6418-S

AN ACT Relating to immunizations; adding new sections to chapter 43.70 RCW; adding a new section to chapter 43.20A RCW; adding a new section to chapter 70.47 RCW; adding a new section to chapter 41.05 RCW; and creating a new section.

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

NEW SECTION. Sec. 1. A new section is added to chapter 43.70 RCW to read as follows:

INTENT‑-DECLARATION. 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 disabling and life-threatening diseases;

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

(4) Adults may not be aware 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 adults and children should be appropriately immunized.

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

STATE SERVICE RECIPIENTS‑-DEPARTMENT OF SOCIAL AND HEALTH SERVICES. (1) Upon federal approval of necessary waivers to implement sections 1 through 7 of this act, the parent or legal guardian of a child up to five years of age who is eligible to receive services from, through, or purchased by the department is responsible for providing to the department within ninety days of receiving such services:

(a) A certificate showing that the child has completed the state board of health recommended infectious disease immunization schedule, and the minimum standards for the early and periodic screening, diagnosis, and treatment schedule for preschool children or is making satisfactory progress in complying with the schedule;

(b) A waiver signed by a physician licensed under chapter 18.71 or 18.57 RCW stating that a particular vaccine is not medically advisable for the child. If it is determined by the physician that a particular vaccine is not contraindicated, the child will be required to receive the immunization;

(c) A written certification signed by a parent or legal guardian of the child stating that the signer has objections to the required immunizations based upon religious beliefs; or

(d) A written certification signed by a parent or legal guardian of the child stating that the signer has either a philosophical or personal objection to immunizing the child.

(2) The secretary shall grant to parents or guardians of children who are receiving department services on or before the effective date of this section, ninety days to comply with the requirements of this section.

(3) The secretary shall decide the manner in which certificates and waivers required by this section shall be prepared and made available.

(4) The secretary may establish by rule a procedure to periodically check whether children are making satisfactory progress in complying with the appropriate immunization schedules. The monitoring shall, to the extent possible, be conducted during the course of routine contact with the parent or guardian of the child.

(5) The secretary shall coordinate with the secretary of health, in the preparation of certificates and waivers and required for the administration of this section to assure minimum paperwork and prevent duplicative compliance requirements for children receiving state services or benefits from more than one state agency.

(6) The secretary shall seek whatever federal waivers are necessary to implement the provisions of this section.

(7) The secretary shall establish a pilot program under this section, either in one departmental region or in a group of community service offices representational of the average demographics of public assistance recipients in the state of Washington. The department shall track and analyze data regarding immunization compliance in the pilot area.

(8) The secretary may provide support services to families, as needed, including translation and cultural services, in order that they understand and fulfill their responsibilities under this section. If parents cannot meet responsibilities under this section, the department shall work with them until they are able to comply with one of the options in subsection (1) (a) through (d) of this section.

NEW SECTION. Sec. 3. A new section is added to chapter 43.70 RCW to read as follows:

STATE SERVICE RECIPIENTS--DEPARTMENT OF HEALTH. (1) Upon federal approval of necessary waivers to implement sections 1 through 7 of this act, the parent or guardian of a child under age five who is eligible to receive services from, through, or purchased by the department is responsible for providing to the department within ninety days of receiving such services:

(a) A certificate showing that the child has completed the state board of health recommended infectious disease immunization schedule or is making satisfactory progress in complying with the schedule;

(c) A written certification signed by a parent or legal guardian of the child stating that the signer has objections to the required immunizations based upon religious beliefs; or

(d) A written certification signed by a parent or legal guardian of the child stating that the signer has either a philosophical or personal objection to immunizing the child.

(3) The secretary shall decide the manner in which certificates and waivers required by this section may be prepared and made available.

(5) The secretary shall coordinate with the secretary of social and health services in the preparation of certificates and waivers and required for the administration of this section to assure minimum paperwork and duplicative compliance requirements for children receiving state services or benefits from more than one state agency.

(6) The secretary shall seek whatever federal waivers are necessary to implement the provisions of this section.

(7) The secretary may provide support services to families, as needed, including translation and cultural services, in order that they understand and fulfill their responsibilities under this section. If parents cannot meet responsibilities under this section, the department shall work with them until they are able to comply with one of the options in subsection (1) (a) through (d) of this section.

NEW SECTION. Sec. 4. A new section is added to chapter 70.47 RCW to read as follows:

STATE-SUBSIDIZED HEALTH CARE INSURANCE RECIPIENTS--BASIC HEALTH PLAN. (1) Upon federal approval of necessary waivers to implement sections 1 through 7 of this act, the parent or guardian of a child under age five who is enrolled in the plan is responsible for providing to the plan administrator within ninety days of enrollment:

(c) A written certification signed by a parent or legal guardian of the child stating that the signer has objections to the required immunizations based upon religious beliefs; or

(d) A written certification signed by a parent or legal guardian of the child stating that the signer has either a philosophical or personal objection to immunizing the child.

(2) The administrator shall grant to parents and guardians of children enrolled in the plan on or before the effective date of this section, ninety days to comply with the requirements of this section.

(3) The administrator shall decide the manner in which certificates and waivers required by this section shall be prepared and made available.

(4) The administrator may establish by rule a procedure to periodically check whether children are making satisfactory progress in complying with the appropriate immunization schedules. The monitoring shall, to the extent possible, be conducted when the parent or guardian of the child has routine contact with the plan or health care contractors authorized to provide services under the plan.

(5) The administrator may provide support services to families, as needed, including translation and cultural services, in order that they understand and fulfill their responsibilities under this section. If parents cannot meet responsibilities under this section, the department shall work with them until they are able to comply with one of the options in subsection (1) (a) through (d) of this section.

NEW SECTION. Sec. 5. A new section is added to chapter 41.05 RCW to read as follows:

STATE EMPLOYEE BENEFIT RECIPIENTS--STATE HEALTH CARE AUTHORITY. (1) Upon federal approval of necessary waivers to implement sections 1 through 7 of this act, the parent or guardian of a child under age five who is enrolled as a dependent in the plan is responsible for providing to the administrator within ninety days of enrollment:

(c) A written certification signed by a parent or legal guardian of the child stating that the signer has objections to the required immunizations based upon religious beliefs; or

(d) A written certification signed by a parent or legal guardian of the child stating that the signer has either a philosophical or personal objection to immunizing the child.

(3) The administrator shall decide the manner in which certificates and waivers required by this section shall be prepared and made available.

(4) The administrator may establish by rule a procedure to periodically check whether children are making satisfactory progress in complying with the appropriate immunization schedules. The monitoring shall, to the extent possible, be conducted when the parent or guardian of the child has any routine contact with the plan or health care contractors authorized to provide services under the plan. The administrator shall adopt standards for encouraging immunizations under this section.

NEW SECTION. Sec. 6. A new section is added to chapter 43.70 RCW to read as follows:

IMMUNIZATION ASSESSMENT AND ENHANCEMENT PROPOSALS. (1) The department shall require that each local health jurisdiction submit an immunization assessment and enhancement proposal to assist public agencies to obtain compliance with the terms of sections 1 through 5 of this act. The proposal shall meet the requirements of this section. It shall include a description of how the local health jurisdictions will consult and involve existing health care providers that have previously been involved in the administration of state-supplied immunizations or have shown an interest to become involved.

(2) A local health jurisdiction must include at least the following in the proposal:

(a) A description of the population groups in the jurisdiction that are in greatest need for immunizations;

(b) A description of providers in the jurisdiction that are capable and willing to administer immunizations and how the providers will be utilized in enhancing immunization compliance with established target rates;

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

(e) A description of strategies to use outreach, volunteer, and other local educational resources to enhance immunization rates.

(3) The secretary shall approve the immunization assessment and enhancement proposal if he or she finds it offers maximum feasible likelihood of providing ready access to affordable immunization for all state residents including recipients of publicly funded services.

(4) This section shall be implemented consistent with available funding.

(5) The funding authorized under this act shall be used to supplement but not replace current fees used to support local immunization efforts that are charged to patients.

(6) The secretary shall report biennially to the health care and fiscal committees of the house of representatives and senate on the status of the program and progress made toward target immunization rates, which he or she may establish in rule.

NEW SECTION. Sec. 7. A new section is added to chapter 43.70 RCW to read as follows:

COMPLIANCE. If the recipient of a service provided by the department of social and health services or the department of health fails to comply with the provisions of sections 1 through 6 of this act, the secretaries of health or social and health services shall withhold twenty-five dollars of the benefits the recipients may be receiving for each month until compliance is documented according to the terms of sections 1 through 6 of this act. Any withheld benefits shall be promptly reinstated to recipients upon proof of compliance or exemption from compliance under sections 1 through 6 of this act.

NEW SECTION. Sec. 8. Captions used in this act do not constitute any part of the law.