81R31559 SJM-F By: Van de Putte S.B. No. 424 Substitute the following for S.B. No. 424: By: Kolkhorst C.S.S.B. No. 424 A BILL TO BE ENTITLED AN ACT relating to a school-based influenza vaccination pilot program and study. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: SECTION 1. ADMINISTRATION OF PILOT PROGRAM AND STUDY. (a) The Department of State Health Services and the Texas Education Agency shall jointly implement a school-based influenza vaccination pilot program and conduct a joint study of school-based influenza vaccination programs in accordance with this Act. (b) For purposes of the pilot program and study, the Texas Immunization Stakeholder Working Group shall establish within the working group a subcommittee composed of representatives from: (1) the Texas Pediatric Society; (2) the Texas Academy of Family Physicians; (3) the Texas Medical Association; (4) the Texas Association of School Administrators; (5) the Texas Association of School Boards; (6) the Texas School Nurses Organization; (7) an entity with knowledge of best practices for the effective use of state and local public health resources based on information from other states that have implemented school-based influenza vaccination programs; (8) each school district in which the pilot program will operate, after the selection of those districts under Section 2(a) of this Act; (9) the state Medicaid medical director; and (10) each local health department that serves the geographic area in which a participating school district is located. (c) Members of the Texas Immunization Stakeholder Working Group that do not serve on the subcommittee shall serve in an advisory role for the planning and implementation of the school-based influenza vaccination pilot program and study. SECTION 2. PILOT PROGRAM. (a) The Department of State Health Services and the Texas Education Agency shall jointly establish and implement for the 2009-2010 school year a school-based influenza vaccination pilot program using both killed vaccine and live attenuated vaccine in: (1) a school district with a student population of 50,000 or more that is at least 85 percent economically disadvantaged and located in a home-rule municipality with a population of more than 1.1 million; (2) a school district with a student population that is less than five percent economically disadvantaged and located in a municipality with a population of more than 600,000 and less than one million; and (3) two school districts selected by the Texas Immunization Stakeholder Working Group including: (A) one school district with a student population that is at least 90 percent economically disadvantaged and located in a county with a population of 50,000 or less; and (B) one school district with a student population that is at least 90 percent economically disadvantaged and located in a county on the international border. (b) The Department of State Health Services, the Texas Education Agency, and the Texas Immunization Stakeholder Working Group subcommittee shall plan the school-based influenza vaccination pilot program established and implemented under this section. (c) The Department of State Health Services, the Texas Education Agency, and the Texas Immunization Stakeholder Working Group subcommittee shall: (1) implement the school-based influenza vaccination pilot program in the school districts selected under Subsection (a) of this section for the 2009-2010 school year; and (2) collect all relevant data related to the program during the 2009-2010 school year. (d) The Department of State Health Services and the Texas Education Agency may seek, receive, and spend money received through an appropriation, grant, donation, or reimbursement from any public or private source to implement the school-based influenza vaccination pilot program. (e) The Department of State Health Services, the Texas Education Agency, and the Texas Immunization Stakeholder Working Group subcommittee may not, during the period a declaration of a state of disaster is in effect or the period of school closure, initiate or continue to administer the school-based influenza vaccination pilot program in any school district selected under Subsection (a) of this section if: (1) the governor declares a state of disaster related to a communicable disease, public health emergency, or public health disaster that applies to an area in which one of the school districts is located; or (2) all schools in one of the school districts are closed in compliance with an order issued because of a communicable disease under Chapter 81, Health and Safety Code, or other law. (f) If the presiding officer of the governing body of a political subdivision declares a local state of disaster related to a communicable disease, public health emergency, or public health disaster that applies to an area in which one of the school districts selected under Subsection (a) of this section is located, the Department of State Health Services, the Texas Education Agency, and the Texas Immunization Stakeholder Working Group subcommittee may not, during the period of the state of disaster, initiate or continue to administer the school-based influenza vaccination pilot program in that school district. SECTION 3. STUDY. (a) The Department of State Health Services and the Texas Education Agency shall conduct a joint study of school-based influenza vaccination programs. (b) Members of the Texas Immunization Stakeholder Working Group subcommittee shall make recommendations to the Department of State Health Services and the Texas Education Agency regarding: (1) the design of the survey instrument used to collect data from schools with an influenza vaccination program under Subsection (c)(2) of this section; and (2) the content of the report required under Section 4 of this Act. (c) The Department of State Health Services and the Texas Education Agency shall: (1) identify school districts in this state in which a school-based influenza vaccination program has been conducted on or after September 1, 2006; (2) collect relevant data related to the programs, including, when available: (A) how an influenza vaccine was purchased or obtained; (B) a comparison of how insured and uninsured students were managed under the program; (C) the costs associated with administering the program; (D) for each school year that the program was administered, the number of students, by grade level, that: (i) were vaccinated, refused the vaccine, or were not vaccinated; and (ii) were enrolled in the school district; (E) the number of school faculty and staff vaccinated; (F) student absentee rates during a school year that the school district: (i) administered a program; and (ii) did not administer a program; (G) the number of schools that closed due to influenza or influenza-like illness and the number of days that each school was closed; (H) the nature and degree of involvement in the implementation of a program of: (i) a public health department; (ii) other community resources; or (iii) private health care providers; and (I) whether the vaccinations were reported to the immunization registry maintained by the Department of State Health Services under Section 161.007, Health and Safety Code; (3) identify best practices of a school district that implemented a school-based influenza vaccination program; and (4) identify barriers encountered by a school district that implemented a school-based influenza vaccination program and how the barriers were overcome. SECTION 4. REPORT. Not later than December 1, 2010, the Department of State Health Services and the Texas Education Agency shall submit to the governor, lieutenant governor, speaker of the house of representatives, and presiding officer of each standing committee of the legislature with jurisdiction over the department and the agency a jointly written report, based on the implementation and results of the school-based influenza vaccination pilot program and the study of school-based influenza vaccination programs, that evaluates the feasibility of implementing an annual statewide school-based influenza vaccination program. The report must include: (1) an analysis of the costs and benefits of implementing the school-based influenza vaccination pilot program in each school district listed by Section 2(a) of this Act; (2) an analysis of the costs and benefits of implementing school-based influenza vaccination programs throughout this state; (3) identification of barriers to implementing the school-based influenza vaccination pilot program and other similar programs throughout this state and recommendations for removing those barriers; (4) a projection of the fiscal impact of implementing a statewide school-based influenza vaccination program; (5) an analysis of the impact of the pilot program and the other programs studied on private practice physicians and health care providers who administer influenza vaccinations in this state, based on the programs studied; (6) an analysis of the impact of a statewide school-based influenza vaccination program on private practice physicians and health care providers who administer influenza vaccinations in this state and recommendations for how to overcome any barriers; and (7) the role of public health departments and community resources in the administration of school-based influenza vaccination programs. SECTION 5. EXPIRATION. This Act expires September 1, 2011. SECTION 6. FISCAL IMPACT. This Act does not make an appropriation. A provision in this Act that creates a new governmental program, creates a new entitlement, or imposes a new duty on a governmental entity is not mandatory during a fiscal period for which the legislature has not made a specific appropriation to implement the provision. SECTION 7. EFFECTIVE DATE. This Act takes effect immediately if it receives a vote of two-thirds of all the members elected to each house, as provided by Section 39, Article III, Texas Constitution. If this Act does not receive the vote necessary for immediate effect, this Act takes effect September 1, 2009.