CALIFORNIA SCHOOL CODES AND REGULATIONS California Department of

CALIFORNIA SCHOOL CODES AND REGULATIONS California Department of Public Health Immunization Branch

Sandra Jo Hammer, RN, MSN, MPH Nurse Consultant III Immunization Branch California Department of Public Health (510) 620 -3735 E-mail: Sandrajo. Hammer@CDPH. CA. GOV California Department of Public Health Immunization Branch

Polio vaccine was delivered in schools California Department of Public Health Immunization Branch

History of CA School Law Smallpox 1961 Polio 1967 Measles 1972 Diphtheria, Tetanus, Pertussis 1980 Mumps, Rubella Broad regulatory authority to DHS 1991 1977 Enforcement, implementation strengthened; Day care added Hib Hep B, 7 th Gr 1994 1992 -6 Family Childcare Pertussis 2011 1999 1997 Hep B at K 2001 Varicella California Department of Public Health Immunization Branch

Vaccines: Required vs. Recommended • Required is by state law and/or regulations • Recommended is by a recognized group or advising agency (CDC, ACIP, AAP) and is practice standard • Very important: ØDo not to use the two words as the same Ø Recognize the difference. California Department of Public Health Immunization Branch

Vaccines Required § Vaccines required are specific or can be determined by the department • California H&S Code, Section 120325 -120380 § Authority to department (CDPH) to implement vaccine and dose requirements via regulations (rules) • California Code of Regulations (CCR), Title 17 § 6000 -6075) California Department of Public Health Immunization Branch

Vaccines Required § Code restrictions must be accommodated in regulations • Varicella • Age restriction • Example: 7 th grade Hepatitis B California Department of Public Health Immunization Branch

HEALTH AND SAFETY CODE SECTION 120325 -120380 …it is the intent of the Legislature to provide: (a) A means for the eventual achievement of total immunization of appropriate age groups against the following childhood diseases: (1) (2) (3) (4) Diphtheria. Hepatitis B. Haemophilus influenzae type b. Measles. (5) (6) (7) (8) (9) Mumps. Pertussis (whooping cough). Poliomyelitis. Rubella. Tetanus. Any other disease that is consistent with the most current recommendations of the United States Public Health Services' Centers for Disease Control Immunization Practices Advisory Committee and the American Academy of Pediatrics Committee of Infectious Diseases, and deemed appropriate by the department. California Department of Public Health Immunization Branch

Regulations 120330. The department, in consultation with the Department of Education, shall adopt and enforce all regulations necessary to carry out Chapter 1…. California Department of Public Health Immunization Branch

What are regulations? (CCR, Title 17, § 6020) § “The rules” • Definitions, like what is a pupil, what is school entry • Number of vaccine doses by age and grade (table on page D-78 of blue book) • Unconditional and conditional admission California Department of Public Health Immunization Branch

Nothing is Easy! § California Immunization Childcare and School Laws and Regulations are complicated • Based on number of doses received • Requires California Department of Public Health Immunization Branch

Why was Varicella Different? (10) Varicella (chickenpox), effective July 1, 2001. Persons already admitted into California public or private schools at the kindergarten level or above before July 1, 2001, shall be exempt from the varicella immunization requirement for school entry. California Department of Public Health Immunization Branch

Varicella California Department of Public Health Immunization Branch

CALIFORNIA SCHOOL CODES AND REGULATIONS California Department of Public Health Immunization Branch

California Department of Public Health Immunization Branch

Shotsfor. School. org Website California Department of Public Health Immunization Branch

California Department of Public Health Immunization Branch

Footnote regarding 4 -day “grace period” In some situations, local or state requirements may mandate that doses of certain vaccines be administered on or after specific ages. For example, a school entry requirement may not accept a dose of MMR or varicella vaccine given prior to the first birthday. California will accept any dose administered up to 4 days before a specific birthday except Tdap. California Department of Public Health Immunization Branch

Pertussis 7 th Grade Requirement On and after July 1, 2012, the governing authority shall not unconditionally admit any pupil to the 7 th grade level, nor unconditionally advance any pupil to the 7 th grade level, of any of the institutions listed in subdivision (b) unless the pupil has been fully immunized against Pertussis. California Department of Public Health Immunization Branch

Materials for Schools – Tdap Sticker California Department of Public Health Immunization Branch

Vaccine Exemptions California Department of Public Health Immunization Branch

Medical Exemption’s (PME’s) § Allowed by statute and regulation in California § Can be temporary or permanent § Must have signed physician statement describing circumstance and length of exemption California Department of Public Health Immunization Branch

Personal Belief Exemptions (PBE’s) § Allowed by statute and regulation in California § Should not be used a “convenience” but reflect parent’s beliefs California Department of Public Health Immunization Branch

PBE § Parent or guardian must submit letter or affidavit • “Blue card” provides an affidavit for parents § For 7 th grade, a separate PBE form provided or submit letter or affidavit California Department of Public Health Immunization Branch

California Department of Public Health Immunization Branch

California Department of Public Health Immunization Branch

PBE Education California Department of Public Health Immunization Branch

Schools’ Responsibilities § Complete a CA Student Immunization Record for each child (CSIR – “blue cards”) Unconditionally admit all students who have completed required number of doses • Conditionally admit students who are “up-to-date”. Follow-up with these students when doses become due • Admit children with signed PBE affidavit (back of blue card, 7 th grade sheet) or medical exemptions § Exclude students not up-to-date, conditional admissions who have not complied with series continuation or completion § Complete and submit California School Assessment Forms on-line California Department of Public Health Immunization Branch

‘New’ 7 th Grade Reporting Page California Department of Public Health Immunization Branch

Additions to School Law § Bills can always be introduced that might affect school immunization law • Nothing is law until it is signed by the governor • CDPH can not comment on any bill in process § Process issues • New bill (law) – maybe swift • Regulations – often take years but “overhaul” package is in process § Budget can be a barrier • All bills and regulations require fiscal analysis California Department of Public Health Immunization Branch

California Department of Public Health Immunization Branch