,,ii  #aad? ,,congress  #a/ ,session    
,s4 #aiba  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,augu/ #d1 #bjae ,mr4  
,murphy introduc$ ! foll[+ bill2 :i* 0  
read twice & ref]r$ to ! ,committee on  
,f9ance  ,a ,,bill  ,to am5d title ,,xix
 ( ! ,social ,security ,act to enc\rage 
,/ates to adopt adm9i/rative proc$ures )
 respect to nonm$ical exemptions = ,/ate
 immunization requirem5ts4  #a4 ,%ort   
title  ,?is ,act may be cit$ z !        
,vacc9ate ,am]ica's ,*ildr5 ?r\gh       
,complete ,in=mation  ,education ,act ( 
#bjae4  #b4 ,enc\rag+ ,/ates to /r5g!n  
adm9i/rative proc$ures relat$ to        
nonm$ical exemptions f ,/ate vacc9ation 
requirem5ts  7a7 ,9 g5]al ,section #aibh
 ( ! ,social ,security ,act 7#db        
,u4,s4,c4 #acifs7 is am5d$-- 7#a7 by    
r$esignat+ subsection 7h7 z subsection  
7i72 &  7#b7 by ins]t+ aft] subsection  
7g7 ! foll[+ new subsection3  7h7       
,adm9i/rative proc$ures = grant+        
nonm$ical exemptions  7#a7 ,c]tification
 ( adoption ( proc$ures  7,a7 ,9 g5]al  

,a ,/ate program "u ?is section does n  
comply ) ! requirem5ts ( ?is section    
unless ! ,/ate c]tifies to ! ,secret>y t
 ! ,/ate has e/abli%$ adm9i/rative      
proc$ures = grant+ nonm$ical exemptions 
f ,/ate immunization requirem5ts 7z     
def9$ 9 subp>agraph 7,b77 t include at  
lea/ #b ( ! pr]equisites describ$ 9     
p>agraph 7#b74  7,b7 ,nonm$ical         
exemption f ,/ate immunization          
requirem5t ,= purposes ( ?is subsection1
 ! t]m nonm$ical exemption f ,/ate      
immunization requirem5ts means any      
exemption f a ,/ate law t requires a    
*ild to receive a p$iatric vacc9e       
7includ+ s*ool immunization requirem5ts7
 t is n bas$ on a m$ical reason4  7#b7  
,nonm$ical exemption pr]equisites ,!    
pr]equisites = grant+ a nonm$ical       
exemption f ,/ate immunization          
requirem5ts describ$ 9 ?is p>agraph are 
! foll[+3  7,a7 ,! ,/ate requires t     
prior to ! exemption be+ grant$1 a p>5t 
or gu>dian seek+ a nonm$ical exemption f
 ,/ate immunization requirem5ts = a *ild

 %all discuss ! consequ5ces (           
nonvacc9ation ) ! *ild's p$iatrician or 
o!r prim>y c>e provid] & t ! discussion 
is not$ 9 ! *ild's m$ical record4  7,b7 
,! ,/ate requires t prior to ! exemption
 be+ grant$1 a p>5t or gu>dian seek+ a  
nonm$ical exemption f ,/ate immunization
 requirem5ts = a *ild read & sign a =m t
 discusses ! risks ( nonvacc9ation &    
submits ! =m to ! ,/ate4  7,c7 ,! ,/ate 
requires t prior to ! exemption be+     
grant$1 a p>5t or gu>dian seek+ a       
nonm$ical exemption f ,/ate immunization
 requirem5ts = a *ild submits to ! ,/ate
 a not>iz$ lett] describ+ ! p>5t's or   
gu>dian's reasons = seek+ ! exemption4  
7,d7 ,! ,/ate requires t all nonm$ical  
exemptions f ,/ate immunization         
requirem5ts %all only be grant$ = a     
#a-ye> p]iod & %all be requir$ to be    
r5ew$ annually if a p>5t or gu>dian ( a 
*ild wants ! exemption to cont9ue =     
ano!r ye>4  7#c7 ,p5alty  7,a7 ,9 g5]al 
,) respect to a fiscal ye>1 if a ,/ate  
fails to submit ! c]tification requir$  

"u p>agraph 7#a7 or if ! adm9i/rative   
proc$ures e/abli%$ by ! ,/ate = grant+  
nonm$ical exemptions f ,/ate            
immunization requirem5ts d n include at 
lea/ #b ( ! pr]equisites describ$ 9     
p>agraph 7#b71 ! ,/ate %all pay !       
,secret>y an am\nt equal to--  7i7 9 !  
case ( a ,/ate t is n a manufactur] (   
p$iatric vacc9es1 #e p]c5t ( ! value 7z 
det]m9$ by ! ,secret>y7 ( ! vacc9es     
provid$ to ! ,/ate "u subsection        
7b77#b77;,a7 = t fiscal ye>2 &  7ii7 9 !
 case ( a ,/ate t is a manufactur] (    
p$iatric vacc9es1 #e p]c5t ( ! sum (--  
7,i7 ! value 7z det]m9$ by ! ,secret>y7 
( any vacc9es provid$ to ! ,/ate "u     
subsection 7b77#b77;,a7 = t fiscal ye>2 
&  7,,ii7 ! am\nt paid to ! ,/ate = !   
fiscal ye> "u subsection 7b77#b77;,c74  
7,b7 ,treatm5t z an ov]paym5t ,a ,/ate  
paym5t requir$ to be made to ! ,secret>y
 "u subp>agraph 7,a7 %all be deem$ an   
ov]paym5t to ! ,/ate "u ?is title to be 
disall[$ aga9/ ! ,/ate's regul> qu>t]ly 
draw = all sp5d+ "u section             

#aijc7;d77#b74 ,su* a disall[ance is n  
subject to a reconsid]ation "u section  
#aaaf7;e74  4  7b7 ,con=m+ am5dm5ts     
7#a7 ,section #aibh ( ! ,social         
,security ,act 7#db ,u4,s4,c4 #acifs71 z
 am5d$ by subsection 7a71 is fur!r      
am5d$--  7,a7 9 subsection 7a77#a77;,a71
 by /rik+ subsection 7h77#h7 & ins]t+   
subsection 7i77#h72 &  7,b7 9 subsection
 7b77#b77;,a77iv71 by /rik+ subsection  
7h77#c7 & ins]t+ subsection 7i77#c74    
7#b7 ,section #fji7;d7 ( ! ,employee    
,retirem5t ,income ,security ,act (     
#aigd 7#db ,u4,s4,c4 #aafi7;d77 is am5d$
 by /rik+ section #aibh7;h77#f7 & ins]t+
 section #aibh7;i77#f74  7c7 ,effective 
date ,! am5dm5ts made by ?is ,act %all  
take effect on ! date t is #a ye> aft] !
 date ( ! enactm5t ( ?is ,act4