join the cool folks
and advertise on

california political news & opinion
california legislation > AB 2109

Microsoft Word version

Page 1

AB 2109 (Pan)
As Amended April 23, 2012
Majority vote


|Ayes:|Monning, Ammiano, Atkins, |Ayes:|Fuentes, Blumenfield, |
| |Bonilla, Eng, Gordon, | |Bradford, Charles |
| |Hayashi, | |Calderon, Campos, Davis, |
| |Roger Hernández, Bonnie | |Gatto, Hall, Hill, Lara, |
| |Lowenthal, Mitchell, Pan, | |Mitchell, Solorio |
| |V. Manuel Pérez, Williams | | |
| | | | |
|Nays:|Logue, Mansoor, Nestande, |Nays:|Harkey, Donnelly, |
| |Silva, Smyth | |Nielsen, Norby, Wagner |
| | | | |
SUMMARY : Makes changes to existing requirements which allow
school-aged children, as specified, to be exempt from
immunization requirements as long as a parent or a guardian
files a letter or affidavit to the governing authority
indicating that immunization is contrary to the parent or
guardian's beliefs. Specifically, this bill :

1) Requires, on and after July 1, 2012, a separate form
prescribed by the California Department of Public Health
(DPH), to accompany the letter or affidavit to exempt a
child, as specified, from required immunization
requirements because immunization is contrary to the
child's parent's or guardian's beliefs.

2) Requires the form in 1) above to include both of the

a) A written statement signed by a health care practitioner
that indicates that the health care practitioner provided
the parent or guardian of the person, or the person if an
emancipated minor, who is subject to the immunization
requirements, with information regarding the benefits and
risks of the immunization and the health risks of the
communicable diseases, as specified, to the person and to

AB 2109
Page 2

the community; and,

b) A written statement signed by the parent or guardian of
the person, or the person if an emancipated minor, who is
subject to the immunization requirements that indicates the
information specified in 2) a) above was received.

3) Requires the written statements signed by the health
care practitioner and the parent or guardian, as specified
in 2) a) and b) above to be signed not more than six months
from the date when the person subject to the immunization
requirements is first admitted to the school. States that
if the person was admitted to the school prior to entering
the seventh grade and is about to enter the seventh grade,
then an additional letter or affidavit shall be filed with
the written statement signed by the parent or health care
practitioner not more than six months from the first day of

4) Authorizes a copy of the signed written statement to be
accepted in lieu of the original form. Requires a signed
letter from the health care practitioner that references
the person's name to be accepted in lieu of a statement on
the original form.
5) Defines a health care practitioner for purposes of this
bill as any of the following:

a) A physician and surgeon licensed by the Medical Board of

b) A nurse practitioner who is authorized to furnish drugs,
as authorized by

c) A physician assistant who is authorized to administer or
provide medication, as authorized by law;

d) An osteopathic physician, as specified; or,

e) A naturopathic doctor who is authorized to furnish or
order drugs under a physician and surgeon's supervision, as

FISCAL EFFECT : According to the Assembly Appropriations

AB 2109
Page 3


1)Based on DPH experience with another recent change to
immunization requirements, one-time costs for notification
including printing, mailing, and development of informational
materials in the range of $80,000 federal funds. Issuing
regulations and developing the form would result in one-time
staff time costs of $50,000, distributed among a number of
existing federally funded staff.

2)Minor, absorbable one-time costs to Department of Social
Services (DSS) Child Care Licensing Division staff and K-12
school administrative staff for training on the new

3)Potential increase of $20,000 General Fund under Proposition
98 funds annually in state-reimbursable mandate costs to K-12
school administrative staff to ensure compliance with the new
form. DSS costs related to ongoing enforcement are expected
be minor and absorbable.

4)Any impact on Medi-Cal or Healthy Families Program from a
small number of increased office visits, to the extent any
program enrollees seek exemptions and require additional
office visits to do so, is likely to be negligible.

COMMENTS : According to the author, "California is one of only
20 states that allows for a personal beliefs, or philosophical
exemption to school or childcare immunization requirements.
Under existing law, to exempt the child from the immunization
requirements, a parent or guardian must only provide a signed
written statement or sign their name to a two-sentence standard
exemption statement on the back of the School Immunization
Record. While parents do have a choice to exempt their
children, they are not required to document their concerns about
vaccines or affirm that they have reviewed fact-based, accurate
information regarding the risks and benefits of vaccines and the
risks of vaccine-preventable diseases. The continued increase
in personal belief exemptions and resultant decreases in
community immunization rates in California will result in
outbreaks of diseases such as measles, mumps, and pertussis.
Exposure to these preventable diseases not only places the
individual child at risk, but the entire community, including
infants too young to be fully immunized and individuals with

AB 2109
Page 4

compromised immune systems, who are vulnerable to complications
of vaccine-preventable diseases, including death. This measure
would rectify this problem by creating a process where parents
would be able make an informed decision for their children."

School-aged children are required to obtain immunizations for
certain types of diseases to be admitted in school. There are
exceptions to this requirement. First, if the physical or
medical condition of a child would make immunization unsafe, as
long as a statement by a licensed physician to this effect is
submitted to the governing authority. Second, if a letter or
affidavit is filed with the governing authority indicating that
the immunization is contrary to the beliefs of a parent or
guardian; this exemption is generally referred to as the
personal belief exemption or philosophic exemption. According
to the Centers for Disease Control and Prevention, aside from
the philosophic exemption, some states allow for religious
exemptions on the grounds that the religious beliefs of some
people are in opposition to vaccination.

Analysis Prepared by
: Rosielyn Pulmano / HEALTH / (916)

FN: 0003463