Massachusetts 2023-2024 Regular Session

Massachusetts Senate Bill S1458 Compare Versions

Only one version of the bill is available at this time.

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1	1	1 of 1
2	2	SENATE DOCKET, NO. 1491 FILED ON: 1/19/2023
3	3	SENATE . . . . . . . . . . . . . . No. 1458
4	4	The Commonwealth of Massachusetts
5	5	_________________
6	6	PRESENTED BY:
7	7	Rebecca L. Rausch
8	8	_________________
9	9	To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
10	10	Court assembled:
11	11	The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
12	12	An Act promoting community immunity.
13	13	_______________
14	14	PETITION OF:
15	15	NAME:DISTRICT/ADDRESS :Rebecca L. RauschNorfolk, Worcester and MiddlesexPaul J. Donato35th MiddlesexMichael J. BarrettThird Middlesex1/26/2023Carmine Lawrence Gentile13th Middlesex2/3/2023Vanna Howard17th Middlesex2/9/2023James B. EldridgeMiddlesex and Worcester2/10/2023John F. KeenanNorfolk and Plymouth2/28/2023 1 of 9
16	16	SENATE DOCKET, NO. 1491 FILED ON: 1/19/2023
17	17	SENATE . . . . . . . . . . . . . . No. 1458
18	18	By Ms. Rausch, a petition (accompanied by bill, Senate, No. 1458) of Rebecca L. Rausch, Paul J.
19	19	Donato, Michael J. Barrett, Carmine Lawrence Gentile and other members of the General Court
20	20	for legislation to promote community immunity. Public Health.
21	21	The Commonwealth of Massachusetts
22	22	_______________
23	23	In the One Hundred and Ninety-Third General Court
24	24	(2023-2024)
25	25	_______________
26	26	An Act promoting community immunity.
27	27	Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
28	28	of the same, as follows:
29	29	1 SECTION 1. Chapter 76 of the General Laws is hereby amended by striking out section
30	30	215, as appearing in the 2020 Official Edition, and inserting in place thereof the following
31	31	3section:-
32	32	4 Section 15. All schools shall comply with the requirements established in chapter 111P.
33	33	5 SECTION 2. Said chapter 76, as so appearing, is hereby further amended by striking out
34	34	6section 15C and inserting in place thereof the following section:-
35	35	7 Section 15C. All institutions of higher learning shall comply with the requirements
36	36	8established in chapter 111P.
37	37	9 SECTION 3. Section 15D of said chapter 76, as so appearing, is hereby repealed. 2 of 9
38	38	10 SECTION 4. Section 24N of chapter 111 of the General Laws, as appearing in the 2020
39	39	11Official Edition, is hereby amended, in line 32, by inserting after the word “24M” the following
40	40	12words:- , and to administer chapter 111P.
41	41	13 SECTION 5. The General Laws are hereby amended by inserting after chapter 111O the
42	42	14following chapter:-
43	43	15 CHAPTER 111P.
44	44	16 COMMUNITY IMMUNITY.
45	45	17 Section 1. This chapter shall be known and may be cited as the Community Immunity
46	46	18Act.
47	47	19 Section 2. As used in this chapter, the following words shall have the following meanings
48	48	20unless the context clearly requires otherwise:-
49	49	21 “Covered program”, (a) a child care center, an early education and care program, a family
50	50	22child care home, a large family child care home, a public preschool program, or a school-aged
51	51	23child care program, as defined in section 1A of chapter 15D; (b) a school, whether public, private
52	52	24or charter, that provides education to students in any combination of grade levels from
53	53	25kindergarten to grade 12, inclusive, and including, but not limited to, any school activity open to
54	54	26children who are otherwise instructed in accordance with section 1 of chapter 76; (c) a
55	55	27recreational camp; or (d) an institution of higher education, whether public or private.
56	56	28 “Department”, the department of public health.
57	57	29 “Exemption”, written acknowledgement from the department that a participant is excused
58	58	30from the schedule. 3 of 9
59	59	31 “Herd immunity”, population-wide resistance to the spread of an infectious disease
60	60	32within that population, resulting from a sufficient percentage of people receiving one or more
61	61	33immunizations against the disease.
62	62	34 “Immunization”, an inoculation administered for the purpose of making a person resistant
63	63	35to an infectious disease.
64	64	36 “Participant”, a person who engages in 1 or more activities of a covered program through
65	65	37enrollment or other registration process.
66	66	38 “Provider”, a health care provider licensed by an agency, board or division of the
67	67	39commonwealth who, acting within their scope of practice, may lawfully administer an
68	68	40immunization.
69	69	41 “Responsible adult”, a parent or legal guardian of a participant, a participant who is an
70	70	42emancipated minor, or a participant who has achieved the age of majority.
71	71	43 “Schedule”, the immunization administration schedule established by the department and
72	72	44consistent with generally accepted medical practice.
73	73	45 Section 3. To enroll in a covered program, a participant’s records shall include: (a)
74	74	46documentation of immunizations in accordance with the schedule; (b) an exemption
75	75	47acknowledgement letter issued by the department, consistent with this chapter; (c) evidence that
76	76	48the participant is in the process of obtaining immunizations with the objective of compliance
77	77	49with the schedule; (d) for public schools only, evidence that the participant moved into the
78	78	50commonwealth not more than 90 days before the date of enrollment and the responsible adult is
79	79	51making a good faith effort to obtain the necessary immunization documentation or exemption 4 of 9
80	80	52acknowledgement; or (e) evidence that more than 30 days have elapsed since a declaration of
81	81	53exemption form was submitted to the department. A private covered program may implement
82	82	54immunization requirements more stringent than those set forth in this chapter; provided, that the
83	83	55program creates and maintains a written immunization policy, which shall be made available to
84	84	56all responsible adults; and provided further, that no private covered program shall refuse to
85	85	57accept medical exemptions.
86	86	58 Section 4. There shall be two types of immunization exemptions: (a) medical, for a
87	87	59participant whose medical conditions or circumstances preclude the administration of an
88	88	60immunization, as determined in the best medical judgment of a provider; and (b) religious, for a
89	89	61participant who holds, or whose family holds, sincere religious beliefs conflicting with
90	90	62immunizations.
91	91	63 Section 5. The department shall prepare and maintain separate standardized declaration of
92	92	64exemption forms for medical and religious exemptions to required vaccinations. The department
93	93	65shall make the forms available to covered programs and the public online and, as necessary, in
94	94	66hard copy. Covered programs shall provide a declaration of exemption form to a responsible
95	95	67adult or a participant only upon request.
96	96	68 Section 6. The declaration of medical exemption form shall include, without limitation:
97	97	69(i) a checklist of generally accepted contraindications to immunizations that shall be completed
98	98	70by a provider; (ii) a statement that the provider has an established provider-patient relationship
99	99	71with the participant; (iii) a request for the signature of the provider; (iv) a request for a unique
100	100	72government-issued professional identification number assigned to the provider; (v) a request for
101	101	73the signature of the responsible adult; and (vi) requests for dates for all signatures. 5 of 9
102	102	74 Section 7. The declaration of religious exemption form shall include, without limitation:
103	103	75(i) a statement that the participant or responsible adult has a sincere religious belief conflicting
104	104	76with immunizations; (ii) a certification that the responsible adult has provided a complete and
105	105	77accurate copy of the religious exemption declaration to the participant’s primary health care
106	106	78provider, including the provider’s name and contact information; (iii) an acknowledgement of
107	107	79receipt from a provider on the participant’s primary health care team; and (iv) a request for the
108	108	80dated signature of the responsible adult. The form shall include a statement from the department
109	109	81that refusing to immunize is against public health policy and may result in serious illness or
110	110	82death of the participant or others. The department may provide alternative requirements to
111	111	83clauses (ii) and (iii) of this section if a participant does not have a primary health care provider.
112	112	84The form shall not require disclosure of a participant’s particular religious beliefs.
113	113	85 Section 8. A responsible adult shall submit a completed declaration of exemption form to
114	114	86the department for review. The department shall determine the method of submission, whether
115	115	87electronic, hard copy, or both.
116	116	88 Section 9. The department shall review each declaration of exemption form submitted in
117	117	89accordance with this chapter. The department shall acknowledge each validly executed and
118	118	90accurately completed form with a letter indicating that the participant is exempt from required
119	119	91vaccinations and including the expiration date of the exemption. If the declaration of exemption
120	120	92form is improperly completed, the department shall advise the responsible adult of the remedial
121	121	93action necessary for resubmission.
122	122	94 Section 10. Whenever practicable, the department shall review and issue a response in
123	123	95accordance with section 9 of this chapter not more than 30 days after receipt of the declaration of 6 of 9
124	124	96exemption form. An exemption acknowledged by the department shall be valid for a period of
125	125	97not more than 1 year from the final signature date on the declaration. The department may, in its
126	126	98sole discretion, require covered programs to exclude exempted participants during a public
127	127	99health emergency.
128	128	100 Section 11. All covered programs shall annually report total numbers of participants who
129	129	101have been immunized and participants who are exempt from immunization requirements,
130	130	102delineated by exemption type, as applicable, to the department, in a method determined by the
131	131	103department, and shall distribute the data from the report to all responsible adults electronically or
132	132	104in hard copy. Distribution shall not be required if it would result in disclosure of personal
133	133	105information as defined in section 1 of chapter 93H or otherwise violate applicable privacy laws.
134	134	106 Section 12. The department shall annually publish immunizations and exemptions data,
135	135	107delineated by exemption type, as applicable, for each covered program and school district on its
136	136	108website and may publish such data in hard copy. The department may also publish data by
137	137	109municipality, county, or other geographic designation, or by other criteria in its discretion.
138	138	110Publication shall not be required whenever doing so would result in disclosure of personal
139	139	111information as defined in section 1 of chapter 93H or otherwise violate applicable privacy laws.
140	140	112The department shall directly disseminate electronic copies of any published data to the school
141	141	113physician or nurse assigned to any public covered program pursuant to section 53 of chapter 71.
142	142	114 Section 13. Any covered program that has not achieved herd immunity shall be
143	143	115designated as an elevated risk program. Any covered program that fails to report immunization
144	144	116and exemption rates consistent with this chapter shall be designated an elevated risk program.
145	145	117Elevated risk program designations shall remain in place until the department, in its sole 7 of 9
146	146	118discretion, determines that the covered program has sufficiently improved immunity rates in the
147	147	119covered program population. The department shall maintain a public, online list of elevated risk
148	148	120programs.
149	149	121 Section 14. The department shall create a notice to responsible adults about an elevated
150	150	122risk designation. An elevated risk program shall issue the notice to all responsible adults for
151	151	123participants or those seeking enrollment in the program during the period in which the
152	152	124designation is in place not more than 10 days after receiving an elevated risk program
153	153	125designation. The department may require elevated risk programs to organize and invite all
154	154	126responsible adults to a presentation by the department about immunization safety, immunization
155	155	127efficacy and herd immunity. Whenever practicable, the presentation shall be conducted within 45
156	156	128days after the designation is received.
157	157	129 Section 15. The department shall develop and make available online an informational
158	158	130pamphlet about immunization safety and immunization efficacy. The department shall distribute
159	159	131the informational pamphlet, either electronically or in hard copy, to every responsible adult who
160	160	132submits a declaration of exemption form pursuant to this chapter. All elevated risk programs
161	161	133shall distribute the informational pamphlet, either electronically or in hard copy, to all
162	162	134responsible adults for participants or those seeking enrollment in the program during the period
163	163	135in which the designation is in place.
164	164	136 Section 16. The department shall promulgate regulations to implement this chapter,
165	165	137except that the department of early education and care, department of elementary and secondary
166	166	138education, and department of higher education shall promulgate regulations to implement
167	167	139application of this chapter to covered programs falling within each department’s jurisdiction. 8 of 9
168	168	140 Section 17. In conjunction with and as facilitated by the departments listed in section 16
169	169	141of this chapter, as well as partnerships with trusted community-based organizations and local
170	170	142public health departments, health care providers, or clergy, the department shall conduct
171	171	143outreach to support the delivery of medically accurate information about immunizations,
172	172	144including but not limited to the availability of programs funded through the Vaccine Purchase
173	173	145Trust Fund established in section 24N of chapter 111. Such outreach shall focus on, but not be
174	174	146limited to, immunization gap populations in under-vaccinated communities.
175	175	147 Section 18. The department shall collect and report data on immunizations against any
176	176	148infectious disease which has given rise to a declared public health state of emergency in the
177	177	149commonwealth. Daily immunization data reports, which the department shall publish on its
178	178	150website, shall include the number of individuals receiving the immunization, delineated by age
179	179	151and geographic location, including municipal, county, and statewide counts. The department
180	180	152shall collect infectious disease immunization data by key socioeconomic and demographic
181	181	153indicators, including race, gender, ethnicity, disability, sexual orientation and gender identity,
182	182	154primary language, occupation, household income, residence in elder care facilities and other
183	183	155congregate care settings, and housing status, and report such data on its website not less than
184	184	156weekly, except where publication would result in disclosure of personal information as defined
185	185	157in section 1 of chapter 93H or would otherwise violate applicable privacy laws.
186	186	158 SECTION 6. Section 12F of chapter 112 of the General Laws, as appearing in the 2020
187	187	159Official Edition, is hereby amended by striking out, in lines 14 and 15, the words “have come in
188	188	160contact with” and inserting in place thereof the following words:- be at risk of contracting. 9 of 9
189	189	161 SECTION 7. Said section 12F of said chapter 112, as so appearing, is hereby further
190	190	162amended by inserting after the word “diagnosis”, in line 18, the following word:- , prevention.
191	191	163 SECTION 8. Chapter 5 of the Acts of 1995 is hereby amended by striking out section
192	192	164122.
193	193	165 SECTION 9. Sections 1 through 5, inclusive, of this act shall take effect on July 1, 2025.
194	194	166Remaining sections of this act shall take effect upon its passage.