90TH GENERAL ASSEMBLY
ANNE C. WALKER, Chief Clerk
AN ACT
To repeal section 167.181, RSMo Supp. 1999, relating to immunizations, and to enact in lieu thereof two new sections relating to the same subject.
Section A. Section 167.181, RSMo Supp. 1999, is repealed and two new sections enacted in lieu thereof, to be known as sections 167.181 and 192.905, to read as follows:
167.181. 1. The department of health, after consultation with the department of elementary and secondary education, shall promulgate rules and regulations governing the immunization against poliomyelitis, rubella, rubeola, mumps, tetanus, pertussis, diphtheria, and hepatitis B, to be required of children attending public, private, parochial or parish schools. Such rules and regulations may modify the immunizations that are required of children in this subsection. The immunizations required and the manner and frequency of their administration shall conform to recognized standards of medical practice. The department of health shall supervise and secure the enforcement of the required immunization program. In accordance with section 210.003, RSMo, the department of health shall promulgate rules requiring immunizations against varicella and hepatitis A for children attending day care centers, preschools or nursery schools. The department of health shall promulgate rules requiring immunizations against varicella and hepatitis A for children attending public, private, parochial or parish schools beginning with the 2002-2003 school year and every year thereafter.
2. It is unlawful for any student to attend school unless he or she has been immunized as required [under] pursuant to the rules and regulations of the department of health, and can provide satisfactory evidence of such immunization; except that if he or she produces satisfactory evidence of having begun the process of immunization, he or she may continue to attend school as long as the immunization process is being accomplished in the prescribed manner. It is unlawful for any parent or guardian to refuse or neglect to have his or her child immunized as required by this section, unless the child is properly exempted.
3. This section shall not apply to any child if one parent or guardian objects in writing to his or her school administrator against the immunization of the child, because of religious beliefs, philosophical beliefs or medical contraindications. In cases where any such objection is philosophical, a notarized statement must also be provided annually to the school administrator. If the objection is for reasons of medical contraindications, a statement from a duly licensed physician must also be provided to the school administrator.
4. Each school superintendent, whether of a public, private, parochial or parish school, shall cause to be prepared a record showing the immunization status of every child enrolled in or attending a school under his or her jurisdiction. The name of any parent or guardian who neglects or refuses to permit a nonexempted child to be immunized against diseases as required by the rules and regulations promulgated pursuant to the provisions of this section shall be reported by the school superintendent to the department of health.
5. The immunization required may be done by any duly licensed physician or by someone under his or her direction. If the parent or guardian is unable to pay, the child shall be immunized at public expense by a physician or nurse at or from the county, district, city public health center or a school nurse or by a nurse or physician in the private office or clinic of the child's personal physician with the costs of immunization paid through the state Medicaid program, private insurance or in a manner to be determined by the department of health subject to state and federal appropriations, and after consultation with the school superintendent and the advisory committee established in section 192.630, RSMo.
6. Funds for the administration of this section and for the purchase of vaccines for children of families unable to afford them shall be appropriated to the department of health from general revenue or from federal funds if available.
7. No rule or portion of a rule promulgated [under] pursuant to the authority of this section shall become effective unless it has been promulgated pursuant to the provisions of [section 536.024] chapter 536, RSMo.
192.905. 1. Any establishment described in section 196.190, RSMo, with an employee who has contracted hepatitis A in which the public is at risk of exposure shall be liable to the department of health or a local public health agency for up to fifty percent of the cost of administering immune globulin and the per dose cost of the immune globulin for other employees and patrons of the establishment who are treated through the department of health or a local public health agency as a result of their exposure to hepatitis A. Such liability to the department of health or a local public health agency shall be waived if the establishment voluntarily requires all employees of the establishment who handle food to be immunized for hepatitis A as a condition of employment and has implemented safe food handling practices.
2. The provisions of this section shall not apply to any employee who objects to such immunization because of
such person's religious beliefs or medical contraindications. If the objection is for reasons of medical
contraindications, a statement from a duly licensed physician must be provided to the
establishment.
Missouri
House of Representatives