IL
Illinois House Bill HB5043

Illinois 2023-2024 Regular Session

Illinois House Bill HB5043 Compare Versions

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1+103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB5043 Introduced , by Rep. Maura Hirschauer SYNOPSIS AS INTRODUCED: 20 ILCS 2310/2310-70020 ILCS 2310/2310-391 rep.105 ILCS 5/27-8.1 from Ch. 122, par. 27-8.1 Amends the Department of Public Health Powers and Duties Law of the Civil Administrative Code of Illinois. Repeals a requirement for the Department of Public Health to provide to school districts educational materials on meningococcal disease and meningococcal vaccines. Amends the School Code to make conforming changes. LRB103 39160 RJT 69306 b A BILL FOR 103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB5043 Introduced , by Rep. Maura Hirschauer SYNOPSIS AS INTRODUCED: 20 ILCS 2310/2310-70020 ILCS 2310/2310-391 rep.105 ILCS 5/27-8.1 from Ch. 122, par. 27-8.1 20 ILCS 2310/2310-700 20 ILCS 2310/2310-391 rep. 105 ILCS 5/27-8.1 from Ch. 122, par. 27-8.1 Amends the Department of Public Health Powers and Duties Law of the Civil Administrative Code of Illinois. Repeals a requirement for the Department of Public Health to provide to school districts educational materials on meningococcal disease and meningococcal vaccines. Amends the School Code to make conforming changes. LRB103 39160 RJT 69306 b LRB103 39160 RJT 69306 b A BILL FOR
2+103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB5043 Introduced , by Rep. Maura Hirschauer SYNOPSIS AS INTRODUCED:
3+20 ILCS 2310/2310-70020 ILCS 2310/2310-391 rep.105 ILCS 5/27-8.1 from Ch. 122, par. 27-8.1 20 ILCS 2310/2310-700 20 ILCS 2310/2310-391 rep. 105 ILCS 5/27-8.1 from Ch. 122, par. 27-8.1
4+20 ILCS 2310/2310-700
5+20 ILCS 2310/2310-391 rep.
6+105 ILCS 5/27-8.1 from Ch. 122, par. 27-8.1
7+Amends the Department of Public Health Powers and Duties Law of the Civil Administrative Code of Illinois. Repeals a requirement for the Department of Public Health to provide to school districts educational materials on meningococcal disease and meningococcal vaccines. Amends the School Code to make conforming changes.
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10+A BILL FOR
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313 1 AN ACT concerning health.
414 2 Be it enacted by the People of the State of Illinois,
515 3 represented in the General Assembly:
616 4 Section 5. The Department of Public Health Powers and
717 5 Duties Law of the Civil Administrative Code of Illinois is
818 6 amended by changing Section 2310-700 as follows:
919 7 (20 ILCS 2310/2310-700)
1020 8 Sec. 2310-700. Influenza and meningococcal disease and
1121 9 vaccine information; school districts. The Department shall
1222 10 develop, provide, or approve and shall publish informational
1323 11 materials for school districts in this State regarding
1424 12 influenza and influenza vaccinations and meningococcal disease
1525 13 and meningococcal vaccinations in accordance with the latest
1626 14 information provided by the Advisory Committee on Immunization
1727 15 Practices of the Centers for Disease Control and Prevention.
1828 16 (Source: P.A. 100-977, eff. 1-1-19.)
1929 17 (20 ILCS 2310/2310-391 rep.)
2030 18 Section 10. The Department of Public Health Powers and
2131 19 Duties Law of the Civil Administrative Code of Illinois is
2232 20 amended by repealing Section 2310-391.
2333 21 Section 15. The School Code is amended by changing Section
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37+103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB5043 Introduced , by Rep. Maura Hirschauer SYNOPSIS AS INTRODUCED:
38+20 ILCS 2310/2310-70020 ILCS 2310/2310-391 rep.105 ILCS 5/27-8.1 from Ch. 122, par. 27-8.1 20 ILCS 2310/2310-700 20 ILCS 2310/2310-391 rep. 105 ILCS 5/27-8.1 from Ch. 122, par. 27-8.1
39+20 ILCS 2310/2310-700
40+20 ILCS 2310/2310-391 rep.
41+105 ILCS 5/27-8.1 from Ch. 122, par. 27-8.1
42+Amends the Department of Public Health Powers and Duties Law of the Civil Administrative Code of Illinois. Repeals a requirement for the Department of Public Health to provide to school districts educational materials on meningococcal disease and meningococcal vaccines. Amends the School Code to make conforming changes.
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45+A BILL FOR
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3272 1 27-8.1 as follows:
3373 2 (105 ILCS 5/27-8.1) (from Ch. 122, par. 27-8.1)
3474 3 Sec. 27-8.1. Health examinations and immunizations.
3575 4 (1) In compliance with rules and regulations which the
3676 5 Department of Public Health shall promulgate, and except as
3777 6 hereinafter provided, all children in Illinois shall have a
3878 7 health examination as follows: within one year prior to
3979 8 entering kindergarten or the first grade of any public,
4080 9 private, or parochial elementary school; upon entering the
4181 10 sixth and ninth grades of any public, private, or parochial
4282 11 school; prior to entrance into any public, private, or
4383 12 parochial nursery school; and, irrespective of grade,
4484 13 immediately prior to or upon entrance into any public,
4585 14 private, or parochial school or nursery school, each child
4686 15 shall present proof of having been examined in accordance with
4787 16 this Section and the rules and regulations promulgated
4888 17 hereunder. Any child who received a health examination within
4989 18 one year prior to entering the fifth grade for the 2007-2008
5090 19 school year is not required to receive an additional health
5191 20 examination in order to comply with the provisions of Public
5292 21 Act 95-422 when he or she attends school for the 2008-2009
5393 22 school year, unless the child is attending school for the
5494 23 first time as provided in this paragraph.
5595 24 A tuberculosis skin test screening shall be included as a
5696 25 required part of each health examination included under this
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67107 1 Section if the child resides in an area designated by the
68108 2 Department of Public Health as having a high incidence of
69109 3 tuberculosis. Additional health examinations of pupils,
70110 4 including eye examinations, may be required when deemed
71111 5 necessary by school authorities. Parents are encouraged to
72112 6 have their children undergo eye examinations at the same
73113 7 points in time required for health examinations.
74114 8 (1.5) In compliance with rules adopted by the Department
75115 9 of Public Health and except as otherwise provided in this
76116 10 Section, all children in kindergarten and the second, sixth,
77117 11 and ninth grades of any public, private, or parochial school
78118 12 shall have a dental examination. Each of these children shall
79119 13 present proof of having been examined by a dentist in
80120 14 accordance with this Section and rules adopted under this
81121 15 Section before May 15th of the school year. If a child in the
82122 16 second, sixth, or ninth grade fails to present proof by May
83123 17 15th, the school may hold the child's report card until one of
84124 18 the following occurs: (i) the child presents proof of a
85125 19 completed dental examination or (ii) the child presents proof
86126 20 that a dental examination will take place within 60 days after
87127 21 May 15th. A school may not withhold a child's report card
88128 22 during a school year in which the Governor has declared a
89129 23 disaster due to a public health emergency pursuant to Section
90130 24 7 of the Illinois Emergency Management Agency Act. The
91131 25 Department of Public Health shall establish, by rule, a waiver
92132 26 for children who show an undue burden or a lack of access to a
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103143 1 dentist. Each public, private, and parochial school must give
104144 2 notice of this dental examination requirement to the parents
105145 3 and guardians of students at least 60 days before May 15th of
106146 4 each school year.
107147 5 (1.10) Except as otherwise provided in this Section, all
108148 6 children enrolling in kindergarten in a public, private, or
109149 7 parochial school on or after January 1, 2008 (the effective
110150 8 date of Public Act 95-671) and any student enrolling for the
111151 9 first time in a public, private, or parochial school on or
112152 10 after January 1, 2008 (the effective date of Public Act
113153 11 95-671) shall have an eye examination. Each of these children
114154 12 shall present proof of having been examined by a physician
115155 13 licensed to practice medicine in all of its branches or a
116156 14 licensed optometrist within the previous year, in accordance
117157 15 with this Section and rules adopted under this Section, before
118158 16 October 15th of the school year. If the child fails to present
119159 17 proof by October 15th, the school may hold the child's report
120160 18 card until one of the following occurs: (i) the child presents
121161 19 proof of a completed eye examination or (ii) the child
122162 20 presents proof that an eye examination will take place within
123163 21 60 days after October 15th. A school may not withhold a child's
124164 22 report card during a school year in which the Governor has
125165 23 declared a disaster due to a public health emergency pursuant
126166 24 to Section 7 of the Illinois Emergency Management Agency Act.
127167 25 The Department of Public Health shall establish, by rule, a
128168 26 waiver for children who show an undue burden or a lack of
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139179 1 access to a physician licensed to practice medicine in all of
140180 2 its branches who provides eye examinations or to a licensed
141181 3 optometrist. Each public, private, and parochial school must
142182 4 give notice of this eye examination requirement to the parents
143183 5 and guardians of students in compliance with rules of the
144184 6 Department of Public Health. Nothing in this Section shall be
145185 7 construed to allow a school to exclude a child from attending
146186 8 because of a parent's or guardian's failure to obtain an eye
147187 9 examination for the child.
148188 10 (2) The Department of Public Health shall promulgate rules
149189 11 and regulations specifying the examinations and procedures
150190 12 that constitute a health examination, which shall include an
151191 13 age-appropriate developmental screening, an age-appropriate
152192 14 social and emotional screening, and the collection of data
153193 15 relating to asthma and obesity (including at a minimum, date
154194 16 of birth, gender, height, weight, blood pressure, and date of
155195 17 exam), and a dental examination and may recommend by rule that
156196 18 certain additional examinations be performed. The rules and
157197 19 regulations of the Department of Public Health shall specify
158198 20 that a tuberculosis skin test screening shall be included as a
159199 21 required part of each health examination included under this
160200 22 Section if the child resides in an area designated by the
161201 23 Department of Public Health as having a high incidence of
162202 24 tuberculosis. With respect to the developmental screening and
163203 25 the social and emotional screening, the Department of Public
164204 26 Health must, no later than January 1, 2019, develop rules and
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175215 1 appropriate revisions to the Child Health Examination form in
176216 2 conjunction with a statewide organization representing school
177217 3 boards; a statewide organization representing pediatricians;
178218 4 statewide organizations representing individuals holding
179219 5 Illinois educator licenses with school support personnel
180220 6 endorsements, including school social workers, school
181221 7 psychologists, and school nurses; a statewide organization
182222 8 representing children's mental health experts; a statewide
183223 9 organization representing school principals; the Director of
184224 10 Healthcare and Family Services or his or her designee, the
185225 11 State Superintendent of Education or his or her designee; and
186226 12 representatives of other appropriate State agencies and, at a
187227 13 minimum, must recommend the use of validated screening tools
188228 14 appropriate to the child's age or grade, and, with regard to
189229 15 the social and emotional screening, require recording only
190230 16 whether or not the screening was completed. The rules shall
191231 17 take into consideration the screening recommendations of the
192232 18 American Academy of Pediatrics and must be consistent with the
193233 19 State Board of Education's social and emotional learning
194234 20 standards. The Department of Public Health shall specify that
195235 21 a diabetes screening as defined by rule shall be included as a
196236 22 required part of each health examination. Diabetes testing is
197237 23 not required.
198238 24 Physicians licensed to practice medicine in all of its
199239 25 branches, licensed advanced practice registered nurses, or
200240 26 licensed physician assistants shall be responsible for the
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211251 1 performance of the health examinations, other than dental
212252 2 examinations, eye examinations, and vision and hearing
213253 3 screening, and shall sign all report forms required by
214254 4 subsection (4) of this Section that pertain to those portions
215255 5 of the health examination for which the physician, advanced
216256 6 practice registered nurse, or physician assistant is
217257 7 responsible. If a registered nurse performs any part of a
218258 8 health examination, then a physician licensed to practice
219259 9 medicine in all of its branches must review and sign all
220260 10 required report forms. Licensed dentists shall perform all
221261 11 dental examinations and shall sign all report forms required
222262 12 by subsection (4) of this Section that pertain to the dental
223263 13 examinations. Physicians licensed to practice medicine in all
224264 14 its branches or licensed optometrists shall perform all eye
225265 15 examinations required by this Section and shall sign all
226266 16 report forms required by subsection (4) of this Section that
227267 17 pertain to the eye examination. For purposes of this Section,
228268 18 an eye examination shall at a minimum include history, visual
229269 19 acuity, subjective refraction to best visual acuity near and
230270 20 far, internal and external examination, and a glaucoma
231271 21 evaluation, as well as any other tests or observations that in
232272 22 the professional judgment of the doctor are necessary. Vision
233273 23 and hearing screening tests, which shall not be considered
234274 24 examinations as that term is used in this Section, shall be
235275 25 conducted in accordance with rules and regulations of the
236276 26 Department of Public Health, and by individuals whom the
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247287 1 Department of Public Health has certified. In these rules and
248288 2 regulations, the Department of Public Health shall require
249289 3 that individuals conducting vision screening tests give a
250290 4 child's parent or guardian written notification, before the
251291 5 vision screening is conducted, that states, "Vision screening
252292 6 is not a substitute for a complete eye and vision evaluation by
253293 7 an eye doctor. Your child is not required to undergo this
254294 8 vision screening if an optometrist or ophthalmologist has
255295 9 completed and signed a report form indicating that an
256296 10 examination has been administered within the previous 12
257297 11 months.".
258298 12 (2.5) With respect to the developmental screening and the
259299 13 social and emotional screening portion of the health
260300 14 examination, each child may present proof of having been
261301 15 screened in accordance with this Section and the rules adopted
262302 16 under this Section before October 15th of the school year.
263303 17 With regard to the social and emotional screening only, the
264304 18 examining health care provider shall only record whether or
265305 19 not the screening was completed. If the child fails to present
266306 20 proof of the developmental screening or the social and
267307 21 emotional screening portions of the health examination by
268308 22 October 15th of the school year, qualified school support
269309 23 personnel may, with a parent's or guardian's consent, offer
270310 24 the developmental screening or the social and emotional
271311 25 screening to the child. Each public, private, and parochial
272312 26 school must give notice of the developmental screening and
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283323 1 social and emotional screening requirements to the parents and
284324 2 guardians of students in compliance with the rules of the
285325 3 Department of Public Health. Nothing in this Section shall be
286326 4 construed to allow a school to exclude a child from attending
287327 5 because of a parent's or guardian's failure to obtain a
288328 6 developmental screening or a social and emotional screening
289329 7 for the child. Once a developmental screening or a social and
290330 8 emotional screening is completed and proof has been presented
291331 9 to the school, the school may, with a parent's or guardian's
292332 10 consent, make available appropriate school personnel to work
293333 11 with the parent or guardian, the child, and the provider who
294334 12 signed the screening form to obtain any appropriate
295335 13 evaluations and services as indicated on the form and in other
296336 14 information and documentation provided by the parents,
297337 15 guardians, or provider.
298338 16 (3) Every child shall, at or about the same time as he or
299339 17 she receives a health examination required by subsection (1)
300340 18 of this Section, present to the local school proof of having
301341 19 received such immunizations against preventable communicable
302342 20 diseases as the Department of Public Health shall require by
303343 21 rules and regulations promulgated pursuant to this Section and
304344 22 the Communicable Disease Prevention Act.
305345 23 (4) The individuals conducting the health examination,
306346 24 dental examination, or eye examination shall record the fact
307347 25 of having conducted the examination, and such additional
308348 26 information as required, including for a health examination
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319359 1 data relating to asthma and obesity (including at a minimum,
320360 2 date of birth, gender, height, weight, blood pressure, and
321361 3 date of exam), on uniform forms which the Department of Public
322362 4 Health and the State Board of Education shall prescribe for
323363 5 statewide use. The examiner shall summarize on the report form
324364 6 any condition that he or she suspects indicates a need for
325365 7 special services, including for a health examination factors
326366 8 relating to asthma or obesity. The duty to summarize on the
327367 9 report form does not apply to social and emotional screenings.
328368 10 The confidentiality of the information and records relating to
329369 11 the developmental screening and the social and emotional
330370 12 screening shall be determined by the statutes, rules, and
331371 13 professional ethics governing the type of provider conducting
332372 14 the screening. The individuals confirming the administration
333373 15 of required immunizations shall record as indicated on the
334374 16 form that the immunizations were administered.
335375 17 (5) If a child does not submit proof of having had either
336376 18 the health examination or the immunization as required, then
337377 19 the child shall be examined or receive the immunization, as
338378 20 the case may be, and present proof by October 15 of the current
339379 21 school year, or by an earlier date of the current school year
340380 22 established by a school district. To establish a date before
341381 23 October 15 of the current school year for the health
342382 24 examination or immunization as required, a school district
343383 25 must give notice of the requirements of this Section 60 days
344384 26 prior to the earlier established date. If for medical reasons
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355395 1 one or more of the required immunizations must be given after
356396 2 October 15 of the current school year, or after an earlier
357397 3 established date of the current school year, then the child
358398 4 shall present, by October 15, or by the earlier established
359399 5 date, a schedule for the administration of the immunizations
360400 6 and a statement of the medical reasons causing the delay, both
361401 7 the schedule and the statement being issued by the physician,
362402 8 advanced practice registered nurse, physician assistant,
363403 9 registered nurse, or local health department that will be
364404 10 responsible for administration of the remaining required
365405 11 immunizations. If a child does not comply by October 15, or by
366406 12 the earlier established date of the current school year, with
367407 13 the requirements of this subsection, then the local school
368408 14 authority shall exclude that child from school until such time
369409 15 as the child presents proof of having had the health
370410 16 examination as required and presents proof of having received
371411 17 those required immunizations which are medically possible to
372412 18 receive immediately. During a child's exclusion from school
373413 19 for noncompliance with this subsection, the child's parents or
374414 20 legal guardian shall be considered in violation of Section
375415 21 26-1 and subject to any penalty imposed by Section 26-10. This
376416 22 subsection (5) does not apply to dental examinations, eye
377417 23 examinations, and the developmental screening and the social
378418 24 and emotional screening portions of the health examination. If
379419 25 the student is an out-of-state transfer student and does not
380420 26 have the proof required under this subsection (5) before
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391431 1 October 15 of the current year or whatever date is set by the
392432 2 school district, then he or she may only attend classes (i) if
393433 3 he or she has proof that an appointment for the required
394434 4 vaccinations has been scheduled with a party authorized to
395435 5 submit proof of the required vaccinations. If the proof of
396436 6 vaccination required under this subsection (5) is not
397437 7 submitted within 30 days after the student is permitted to
398438 8 attend classes, then the student is not to be permitted to
399439 9 attend classes until proof of the vaccinations has been
400440 10 properly submitted. No school district or employee of a school
401441 11 district shall be held liable for any injury or illness to
402442 12 another person that results from admitting an out-of-state
403443 13 transfer student to class that has an appointment scheduled
404444 14 pursuant to this subsection (5).
405445 15 (6) Every school shall report to the State Board of
406446 16 Education by November 15, in the manner which that agency
407447 17 shall require, the number of children who have received the
408448 18 necessary immunizations and the health examination (other than
409449 19 a dental examination or eye examination) as required,
410450 20 indicating, of those who have not received the immunizations
411451 21 and examination as required, the number of children who are
412452 22 exempt from health examination and immunization requirements
413453 23 on religious or medical grounds as provided in subsection (8).
414454 24 On or before December 1 of each year, every public school
415455 25 district and registered nonpublic school shall make publicly
416456 26 available the immunization data they are required to submit to
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427467 1 the State Board of Education by November 15. The immunization
428468 2 data made publicly available must be identical to the data the
429469 3 school district or school has reported to the State Board of
430470 4 Education.
431471 5 Every school shall report to the State Board of Education
432472 6 by June 30, in the manner that the State Board requires, the
433473 7 number of children who have received the required dental
434474 8 examination, indicating, of those who have not received the
435475 9 required dental examination, the number of children who are
436476 10 exempt from the dental examination on religious grounds as
437477 11 provided in subsection (8) of this Section and the number of
438478 12 children who have received a waiver under subsection (1.5) of
439479 13 this Section.
440480 14 Every school shall report to the State Board of Education
441481 15 by June 30, in the manner that the State Board requires, the
442482 16 number of children who have received the required eye
443483 17 examination, indicating, of those who have not received the
444484 18 required eye examination, the number of children who are
445485 19 exempt from the eye examination as provided in subsection (8)
446486 20 of this Section, the number of children who have received a
447487 21 waiver under subsection (1.10) of this Section, and the total
448488 22 number of children in noncompliance with the eye examination
449489 23 requirement.
450490 24 The reported information under this subsection (6) shall
451491 25 be provided to the Department of Public Health by the State
452492 26 Board of Education.
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463503 1 (7) Upon determining that the number of pupils who are
464504 2 required to be in compliance with subsection (5) of this
465505 3 Section is below 90% of the number of pupils enrolled in the
466506 4 school district, 10% of each State aid payment made pursuant
467507 5 to Section 18-8.05 or 18-8.15 to the school district for such
468508 6 year may be withheld by the State Board of Education until the
469509 7 number of students in compliance with subsection (5) is the
470510 8 applicable specified percentage or higher.
471511 9 (8) Children of parents or legal guardians who object to
472512 10 health, dental, or eye examinations or any part thereof, to
473513 11 immunizations, or to vision and hearing screening tests on
474514 12 religious grounds shall not be required to undergo the
475515 13 examinations, tests, or immunizations to which they so object
476516 14 if such parents or legal guardians present to the appropriate
477517 15 local school authority a signed Certificate of Religious
478518 16 Exemption detailing the grounds for objection and the specific
479519 17 immunizations, tests, or examinations to which they object.
480520 18 The grounds for objection must set forth the specific
481521 19 religious belief that conflicts with the examination, test,
482522 20 immunization, or other medical intervention. The signed
483523 21 certificate shall also reflect the parent's or legal
484524 22 guardian's understanding of the school's exclusion policies in
485525 23 the case of a vaccine-preventable disease outbreak or
486526 24 exposure. The certificate must also be signed by the
487527 25 authorized examining health care provider responsible for the
488528 26 performance of the child's health examination confirming that
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499539 1 the provider provided education to the parent or legal
500540 2 guardian on the benefits of immunization and the health risks
501541 3 to the student and to the community of the communicable
502542 4 diseases for which immunization is required in this State.
503543 5 However, the health care provider's signature on the
504544 6 certificate reflects only that education was provided and does
505545 7 not allow a health care provider grounds to determine a
506546 8 religious exemption. Those receiving immunizations required
507547 9 under this Code shall be provided with the relevant vaccine
508548 10 information statements that are required to be disseminated by
509549 11 the federal National Childhood Vaccine Injury Act of 1986,
510550 12 which may contain information on circumstances when a vaccine
511551 13 should not be administered, prior to administering a vaccine.
512552 14 A healthcare provider may consider including without
513553 15 limitation the nationally accepted recommendations from
514554 16 federal agencies such as the Advisory Committee on
515555 17 Immunization Practices, the information outlined in the
516556 18 relevant vaccine information statement, and vaccine package
517557 19 inserts, along with the healthcare provider's clinical
518558 20 judgment, to determine whether any child may be more
519559 21 susceptible to experiencing an adverse vaccine reaction than
520560 22 the general population, and, if so, the healthcare provider
521561 23 may exempt the child from an immunization or adopt an
522562 24 individualized immunization schedule. The Certificate of
523563 25 Religious Exemption shall be created by the Department of
524564 26 Public Health and shall be made available and used by parents
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535575 1 and legal guardians by the beginning of the 2015-2016 school
536576 2 year. Parents or legal guardians must submit the Certificate
537577 3 of Religious Exemption to their local school authority prior
538578 4 to entering kindergarten, sixth grade, and ninth grade for
539579 5 each child for which they are requesting an exemption. The
540580 6 religious objection stated need not be directed by the tenets
541581 7 of an established religious organization. However, general
542582 8 philosophical or moral reluctance to allow physical
543583 9 examinations, eye examinations, immunizations, vision and
544584 10 hearing screenings, or dental examinations does not provide a
545585 11 sufficient basis for an exception to statutory requirements.
546586 12 The local school authority is responsible for determining if
547587 13 the content of the Certificate of Religious Exemption
548588 14 constitutes a valid religious objection. The local school
549589 15 authority shall inform the parent or legal guardian of
550590 16 exclusion procedures, in accordance with the Department's
551591 17 rules under Part 690 of Title 77 of the Illinois
552592 18 Administrative Code, at the time the objection is presented.
553593 19 If the physical condition of the child is such that any one
554594 20 or more of the immunizing agents should not be administered,
555595 21 the examining physician, advanced practice registered nurse,
556596 22 or physician assistant responsible for the performance of the
557597 23 health examination shall endorse that fact upon the health
558598 24 examination form.
559599 25 Exempting a child from the health, dental, or eye
560600 26 examination does not exempt the child from participation in
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