Immunizations


California Senate Bill 277 Potential Impact on Homeschoolers

SB 277 would require that children admitted to a school or certain other institutions be fully vaccinated on schedule in accordance with Health and Safety Code Section 120355. This applies to pupils of "...any public or private elementary or secondary school, child care center, day nursery, nursery school, family day care home, or development center." It removes the "personal beliefs" exemption and, therefore, the only exception will be for medical reasons as specified by a physician.

While several lawmakers have made public statements to the effect that parents can "either vaccinate or homeschool," based on the way that the law is currently written, this is simply not true. If SB277 passes as written, there will be no non-medically based exemptions for mandatory immunization of school aged children (ages 6 and up) in California at all, homeschoolers included, other than those using the private tutoring option. This option requires that the parent hold a current California multiple-subject teaching credential and has various other restrictions.


Nearly all homeschoolers in California choose one of three legal options - a public home-based charter program, a private school satellite program (PSP), or they file a private school affidavit (PSA). AB 277 would apply to all of these homeschooling options. The consequence for failure to comply with the vaccination schedule is that students are to be prohibited from further attendance until they receive a medical exemption or are fully caught up with the required immunizations.


Charter school homeschoolers will likely face the choice of being asked to leave for failure to comply or will not be accepted for admission at all.

For homeschoolers enrolled in private school satellite programs (PSPs), the private school will have to decide what it means to prohibit attendance. It is possible they could decide that their students are already "staying home" and that no further action is necessary for those who are not fully immunized. Or they may decide that the law requires them to un-enroll students who are not in compliance. Also, immunization status of students is not necessarily private since the private school is required to report immunization rates to the health department and the health department has the authority to examine the school's immunization records.


The law would also apply to homeschoolers who establish their own private school in their own home although it is unclear what the impact would be for those individuals. The only stated consequence of failure to comply is that non-immunized students are to be prohibited from attending. What this means when school and home are the same place is open to interpretation. To our knowledge, the health department has never requested immunization information from private schools with fewer than six students, but, legally and technically, that is also possible.

FAQ
Q: Can I homeschool if my children are not up-to-date on vaccinations?
A: There is no simple answer to this question other than to say that any public or private school homeschooling option will require children to be up-to-date on immunizations otherwise you will be out of compliance with the law. This may or may not result in consequences that prevent you from homeschooling. We cannot predict with certainty what type of enforcement will be engaged in by health departments or school districts.

Q: Can you provide more details about the tutoring option?
A:Full information about the tutoring option is here.


Q: What does the bill say about homeschooling?
A: The bill does not mention homeschooling directly. It applies to all public and private schools including home-based charter programs, public school independent study programs, private school satellite programs, and home-based private schools.

Q: Is there a way to use an out-of-state school to avoid the immunization requirements?
A: No. Enrollment in an out-of-state school does not provide an exception to the California compulsory education law.

Q: Would the law apply to online or distance education programs?
A: Yes. The bill does not distinguish between types of schooling methods. It applies to all private and public school programs.

Q: Is this bill going to pass? Will it be changed?
A: We can't predict whether or not it will pass. It is possible that it will be changed as it goes through the usual committee processes. If the senate passes it, an identical bill must be passed by the state assembly and the final version must be signed by the governor before it becomes law.

Q: Will quantitative blood titers be accepted as proof of immunity?
A: Yes, a physician can write a statement that the child should be permanently exempted from the vaccination based on a blood titer showing immunity.





The Health and Safety Codes (hereinafter H&S) §§120335 and 120375 require all schools, including home-based private schools operated by families for their own children, to maintain documentation showing that each pupil has received specified immunizations. For a specific list of required immunizations, see H&S §120355, included in this booklet. These immunization requirements do not apply to children who are tutored under Ed. Code §48224, only to children enrolled in public or private schools.

This page of the CDE website explains exactly the requirements for immunizations:
http://www.cde.ca.gov/ls/he/hn/cefimmunization.asp.


Medical Records
Most families are given a yellow booklet by their doctors showing the immunizations administered to their child and the dates of administration. These yellow booklets are important and should be kept with a family's important papers. If you don't have such a booklet or think it might not be up to date, contact your doctor.


PM286 Form
The yellow immunization booklets are not given to schools to keep. Rather, schools are required by law to keep immunization records on a particular form, called the pm286; schools copy over the immunization records from the original yellow book to the form and return the original to the family. Technically, all private schools, even schools operated by a family exclusively for its own children, are supposed to maintain immunization records on this form, which is available here:


If your child is enrolled in a public school ISP, a public charter program or a PSP, that school will ask you for your immunization documentation so that they can prepare the required forms.

If you operate your own private school, we believe that you can determine for yourself whether you wish to prepare and maintain the pm286 forms for your students. If you do not maintain the pm286 forms but have properly updated original yellow immunization books showing which immunizations have been administered, we think this is probably adequate documentation for purposes of meeting legal requirements. If you have children other than your own enrolled in your school, you should be maintaining the pm286 forms for them since you don't have their original immunization records (these should be kept by the child's parents or guardian).

The CAIR Database is an online immunization database used by most regular brick and mortar schools. There is nothing preventing small private schools from joining, but there is certainly no requirement to do so.



Starting January 1, 2014, the process for obtaining exemptions to student immunization requirements was modified by Assembly Bill (AB) 2109 which requires documentation that health care practictioners have informed parents about vaccines and diseases.

Medical Reasons:

If you believe your child should not receive particular immunizations for medical reasons, contact your doctor and obtain a doctor's written statement. Once this statement is signed by your doctor, your child will be exempted from the immunizations specifically identified on the medical waiver form. (H&S §120370).


Personal Beliefs:

If you decline to have any or all vaccinations given to your child because of your personal beliefs, you can exempt your child from the immunization requirements by having properly signed waiver forms in your school records. (H&S §120365.)


Q What are the requirements for the “personal beliefs” statement?

A  If you decline to have any or all vaccinations given to your child because of your personal beliefs, you can exempt your child from the immunization requirements. You must document which immunizations have been given and which have not been given based on personal beliefs. You must attach to that document a form from the State Department of Public Health which has both a health practitioner’s and parent/guardian’s signature. The form is available here: http://eziz.org/assets/docs/CDPH-8262.pdf


Q What is the health practitioner attesting to with his/her signature?

A  The health practitioner is attesting that he/she has given information regarding the benefits and risks of the immunization and the health risks of the communicable diseases listed in H&S Code 120335. The health practitioner is not consenting or approving the personal beliefs exemption; he/she is only stating that information about immunizations has been provided to the parent/guardian.

Q What is the parent/guardian signing?
A The parent is stating that he/she has received the information provided by the health care practitioner. This must be signed within 6 months of when the child becomes subject to the immunization reporting requirement.

 

Q  Which health care practitioners are allowed to sign the form?
A  Any of the following: 1) A physician and surgeon, licensed pursuant to Section 2050 of the Business and Professions Code; 2) A nurse practitioner who is authorized to furnish drugs pursuant to Section 2836.1 of the Business and Professions Code; 3) A physician assistant who is authorized to administer or provide medication pursuant to Section 3502.1 of the Business and Professions Code; 4) An osteopathic physician and surgeon, as defined in the Osteopathic Initiative Act; 5) A naturopathic doctor who is authorized to furnish or order drugs under a physician and surgeon’s supervision pursuant to Section 3640.5 of the Business and Professions Code; 6) A credentialed school nurse, as described in Section 49426 of the Education Code.


Religious Beliefs

Q. What if my religion prohibits me from seeking medical care from the authorized health care practitioners?

A. There is a place on the form for exemption due to religious beliefs which prevent you from seeking advice or treatment from any of the authorized health care practitioners. You do not need the health care practitioner signature in that case.



When does proof of immunization or a signed waiver have to be filed and where is it filed?

Proof of immunization or a signed waiver must be filed with the school (placed into your school files):
    • the first time a child enters school
    • upon transferring to a different public or private school
    • upon entering 7th grade (additional 7th grade requirements)

If a child’s parent or guardian has signed the California School Immunization Record exempting their child from immunizations prior to any changes in the law taking effect, that exemption is still valid.  

The California Department of Public Health states that, "Children transferring from one grade school in California to another in California, and not starting kindergarten or the 7th grade for the first time, do not need to provide a new exemption form. Exemptions from the prior schools should be part of the records transferred to the new schools."


Private schools are required to maintain the immunization records specified above, but it is unlikely that anyone will ever want or be able to look at them. No school district or truancy officer would be entitled to examine these records (they are only entitled to see your filed affidavit and attendance records). It is possible that your local health department could ask to see them; some larger private schools have been audited and deficiencies in record-keeping were noted, but the schools were given a generous amount of time to correct the problems and no other penalties applied.


One could read the H&S §§121525 and 121545 to say that parents are required to have updated TB tests, because all employees and volunteers in private schools must have them. Since there is an argument that parents are neither "employees" nor "volunteers" in the strict meaning of the words, it is unknown whether a court would apply this requirement to parents. If you have taken the test, by all means include the results in your records, but if you have not, you should make your own decision as to whether you wish to do so. People whom you hire as employees or volunteers in your private school having regular and prolonged contact with children would need to have an updated TB certificate.



 

 




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                         August 6-August 9, 2015