BP BHEAD INT H

AN ACT Relating to immunization; adding a new section to chapter 43.20 RCW; adding new sections to chapter 43.70 RCW; and declaring an emergency.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION. Sec. 1. The legislature finds that:

(1) There has been an increase in the number of children contracting vaccine-preventable infectious diseases;

(2) This trend has occurred despite the availability of safe and effective immunizations which can prevent these debilitating and life-threatening diseases;

(3) Parents and guardians of children are often unaware of the need for timely immunizations and the public health risks of the failure to be properly immunized;

(4) Many adults are unaware of their risk of contracting vaccine-preventable infectious diseases and the availability of effective immunizations.

The legislature declares that it is in the public health interest of the people of the state of Washington that all children and adults should be properly immunized.

NEW SECTION. Sec. 2. A new section is added to chapter 43.20 RCW to read as follows:

(1) The state board of health shall adopt rules by October 1, 1993, that establish a schedule of appropriate immunizations against vaccine-preventable infectious diseases for children and adults. The schedule shall include the type of immunization recommended and the appropriate age for receiving vaccines. The state board of health shall consider and define increased risk factors for vaccine-preventable disease for adults in special settings or with special workplace hazards. When implementing this section the state board of health shall consider recommended immunization schedules developed by such entities as the United States public health service advisory committee on immunization practices and the American academy of pediatrics committee on infectious diseases, or their successors. The state board of health may modify by rule the recommended immunization schedule from time to time based on emerging medical and public health needs.

(2) The state board of health shall make immunization schedules required by this section available to the secretary of health, the secretary of social and health services, and the general public no later than November 1, 1993.

(3) The state board of health shall develop rules for storage, maintenance, and delivery of state-purchased vaccine products consistent with national standards. The state board of health shall consider recommendations by the product manufacturer, the federal centers for disease control, the United States public health service advisory committee on immunization practices, and the American academy of pediatrics committee on infectious diseases, or their successors. The rules shall include appropriate and updated education for providers of vaccine products which is consistent with national standards. In adopting rules regarding education for providers, the state board of health shall consider recommendations from the federal centers for disease control, the United States public health service advisory committee on immunization practices, and the American academy of pediatrics committee on infectious diseases, or their successors.

(4) The state board of health shall adopt rules which require proof of immunization of students entering public and private higher education programs in this state, including four-year institutions, community colleges, and vocational schools.

NEW SECTION. Sec. 3. (1) Effective July 1, 1993, the secretary of health, in consultation with the department of social and health services, shall establish up to five demonstration projects for the purpose of increasing immunization utilization rates among preschool children. The projects shall be established to identify the most effective, cost-efficient, and least burdensome manner to achieve immunization target rates as a part of the programs. In the development of projects, the secretary of health shall utilize age-appropriate immunization schedules as developed by the state board of health by rule. The secretary of health shall also consider enhanced immunization target rates as established in national public health goals regarding vaccine-preventable infectious diseases.

In selecting demonstration project sites, the secretary of health shall select sites in both rural and urban areas of the state and in areas east and west of the Cascade mountains. The projects shall be structured in a manner to permit the evaluation of different approaches to enhance timely immunization utilization rates among the targeted population. The projects shall be utilized to demonstrate a state-wide registry system as provided in section 5 of this act. In meeting the requirements of this section, the secretary of health shall establish projects using specific state-administered social and health services programs for preschool children. Projects may also be determined by selecting particular geographic regions of the state which show high incidence rates or low utilization rates of immunizations, or both. Projects may also be delivered through community health providers which have authorized participation in state-supplied vaccine delivery.

(2) The secretary of health shall report biennially to the appropriate standing committees of the senate and the house of representatives with an evaluation of the effectiveness of the various methods used to enhance immunization target rates.

NEW SECTION. Sec. 4. (1) The secretary of health shall establish an immunization enhancement grant program for the purpose of providing funding to counties for activities that increase immunization for vaccine-preventable infectious diseases, with an emphasis on program components for timely immunization of preschool children. The department of health shall request that each local health department submit a county immunization enhancement plan that meets the requirements of subsection (2) of this section. The plan shall include a description of how the local health department will consult and involve existing health care providers within its jurisdiction where the providers have previously been involved in the administration of state-supplied immunizations or have shown an interest in becoming involved. The plan shall include the establishment of a county-wide immunization task force. This task force shall include, but not be limited to, members from social and health services, public health, and minority outreach communities, community service organizations, private medical providers, and advocacy groups.

(2) The immunization enhancement plan shall include at least the following components:

(a) A description of the population groups in the county which are in greatest need of immunizations;

(b) A description of providers in the county capable of and willing to administer immunizations and how the providers will be used in the implementation of the plan;

(c) A description of steps to meet immunization target rates set forth by the department of health and national public health goals;

(d) A description of how the plan will be implemented;

(e) A description of current fees used to support local immunization efforts and charged to patients. Funding provided through grants shall be used to supplement not replace such fees;

(f) An analysis of financial and nonfinancial barriers that are preventing children from receiving immunizations and a description of how the plan will remove such barriers;

(g) A description of strategies to use outreach, volunteer, and other local educational resources to increase immunization awareness and to enhance utilization of immunization;

(h) A description of how implementation of the plan will be coordinated with other state and local vaccine-preventable infectious disease immunization efforts;

(i) A program of utilization of the state-wide immunization registry set forth in section 5 of this act; and

(j) An annual program evaluation to be reviewed by the department of health.

(3) The secretary of health shall use immunization target rates in approving local immunization enhancement plans and for monitoring and evaluating progress toward implementing the plans.

(4) The secretary of health shall approve the immunization enhancement plans and disperse the program funding.

(5) The secretary of health may contract with a nonprofit entity to prepare and administer the immunization enhancement plan should a plan not be submitted by the local health department or not approved by the department of health.

(6) This section shall be implemented consistent with available funds.

(7) The secretary of health shall report biennially to the appropriate standing and fiscal committees of the senate and the house of representatives on the status of the program and progress made toward meeting the immunization target rates.

NEW SECTION. Sec. 5. (1) The secretary of health shall establish a state-wide registry for immunization tracking. In selecting a system of registry, the secretary of health shall consult with the federal centers for disease control for partnership in a national registry. The secretary of health shall establish an immunization advisory committee which will assist in the selection and implementation of a state-wide immunization registry and provide consultation on all other components of this chapter. The department shall request funding for design, implementation, maintenance, and evaluation of a state-wide immunization registry. The secretary of health may choose to use additional funding from grants and donations for immunization program enhancement.

(2) Appropriate funding shall be requested by the department of health for a five-year state-wide awareness campaign. This campaign shall enhance existing community resources and support the local grant process with a state-wide campaign.

NEW SECTION. Sec. 6. Sections 1 and 3 through 5 of this act are each added to chapter 43.70 RCW.

NEW SECTION. Sec. 7. This act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and shall take effect immediately.