104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 HB1374

Introduced , by Rep. Jennifer Gong-Gershowitz

SYNOPSIS AS INTRODUCED:

105 ILCS 5/27-8.1 from Ch. 122, par. 27-8.1

Amends the School Code. In provisions concerning health examinations and immunizations, requires questions on the safe storage of firearms in a child's home to be included as a part of each health examination. Requires the Department of Public Health to develop rules and appropriate revisions to the child health examination form to implement this requirement.

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A BILL FOR

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1 AN ACT concerning education.

2 Be it enacted by the People of the State of Illinois,

3 represented in the General Assembly:

4 Section 5. The School Code is amended by changing Section

5 27-8.1 as follows:

6 (105 ILCS 5/27-8.1) (from Ch. 122, par. 27-8.1)

7 Sec. 27-8.1. Health examinations and immunizations.

8 (1) In compliance with rules and regulations which the

9 Department of Public Health shall promulgate, and except as

10 hereinafter provided, all children in Illinois shall have a

11 health examination as follows: within one year prior to

12 entering kindergarten or the first grade of any public,

13 private, or parochial elementary school; upon entering the

14 sixth and ninth grades of any public, private, or parochial

15 school; prior to entrance into any public, private, or

16 parochial nursery school; and, irrespective of grade,

17 immediately prior to or upon entrance into any public,

18 private, or parochial school or nursery school, each child

19 shall present proof of having been examined in accordance with

20 this Section and the rules and regulations promulgated

21 hereunder. Any child who received a health examination within

22 one year prior to entering the fifth grade for the 2007-2008

23 school year is not required to receive an additional health

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1 examination in order to comply with the provisions of Public

2 Act 95-422 when he or she attends school for the 2008-2009

3 school year, unless the child is attending school for the

4 first time as provided in this paragraph.

5 A tuberculosis skin test screening shall be included as a

6 required part of each health examination included under this

7 Section if the child resides in an area designated by the

8 Department of Public Health as having a high incidence of

9 tuberculosis. Additional health examinations of pupils,

10 including eye examinations, may be required when deemed

11 necessary by school authorities. Parents are encouraged to

12 have their children undergo eye examinations at the same

13 points in time required for health examinations.

14 (1.5) In compliance with rules adopted by the Department

15 of Public Health and except as otherwise provided in this

16 Section, all children in kindergarten and the second, sixth,

17 and ninth grades of any public, private, or parochial school

18 shall have a dental examination. Each of these children shall

19 present proof of having been examined by a dentist in

20 accordance with this Section and rules adopted under this

21 Section before May 15th of the school year. If a child in the

22 second, sixth, or ninth grade fails to present proof by May

23 15th, the school may hold the child's report card until one of

24 the following occurs: (i) the child presents proof of a

25 completed dental examination or (ii) the child presents proof

26 that a dental examination will take place within 60 days after

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1 May 15th. A school may not withhold a child's report card

2 during a school year in which the Governor has declared a

3 disaster due to a public health emergency pursuant to Section

4 7 of the Illinois Emergency Management Agency Act. The

5 Department of Public Health shall establish, by rule, a waiver

6 for children who show an undue burden or a lack of access to a

7 dentist. Each public, private, and parochial school must give

8 notice of this dental examination requirement to the parents

9 and guardians of students at least 60 days before May 15th of

10 each school year.

11 (1.10) Except as otherwise provided in this Section, all

12 children enrolling in kindergarten in a public, private, or

13 parochial school on or after January 1, 2008 (the effective

14 date of Public Act 95-671) and any student enrolling for the

15 first time in a public, private, or parochial school on or

16 after January 1, 2008 (the effective date of Public Act

17 95-671) shall have an eye examination. Each of these children

18 shall present proof of having been examined by a physician

19 licensed to practice medicine in all of its branches or a

20 licensed optometrist within the previous year, in accordance

21 with this Section and rules adopted under this Section, before

22 October 15th of the school year. If the child fails to present

23 proof by October 15th, the school may hold the child's report

24 card until one of the following occurs: (i) the child presents

25 proof of a completed eye examination or (ii) the child

26 presents proof that an eye examination will take place within

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1 60 days after October 15th. A school may not withhold a child's

2 report card during a school year in which the Governor has

3 declared a disaster due to a public health emergency pursuant

4 to Section 7 of the Illinois Emergency Management Agency Act.

5 The Department of Public Health shall establish, by rule, a

6 waiver for children who show an undue burden or a lack of

7 access to a physician licensed to practice medicine in all of

8 its branches who provides eye examinations or to a licensed

9 optometrist. Each public, private, and parochial school must

10 give notice of this eye examination requirement to the parents

11 and guardians of students in compliance with rules of the

12 Department of Public Health. Nothing in this Section shall be

13 construed to allow a school to exclude a child from attending

14 because of a parent's or guardian's failure to obtain an eye

15 examination for the child.

16 (2) The Department of Public Health shall promulgate rules

17 and regulations specifying the examinations and procedures

18 that constitute a health examination, which shall include an

19 age-appropriate developmental screening, an age-appropriate

20 social and emotional screening, and the collection of data

21 relating to asthma and obesity (including at a minimum, date

22 of birth, gender, height, weight, blood pressure, and date of

23 exam), and a dental examination and may recommend by rule that

24 certain additional examinations be performed. The rules and

25 regulations of the Department of Public Health shall specify

26 that a tuberculosis skin test screening shall be included as a

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1 required part of each health examination included under this

2 Section if the child resides in an area designated by the

3 Department of Public Health as having a high incidence of

4 tuberculosis. With respect to the developmental screening and

5 the social and emotional screening, the Department of Public

6 Health must, no later than January 1, 2019, develop rules and

7 appropriate revisions to the Child Health Examination form in

8 conjunction with a statewide organization representing school

9 boards; a statewide organization representing pediatricians;

10 statewide organizations representing individuals holding

11 Illinois educator licenses with school support personnel

12 endorsements, including school social workers, school

13 psychologists, and school nurses; a statewide organization

14 representing children's mental health experts; a statewide

15 organization representing school principals; the Director of

16 Healthcare and Family Services or his or her designee, the

17 State Superintendent of Education or his or her designee; and

18 representatives of other appropriate State agencies and, at a

19 minimum, must recommend the use of validated screening tools

20 appropriate to the child's age or grade, and, with regard to

21 the social and emotional screening, require recording only

22 whether or not the screening was completed. The rules shall

23 take into consideration the screening recommendations of the

24 American Academy of Pediatrics and must be consistent with the

25 State Board of Education's social and emotional learning

26 standards. The Department of Public Health shall specify that

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1 a diabetes screening as defined by rule shall be included as a

2 required part of each health examination. Diabetes testing is

3 not required. Questions on the safe storage of firearms in a

4 child's home shall be included as a required part of each

5 health examination. The Department of Public Health shall

6 develop rules and appropriate revisions to the child health

7 examination form to implement this requirement. The questions

8 shall include: "Are there firearms in your home?" and "If so,

9 are they stored in a locked safe and inaccessible to any minor

10 in the home?".

11 Physicians licensed to practice medicine in all of its

12 branches, licensed advanced practice registered nurses, or

13 licensed physician assistants shall be responsible for the

14 performance of the health examinations, other than dental

15 examinations, eye examinations, and vision and hearing

16 screening, and shall sign all report forms required by

17 subsection (4) of this Section that pertain to those portions

18 of the health examination for which the physician, advanced

19 practice registered nurse, or physician assistant is

20 responsible. If a registered nurse performs any part of a

21 health examination, then a physician licensed to practice

22 medicine in all of its branches must review and sign all

23 required report forms. Licensed dentists shall perform all

24 dental examinations and shall sign all report forms required

25 by subsection (4) of this Section that pertain to the dental

26 examinations. Physicians licensed to practice medicine in all

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1 its branches or licensed optometrists shall perform all eye

2 examinations required by this Section and shall sign all

3 report forms required by subsection (4) of this Section that

4 pertain to the eye examination. For purposes of this Section,

5 an eye examination shall at a minimum include history, visual

6 acuity, subjective refraction to best visual acuity near and

7 far, internal and external examination, and a glaucoma

8 evaluation, as well as any other tests or observations that in

9 the professional judgment of the doctor are necessary. Vision

10 and hearing screening tests, which shall not be considered

11 examinations as that term is used in this Section, shall be

12 conducted in accordance with rules and regulations of the

13 Department of Public Health, and by individuals whom the

14 Department of Public Health has certified. In these rules and

15 regulations, the Department of Public Health shall require

16 that individuals conducting vision screening tests give a

17 child's parent or guardian written notification, before the

18 vision screening is conducted, that states, "Vision screening

19 is not a substitute for a complete eye and vision evaluation by

20 an eye doctor. Your child is not required to undergo this

21 vision screening if an optometrist or ophthalmologist has

22 completed and signed a report form indicating that an

23 examination has been administered within the previous 12

24 months.".

25 (2.5) With respect to the developmental screening and the

26 social and emotional screening portion of the health

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1 examination, each child may present proof of having been

2 screened in accordance with this Section and the rules adopted

3 under this Section before October 15th of the school year.

4 With regard to the social and emotional screening only, the

5 examining health care provider shall only record whether or

6 not the screening was completed. If the child fails to present

7 proof of the developmental screening or the social and

8 emotional screening portions of the health examination by

9 October 15th of the school year, qualified school support

10 personnel may, with a parent's or guardian's consent, offer

11 the developmental screening or the social and emotional

12 screening to the child. Each public, private, and parochial

13 school must give notice of the developmental screening and

14 social and emotional screening requirements to the parents and

15 guardians of students in compliance with the rules of the

16 Department of Public Health. Nothing in this Section shall be

17 construed to allow a school to exclude a child from attending

18 because of a parent's or guardian's failure to obtain a

19 developmental screening or a social and emotional screening

20 for the child. Once a developmental screening or a social and

21 emotional screening is completed and proof has been presented

22 to the school, the school may, with a parent's or guardian's

23 consent, make available appropriate school personnel to work

24 with the parent or guardian, the child, and the provider who

25 signed the screening form to obtain any appropriate

26 evaluations and services as indicated on the form and in other

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1 information and documentation provided by the parents,

2 guardians, or provider.

3 (3) Every child shall, at or about the same time as he or

4 she receives a health examination required by subsection (1)

5 of this Section, present to the local school proof of having

6 received such immunizations against preventable communicable

7 diseases as the Department of Public Health shall require by

8 rules and regulations promulgated pursuant to this Section and

9 the Communicable Disease Prevention Act.

10 (4) The individuals conducting the health examination,

11 dental examination, or eye examination shall record the fact

12 of having conducted the examination, and such additional

13 information as required, including for a health examination

14 data relating to asthma and obesity (including at a minimum,

15 date of birth, gender, height, weight, blood pressure, and

16 date of exam), on uniform forms which the Department of Public

17 Health and the State Board of Education shall prescribe for

18 statewide use. The examiner shall summarize on the report form

19 any condition that he or she suspects indicates a need for

20 special services, including for a health examination factors

21 relating to asthma or obesity. The duty to summarize on the

22 report form does not apply to social and emotional screenings.

23 The confidentiality of the information and records relating to

24 the developmental screening and the social and emotional

25 screening shall be determined by the statutes, rules, and

26 professional ethics governing the type of provider conducting

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1 the screening. The individuals confirming the administration

2 of required immunizations shall record as indicated on the

3 form that the immunizations were administered.

4 (5) If a child does not submit proof of having had either

5 the health examination or the immunization as required, then

6 the child shall be examined or receive the immunization, as

7 the case may be, and present proof by October 15 of the current

8 school year, or by an earlier date of the current school year

9 established by a school district. To establish a date before

10 October 15 of the current school year for the health

11 examination or immunization as required, a school district

12 must give notice of the requirements of this Section 60 days

13 prior to the earlier established date. If for medical reasons

14 one or more of the required immunizations must be given after

15 October 15 of the current school year, or after an earlier

16 established date of the current school year, then the child

17 shall present, by October 15, or by the earlier established

18 date, a schedule for the administration of the immunizations

19 and a statement of the medical reasons causing the delay, both

20 the schedule and the statement being issued by the physician,

21 advanced practice registered nurse, physician assistant,

22 registered nurse, or local health department that will be

23 responsible for administration of the remaining required

24 immunizations. If a child does not comply by October 15, or by

25 the earlier established date of the current school year, with

26 the requirements of this subsection, then the local school

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1 authority shall exclude that child from school until such time

2 as the child presents proof of having had the health

3 examination as required and presents proof of having received

4 those required immunizations which are medically possible to

5 receive immediately. During a child's exclusion from school

6 for noncompliance with this subsection, the child's parents or

7 legal guardian shall be considered in violation of Section

8 26-1 and subject to any penalty imposed by Section 26-10. This

9 subsection (5) does not apply to dental examinations, eye

10 examinations, and the developmental screening and the social

11 and emotional screening portions of the health examination. If

12 the student is an out-of-state transfer student and does not

13 have the proof required under this subsection (5) before

14 October 15 of the current year or whatever date is set by the

15 school district, then he or she may only attend classes (i) if

16 he or she has proof that an appointment for the required

17 vaccinations has been scheduled with a party authorized to

18 submit proof of the required vaccinations. If the proof of

19 vaccination required under this subsection (5) is not

20 submitted within 30 days after the student is permitted to

21 attend classes, then the student is not to be permitted to

22 attend classes until proof of the vaccinations has been

23 properly submitted. No school district or employee of a school

24 district shall be held liable for any injury or illness to

25 another person that results from admitting an out-of-state

26 transfer student to class that has an appointment scheduled

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1 pursuant to this subsection (5).

2 (6) Every school shall report to the State Board of

3 Education by November 15, in the manner which that agency

4 shall require, the number of children who have received the

5 necessary immunizations and the health examination (other than

6 a dental examination or eye examination) as required,

7 indicating, of those who have not received the immunizations

8 and examination as required, the number of children who are

9 exempt from health examination and immunization requirements

10 on religious or medical grounds as provided in subsection (8).

11 On or before December 1 of each year, every public school

12 district and registered nonpublic school shall make publicly

13 available the immunization data they are required to submit to

14 the State Board of Education by November 15. The immunization

15 data made publicly available must be identical to the data the

16 school district or school has reported to the State Board of

17 Education.

18 Every school shall report to the State Board of Education

19 by June 30, in the manner that the State Board requires, the

20 number of children who have received the required dental

21 examination, indicating, of those who have not received the

22 required dental examination, the number of children who are

23 exempt from the dental examination on religious grounds as

24 provided in subsection (8) of this Section and the number of

25 children who have received a waiver under subsection (1.5) of

26 this Section.

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1 Every school shall report to the State Board of Education

2 by June 30, in the manner that the State Board requires, the

3 number of children who have received the required eye

4 examination, indicating, of those who have not received the

5 required eye examination, the number of children who are

6 exempt from the eye examination as provided in subsection (8)

7 of this Section, the number of children who have received a

8 waiver under subsection (1.10) of this Section, and the total

9 number of children in noncompliance with the eye examination

10 requirement.

11 The reported information under this subsection (6) shall

12 be provided to the Department of Public Health by the State

13 Board of Education.

14 (7) Upon determining that the number of pupils who are

15 required to be in compliance with subsection (5) of this

16 Section is below 90% of the number of pupils enrolled in the

17 school district, 10% of each State aid payment made pursuant

18 to Section 18-8.05 or 18-8.15 to the school district for such

19 year may be withheld by the State Board of Education until the

20 number of students in compliance with subsection (5) is the

21 applicable specified percentage or higher.

22 (8) Children of parents or legal guardians who object to

23 health, dental, or eye examinations or any part thereof, to

24 immunizations, or to vision and hearing screening tests on

25 religious grounds shall not be required to undergo the

26 examinations, tests, or immunizations to which they so object

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1 if such parents or legal guardians present to the appropriate

2 local school authority a signed Certificate of Religious

3 Exemption detailing the grounds for objection and the specific

4 immunizations, tests, or examinations to which they object.

5 The grounds for objection must set forth the specific

6 religious belief that conflicts with the examination, test,

7 immunization, or other medical intervention. The signed

8 certificate shall also reflect the parent's or legal

9 guardian's understanding of the school's exclusion policies in

10 the case of a vaccine-preventable disease outbreak or

11 exposure. The certificate must also be signed by the

12 authorized examining health care provider responsible for the

13 performance of the child's health examination confirming that

14 the provider provided education to the parent or legal

15 guardian on the benefits of immunization and the health risks

16 to the student and to the community of the communicable

17 diseases for which immunization is required in this State.

18 However, the health care provider's signature on the

19 certificate reflects only that education was provided and does

20 not allow a health care provider grounds to determine a

21 religious exemption. Those receiving immunizations required

22 under this Code shall be provided with the relevant vaccine

23 information statements that are required to be disseminated by

24 the federal National Childhood Vaccine Injury Act of 1986,

25 which may contain information on circumstances when a vaccine

26 should not be administered, prior to administering a vaccine.

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1 A healthcare provider may consider including without

2 limitation the nationally accepted recommendations from

3 federal agencies such as the Advisory Committee on

4 Immunization Practices, the information outlined in the

5 relevant vaccine information statement, and vaccine package

6 inserts, along with the healthcare provider's clinical

7 judgment, to determine whether any child may be more

8 susceptible to experiencing an adverse vaccine reaction than

9 the general population, and, if so, the healthcare provider

10 may exempt the child from an immunization or adopt an

11 individualized immunization schedule. The Certificate of

12 Religious Exemption shall be created by the Department of

13 Public Health and shall be made available and used by parents

14 and legal guardians by the beginning of the 2015-2016 school

15 year. Parents or legal guardians must submit the Certificate

16 of Religious Exemption to their local school authority prior

17 to entering kindergarten, sixth grade, and ninth grade for

18 each child for which they are requesting an exemption. The

19 religious objection stated need not be directed by the tenets

20 of an established religious organization. However, general

21 philosophical or moral reluctance to allow physical

22 examinations, eye examinations, immunizations, vision and

23 hearing screenings, or dental examinations does not provide a

24 sufficient basis for an exception to statutory requirements.

25 The local school authority is responsible for determining if

26 the content of the Certificate of Religious Exemption

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1 constitutes a valid religious objection. The local school

2 authority shall inform the parent or legal guardian of

3 exclusion procedures, in accordance with the Department's

4 rules under Part 690 of Title 77 of the Illinois

5 Administrative Code, at the time the objection is presented.

6 If the physical condition of the child is such that any one

7 or more of the immunizing agents should not be administered,

8 the examining physician, advanced practice registered nurse,

9 or physician assistant responsible for the performance of the

10 health examination shall endorse that fact upon the health

11 examination form.

12 Exempting a child from the health, dental, or eye

13 examination does not exempt the child from participation in

14 the program of physical education training provided in

15 Sections 27-5 through 27-7 of this Code.

16 (8.5) The school board of a school district shall include

17 informational materials regarding influenza and influenza

18 vaccinations developed, provided, or approved by the

19 Department of Public Health under Section 2310-700 of the

20 Department of Public Health Powers and Duties Law of the Civil

21 Administrative Code of Illinois when the board provides

22 information on immunizations, infectious diseases,

23 medications, or other school health issues to the parents or

24 guardians of students.

25 (9) For the purposes of this Section, "nursery schools"

26 means those nursery schools operated by elementary school

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