SB1377 - Immunizations: medical exemptions.

Amended IN Senate March 25, 2026 CALIFORNIA LEGISLATURE— 2025–2026 REGULAR SESSION Senate Bill No. 1377 Introduced by Senator Jones February 20, 2026 An act to amend Section 1250.06 of the Health and Safety Code, relating to health facilities. add Article 16 (commencing with Section 2380) to Chapter 5 of Division 2 of the Business and Professions Code, to amend Sections 120325 and 120375 of, to add Sections 1272.5 and 1374.199 to, to repeal Section 120372.05 of, and to repeal and add Sections 120370 and 120372 of, the Health and Safety Code, and to add Section 10127.22 to the Insurance Code, relating to immunizations. LEGISLATIVE COUNSEL'S DIGEST SB 1377, as amended, Jones. Health facilities. Immunizations: medical exemptions. (1) Existing law prohibits the governing authority of a school or other institution from unconditionally admitting any person as a pupil unless, before the person’s admission to that institution, the person has been fully immunized against various diseases, including any disease deemed appropriate by the State Department of Public Health. Existing law provides for medical exemptions from immunization requirements. Existing law requires the department to develop and make available for use by licensed physicians and surgeons an electronic, standardized, statewide medical exemption certification form to be transmitted directly to the department’s California Immunization Registry (CAIR) and submitted directly to the school or institution at which the child will attend, submitted directly to the governing authority of the school or institution, or submitted to that governing authority through the CAIR where applicable. Existing law requires the form to be the only documentation of a medical exemption that the governing authority may accept. Existing law requires the department to identify medical exemption forms that do not meet specified criteria for appropriate medical exemptions. Existing law requires inappropriate or otherwise invalid exemptions to be reviewed by the State Public Health Officer or a physician and surgeon, and authorizes the revocation of the medical exemption. Existing law requires the department to notify the Medical Board of California or the Osteopathic Medical Board of California, as appropriate, of any physician and surgeon who has 5 or more medical exemption forms in a calendar year that are revoked. Existing law authorizes the appeal of a revoked medical exemption by a parent or guardian, as specified. This bill would repeal these provisions. Existing law, prior to January 1, 2021, exempts a child from immunization requirements if the parent or guardian files with the governing authority a written statement by a licensed physician and surgeon to the effect that the physical condition of the child is such, or medical circumstances relating to the child are such, that immunization is not considered safe, indicating the specific nature and probable duration of the medical condition or circumstances for which the physician and surgeon does not recommend immunization. This bill would exempt a child from immunization requirements if the parent or guardian files with the governing authority a written statement, as described above. The bill would prohibit the department, a local health department, or a third-party review panel from revoking, invalidating, or conditioning a medical exemption duly issued by a licensed physician and surgeon, except by final order of a court upon clear and convincing evidence of fraud. The bill would prohibit the department and local health departments from auditing, disciplining, or referring a physician and surgeon to the Medical Board of California or Osteopathic Medical Board of California based solely on the number of medical exemptions issued. (2) Existing law establishes the Medical Board of California and the Osteopathic Medical Board of California for the licensure and regulation of physicians and surgeons and osteopathic physicians and surgeons. Existing law authorizes the boards to, among other things, investigate and discipline licensees for misconduct. This bill would prohibit a physician and surgeon from being investigated, disciplined, or otherwise acted against by any state department or board based on their issuance of medical exemptions unless the medical exemption is found to be fraudulent or otherwise invalid. The bill would prohibit a medical exemption from being considered in any investigation or action against a physician and surgeon that is otherwise unrelated to medical exemptions. (3) Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care, and makes a willful violation of the act a crime. Existing law provides for the regulation of health insurers by the Department of Insurance. This bill would prohibit a health care service plan or health insurer from denying coverage, imposing higher premiums, canceling a policy, or otherwise penalizing an enrollee or insured because a covered minor holds a medical exemption. Because a violation of this requirement by a health care service plan would be a crime, this bill would impose a state-mandated local program. (4) Existing law provides for the licensure and regulation of health facilities, as defined, by the State Department of Public Health. Existing law makes a violation of those provisions a misdemeanor. This bill would prohibit a health facility from denying medically necessary care on the basis of a medical exemption. Because a violation of this provision would be a crime, this bill would impose a state-mandated local program. (5) The bill would require the State Department of Public Health to repeal or amend any regulation inconsistent with this bill on or before July 1, 2027. (6) The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason. Existing law requires a licensed general acute care hospital or acute psychiatric hospital to adopt policies and procedures regarding the responsibility for ensuring proper methods of repackaging and labeling of bulk cleaning agents, solvents, chemicals, and nondrug hazardous substances used throughout the hospital and does not require these health facilities to consult a pharmacist regarding the repackaging and labeling of these substances, except as specified. This bill would make technical, nonsubstantive changes to these provisions. Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: NO YES Local Program: NO YES Bill Text The people of the State of California do enact as follows: SECTION 1. Article 16 (commencing with Section 2380) is added to Chapter 5 of Division 2 of the Business and Professions Code, to read: Article 16. Immunization Medical Exemptions 2380. For purposes of this article, “medical exemption” has the same meaning as described in Section 120370 of the Health and Safety Code. 2381. A physician and surgeon shall not be investigated, disciplined, or otherwise acted against by any state department or board based on their issuance of a medical exemption unless the medical exemption is found to be fraudulent or otherwise invalid. 2382. A medical exemption shall not be considered in any investigation or action against a physician and surgeon that is otherwise unrelated to medical exemptions. 2383. A medical exemption shall not be revoked or invalidated based on any investigation or action against a physician if that investigation does not relate to medical exemptions. SEC. 2. Section 1272.5 is added to the Health and Safety Code, to read: 1272.5. A health facility shall not deny medically necessary care on the basis of a medical exemption, as described in Section 120370. SEC. 3. Section 1374.199 is added to the Health and Safety Code, to read: 1374.199. A health care service plan shall not deny coverage, impose higher premiums, cancel a policy, or otherwise penalize an enrollee because a covered minor holds a medical exemption, as described in Section 120370. SEC. 4. Section 120325 of the Health and Safety Code is amended to read: 120325. In enacting this chapter, but excluding Section 120380, and in enacting Sections 120400, 120405, 120410, and 120415, it is the intent of the Legislature to provide: (a) A means for the eventual achievement of total immunization of appropriate age groups against the following childhood diseases: (1) Diphtheria. (2) Hepatitis B. (3) Haemophilus influenzae type b. (4) Measles. (5) Mumps. (6) Pertussis (whooping cough). (7) Poliomyelitis. (8) Rubella. (9) Tetanus. (10) Varicella (chickenpox). (11) Any other disease deemed appropriate by the department, taking into consideration the recommendations of the Advisory Committee on Immunization Practices of the United States Department of Health and Human Services, the American Academy of Pediatrics, and the American Academy of Family Physicians. (a) For the prevention and control of communicable diseases. (b) That the persons required to be immunized be allowed to obtain immunizations from whatever medical source they so desire, subject only to the condition that the immunization be performed in accordance with the regulations of the department and that a record of the immunization is made in accordance with the regulations. (c) Exemptions from immunization for medical reasons. (d) For the keeping of adequate records of immunization so that health departments, schools, and other institutions, parents or guardians, and the persons immunized will be able to ascertain that a child is fully or only partially immunized, and so that appropriate public agencies will be able to ascertain the immunization needs of groups of children in schools or other institutions. (e) Incentives to public health authorities to design innovative and creative programs that will promote and achieve full and timely immunization of children. SEC. 5. Section 120370 of the Health and Safety Code is repealed. 120370. (a) (1) Prior to January 1, 2021, if the parent or guardian files with the governing authority a written statement by a licensed physician and surgeon to the effect that the physical condition of the child is such, or medical circumstances relating to the child are such, that immunization is not considered safe, indicating the specific nature and probable duration of the medical condition or circumstances, including, but not limited to, family medical history, for which the physician and surgeon does not recommend immunization, that child shall be exempt from the requirements of this chapter, except for Section 120380, and exempt from Sections 120400, 120405, 120410, and 120415 to the extent indicated by the physician and surgeon’s statement. (2) Commencing January 1, 2020, a child who has a medical exemption issued before January 1, 2020, shall be allowed continued enrollment to any public or private elementary or secondary school, child care center, day nursery, nursery school, family day care home, or developmental center within the state until the child enrolls in the next grade span. For purposes of this subdivision, “grade span” means each of the following: (A) Birth to preschool, inclusive. (B) Kindergarten and grades 1 to 6, inclusive, including transitional kindergarten. (C) Grades 7 to 12, inclusive. (3) Except as provided in this subdivision, on and after July 1, 2021, the governing authority shall not unconditionally admit or readmit to any of those institutions specified in this subdivision, or admit or advance any pupil to 7th grade level, unless the pupil has been immunized pursuant to Section 120335 or the parent or guardian files a medical exemption form that complies with Section 120372. (b) If there is good cause to believe that a child has been exposed to a disease listed in subdivision (b) of Section 120335 and the child’s documentary proof of immunization status does not show proof of immunization against that disease, that child may be temporarily excluded from the school or institution until the local health officer is satisfied that the child is no longer at risk of developing or transmitting the disease. SEC. 6. Section 120370 is added to the Health and Safety Code, to read: 120370. (a) If the parent or guardian files with the governing authority a written statement by a licensed physician and surgeon to the effect that the physical condition of the child is such, or medical circumstances relating to the child are such, that immunization is not considered safe, indicating the specific nature and probable duration of the medical condition or circumstances, including, but not limited to, family medical history, for which the physician and surgeon does not recommend immunization, that child shall be exempt from the requirements of this chapter, except for Section 120380, and exempt from Sections 120400, 120405, 120410, and 120415 to the extent indicated by the physician and surgeon’s statement. (b) When determining whether a medical exemption is appropriate pursuant to subdivision (a), a physician and surgeon shall use accepted standards of care and shall not be required to use criteria established by the department. (c) A medical exemption, as described in Section 120370, shall not be grounds for the denial of education or access to education or admission to any education or childcare facility nor for the participation in any school programs, extracurricular activities, scholarships, housing, or anything else related to schooling and education in the state at any level. A pupil with a medical exemption shall not be excluded, segregated, or otherwise treated differently from similarly situated pupils. SEC. 7. Section 120372 of the Health and Safety Code is repealed. 120372. (a) (1) By January 1, 2021, the department shall develop and make available for use by licensed physicians and surgeons an electronic, standardized, statewide medical exemption certification form that shall be transmitted directly to the department’s California Immunization Registry (CAIR) established pursuant to Section 120440. Pursuant to Section 120375, the form shall be printed, signed, and submitted directly to the school or institution at which the child will attend, submitted directly to the governing authority of the school or institution, or submitted to that governing authority through the CAIR where applicable. Notwithstanding Section 120370, commencing January 1, 2021, the standardized form shall be the only documentation of a medical exemption that the governing authority may accept. (2) At a minimum, the form shall require all of the following information: (A) The name, California medical license number, business address, and telephone number of the physician and surgeon who issued the me [Text truncated for display. Full text available on Congress.gov.]