[Congressional Bills 103th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1840 Introduced in House (IH)]

103d CONGRESS
  1st Session
                                H. R. 1840

To amend part A of title IV of the Social Security Act to deny benefits 
   under the program of aid to families with dependent children with 
  respect to any child who has not received preventive health care or 
been immunized in accordance with recommendations issued by the Surgeon 
 General of the Public Health Service, and to amend the Child Care and 
 Development Block Grant Act to require that child care providers that 
receive assistance, directly or indirectly, under such Act require all 
   children to be immunized in accordance with such recommendations.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             April 22, 1993

Mrs. Roukema introduced the following bill; which was referred jointly 
      to the Committees on Ways and Means and Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
To amend part A of title IV of the Social Security Act to deny benefits 
   under the program of aid to families with dependent children with 
  respect to any child who has not received preventive health care or 
been immunized in accordance with recommendations issued by the Surgeon 
 General of the Public Health Service, and to amend the Child Care and 
 Development Block Grant Act to require that child care providers that 
receive assistance, directly or indirectly, under such Act require all 
   children to be immunized in accordance with such recommendations.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Child Immunization Incentive Act of 
1993''.

SEC. 2. AFDC BENEFITS DENIED FOR CHILDREN WHO HAVE NOT RECEIVED 
              PREVENTIVE HEALTH CARE OR IMMUNIZATIONS.

    Section 402(a) of the Social Security Act (42 U.S.C. 602(a)) is 
amended--
            (1) by striking ``and'' at the end of paragraph (44);
            (2) by striking the period at the end of paragraph (45) and 
        inserting ``; and''; and
            (3) by inserting after paragraph (45) the following:
            ``(46) provide that--
                    ``(A) aid under the plan shall not be payable with 
                respect to any child who has not attained the age of 6 
                years, unless the State agency has received from 1 or 
                more physicians written verification (on a form 
                prescribed by the State)--
                            ``(i) that the child has been examined by a 
                        physician not less frequently than--
                                    ``(I) in the case of a child who 
                                has not attained the age of 19 months, 
                                every 6 months since the child was 
                                born; and
                                    ``(II) in the case of any other 
                                child, every 6 months until the child 
                                attained the age of 19 months, and 
                                every year thereafter;
                            ``(ii) that the child has been immunized in 
                        accordance with recommendations issued by the 
                        Surgeon General of the Public Health Service; 
                        and
                            ``(iii) of any contraindication which 
                        exempts the child from receiving an 
                        immunization;
                    ``(B) the State will conduct appropriate education 
                and outreach activities designed to--
                            ``(i) increase public awareness of the 
                        importance of preventive health care and 
                        immunizations for pre-school children; and
                            ``(ii) inform the public about--
                                    ``(I) the availability of 
                                preventive health care and immunization 
                                services for pre-school children;
                                    ``(II) any transportation, child 
                                care, or other support services that 
                                may be available to assist parents in 
                                obtaining such services for their 
                                children; and
                                    ``(III) the clinics at which any 
                                child may receive immunizations free or 
                                at a reduced charge.''.

SEC. 3. AMENDMENTS TO THE CHILD CARE AND DEVELOPMENT BLOCK GRANT.

    Section 658E(2) of the Child Care and Development Block Grant Act 
(42 U.S.C. 9858c(2)) is amended--
            (1) in subparagraph (F)--
                    (A) in clause (ii) by striking ``and'' at the end,
                    (B) in clause (iii) by striking the period at the 
                end and inserting ``; and'',
                    (C) by inserting after subclause (III), as so 
                redesignated, the following:
                            ``(iv) a requirement that such providers 
                        require with respect to each child who receives 
                        child care services from any of such providers 
                        that certificates signed by a physician who 
                        verifies that such child has been immunized in 
                        accordance with recommendations issued by the 
                        Surgeon General of the Public Health Service be 
                        submitted, at required intervals and in 
                        accordance with rules issued by the Secretary, 
                        to the child care provider involved.'', and
                    (D) by striking the last sentence, and
            (2) in subparagraph (G<plus-minus>)--
                    (i) by inserting ``(i)'' before ``Provide'', and
                    (ii) by adding at the end the following:
                    ``(ii) For the purpose of enforcing the requirement 
                described in subparagraph (F)(iv), such procedures 
                shall ensure that each of such providers gives to 
                parents of each child who receives child care services 
                from the provider involved written notice of--
                            ``(I) each immunization requirement 
                        applicable to such child;
                            ``(II) an opportunity of not less than 30 
                        days, and not more than 45 days, to correct the 
                        failure to satisfy such requirement; and
                            ``(III) the fact that child care services 
                        for such child will be terminated for failure 
                        to satisfy such requirement before the 
                        expiration of the 45-day period beginning on 
                        the date such notice is received.''.

SEC. 4. ISSUANCE OF IMMUNIZATION RECOMMENDATIONS BY THE SURGEON GENERAL 
              OF THE PUBLIC HEALTH SERVICE.

    After taking into consideration the then most recent report of the 
Committee on Infectious Diseases of the American Academy of Pediatrics, 
the Surgeon General of the Public Health Service shall issue, and 
revise from time to time, recommendations for the immunization of 
children under 6 years of age. With respect to each recommended 
immunization, such recommendation shall include--
            (1) contraindications (if any) that should be identified to 
        exempt a child from receiving such immunization, and
            (2) remedial action that may be taken to minimize the 
        adverse effect of failure to administer such immunization to a 
        child at the recommended age.

SEC. 5. EFFECTIVE DATES; APPLICATION OF AMENDMENTS.

    (a) Effective Date.--Except as provided in subsections (b) and (c), 
this Act and the amendments made by this Act shall take effect on the 
date of the enactment of this Act.
    (b) Application of Section 2 Amendments.--The amendments made by 
section 2 shall apply, without regard to whether regulations to 
implement the amendments have been promulgated, to--
            (1) payments to individuals under State plan approved under 
        part A of title IV of the Social Security Act, for months 
        ending after the 120-day period that begins with the date of 
        the enactment of this Act; and
            (2) payments to States under such part for calendar 
        quarters ending after such 120-day period.
    (c) Application of Section 3 Amendments.--The amendments made by 
section 3 shall not apply with respect to fiscal years beginning before 
the date of the enactment of this Act.

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