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.