103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 SB2286 Introduced 2/10/2023, by Sen. Laura Ellman SYNOPSIS AS INTRODUCED: 105 ILCS 5/27-8.1 from Ch. 122, par. 27-8.1 Amends the Courses of Study Article of the School Code. Provides that a screening to determine risk of cardiac arrest shall be included in the required health examination. LRB103 27926 RJT 54304 b A BILL FOR 103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 SB2286 Introduced 2/10/2023, by Sen. Laura Ellman SYNOPSIS AS INTRODUCED: 105 ILCS 5/27-8.1 from Ch. 122, par. 27-8.1 105 ILCS 5/27-8.1 from Ch. 122, par. 27-8.1 Amends the Courses of Study Article of the School Code. Provides that a screening to determine risk of cardiac arrest shall be included in the required health examination. LRB103 27926 RJT 54304 b LRB103 27926 RJT 54304 b A BILL FOR 103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 SB2286 Introduced 2/10/2023, by Sen. Laura Ellman SYNOPSIS AS INTRODUCED: 105 ILCS 5/27-8.1 from Ch. 122, par. 27-8.1 105 ILCS 5/27-8.1 from Ch. 122, par. 27-8.1 105 ILCS 5/27-8.1 from Ch. 122, par. 27-8.1 Amends the Courses of Study Article of the School Code. Provides that a screening to determine risk of cardiac arrest shall be included in the required health examination. LRB103 27926 RJT 54304 b LRB103 27926 RJT 54304 b LRB103 27926 RJT 54304 b A BILL FOR SB2286LRB103 27926 RJT 54304 b SB2286 LRB103 27926 RJT 54304 b SB2286 LRB103 27926 RJT 54304 b 1 AN ACT concerning education. 2 Be it enacted by the People of the State of Illinois, 3 represented in the General Assembly: 4 Section 5. The School Code is amended by changing Section 5 27-8.1 as follows: 6 (105 ILCS 5/27-8.1) (from Ch. 122, par. 27-8.1) 7 Sec. 27-8.1. Health examinations and immunizations. 8 (1) In compliance with rules and regulations which the 9 Department of Public Health shall promulgate, and except as 10 hereinafter provided, all children in Illinois shall have a 11 health examination as follows: within one year prior to 12 entering kindergarten or the first grade of any public, 13 private, or parochial elementary school; upon entering the 14 sixth and ninth grades of any public, private, or parochial 15 school; prior to entrance into any public, private, or 16 parochial nursery school; and, irrespective of grade, 17 immediately prior to or upon entrance into any public, 18 private, or parochial school or nursery school, each child 19 shall present proof of having been examined in accordance with 20 this Section and the rules and regulations promulgated 21 hereunder. Any child who received a health examination within 22 one year prior to entering the fifth grade for the 2007-2008 23 school year is not required to receive an additional health 103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 SB2286 Introduced 2/10/2023, by Sen. Laura Ellman SYNOPSIS AS INTRODUCED: 105 ILCS 5/27-8.1 from Ch. 122, par. 27-8.1 105 ILCS 5/27-8.1 from Ch. 122, par. 27-8.1 105 ILCS 5/27-8.1 from Ch. 122, par. 27-8.1 Amends the Courses of Study Article of the School Code. Provides that a screening to determine risk of cardiac arrest shall be included in the required health examination. LRB103 27926 RJT 54304 b LRB103 27926 RJT 54304 b LRB103 27926 RJT 54304 b A BILL FOR 105 ILCS 5/27-8.1 from Ch. 122, par. 27-8.1 LRB103 27926 RJT 54304 b SB2286 LRB103 27926 RJT 54304 b SB2286- 2 -LRB103 27926 RJT 54304 b SB2286 - 2 - LRB103 27926 RJT 54304 b SB2286 - 2 - LRB103 27926 RJT 54304 b 1 examination in order to comply with the provisions of Public 2 Act 95-422 when he or she attends school for the 2008-2009 3 school year, unless the child is attending school for the 4 first time as provided in this paragraph. 5 A tuberculosis skin test screening shall be included as a 6 required part of each health examination included under this 7 Section if the child resides in an area designated by the 8 Department of Public Health as having a high incidence of 9 tuberculosis. Additional health examinations of pupils, 10 including eye examinations, may be required when deemed 11 necessary by school authorities. Parents are encouraged to 12 have their children undergo eye examinations at the same 13 points in time required for health examinations. 14 (1.5) In compliance with rules adopted by the Department 15 of Public Health and except as otherwise provided in this 16 Section, all children in kindergarten and the second, sixth, 17 and ninth grades of any public, private, or parochial school 18 shall have a dental examination. Each of these children shall 19 present proof of having been examined by a dentist in 20 accordance with this Section and rules adopted under this 21 Section before May 15th of the school year. If a child in the 22 second, sixth, or ninth grade fails to present proof by May 23 15th, the school may hold the child's report card until one of 24 the following occurs: (i) the child presents proof of a 25 completed dental examination or (ii) the child presents proof 26 that a dental examination will take place within 60 days after SB2286 - 2 - LRB103 27926 RJT 54304 b SB2286- 3 -LRB103 27926 RJT 54304 b SB2286 - 3 - LRB103 27926 RJT 54304 b SB2286 - 3 - LRB103 27926 RJT 54304 b 1 May 15th. A school may not withhold a child's report card 2 during a school year in which the Governor has declared a 3 disaster due to a public health emergency pursuant to Section 4 7 of the Illinois Emergency Management Agency Act. The 5 Department of Public Health shall establish, by rule, a waiver 6 for children who show an undue burden or a lack of access to a 7 dentist. Each public, private, and parochial school must give 8 notice of this dental examination requirement to the parents 9 and guardians of students at least 60 days before May 15th of 10 each school year. 11 (1.10) Except as otherwise provided in this Section, all 12 children enrolling in kindergarten in a public, private, or 13 parochial school on or after January 1, 2008 (the effective 14 date of Public Act 95-671) and any student enrolling for the 15 first time in a public, private, or parochial school on or 16 after January 1, 2008 (the effective date of Public Act 17 95-671) shall have an eye examination. Each of these children 18 shall present proof of having been examined by a physician 19 licensed to practice medicine in all of its branches or a 20 licensed optometrist within the previous year, in accordance 21 with this Section and rules adopted under this Section, before 22 October 15th of the school year. If the child fails to present 23 proof by October 15th, the school may hold the child's report 24 card until one of the following occurs: (i) the child presents 25 proof of a completed eye examination or (ii) the child 26 presents proof that an eye examination will take place within SB2286 - 3 - LRB103 27926 RJT 54304 b SB2286- 4 -LRB103 27926 RJT 54304 b SB2286 - 4 - LRB103 27926 RJT 54304 b SB2286 - 4 - LRB103 27926 RJT 54304 b 1 60 days after October 15th. A school may not withhold a child's 2 report card during a school year in which the Governor has 3 declared a disaster due to a public health emergency pursuant 4 to Section 7 of the Illinois Emergency Management Agency Act. 5 The Department of Public Health shall establish, by rule, a 6 waiver for children who show an undue burden or a lack of 7 access to a physician licensed to practice medicine in all of 8 its branches who provides eye examinations or to a licensed 9 optometrist. Each public, private, and parochial school must 10 give notice of this eye examination requirement to the parents 11 and guardians of students in compliance with rules of the 12 Department of Public Health. Nothing in this Section shall be 13 construed to allow a school to exclude a child from attending 14 because of a parent's or guardian's failure to obtain an eye 15 examination for the child. 16 (2) The Department of Public Health shall promulgate rules 17 and regulations specifying the examinations and procedures 18 that constitute a health examination, which shall include an 19 age-appropriate developmental screening, an age-appropriate 20 social and emotional screening, a screening to determine risk 21 of cardiac arrest, and the collection of data relating to 22 asthma and obesity (including at a minimum, date of birth, 23 gender, height, weight, blood pressure, and date of exam), and 24 a dental examination and may recommend by rule that certain 25 additional examinations be performed. The rules and 26 regulations of the Department of Public Health shall specify SB2286 - 4 - LRB103 27926 RJT 54304 b SB2286- 5 -LRB103 27926 RJT 54304 b SB2286 - 5 - LRB103 27926 RJT 54304 b SB2286 - 5 - LRB103 27926 RJT 54304 b 1 that a tuberculosis skin test screening shall be included as a 2 required part of each health examination included under this 3 Section if the child resides in an area designated by the 4 Department of Public Health as having a high incidence of 5 tuberculosis. With respect to the developmental screening and 6 the social and emotional screening, the Department of Public 7 Health must, no later than January 1, 2019, develop rules and 8 appropriate revisions to the Child Health Examination form in 9 conjunction with a statewide organization representing school 10 boards; a statewide organization representing pediatricians; 11 statewide organizations representing individuals holding 12 Illinois educator licenses with school support personnel 13 endorsements, including school social workers, school 14 psychologists, and school nurses; a statewide organization 15 representing children's mental health experts; a statewide 16 organization representing school principals; the Director of 17 Healthcare and Family Services or his or her designee, the 18 State Superintendent of Education or his or her designee; and 19 representatives of other appropriate State agencies and, at a 20 minimum, must recommend the use of validated screening tools 21 appropriate to the child's age or grade, and, with regard to 22 the social and emotional screening, require recording only 23 whether or not the screening was completed. The rules shall 24 take into consideration the screening recommendations of the 25 American Academy of Pediatrics and must be consistent with the 26 State Board of Education's social and emotional learning SB2286 - 5 - LRB103 27926 RJT 54304 b SB2286- 6 -LRB103 27926 RJT 54304 b SB2286 - 6 - LRB103 27926 RJT 54304 b SB2286 - 6 - LRB103 27926 RJT 54304 b 1 standards. The Department of Public Health shall specify that 2 a diabetes screening as defined by rule shall be included as a 3 required part of each health examination. Diabetes testing is 4 not required. 5 Physicians licensed to practice medicine in all of its 6 branches, licensed advanced practice registered nurses, or 7 licensed physician assistants shall be responsible for the 8 performance of the health examinations, other than dental 9 examinations, eye examinations, and vision and hearing 10 screening, and shall sign all report forms required by 11 subsection (4) of this Section that pertain to those portions 12 of the health examination for which the physician, advanced 13 practice registered nurse, or physician assistant is 14 responsible. If a registered nurse performs any part of a 15 health examination, then a physician licensed to practice 16 medicine in all of its branches must review and sign all 17 required report forms. Licensed dentists shall perform all 18 dental examinations and shall sign all report forms required 19 by subsection (4) of this Section that pertain to the dental 20 examinations. Physicians licensed to practice medicine in all 21 its branches or licensed optometrists shall perform all eye 22 examinations required by this Section and shall sign all 23 report forms required by subsection (4) of this Section that 24 pertain to the eye examination. For purposes of this Section, 25 an eye examination shall at a minimum include history, visual 26 acuity, subjective refraction to best visual acuity near and SB2286 - 6 - LRB103 27926 RJT 54304 b SB2286- 7 -LRB103 27926 RJT 54304 b SB2286 - 7 - LRB103 27926 RJT 54304 b SB2286 - 7 - LRB103 27926 RJT 54304 b 1 far, internal and external examination, and a glaucoma 2 evaluation, as well as any other tests or observations that in 3 the professional judgment of the doctor are necessary. Vision 4 and hearing screening tests, which shall not be considered 5 examinations as that term is used in this Section, shall be 6 conducted in accordance with rules and regulations of the 7 Department of Public Health, and by individuals whom the 8 Department of Public Health has certified. In these rules and 9 regulations, the Department of Public Health shall require 10 that individuals conducting vision screening tests give a 11 child's parent or guardian written notification, before the 12 vision screening is conducted, that states, "Vision screening 13 is not a substitute for a complete eye and vision evaluation by 14 an eye doctor. Your child is not required to undergo this 15 vision screening if an optometrist or ophthalmologist has 16 completed and signed a report form indicating that an 17 examination has been administered within the previous 12 18 months.". 19 (2.5) With respect to the developmental screening and the 20 social and emotional screening portion of the health 21 examination, each child may present proof of having been 22 screened in accordance with this Section and the rules adopted 23 under this Section before October 15th of the school year. 24 With regard to the social and emotional screening only, the 25 examining health care provider shall only record whether or 26 not the screening was completed. If the child fails to present SB2286 - 7 - LRB103 27926 RJT 54304 b SB2286- 8 -LRB103 27926 RJT 54304 b SB2286 - 8 - LRB103 27926 RJT 54304 b SB2286 - 8 - LRB103 27926 RJT 54304 b 1 proof of the developmental screening or the social and 2 emotional screening portions of the health examination by 3 October 15th of the school year, qualified school support 4 personnel may, with a parent's or guardian's consent, offer 5 the developmental screening or the social and emotional 6 screening to the child. Each public, private, and parochial 7 school must give notice of the developmental screening and 8 social and emotional screening requirements to the parents and 9 guardians of students in compliance with the rules of the 10 Department of Public Health. Nothing in this Section shall be 11 construed to allow a school to exclude a child from attending 12 because of a parent's or guardian's failure to obtain a 13 developmental screening or a social and emotional screening 14 for the child. Once a developmental screening or a social and 15 emotional screening is completed and proof has been presented 16 to the school, the school may, with a parent's or guardian's 17 consent, make available appropriate school personnel to work 18 with the parent or guardian, the child, and the provider who 19 signed the screening form to obtain any appropriate 20 evaluations and services as indicated on the form and in other 21 information and documentation provided by the parents, 22 guardians, or provider. 23 (3) Every child shall, at or about the same time as he or 24 she receives a health examination required by subsection (1) 25 of this Section, present to the local school proof of having 26 received such immunizations against preventable communicable SB2286 - 8 - LRB103 27926 RJT 54304 b SB2286- 9 -LRB103 27926 RJT 54304 b SB2286 - 9 - LRB103 27926 RJT 54304 b SB2286 - 9 - LRB103 27926 RJT 54304 b 1 diseases as the Department of Public Health shall require by 2 rules and regulations promulgated pursuant to this Section and 3 the Communicable Disease Prevention Act. 4 (4) The individuals conducting the health examination, 5 dental examination, or eye examination shall record the fact 6 of having conducted the examination, and such additional 7 information as required, including for a health examination 8 data relating to asthma and obesity (including at a minimum, 9 date of birth, gender, height, weight, blood pressure, and 10 date of exam), on uniform forms which the Department of Public 11 Health and the State Board of Education shall prescribe for 12 statewide use. The examiner shall summarize on the report form 13 any condition that he or she suspects indicates a need for 14 special services, including for a health examination factors 15 relating to asthma or obesity. The duty to summarize on the 16 report form does not apply to social and emotional screenings. 17 The confidentiality of the information and records relating to 18 the developmental screening and the social and emotional 19 screening shall be determined by the statutes, rules, and 20 professional ethics governing the type of provider conducting 21 the screening. The individuals confirming the administration 22 of required immunizations shall record as indicated on the 23 form that the immunizations were administered. 24 (5) If a child does not submit proof of having had either 25 the health examination or the immunization as required, then 26 the child shall be examined or receive the immunization, as SB2286 - 9 - LRB103 27926 RJT 54304 b SB2286- 10 -LRB103 27926 RJT 54304 b SB2286 - 10 - LRB103 27926 RJT 54304 b SB2286 - 10 - LRB103 27926 RJT 54304 b 1 the case may be, and present proof by October 15 of the current 2 school year, or by an earlier date of the current school year 3 established by a school district. To establish a date before 4 October 15 of the current school year for the health 5 examination or immunization as required, a school district 6 must give notice of the requirements of this Section 60 days 7 prior to the earlier established date. If for medical reasons 8 one or more of the required immunizations must be given after 9 October 15 of the current school year, or after an earlier 10 established date of the current school year, then the child 11 shall present, by October 15, or by the earlier established 12 date, a schedule for the administration of the immunizations 13 and a statement of the medical reasons causing the delay, both 14 the schedule and the statement being issued by the physician, 15 advanced practice registered nurse, physician assistant, 16 registered nurse, or local health department that will be 17 responsible for administration of the remaining required 18 immunizations. If a child does not comply by October 15, or by 19 the earlier established date of the current school year, with 20 the requirements of this subsection, then the local school 21 authority shall exclude that child from school until such time 22 as the child presents proof of having had the health 23 examination as required and presents proof of having received 24 those required immunizations which are medically possible to 25 receive immediately. During a child's exclusion from school 26 for noncompliance with this subsection, the child's parents or SB2286 - 10 - LRB103 27926 RJT 54304 b SB2286- 11 -LRB103 27926 RJT 54304 b SB2286 - 11 - LRB103 27926 RJT 54304 b SB2286 - 11 - LRB103 27926 RJT 54304 b 1 legal guardian shall be considered in violation of Section 2 26-1 and subject to any penalty imposed by Section 26-10. This 3 subsection (5) does not apply to dental examinations, eye 4 examinations, and the developmental screening and the social 5 and emotional screening portions of the health examination. If 6 the student is an out-of-state transfer student and does not 7 have the proof required under this subsection (5) before 8 October 15 of the current year or whatever date is set by the 9 school district, then he or she may only attend classes (i) if 10 he or she has proof that an appointment for the required 11 vaccinations has been scheduled with a party authorized to 12 submit proof of the required vaccinations. If the proof of 13 vaccination required under this subsection (5) is not 14 submitted within 30 days after the student is permitted to 15 attend classes, then the student is not to be permitted to 16 attend classes until proof of the vaccinations has been 17 properly submitted. No school district or employee of a school 18 district shall be held liable for any injury or illness to 19 another person that results from admitting an out-of-state 20 transfer student to class that has an appointment scheduled 21 pursuant to this subsection (5). 22 (6) Every school shall report to the State Board of 23 Education by November 15, in the manner which that agency 24 shall require, the number of children who have received the 25 necessary immunizations and the health examination (other than 26 a dental examination or eye examination) as required, SB2286 - 11 - LRB103 27926 RJT 54304 b SB2286- 12 -LRB103 27926 RJT 54304 b SB2286 - 12 - LRB103 27926 RJT 54304 b SB2286 - 12 - LRB103 27926 RJT 54304 b 1 indicating, of those who have not received the immunizations 2 and examination as required, the number of children who are 3 exempt from health examination and immunization requirements 4 on religious or medical grounds as provided in subsection (8). 5 On or before December 1 of each year, every public school 6 district and registered nonpublic school shall make publicly 7 available the immunization data they are required to submit to 8 the State Board of Education by November 15. The immunization 9 data made publicly available must be identical to the data the 10 school district or school has reported to the State Board of 11 Education. 12 Every school shall report to the State Board of Education 13 by June 30, in the manner that the State Board requires, the 14 number of children who have received the required dental 15 examination, indicating, of those who have not received the 16 required dental examination, the number of children who are 17 exempt from the dental examination on religious grounds as 18 provided in subsection (8) of this Section and the number of 19 children who have received a waiver under subsection (1.5) of 20 this Section. 21 Every school shall report to the State Board of Education 22 by June 30, in the manner that the State Board requires, the 23 number of children who have received the required eye 24 examination, indicating, of those who have not received the 25 required eye examination, the number of children who are 26 exempt from the eye examination as provided in subsection (8) SB2286 - 12 - LRB103 27926 RJT 54304 b SB2286- 13 -LRB103 27926 RJT 54304 b SB2286 - 13 - LRB103 27926 RJT 54304 b SB2286 - 13 - LRB103 27926 RJT 54304 b 1 of this Section, the number of children who have received a 2 waiver under subsection (1.10) of this Section, and the total 3 number of children in noncompliance with the eye examination 4 requirement. 5 The reported information under this subsection (6) shall 6 be provided to the Department of Public Health by the State 7 Board of Education. 8 (7) Upon determining that the number of pupils who are 9 required to be in compliance with subsection (5) of this 10 Section is below 90% of the number of pupils enrolled in the 11 school district, 10% of each State aid payment made pursuant 12 to Section 18-8.05 or 18-8.15 to the school district for such 13 year may be withheld by the State Board of Education until the 14 number of students in compliance with subsection (5) is the 15 applicable specified percentage or higher. 16 (8) Children of parents or legal guardians who object to 17 health, dental, or eye examinations or any part thereof, to 18 immunizations, or to vision and hearing screening tests on 19 religious grounds shall not be required to undergo the 20 examinations, tests, or immunizations to which they so object 21 if such parents or legal guardians present to the appropriate 22 local school authority a signed Certificate of Religious 23 Exemption detailing the grounds for objection and the specific 24 immunizations, tests, or examinations to which they object. 25 The grounds for objection must set forth the specific 26 religious belief that conflicts with the examination, test, SB2286 - 13 - LRB103 27926 RJT 54304 b SB2286- 14 -LRB103 27926 RJT 54304 b SB2286 - 14 - LRB103 27926 RJT 54304 b SB2286 - 14 - LRB103 27926 RJT 54304 b 1 immunization, or other medical intervention. The signed 2 certificate shall also reflect the parent's or legal 3 guardian's understanding of the school's exclusion policies in 4 the case of a vaccine-preventable disease outbreak or 5 exposure. The certificate must also be signed by the 6 authorized examining health care provider responsible for the 7 performance of the child's health examination confirming that 8 the provider provided education to the parent or legal 9 guardian on the benefits of immunization and the health risks 10 to the student and to the community of the communicable 11 diseases for which immunization is required in this State. 12 However, the health care provider's signature on the 13 certificate reflects only that education was provided and does 14 not allow a health care provider grounds to determine a 15 religious exemption. Those receiving immunizations required 16 under this Code shall be provided with the relevant vaccine 17 information statements that are required to be disseminated by 18 the federal National Childhood Vaccine Injury Act of 1986, 19 which may contain information on circumstances when a vaccine 20 should not be administered, prior to administering a vaccine. 21 A healthcare provider may consider including without 22 limitation the nationally accepted recommendations from 23 federal agencies such as the Advisory Committee on 24 Immunization Practices, the information outlined in the 25 relevant vaccine information statement, and vaccine package 26 inserts, along with the healthcare provider's clinical SB2286 - 14 - LRB103 27926 RJT 54304 b SB2286- 15 -LRB103 27926 RJT 54304 b SB2286 - 15 - LRB103 27926 RJT 54304 b SB2286 - 15 - LRB103 27926 RJT 54304 b 1 judgment, to determine whether any child may be more 2 susceptible to experiencing an adverse vaccine reaction than 3 the general population, and, if so, the healthcare provider 4 may exempt the child from an immunization or adopt an 5 individualized immunization schedule. The Certificate of 6 Religious Exemption shall be created by the Department of 7 Public Health and shall be made available and used by parents 8 and legal guardians by the beginning of the 2015-2016 school 9 year. Parents or legal guardians must submit the Certificate 10 of Religious Exemption to their local school authority prior 11 to entering kindergarten, sixth grade, and ninth grade for 12 each child for which they are requesting an exemption. The 13 religious objection stated need not be directed by the tenets 14 of an established religious organization. However, general 15 philosophical or moral reluctance to allow physical 16 examinations, eye examinations, immunizations, vision and 17 hearing screenings, or dental examinations does not provide a 18 sufficient basis for an exception to statutory requirements. 19 The local school authority is responsible for determining if 20 the content of the Certificate of Religious Exemption 21 constitutes a valid religious objection. The local school 22 authority shall inform the parent or legal guardian of 23 exclusion procedures, in accordance with the Department's 24 rules under Part 690 of Title 77 of the Illinois 25 Administrative Code, at the time the objection is presented. 26 If the physical condition of the child is such that any one SB2286 - 15 - LRB103 27926 RJT 54304 b SB2286- 16 -LRB103 27926 RJT 54304 b SB2286 - 16 - LRB103 27926 RJT 54304 b SB2286 - 16 - LRB103 27926 RJT 54304 b 1 or more of the immunizing agents should not be administered, 2 the examining physician, advanced practice registered nurse, 3 or physician assistant responsible for the performance of the 4 health examination shall endorse that fact upon the health 5 examination form. 6 Exempting a child from the health, dental, or eye 7 examination does not exempt the child from participation in 8 the program of physical education training provided in 9 Sections 27-5 through 27-7 of this Code. 10 (8.5) The school board of a school district shall include 11 informational materials regarding influenza and influenza 12 vaccinations and meningococcal disease and meningococcal 13 vaccinations developed, provided, or approved by the 14 Department of Public Health under Section 2310-700 of the 15 Department of Public Health Powers and Duties Law of the Civil 16 Administrative Code of Illinois when the board provides 17 information on immunizations, infectious diseases, 18 medications, or other school health issues to the parents or 19 guardians of students. 20 (9) For the purposes of this Section, "nursery schools" 21 means those nursery schools operated by elementary school 22 systems or secondary level school units or institutions of 23 higher learning. 24 (Source: P.A. 100-238, eff. 1-1-18; 100-465, eff. 8-31-17; 25 100-513, eff. 1-1-18; 100-829, eff. 1-1-19; 100-863, eff. 26 8-14-18; 100-977, eff. 1-1-19; 100-1011, eff. 8-21-18; 101-81, SB2286 - 16 - LRB103 27926 RJT 54304 b SB2286- 17 -LRB103 27926 RJT 54304 b SB2286 - 17 - LRB103 27926 RJT 54304 b SB2286 - 17 - LRB103 27926 RJT 54304 b 1 eff. 7-12-19; 101-643, eff. 6-18-20.) SB2286 - 17 - LRB103 27926 RJT 54304 b