My First Take on Senator Pan’s June 17th SB 276 Revision

My First Take on Senator Pan’s June 17th SB 276 Revision

I have to give the guy credit. He’s very good at Legislative tactics, meaning throwing curveballs to the opposition and giving them little time to react.

It’s two days before the hearing and he’s introduced what appears to be a substantially revised bill, which is more complicated and apt to confuse his colleagues in the legislature all the while seeming to address the main points of criticism, thereby taking the wind out the sails of his opposition.

I’ve looked over the new bill carefully and I think I’ve figured out the main points anyway. I’ll go into details and quoting the statute later, but I wanted to get out the big picture quick and dirty:

For current medically exempt: Not much difference from prior versions. Exemptions still have be be submitted and are subject to review and revocation, with some small differences which I’ll discuss later.

The big, at least nominal changes are for new exemptions after the proposed exemption process takes effect on January 1, 2021.

Under prior versions: docs write medical exemptions applications, which are approved or rejected by state public health officials.

Under the new version, docs write “medical exemptions certifications” which seemingly are actual medical exemptions, like under the current law. exemptions.

But here is the rub: The exemptions are reviewable and revocable by a public health official or process, basically anytime a public health official wants to review any exemption. And since the health officials have all the exemptions, I have to believe they will simply target the known few exemption writing physicians which remain.

So practically speaking, the physician writes, let’s call it a conditional exemption, but it seems certain that any exemption which is broader than CDC contraindications, precautions and CDC family history indications (if there is even such a thing) will be rejected. The practical result will be the same as under prior iterations of the bill, no broad based complete, non temporary medical exemptions.

This version really goes after the exemption writing physicians hard, and especially the exemption writing physician’s who are not the child’s PCP.
The bill requires the exemption writing physician to notify the child’s PCP about the exemption.
What do you think a conventional PCP will do after he/she gets that notification? File a complaint with the medical board for fraudulent medical exemption writing.

The new version also provides that once there is an accusation against a physician involving an immunization issue, that physician will no longer be able to right exemptions unless and until he’s cleard of the charges.

There are two other targets painted on the backs of exemption writing physicians.

First, special treatment/negative consideration if the physician writes more than 5 medical exemptions.

Second, each medical exemption certification has to be signed under penalty of perjury. This last requirment will either be meaningless or could end medical exemptions for good, depending on the wording of the certification. I may discuss the differences in a later post.

So to recap: We’ve gone from doctors submitting applications for public health officials’ approval, to physicians writing exemption certifications which are immediately reviewable by public health officals, and will be approved or rejected under basically the same of CDC, APA ACIP guidelines, and heven help the physician who continues to write exemptions, because they will be in a whole world of hurt if they do.

Bottom line: same result, nominally different method to achieve it, and alot nastier for the exemption writing physicians. You really get a sense from this version how much Senator Pan and his allies hate these doctors.

RicK Jaffe, Esq.

11 thoughts on “My First Take on Senator Pan’s June 17th SB 276 Revision

  1. Thank you for providing your views, it is appreciated. It very much seems like an attempt to legislate the practice of medicine into one mold. No second opinions or further investigation allowed. Seems to me the end result might be the stifling of new research in the state as well. I know this is gazing into a crystal ball but I do have to wonder how this type of legislative control of the practice of medicine would come into play down the line if universal health care comes to fruition in California.

  2. Thank you for taking the time to analyze this.
    What physician will even write ME certificates under this? They’ll have to choose the 5 kids a year they deem worthy… the rest can just dangle out in the wind?
    Our Ped agreed our daughter needed one, but refused to write one. Said it was a “slippery slope”. This is so maddening and heartbreaking for CA families.

  3. Thank you very much for this “first take” summary. Very helpful to parents of special needs, vaccine-injured children like me, who have little time to wade through 21 pages of Legislative Counsel Digest and text of bill!

    Pan seems to be nothing but a puppet, with ample evidence in his “spontaneous” (as opposed to “scripted”) speech that his cognition and judgment are impaired and he is paranoid. His “allies” as you call them are the strategists and tacticians behind Pan’s bills, speeches, and maneuvers.

  4. Hi Richard,

    I know you are focused on SB 276, but can you possibly weigh in on something on SB 277? There is much confusion out there. I have been told that Shots for Kids is not the legal truth on what is required for children who have passed the 7th grade advancement checkpoint and are going into 9th grade but at a different school, ie. a 9-12 grade High School. According to the site below, there are only 2 checkpoints and legally, they can’t check at 7th and then again at 9th, even if she is going into a new school with a different grade span. In SB 277 for people with PBE’s prior to 1/1/2016, it reads in Section 120335, in the grade span definitions: 2) …. B) kinder and grades 1-6, inclusive and c): “Grades 7 to 12, inclusive”.

    “They are valid until the next grade span “checkpoint” of TK/K or 7th grade. It doesn’t matter which grades are included in the school. The “checkpoints” are limited to the specific grade. Inclusive is defined to include all grades within the grade span.”

    Someone I know says that this is the law, not what is on Shots for Kids which has entirely different information. So this means, according to her and success she has had in pushing back against her school, that once you are past 7th grade, there are no more legal checks. Is this legally correct or did she luck out with her school district?

    Hoping you can help as this is maddening and confusing many people out there.


    1. Sarabella, it’s correct that there are no legal checkpoints after 7th grade. A “grandfathered” exemption transfers from one school to another, even if the new school is in a different school district, and even if the transfer is public school to private school or private school to public school. The paperwork for the exemption travels to the new school in the student’s cumulative educational record.

      Keep in mind, though, that every school is required to collect information on the vaccination status of each student, even if the student has an exemption. This information is collected so that in the event of an outbreak of a communicable, “vaccine-preventable” illness, public health officials can tell the school which students (if any) should be excluded from school during the outbreak due to lack of vaccination for the illness.

  5. Sorry Sarabella, I don’t know anything about your SB 277 issue. I’ll refer it to my go to guy Greg Glaser. He know just about everything in California vaccine law.

  6. The changes just made to SB276 make it a lot easier for people with influence to get medical exemptions. I wonder if some high-roller Democrat donors, or important politicians, or perhaps his wife, talked to Newsom and said that they really need medical exemptions… With the changes just made to SB276, the state can just not review an exemption and it is valid. Before, the state had to review it before it was valid, which would make it much harder to use different standards for different people.

  7. what I find chilling is that the doctor has to sign under penalty of perjury that the entire document is “accurate and true”. elsewhere it states that the exemption must be within CDC/AICP, etc guidelines.

    While it doesn’t explicitly link “accurate and true” with CDC guidelines, this would seem to open the door to criminal prosecution for going out of the CDC/AICP, etc guidelines.

  8. The court, in Jacobson, gave exemptions from state requirements to the medically vulnerable but state decides who is vulnerable? Seems to circumvent the court and provide the foundation for a suit. Thoughts?

  9. Thank you for keeping us all updated on what’s currently going on. It’s very much appreciated. If a child has an IEP (personal educational plan) will they be automatically exempt from vaccinations if that’s what their parents choose or is that all about to change as well? For the children who already have a medical exemption will that all change for the upcoming school year of 2019/2020 or will that change start in 2021? Again thank you for all of your time and information.

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