1st of each odd-numbered year, to the joint standing committees of the 
Legislature having jurisdiction over health and human services matters and education 
matters concerning any new developments in the evaluation of vaccine safety and 
effectiveness. The joint standing comttees of the Legislature having jurisdiction over 
health and human services matters and education matters are each authorized to submit a 
bill during the legislative session in which the report was submitted. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Approved: 04/12/19 :rwac.. 
LD 798 
LR 80(02) 
An Act To Protect Maine Children and Students from Preventable Diseases by Repealing Certain 
Exemptions from the Laws Governing Immunization Requirements 
Fiscal Detail and Notes 
Fiscal Note for Bill as Amended by Committee Amendment 'A, 1(}1-/ 2/J) 
Committee: Education and Cultural Affairs 
Fiscal Note Required: Yes 
Fiscal Note 
Minor cost increase - General Fund 
Any additional costs to the Department of Health and Human Services and the Depatiment of Education to adopt the 
changes in this bill are expected to be minor and can be absorbed within existing budgeted resources. 
LR0080(02) - Fiscal Note - Page 1 of 1