WSR 18-06-090

PREPROPOSAL STATEMENT OF INQUIRY

[Filed March 6, 2018, 4:05 p.m.]

Subject of Possible Rule Making: Chapter 246-105 WAC, Immunization of child care and school children against certain vaccine-preventable diseases, the state board of health (board) will consider updating the rule regarding documentation of immunization status, the process for students who are in conditional status, the reference to the national immunization standards set by the advisory committee on immunization practices (ACIP), and improving clarity and usability.

Statutes Authorizing the Agency to Adopt Rules on this Subject: RCW 28A.210.140, 28A.210.080, 28A.210.100.

Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: The board will consider updating the rules to improve documentation of immunization status for school and child care entry. The current rule requires parents to report their child's immunizations on the certificate of immunization status before entry into schools and child care. This creates the need for immunization data entry and reentry at multiple points in the process, and creates a system where health care providers are not required to verify that these immunizations are medically valid. Eliminating additional data handoffs and ensuring immunizations are medically valid will help reduce immunization documentation errors in the immunization information system. Updating the rules will improve immunization documentation for children entering school or child care, help schools and child care accurately determine immunization compliance, and provide accurate information for schools and child care to determine if a child is adequately protected in case there is an outbreak of a vaccine-preventable disease.

The board also received requests from several school nurses in 2016 asking to change its rule (chapter 246-105 WAC) to require students to be fully immunized before school entry. The board decided at the time not to engage in rule making and instead suggested that board and department of health (department) staff continue the discussion with stakeholders about strategies to reduce the administrative burden to schools while decreasing the number of children who are out of compliance with school immunization requirements. As board and department staff engage with stakeholders and partners to discuss the potential immunization compliance rule making, staff will use these conversations to also discuss topics and issues related to conditional status and determine if rule making is necessary.

In addition, staff will consider updating the reference to the national immunization standards set by ACIP from the 2017 publication to the current publication. The intent is to provide clarity and consistency for stakeholders by pointing existing guidelines referenced in rule to the most current national immunization standards published by ACIP.

Other Federal and State Agencies that Regulate this Subject and the Process Coordinating the Rule with These Agencies: The department and the board will work collaboratively to update the rule. This will be coordinated through in-person meetings that will include the department of health, office of immunization and child profile senior policy analyst, subject matter experts, and the OICP director. This process will include a rule-making timeline and work plan to help guide this collaborative work.

The board and department will also consult with the office of the superintendent of public instruction, the Washington state department of early learning throughout the rule-making process, and the United States Department of Defense school liaison officer(s).

Process for Developing New Rule: The board and department will use a collaborative rule-making process in developing the proposed rules. The board may consult with an advisory committee to receive recommendations for rule revision. If an advisory committee will be used, it will include school and child care personnel, parents, and other interested stakeholders. Once draft rules are prepared, the board will use a broader informal review and comment process to gather further input prior to the formal proposal of rules and public hearing. The board and department will also take advantage of any standing meetings with stakeholder organizations to inform and involve them in the rule-development process.

Interested parties can participate in the decision to adopt the new rule and formulation of the proposed rule before publication by contacting Michelle Weatherly, P.O. Box 47843, Olympia, WA 98504-7843, phone 360-236-3483, fax 360-236-3591, TTY 360-833-6388 or 711, email michelle.weatherly@doh.wa.gov; or Alexandra Montano, P.O. Box 47990, Olympia, WA 98504-7990, phone 360-236-4106, fax 360-236-4088, TTY 360-833-6388 or 711, email alexandra.montano@sboh.wa.gov.

Additional comments: If you would like to be added to the listserv for this rule making email WSBOH@SBOH.WA.GOV with the subject line "Immunizations - Subscribe."

March 6, 2018

Michelle A. Davis

Executive Director