Attorney: Oregon’s School Exclusion Bill Makes Medical Exemptions MORE Difficult to Obtain
- Bill to exclude children from public school, private school, and day care if missing just one vaccine will be voted on in the Oregon House of Representatives Monday. School exclusion is not good for Oregon.
- Lawmakers say they’ve received thousands of emails, mailed letters, phone calls, and visits from constituents who oppose HB 3063 and are against school exclusion
- Colorado and Washington State defeated similar school exclusion bills
- As the pharmaceutical lobby pushes for mandates in bills across the country German-based pharmaceutical giant Merck, which has a monopoly on the MMR vaccine, reports record earnings this quarter, as vaccine sales soar
- Opponents to HB 3063 say school exclusion is discriminatory and violates the right to privacy and medical freedom
- Lawyer Robert Snee says proposed amendment makes it HARDER for medically fragile children to get medical exemptions. So they may face school exclusion and medical hardship
Some Oregon lawmakers are pushing hard to pass HB 3063, a bill that Republican Kim Thatcher has dubbed the “Forcible Injections Act.”
Parents across the state have been lobbying their lawmakers, arguing that medical decisions are best made in the privacy of a doctor’s office, not in the state legislature.
Similar bills to limit medical freedom and force a one-size-fits-all vaccination schedule onto America’s children in other states have died.
Oregon has among the strictest rules in the country when it comes to doctors writing medical exemptions. Bill sponsors have promised Oregonians that it will be easier to get medical exemptions.
But, according to Robert M. Snee, Esq., these same lawmakers have actually made it more difficult for doctors to exempt medically fragile children out of vaccination.
Most doctors in Oregon refuse to write medical exemptions, even when indicated, because they fear scrutiny from the Oregon Health Authority.
According to Oregonians for Medical Freedom, Medical exemptions have NOT been expanded:
The B-engrossed version of the bill and the claim that it makes medical exemptions “easier” is not true. While the bill creates new sections of law which authorizes the Medical Board, Nursing Board, and Naturopathic Board to review medical exemptions, it does NOT DELETE the existing sections of law that require the local health department to provide a secondary evaluation of the records to determine compliance with section 1 of ORS 433.267. Sections 4,5,6,7 and 8 of ORS 433.2676 remain unchanged, and that is how medical exemptions are currently reviewed and either approved or disqualified.
In his letter to legislatures (reprinted below), Robert M. Snee points out that, “medical exemptions actually become more burdensome.”
The Oregon House of Representatives has scheduled a vote on the bill on Monday.
Robert M. Snee
Attorney at Law
P.O. Box 16866 Portland, Oregon 97292-0866
May 2, 2019
Re: HB3063 (B-engrossed text) and the purported “easing” of medical exemptions
I am an Oregon attorney, admitted to practice law in state and federal courts in the state of Oregon. Although I am one of the founders of Oregonians for Medical Freedom, this letter is not written on their behalf, nor do I represent Oregonians for Medical Freedom. This letter contains my understanding of the medical exemption process under existing law compared to the process to be adopted if HB3603 passes both the House and Senate and is signed into law by Governor Brown.
Following the public hearing before the House Health Committee, in response to concerns raised by the testimony of numerous parents over the difficulty of obtaining a medical exemption under current law, several legislators have stated that there would be amendments forthcoming which would make it “easier” to obtain medical exemptions, than under the current law.
The complaint voiced by all regarding the difficulty of obtaining a medical exemption, focused on the limited reasons which local health departments approve medical exemptions and not of the procedure by which those decisions are made.
Many pointed out the CDC recently amended the information contained on the Vaccine Information Statement (VIS) to recommend additional conditions which would disqualify someone from receiving the MMR vaccine, including situations where a family member has certain auto immune conditions.
These additional recommendations have not yet been adopted by the ACIP. Several legislators have stated that the -53 amendment accomplished the “easing” of obtaining medical exemptions. The B-engrossed version of the bill incorporates all the amendments adopted by both the House Health Committee and the Joint Ways and Means Committee.
Under current law, ORS 433.267, paragraphs 4, 5, 6, 7 and 8 contain the procedures by which local health departments, under the supervision of OHA, review all immunization records submitted to schools, including medical exemptions and either approve them or disqualify the medical exemptions.
In conducting this review, local health departments are guided by an administrative rule adopted by OHA, OAR 333-050-0040 and OAR 333-050-0070.
OAR 333-050-0040 (b) states: “A written statement of medical exemption signed by a physician or authorized representative of the local health department and approved by an authorized representative of the local health department; (emphasis added)
OHA and local health departments have consistently disqualified medical exemptions that are not in compliance with the 2003 recommendations from the Advisory Committee on Immunization Practices, (ACIP).
As published by OHA in a guide for physicians on medical exemptions, OHA states, “Physicians in Oregon are allowed to sign medical exemptions for children with valid medical contraindications to immunization as determined by the Advisory Committee on Immunization Practices.”
This requirement is NOT presently codified in statute or administrative rule. https://www.oregon.gov/oha/ph/PreventionWellness/VaccinesImmunization/Documents/MedEx mpguid.pdf?fbclid=IwAR3xRI2oPvbzjejpnV5CGfj_nQYKbZDlzxR99BO7ToBLkw_LsnMtav_ Q6PE
The guide goes further on to state: “All medical exemptions are subject to the approval of the local health department. Medical exemptions written for reasons of personal belief or spacing preferences will be denied.”
Nothing in current statutes requires the approval of medical exemptions by local health departments, it is a power assumed by OHA when it created rules pursuant to ORS 433.273, specifically, paragraph (6), which authorizes rules which relate to: “The manner in which immunization records for children are established, evaluated and maintained.” This provision regarding the rulemaking authority of OHA remains unchanged and a part of ORS 433.273, even if HB3063 is enacted into law.
Section 3 of the B-engrossed text of HB3063 provides a new section of law to be added to and made a part of ORS 433.235 to 433.284.
That section sets up an oversight system which requires the Oregon Board of Naturopathic Medicine, the Oregon Medical Board, and the Oregon State Board of Nursing, to review the medical exemptions granted by their respective health care practitioners for compliance with the recommendations of the ACIP.
It further requires each board to report annually to OHA and requires each board to adopt rules that must include, but are not limited to, establishing a process for the reviews.
Each board may also consult with OHA in the drafting of those rules.
Consistent with OHA’s prior practice of assuming the right to evaluate immunization records includes the right to disqualify them based on a particular standard, it is reasonable to assume that any rules adopted by the Oregon Board of Naturopathic Medicine, the Oregon Medical Board, and the Oregon State Board of Nursing, to review medical exemptions for compliance, if done in consultation with OHA, will include the right to disqualify those exemptions that are found not to be in compliance with the ACIP guidelines, a standard which would be codified in statute with the passage of HB3063.
Under current law and administrative rules, medical exemptions are either temporary or permanent. All medical exemptions are temporary until reviewed by the local health department.
Any temporary exemption requires a new submittal by a physician with a request for an extension and re-review by the local health department.
Under HB3063 as amended, permanent medical exemptions will no longer be available, as “A document described in this paragraph must be renewed and submitted annually to the administrator.”
Each year, the respective boards will be tasked with evaluating the exemptions for compliance as well as issue annual reports to OHA and an interim legislative health care committee.
Under the current law and administrative rules, naturopaths are already included in the definition of “physicians” that are qualified to write medical exemptions. The only addition under HB3063 is to add nurse practitioners as qualified to write exemptions.
To summarize the changes in the medical exemption process which HB3063 as amended by -53 will bring, affect only the process of obtaining medical exemptions and do not change the standard by which medical exemptions are to be evaluated for compliance with ACIP guidelines.
The proposed changes merely modify the procedures for submitting, reviewing, and evaluating medical exemptions without loosening and easing the medical conditions which would qualify for a medical exemption.
The proposed changes included in the -53 amendment to HB3063 do not expand the list of conditions which qualify for a medical exemption, and therefore, medical exemptions are not any easier to obtain than under the current policies adopted by OHA.
Further, medical exemptions actually become more burdensome, as permanent exemptions will no longer be accepted and all medical exemptions will need to be resubmitted and reviewed on an annual basis.
Robert M. Snee, Attorney at Law
Published: May 4, 2019
Updated: October 16, 2019