ASSEMBLY, No. 131

STATE OF NEW JERSEY

Introduced Pending Technical Review by Legislative Counsel

PRE-FILED FOR INTRODUCTION IN THE 1996 SESSION

By Assemblyman JONES

An Act concerning childhood immunizations and lead screening, supplementing Titles 26 and 44 of the Revised Statutes and making an appropriation.

    Be It Enacted by the Senate and General Assembly of the State of New Jersey:

    1. There is established the Children's Immunization and Lead Screening Program in the Department of Health.

    The department shall provide grants to county welfare agencies, local WIC agencies and other appropriate agencies, within the limits of monies appropriated for this purpose, to enable these agencies to establish and operate childhood immunization and lead screening programs for preschool children in need of immunization and lead screening.

    The department shall establish standards for the programs which include minimum physical plant and staffing requirements, in order to ensure the well being and safety of children who receive immunizations and lead screening pursuant to the program.

    The department shall also establish income eligibility standards based on a sliding fee scale for receipt of immunizations and lead screening.

    2. Prior to receiving a grant from the Department of Health pursuant to section 1 of P.L. , c. (C. )(pending before the Legislature as this bill), an agency shall submit its implementation plan for the childhood immunization and lead screening program. The plan shall demonstrate compliance with the department's standards for the program and shall include such other information as required by the Commissioner of Health.

    The commissioner shall select and fund those plans which best meet the purposes of P.L. , c. (C. )(pending before the Legislature as this bill).

    3. A preschool child of a recipient of aid to families with dependent children pursuant to P.L.1959, c.86 (C.44:10-1 et seq.) shall be required to complete all immunizations that are in accordance with the latest recommendations of the Advisory Committee on Immunization Practices of the United States Public Health Service and of the Department of Health as a condition of receiving the full amount of the aid to families with dependent children monthly grant to which that child and his family would otherwise be entitled.

    a. Within 180 days of the operative date of this act, every recipient of aid to families with dependent children with a preschool child shall provide the county welfare agency with documentation of the immunizations the recipient's child has received to date. In the case of a parent or guardian who applies for aid to families with dependent children after the operative date of this act, the parent or guardian shall be required to provide the county welfare agency with documentation of the immunizations the recipient's child has received to date, within two weeks of applying for public assistance.

    If the child has not received all immunizations required pursuant to this section, the child shall be required to complete the required immunizations within 90 days; except that, the director of the county welfare agency may extend the 90-day deadline for good cause shown by the parent or guardian.

    b. The documentation of the immunizations required and the medical and religious exemptions set forth in N.J.A.C.8:57-4.1 et seq. shall apply for the purposes of this act.

    c. A preschool child who has not received all immunizations required pursuant to this section may participate in the Children's Immunization and Lead Screening Program established pursuant to P.L. , c. (C. )(pending before the Legislature as this bill), at the option of the child's parent or guardian, and obtain the needed immunizations at the designated program service delivery site, or alternatively, the parent or guardian may seek to obtain the needed immunizations at any other appropriate site.

    4. A preschool child age six months through five years of an applicant for or recipient of aid to families with dependent children pursuant to P.L.1959, c.86 (C.44:10-1 et seq.) shall be required to undergo screening for elevated levels of lead exposure pursuant to this section as a condition of receiving the full amount of the aid to families with dependent children monthly grant to which that child and his family would otherwise be entitled.

    A preschool child shall be required to receive an initial screening, and if the child is six months to one year of age at the time of the initial screening, the child shall be required to receive an additional screening at two years of age.

    a. Within 180 days of the operative date of this act, every recipient of aid to families with dependent children with a preschool child age six months through five years shall provide the county welfare agency with documentation of the child's having received screening for elevated levels of lead exposure. In the case of a parent or guardian who applies for aid to families with dependent children after the operative date of this act, the parent or guardian shall be required to provide the county welfare agency with documentation of the child's having received screening for elevated levels of lead exposure, within two weeks of applying for public assistance.

    If the child has not been screened pursuant to the requirements of this act, the child shall be required to obtain the required screening within 90 days; except that, the director of the county welfare agency may extend the 90-day deadline for good cause shown by the parent or guardian.

    b. A preschool child who has not been screened for elevated levels of lead exposure may participate in the Children's Immunization and Lead Screening Program established pursuant to P.L. , c. (C. )(pending before the Legislature as this bill), at the option of the child's parent or guardian, and receive the required screening at the designated program service delivery site, or alternatively, the parent or guardian may seek to obtain the screening at any other appropriate site.

    5. The parent or guardian of a preschool child who does not provide appropriate documentation of the immunizations for that child within the time specified pursuant to section 3 of P.L. , c. (C. )(pending before the Legislature as this bill), or who has not had his child screened for elevated levels of lead exposure within the time specified pursuant to section 4 of P.L. , c. (C. )(pending before the Legislature as this bill), and has not been granted an exemption or extension of the deadline by the director of the county welfare agency, shall be subject to financial sanctions as provided in this section.

    a. The recipient's aid to families with dependent children monthly grant shall be reduced $25 for each child included in the grant who is not in compliance with the requirements of P.L. , c. (C. )(pending before the Legislature as this bill). The reduction in the monthly grant shall continue until such time as the parent or guardian provides the county welfare agency with appropriate documentation of immunization and lead screening. Upon receipt of appropriate documentation, the county welfare agency shall restore the monthly grant to its full amount and shall make a retroactive payment to the recipient for the full amount that was withheld from the grant for noncompliance with the requirements of P.L. , c. (C. )(pending before the Legislature as this bill).

    b. Notwithstanding the provisions of this section to the contrary, if there is no Children's Immunization and Lead Screening Program designated service delivery site in the county, the county welfare agency shall not impose financial sanctions on a parent or guardian whose preschool child is not in compliance with the requirements of P.L. , c. (C. )(pending before the Legislature as this bill).

    6. The Commissioner of Health shall establish by regulation the type of screening for elevated levels of lead exposure and the documentation of the lead screening required for preschool children of aid to families with dependent children recipients pursuant to section 4 of P.L. , c. (C. )(pending before the Legislature as this bill). The commissioner shall also establish by regulation medical and religious exemptions that shall apply for the purposes of that act.

    7. The Department of Human Services shall apply to the Secretary of the United States Department of Health and Human Services for any necessary waivers of federal regulations in order to implement the provisions of sections 3, 4 and 5 of P.L. , c. (C. )(pending before the Legislature as this bill).

    8. The Department of Health, to the greatest extent possible, shall coordinate the funding of the Children's Immunization and Lead Screening Program with the State Medicaid program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.) so as to ensure that the State receives the maximum amount of federal financial participation available for services provided pursuant to the program.

    9. The Department of Health shall adopt rules and regulations pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.) necessary to carry out the purposes of this act.

    10. There is appropriated $6 million from the General Fund to the Department of Health for the Children's Immunization and Lead Screening Program.

    11. This act shall take effect on July 1, 1995, but sections 3, 4 and 5 shall remain inoperative until the Department of Human Services receives any necessary waivers of federal regulations.

STATEMENT

    This bill establishes the Children's Immunization and Lead Screening Program in the Department of Health.

    Under the program, the department will provide grants to county welfare agencies, local WIC agencies and other appropriate agencies, within the limits of monies appropriated for this purpose, to enable these agencies to establish and operate childhood immunization and lead screening programs for preschool children in need of immunization and lead screening.

    The bill requires, subject to federal approval, that a preschool child of a recipient of aid to families with dependent children (AFDC) complete all immunizations required by the Department of Health and undergo screening for elevated levels of lead exposure as a condition of receiving the full amount of the AFDC monthly grant to which the child and the family would otherwise be entitled. A recipient's monthly grant will be reduced $25 for each month that the recipient is out of compliance with the requirements in the bill; however, the recipient will receive a retroactive payment for the amount withheld when the recipient provides appropriate documentation that the child has been immunized and has undergone lead screening.

    The department must coordinate this program with the State Medicaid program to maximize federal financial participation.

Establishes the Children's Immunization and Lead Screening Program in DOH; appropriates $6 million.