HS HCS HB 1489, 1488 & 1650 -- IMMUNIZATIONS FOR SCHOOL CHILDREN
(Kennedy)

This substitute requires the Department of Health to develop
rules requiring immunizations for varicella (chickenpox) and
hepatitis A for children attending day care centers, preschools,
or nursery schools.  The department is also required to develop
rules requiring immunizations for varicella and hepatitis A for
children attending public, private, parochial, and parish
schools beginning with the 2002-2003 school year and every
following year.

In addition to exemptions based on religious and medical
contraindications, the substitute allows children to be exempted
from the immunization requirement for varicella and hepatitis A
if one parent or guardian objects in writing to the school
administrator because of philosophical beliefs.  For written
objections based on philosophical beliefs, a notarized statement
must be provided to the school administrator annually.

FISCAL NOTE:  Estimated Net Cost to General Revenue Fund of
$559,808 to $1,261,977 in FY 2001, $496,700 to $1,364,928 in FY
2002, and $582,207 to $1,476,482 in FY 2003.

HCS HB 1489, 1488 & 1650 -- IMMUNIZATIONS FOR SCHOOL CHILDREN;
HEPATITIS A EXPOSURE

SPONSOR:  Ladd Stokan (Kennedy)

COMMITTEE ACTION:  Voted "do pass" by the Committee on Public
Health by a vote of 9 to 3.

This substitute requires the Department of Health to develop
rules requiring immunizations for varicella (chickenpox) and
hepatitis A for children attending day care centers, preschools,
or nursery schools.  The department is also required to develop
rules requiring immunizations for varicella (chickenpox) and
hepatitis A for children attending public, private, parochial,
and parish schools beginning with the 2002-2003 school year and
every following year.

In addition to exemptions based on religious and medical
contraindications, the substitute allows children to be exempted
from the immunization requirement if one parent or guardian
objects in writing to the school administrator because of
philosophical beliefs.  For written objections based on
philosophical beliefs, a notarized statement must be provided to
the school administrator annually.

The substitute also requires establishments listed in Section
196.190, RSMo (restaurants, hotels, grocery stores, etc.), with
an employee who has contracted hepatitis A, to be liable to the
Department of Health or a local public health agency for up to
50% of the cost of administering immune globulin and the per
dose cost of the immune globulin for treating co-workers or
customers who are exposed to hepatitis A and are treated through
the Department of Health or a local public health agency.

The liability to the department or the local public health agency

is waived if such establishments voluntarily require employees
to be immunized for hepatitis A as a condition of employment and
implement safe food handling practices.  Establishments are also
exempted from the liability if an employee objects to the
hepatitis A immunization because of religious beliefs or medical
contraindications.  If the objection is based on medical
contraindications, a statement must be provided to the
establishment by a licensed physician.

FISCAL NOTE:  Estimated Net Cost to General Revenue Fund of
$889,927 in FY 2001, $1,069,478 in FY 2002, and $1,096,083 in FY
2003.

PROPONENTS:  Supporters say that about 4 million persons (mostly
children) contract chickenpox (varicella) and that 100 die
annually from it.  Further, it is estimated that 10% to 15% of
children who contract chickenpox could have secondary infections
such as encephalitis.  Parents or guardians of children who have
contracted chickenpox have lost time and income as a result of
caring for infected children.  Children who have contacted the
hepatitis A virus can display no symptoms, and parents and
guardians can contract hepatitis A from such children.
Immunizing school children against varicella and hepatitis A
could alleviate the incidence of such diseases and secondary
infections and could lower the amount of time and income lost by
parents and guardians.  Supporters also state that the public's
health would be safeguarded when establishments voluntarily
require employees to be immunized for hepatitis A and by
implementing safe food handling practices.

Testifying for HB 1489 were Representatives Kennedy and Dolan;
Greater Kansas City Pediatric Society; Mid-America Immunization
Coalition; Brian Conley, M.D.; Department of Health; Missouri
Nurses Association; Merck Pharmaceuticals; and Missouri State
Medical Association.  Testifying for HB 1488 and HB 1650 were
Representatives Kennedy and Akin; Department of Health; and Joy
Davis.

OPPONENTS:  Those who oppose the bill say that parents should be
concerned about the potential for adverse reactions from the
mandated child immunizations for chickenpox and hepatitis A.
Opponents also stated that the additional immunizations should
not be mandated.  Opponents were also against mandating
hepatitis A immunizations for adults who work in establishments
which handle, process, or prepare food.

Testifying against HB 1489 were Concerned Women of America,
Missouri Chapter; Joy Davis; Missouri Coalition for Freedom in
Health Care; Christine Annand; and Cindy Paris.  Written letters
of opposition were provided by Andrew Kendrick; Ann Hrebec;
Julie Griffeth; and Randy and Patty White.  Testifying against
HB 1488 and HB 1650 were Cindy Paris; Missouri Retailers
Association; Missouri Grocers Association; and Missouri
Coalition for Freedom in Health Care.

Joseph Deering, Legislative Analyst

HB 1489 -- Immunizations of School Children

Co-Sponsors:  Kennedy, Ladd Stokan, Abel, Barry, Selby, Carter

This bill adds immunization against varicella (chickenpox) and
hepatitis A to the immunizations required for school children
who attend public, private, parochial, or parish schools.