School and Child Care Immunization

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This web page accommodates info and sources relating to college and little one care immunization necessities and reporting. We replace it often to mirror modifications from yr to yr.

Click on any of the hyperlinks beneath to leap to a selected subject.

Immunization Manual for Schools, Preschools and Child Care Facilities

Immunization Laws and Rules

Immunization Requirements

Certificate of Immunization Status (CIS)

Exemptions from Immunization Requirements – Certificate of Exemption (COE)

Conditional Status Attendance

Excluding Children Out-of-Compliance with Immunization Requirements

Outbreaks and Exclusion

Immunization Status Reporting – Due Annually by November 1st

Immunization Information System School Module

General Resources

Preschool and Child Care Resources

School K-12 Resources and Sample Letters

Vaccine Information

Program Webpages

Frequently Asked Questions

Immunization Handbook for Colleges, Preschools and Youngster Care Services

The Immunization Handbook for Colleges, Preschools, and Youngster Care Services helps workers who serve on the immunization frontline at faculties, preschools, and little one care amenities. You will discover useful info and sources to reply questions on immunization necessities, course of Certificates of Immunization Standing, and full standing experiences.

Immunization Legal guidelines and Guidelines

Immunization Necessities

IVRS – Particular person Vaccine Necessities Abstract for Colleges and Youngster Care: Detailed medical steering on immunizations required for varsity and little one care/preschool together with catch-up schedules and exceptions

Youngster Care Necessities Charts

Youngsters getting into little one care should get the required doses listed on this chart to be in compliance with immunization necessities. College-aged youngsters (preschool – grade 12) in earlier than and after-school applications should meet the immunization necessities for his or her grade in class. The necessities comply with the nationwide Advisory Committee on Immunization Practices (ACIP) Immunization Schedule.

To learn the chart, discover the kid’s age vary and comply with the row throughout to seek out the variety of vaccine doses required by that age. For instance, if a baby is 6 ½ months outdated (not but 7 months outdated), have a look at the row “By 5 months”. A 6 ½ month outdated little one wants a complete of two doses of DTaP vaccine. By the point the kid reaches 7 months, they may want 3 whole doses (have a look at the DTaP column and row “By 7 months”).

For Mother and father

For Youngster Care Suppliers

College Necessities Charts

College students getting into college (preschool – grade 12) should get the required doses listed on this chart to be in compliance with immunization necessities. The necessities comply with the nationwide Advisory Committee on Immunization Practices (ACIP) Immunization Schedule with necessities specified by grade stage.

To seek out the doses required, have a look at the row that features the coed’s grade and the column for the required vaccine. For instance, a pupil getting into kindergarten wants two doses of MMR vaccine. The necessities and guidelines fluctuate relying on the coed’s grade.

College Immunization Chart Adjustments for 2022-2023 (PDF)

For Mother and father

For College Employees

Really helpful Childhood and Adolescent Immunization Schedule

In accordance with WAC 246-105-040, the college, preschool, and little one care immunization necessities at present seek advice from the Advisory Committee on Immunization Practices immunization schedule.

Certificates of Immunization Standing (CIS)

Earlier than a baby might attend a faculty or little one care heart, a mother or father or guardian should present proof of the required immunizations or immunity utilizing a department-approved Certificates of Immunization Standing (CIS) kind. The CIS could also be printed from the WA Immunization Data System (IIS). Mother and father can even print a CIS by signing up with MyIR or full the hardcopy kind beneath. If the hardcopy kind is used it have to be medically verified by accuracy with both a well being care supplier signature or by attaching medical immunization data to the finished CIS so college or little one care workers can confirm it for accuracy.

College and Youngster Care Exemptions from Immunization Necessities

Washington State Regulation permits mother and father or guardians to exempt their little one from the college or childcare immunization necessities. Exemptions could also be claimed for private/philosophical, non secular or medical causes. Measles, mumps, and rubella will not be exempted for private/philosophical causes. To request an exemption a accomplished Certificates of Exemption have to be submitted to the college or little one care heart. Extra details about exemptions is offered within the Ceaselessly Requested Questions doc beneath.

Conditional Standing Attendance

Youngsters who’re within the strategy of finishing their required immunizations might stay in class or little one care in a short lived conditional standing.

Excluding Youngsters Out-of-Compliance with Immunization Necessities

By regulation, RCW 28A.210.120, it’s the obligation of the administrator of each private and non-private college and day care heart to ban the additional presence on the college or day care heart for any and all functions of every little one for whom proof of immunization, certification of exemption, or proof of compliance with an permitted schedule of immunization has not been supplied in accordance with RCW 28A.210.080 and to proceed to ban the kid’s presence till such proof of immunization, certification of exemption, or permitted schedule has been supplied. College students missing immunization data who’re lined underneath the federal McKinney-Vento Act will not be excluded. The exclusion of a kid from a faculty shall be completed in accordance with guidelines of the Workplace of the Superintendent of Public Instruction, in session with the State Board of Well being WAC 392-380-050 (Public faculties) WAC 180-38-050 (Personal faculties).

Outbreaks and Exclusion

To manage the unfold of illness a neighborhood well being officer might exclude youngsters and workers in faculties and little one care amenities. WAC 246-110-020 It’s inspired for all for varsity and little one care amenities to maintain or have prepared entry to immunization data of workers in addition to youngsters ought to they be required within the occasion of an outbreak.

Immunization Standing Reporting – Due Yearly by November 1st

College Module

The College Module is constructed into the Washington State Immunization Data System (IIS) for faculties to trace immunization data for college students. The College Module web page has extra details about this free useful resource and find out how to use it.

Normal Assets

Preschool and Youngster Care Assets

College Okay-12 Assets and Pattern Letters

Rule Change Supplies for 2020

Vaccine Data

Program Webpages

Ceaselessly Requested Questions

CIS – Certificates of Immunization Standing
What’s the Certificates of Immunization Standing (CIS) kind?

The CIS is a kind that have to be accomplished and become a baby’s college or little one care to doc the vaccinations required to doc full immunity for kids attending college or little one care in Washington State.

Does the Certificates of Immunization Standing (CIS) need to be turned in earlier than my little one can register for varsity?

Immunization paperwork have to be turned in to the college or little one care on or earlier than the kid’s first day of attendance. The CIS is normally collected throughout the registration course of.

What are the totally different Certificates of Immunization Standing (CIS) choices?

The CIS could be printed from the Immunization Data System (IIS) or a hardcopy CIS accomplished by hand:

  • Certificates of Immunization Standing printed from the WA Immunization Data System (IIS). The CIS printed from the IIS reveals the immunizations that well being care suppliers and faculty nurses have documented within the IIS. It’s medically verified by the IIS. No further mother or father or well being care supplier verification signature is required. There are two variations that print from the IIS:
    • Validated CIS
    • CIS printed from MyIR
  • Hardcopy Certificates of Immunization Standing (CIS) accomplished by hand. It’s verified as correct by a signature from:
    • A well being care supplier, Or
    • A college nurse, administrator, little one care well being marketing consultant or their designee after evaluating the knowledge on the CIS with medical vaccination data hooked up to the CIS
The place can I get a clean copy of the Certificates of Immunization Standing (CIS)? How can I get copies of the CIS in different languages?

Yow will discover the arduous copy CIS in English and a number of other different languages at: www.doh.wa.gov/SCCI

Can a well being care supplier ship my kid’s data on to the college, or do I’ve to show them in?

Well being care suppliers might ship a medically verified Certificates of Immunization Standing on to the college or little one care. That is allowable with verbal or written settlement from the mother or father or guardian underneath the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule.

Who can print the validated Certificates of Immunization Standing (CIS) by means of the Immunization Data System (IIS)?

Well being care suppliers, college and little one care workers which have entry to the IIS can print the validated CIS. Printing directions (PDF). A CIS printed from the IIS is medically verified by the IIS. No further mother or father or well being care supplier verification signature is required.

What’s the which means of ‘COMPLETE, NOT COMPLETE and CONDITIONAL’ that seem on the Validated Certificates of Immunization Standing (CIS) imply?

These phrases point out whether or not a baby has accomplished or not accomplished the vaccinations wanted to satisfy the immunization necessities for varsity or little one care entry. The phrases are outlined as:

  • COMPLETE – A toddler has all of the required immunizations for varsity or little one care
  • NOT COMPLETE – A toddler has not accomplished all of the required immunizations and is previous the momentary conditional interval
  • CONDITIONAL – A toddler is within the strategy of finishing a sequence of vaccinations and is throughout the momentary conditional interval. For a kid to attend college in conditional standing the mother or father or guardian should signal the conditional standing acknowledgment on the CIS.
If a baby has a “NOT COMPLETE” or “CONDITIONAL” standing on their Certificates of Immunization Standing (CIS), do I have to print a brand new CIS from the Immunization Data System (IIS) as soon as the kid receives the required immunizations?

It isn’t required that you simply print out a brand new CIS from the IIS. You could write within the immunization dates on the prevailing CIS and alter the standing by hand, or you possibly can print a brand new CIS from the IIS, whichever you favor.

The Certificates of Immunization Standing (CIS) printed from MyIR is the older model. Can it nonetheless be used?

Sure. We’re working with our software program vendor to replace the CIS in MyIR. Within the meantime faculties and little one cares can settle for this older model as a medically verified CIS. A CIS printed from MyIR is medically verified by the IIS. No further mother or father or well being care supplier verification signature is required. Please observe that, not like the validated CIS, the MyIR CIS prints vaccinations dates which might be invalid in the event that they got exterior of the required minimal ages and intervals. College and little one care workers ought to fastidiously evaluation the dates on the MyIR CIS to make sure the dates can be utilized to satisfy the immunization necessities.

What if a baby doesn’t have any immunization dates within the Immunization Data System (IIS)?

The immunization dates could be handwritten on the hardcopy Certificates of Immunization Standing (CIS) . The data on the hardcopy CIS have to be verified as correct by a well being care supplier signature or medical vaccination data could be hooked up to the CIS and a faculty nurse, administrator, little one care well being marketing consultant or their designee can evaluate the medical data with the knowledge written on the CIS, and if correct, can signal the verification signature.

What is taken into account a medical immunization file?

A “medical immunization file” means one of many following:

  • A medical file from a well being care supplier with their title and signature
  • An immunization file printed from a clinic or hospital’s digital well being system
  • A medical file with an official well being facility or supplier emblem/stamp
  • A doc from one other U.S. state or territorial immunization registry
  • An official lifetime immunization file with a singular well being care supplier/clinic stamp, or supplier signature
  • For overseas college students: a translated official immunization file comparable to an immigration kind or lifetime immunization file from one other nation with a clinic or well being care supplier stamp.
What data usually are not thought of a medical immunization file?

Immunization data that are not medically verified embrace:

  • Dates given to a faculty orally or in writing with out medical proof
  • Lifetime Immunization Information not crammed out by a well being care supplier
  • Dwelling vaccine lists, together with child books
  • A Certificates of Immunization Standing accomplished by hand with no well being care supplier signature or with out medical immunization data hooked up.
Can a mother or father staple the medical immunization file to the hardcopy Certificates of Immunization Standing (CIS), or do the vaccination dates nonetheless must be written on the CIS?

It isn’t acceptable to simply connect an immunization file to a clean hardcopy CIS. The CIS have to be crammed out with the immunization info and verified for accuracy.

How can mother and father get assist to fill out the Certificates of Immunization Standing (CIS)?

Mother and father get assist with a CIS within the following methods:

  • Mother and father can join MyIR to view, obtain, and print their kid’s CIS. Steps on find out how to entry MyIR
  • Mother and father can ship an e-mail to the Division of Well being to request a CIS. The e-mail is [email protected]
  • Mother and father can ask college and little one care workers with entry to the Immunization Data System (IIS) to print a validated CIS instantly from the IIS. Colleges might discover it useful to print the CIS throughout registration or different household occasions.
  • Mother and father can request a CIS printed from the IIS from their healthcare supplier. Mother and father can even ask their healthcare supplier to assist them fill out the shape.
How is varicella historical past and illness immunity verified on the Certificates of Immunization Standing (CIS) kind?

If entered into the Immunization Data System (IIS) varicella historical past and illness immunity by blood antibody titer will auto-populate on the CIS. Auto-populated varicella historical past and immunity by titer printed from the IIS are thought of supplier verified and won’t want a healthcare supplier signature.

If the hardcopy CIS is getting used, varicella historical past and immunity by titer could also be crammed out and signed by a healthcare supplier within the “Documentation of Illness Immunity” field discovered on the precise aspect of the shape.

If I print the Certificates of Immunization Standing (CIS) from the Immunization Data System (IIS) and it reveals {that a} pupil had a historical past of varicella (chickenpox), does a healthcare supplier have to signal the CIS?

No. If varicella historical past is within the IIS, the “Historical past of illness verified by the IIS” field will probably be checked within the varicella row on the CIS. That is thought of supplier verified and doesn’t want a healthcare supplier signature.

What are the choices to confirm a historical past of varicella illness?

Verification of varicella illness can occur in 3 ways:

  • Varicella illness historical past is verified by the Immunization Data System (IIS). If varicella historical past is within the IIS, the “Historical past of illness verified by the IIS” field will probably be checked within the varicella row on the Certificates of Immunization Standing (CIS).
  • Illness verified by a healthcare supplier (HCP). The healthcare supplier can test the verification field and signal the hardcopy CIS, or mother and father can present a signed letter from the HCP to be saved with the CIS.
  • If college workers finds verification of varicella illness within the IIS, workers can add this info to the CIS.

Mother or father verification of chickenpox illness is now not acceptable to satisfy the varicella immunization requirement.

I do know that healthcare suppliers enter lab proof of immunity within the Immunization Data System (IIS). Can I exploit this info to replace the Certificates of Immunization Standing (CIS) slightly than getting a healthcare supplier signature and replica of a lab report?

If lab proof of immunity is documented within the IIS, it’ll print on the CIS underneath the “Optimistic Titer” column. It is a legitimate verification of immunity and a healthcare supplier signature isn’t wanted. A replica of the lab report is now not required to accompany well being care supplier documentation of immunity by blood antibody titer.

Does a well being care supplier have to signal the Certificates of Immunization Standing (CIS)?

A well being care supplier signature to medically confirm vaccination dates, constructive titers, or chickenpox historical past isn’t required if the CIS printed from the Immunization Data System (IIS) contains this info. This info is taken into account to be medically validated by the IIS.

A healthcare supplier might signal a hardcopy CIS to confirm that the immunization info is correct. They’ll additionally doc on the hardcopy CIS that the kid has had varicella (chickenpox) illness or immunity by blood antibody titer take a look at.

When does the CIS not want a well being care supplier signature?

If the CIS is printed instantly from the Immunization Data System (IIS), both the validated CIS or the MyIR CIS, it doesn’t want a healthcare supplier signature verifying the knowledge is correct.

If mother or father turns in a hand-written CIS with hooked up medical vaccination data and the chief administrator, little one care well being marketing consultant, college nurse or their designee indicators the CIS verifying the knowledge on the CIS matches the medical data then it doesn’t want an extra healthcare supplier signature verifying the knowledge is correct.

When the Certificates of Immunization Standing (CIS) kind is revised, do mother and father want to show in an up to date CIS for his or her youngsters? Do I have to get a CIS from mother and father/guardians yearly, even when they have already got one on file?

Youngsters who attend the identical college or college district they attended previous to August 1, 2020, don’t have to resubmit data. All new immunization data turned in on or after that date have to be medically verified. Youngsters attending a baby care should flip in an up to date medically verified CIS yearly. When delivering a brand new CIS, the present model from the Immunization Data System, MyIR or the hardcopy kind needs to be used.

Do faculties utilizing the Immunization Data System (IIS) College Module want a Certificates of Immunization Standing (CIS) on file for every pupil?

No. College workers actively utilizing the IIS College Module to do their immunization compliance work can confirm that the coed’s immunizations are COMPLETE within the IIS and file the verification within the pupil’s college file. If the immunizations are full within the IIS then no CIS is required. Colleges utilizing the College Module solely want a CIS for college students who’re in conditional standing or if immunizations must be added to the IIS to finish the file.

Are you able to clarify the 2 locations for a mother or father/guardian signature on the Certificates of Immunization Standing (CIS)?

There are two locations for fogeys to signal on the CIS:

  • One signature is required if a baby is beginning college or little one care in conditional immunization standing. For the kid to be allowed to attend in conditional standing the mother or father/guardian should acknowledge the conditional standing guidelines and timelines with this signature.
  • The opposite signature is to provide permission so as to add lacking immunization info into the Immunization Data System (IIS). That is permits college or little one care workers with entry to the Immunization Data System (IIS) College Module so as to add info wanted to finish immunization info that could be lacking within the IIS.
Do college or little one care workers want mother or father consent each time they add immunizations to the Certificates of Immunization Standing (CIS) obtained from the Immunization Data System (IIS)? How about immunizations from a medical immunization file?

No, college and little one care workers needn’t get mother or father consent to replace the CIS with further immunizations from the IIS or a medical immunization file.

Each really useful and required vaccines for varsity and little one care attendance are listed on the Certificates of Immunization Standing (CIS). Does the CIS have to have all the immunization dates, even when the vaccine isn’t required for varsity or little one care attendance?

No, solely immunization dates required for varsity and little one care attendance should on the CIS. Extra really useful vaccines could also be printed or written on the CIS to supply a extra full immunization file.

Are you able to clarify the area (on the higher proper) for employees signature on the Certificates of Immunization Standing (CIS)?

This field is utilized by the college or little one care workers particular person to doc that they reviewed the CIS and point out if a Certificates of Exemption can be on file for this little one. Use of this field is non-obligatory.

Does a pupil with an exemption have to submit each a Certificates of Immunization Standing (CIS) and a Certificates of Exemption (COE)?

It relies upon, if the COE exempts all the required immunizations a CIS isn’t wanted. If the COE solely exempts a few of the required immunizations, then each a CIS and COE must be on file.

COE – Certificates of Exemption
What’s the Certificates of Exemption (COE) kind?

The COE kind is used when a mother or father or guardian needs to exempt their little one from a number of of the immunization necessities. The finished kind have to be become the college or little one care.

The place can I get a duplicate of the COE? Are there copies of the COE in different languages? Can I get the Certificates of Exemption (COE) by means of the Immunization Data System (IIS)?

The COE in a number of languages is offered on the College and Youngster Care immunization webpage: www.doh.wa.gov/SCCI. A COE can’t be printed from the IIS.

Does a pupil with an exemption have to submit each a Certificates of Immunization Standing (CIS) and a Certificates of Exemption (COE)?

It relies upon, if the COE exempts all the required immunizations a CIS isn’t wanted. If the COE solely exempts a few of the required immunizations then each a CIS and COE must be on file.

When the Certificates of Exemption (COE)is up to date, does a pupil with a COE already on file have to submit the brand new COE?

No. The COE on file is legitimate for all exemptions apart from private/philosophical exemption for the measles, mumps and rubella immunization necessities. A brand new COE isn’t obligatory for all different current exemptions.

When is a brand new Certificates of Exemption (COE) efficient? When ought to we begin utilizing it?

A revised COE is efficient as quickly as it’s revealed on the DOH web site. The date of publication is on the bootom of the shape. Mother and father ought to use essentially the most present COE to request any new exemption from the immunization necessities.

What sorts of exemptions can be found for fogeys who need to exempt their little one from the college or little one care immunization necessities?

There are 4 various kinds of exemptions:

Medical Exemption: A well being care practitioner might grant a medical exemption to a vaccine required by rule of the state board of well being provided that in his or her judgment, the vaccine isn’t advisable for the kid. When it’s decided that this explicit vaccine is now not contraindicated, the kid will probably be required to have the vaccine.

Philosophical/Private Exemption: For use when the mother or father/guardian has a private or philosophical objection to the immunization of the kid. A philosophical/private exemption will not be used to exempt a baby from the measles, mumps or rubella vaccine necessities (efficient July 28, 2019).

Non secular Exemption: For use when the mother or father/guardian has a spiritual perception that’s opposite to the required immunization.

Non secular Membership Exemption: For use when the mother or father/guardian affirms membership in a church or non secular physique that doesn’t enable them to take thier little one for medical therapy from a well being care practitioner (MD, DO, NP, PA. ARNP). As a result of it’s in opposition to their non secular beliefs to get medical therapy from a well being care practitioner this exemption doesn’t require a well being care practitioner signature.; RCW 28A.210.090.

What sorts of exemptions can be found for fogeys who need to exempt their little one from the measles, mumps and rubella (MMR) college or little one care immunization necessities?

There are three kinds of exemptions that may be claimed with a accomplished Certificates of Exemption for MMR:

  • Medical Exemption – signed by each the mother or father and well being care practitioner
  • Non secular Exemption – signed by each the mother or father and well being care practitioner
  • Non secular Membership – signed by the mother or father. This exemption kind is simply used when the non secular perception doesn’t enable for medical therapy by a well being care practitioner, due to this fact no well being care practitioner signature is required.

Private or philosophical exemptions usually are not allowed for MMR. RCW 28A.210.090

For college kids who had a private exemption for measles, mumps and rubella (MMR) on file earlier than the regulation modified in 2019, will these exemptions proceed to be accepted, or will these exemptions be void and the coed might want to get the MMR vaccine or one other kind of exemption?

The regulation didn’t embrace a grandfathering or exclusion clause for college students who had private exemptions for the measles, mumps or rubella immunization necessities in place earlier than the regulation modified. As of July 28, 2019 any exisiting private exemptions to the MMR immunization necessities had been voided.

How do I do know if my little one qualifies for a medical exemption?

Your kid’s healthcare supplier will decide in the event that they must be quickly or completely exempted from receiving a vaccine for a medical motive. Medical contraindications and precautions to vaccination are outlined within the Advisory Committee on Immunization Practices’ (ACIP) recommendations and guidelines revealed by the Facilities for Illness Management and Prevention. Medical contraindications to vaccination are uncommon.

Does a short lived medical exemption have to have an expiration date?

Sure, well being care practitioners should put the date that the momentary exemption ends on the Certificates of Exemption. College, preschool, or little one care workers ought to monitor momentary exemptions. When the momentary exemption ends the kid could be in conditional standing for as much as 30 days with a view to get the lacking immunization or one other exemption.

What’s the distinction between a spiritual and a spiritual membership exemption?

Non secular Exemption: For use when the mother or father/guardian has a spiritual perception that’s opposite to the required immunization. This requires the signature of a well being care practitioner that they’ve supplied the mother or father with details about the advantages and dangers of immunization for the kid.

Non secular Membership Exemption: For use when the mother or father/guardian affirms membership in a church or non secular physique that doesn’t enable them to take their little one for medical therapy from a well being care practitioner (MD, DO, NP, PA. ARNP). As a result of it’s in opposition to their non secular beliefs to get medical therapy from a well being care practitioner this exemption doesn’t require a well being care practitioner signature.; RCW 28A.210.090.

How do well being care practitioners, college or little one care workers decide if a spiritual or non secular membership exemption relies on precise non secular beliefs?

It isn’t really useful that college or little one care workers try to confirm the non secular beliefs of a mother or father/guardian requesting a spiritual or non secular membership exemption. A accomplished Certificates of Exemption is all that’s required. The function of the well being care practitioner is to supply info to the mother or father/guardian. The well being care practitioner’s signature signifies that they’ve supplied the knowledge, not that they’ve assessed the mother or father’s non secular beliefs.

What if I believe a mother or father who’s asking for a spiritual membership exemption takes the kid in for medical therapy?

If the kid receives medical therapy for issues apart from immunizations the non secular membership exemption isn’t the suitable kind of exemption. Ask the mother or father if the kid sees a well being care supplier for damage or sickness care. If the mother or father or guardian says sure, then one other exemption which requires a well being care practitioner signature needs to be used as a substitute.

When finishing medical exemption part of the Certificates of Exemption (COE) kind, does the well being care practitioner have to establish the explanation why the vaccine isn’t advisable for the kid?

It isn’t required to supply the explanation for granting the medical exemption. This info isn’t requested on the Certificates of Exemption kind.

Does the Certificates of Exemption (COE) must be signed by a healthcare practitioner?

Usually, sure. Mother and father or guardians requesting a medical, philosophical, or non secular exemption will need to have the signature of a well being care practitioner (MD, DO, ND, ARNP, PA) licensed in Washington state confirming that they supplied the mother or father with details about the advantages and dangers of immunizations. A practitioner may write and signal a letter containing the identical info as a substitute of signing the COE. This letter have to be hooked up to the mother or father signed COE. If granting a medical exemption, the practitioner should full the medical exemption part of the COE.

A well being care practitioner doesn’t have to signal the COE if the mother or father claims a Non secular Membership exemption. This exemption states that the mother or father’s non secular beliefs don’t enable medical therapy of their little one by a well being care practitioner. As a result of it’s in opposition to their non secular beliefs to get therapy from a well being care practitioner this exemption doesn’t require a well being care practitioner signature. Mother and father/guardians who’ve a spiritual objection to vaccination however whose youngsters acquire care from well being care practitioners want to make use of the non secular exemption which requires a well being care practitioner signature.

Which suppliers are allowed to signal the Certificates of Exemption (COE) ?

Solely a well being care practitioner can signal the COE. A healthcare practitioner is outlined as a doctor (M.D.), doctor assistant (P.A.), osteopath (D.O.), naturopath (N.D.), or superior registered nurse practitioner (A.R.N.P.) licensed in Washington state. For extra particulars, see Revised Code of Washington (RCW) 28A.210.090.

Do well being care practitioners face any legal responsibility for signing the Certificates of Exemption (COE)?

A well being care practitioner who, in good religion, indicators the assertion that they’ve supplied the mother or father with details about the advantages and dangers of immunization for the kid, are immune from civil legal responsibility for offering the signature. For extra particulars, see Revised Code of Washington (RCW) 28A.210.090.

If a household has an out-of-state exemption on file signed by a MD, then do they nonetheless have to have a Washington State Certificates of Exemption (COE)? Can a faculty or little one care supplier settle for a Washington state COE signed by a well being care supplier in one other state or nation?

A certificates from one other state can’t be used to exempt a pupil from the WA state immunization necessities. The Washington state Certificates of Exemption kind have to be used and the well being care practitioner (MD, DO, ND, and ARNP, PA) who indicators it have to be licensed in Washington state. For extra info, see the Revised Code of Washington (RCW) 28A.210.090.

Is a well being care practitioner required to signal a spiritual exemption kind, or can they refuse?

This isn’t addressed in state immunization regulation. A well being care practitioner ought to communicate with their skilled group or talk about with their very own authorized counsel. The function of the practitioner is to supply info and their signature signifies they’ve supplied the knowledge, not that they’ve assessed or agree with the mother or father’s non secular beliefs.

Is a well being care practitioner legally allowed to request proof of faith/church membership if they’re being requested to signal a spiritual exemption?

The function of the well being care practitioner is to supply info to the mother or father about the advantages and dangers of vaccination. Their signature signifies they’ve supplied the knowledge, not that they’ve assessed the validity of the particular person’s non secular beliefs. There’s nothing requiring the supplier to test for documentation. If a supplier feels they need to incorporate this into their apply, they need to talk about with their skilled group or their very own authorized counsel.

Can a mother or father who’s a well being care practitioner licensed in WA signal the well being care practitioner declaration on the Certificates of Exemption (COE) for their very own little one?

Solely a doctor, osteopath, naturopath, doctor assistant, or superior registered nurse practitioner licensed in Washington state might signal the WA COE. If the mother or father is without doubt one of the certified well being care practitioners listed within the regulation (RCW 28A.210.090), it’s as much as that practitioner’s personal greatest judgment, primarily based on their particular person authorized, moral, medical, {and professional} obligations.

Does a pupil with none exemptions want a duplicate of a Certificates of Exemption (COE) in her or his file?

No. College students will need to have a accomplished COE on file of their file provided that they’ve an exemption to a number of of the immunization necessities.

What ought to I do if a Certificates of Exemption (COE) has each private and medical exemptions listed for a similar immunization requirement/illness?

If a mother or father turns in, or throughout file evaluation you uncover, a COE that has been improperly crammed out, return it to the mother or father and allow them to know a correctly accomplished COE is required for the exemption to be legitimate. On this case, inform the mother or father that they might solely have one kind of exemption per illness immunization requirement.

Does a Certificates of Exemption (COE) expire? Does a COE must be renewed yearly?

The one kind of COE with an expiration date is a COE with a short lived medical exemption. The COE doesn’t must be renewed yearly. As soon as a COE is crammed out, it may be used for the size of the coed’s Washington state college profession, together with college transfers. If mother or father’s request modifications to the COE a brand new kind have to be accomplished.

I see {that a} healthcare supplier entered a contraindication of “Mother or father or Affected person Refusal, Private or Non secular” within the Immunization Data System (IIS) for a affected person. Can I exploit this info to doc a private or non secular exemption for a pupil slightly than have the supplier signal the Certificates of Exemption (COE)?

No, documentation of a refusal within the IIS means the mother or father or affected person refused a vaccine supplied to them throughout a supplier go to. It doesn’t imply that the mother or father or affected person requested an exemption from the college or little one care immunization necessities. It additionally doesn’t doc {that a} well being care practitioner (MD, DO, ND, and ARNP, PA) mentioned the advantages and dangers of immunizations with the mother or father. The IIS doesn’t have a spot to doc that info. Mother and father requesting an exemption from the immunization necessities should flip in a accomplished COE to the college or little one care.

I’ve a whole lot of questions on exemptions and find out how to fill out the Certificates of Exemption (COE). The place can I get extra info?

For extra info please e-mail: [email protected]

Conditional Standing Attendance
What does conditional standing imply?

On or earlier than the primary day of faculty or little one care attendance mother and father/guardians are required to supply proof of both, full immunization, a certificates of exemption, or the initiation of and compliance with a schedule of immunization for his or her little one, (per RCW 28A.210-080). Youngsters can enter and keep in class or little one care in conditional standing if they’re catching up on the vaccines required to doc immunity for varsity or little one care entry. Vaccine sequence doses are unfold out amongst minimal intervals, so some youngsters might have to attend a time frame earlier than ending their vaccinations. Conditional standing permits them to attend college or little one care whereas ready for his or her subsequent vaccine dose in accordance with the nationwide immunization catch-up schedule. When the following vaccine dose comes due they’ve 30 calendar days to show in documentation of vaccination. If a pupil is catching up on a number of vaccines, conditional standing continues in the same method till all the vaccines wanted to doc full immunity are accomplished.

 

What situations have to be met for a kid to attend college or little one care in conditional standing?

To attend college or little one care in Conditional Standing the next situations have to be met (WAC 246-105-050):

  • The mother or father/guardian should signal the Conditional Standing assertion on the Certificates of Immunization Standing kind to acknowledge their little one is attending college or little one care in conditional standing with the related timelines.
  • Youngsters have to be updated on their immunizations, having acquired all the vaccine doses they’re eligible to obtain earlier than they’ll begin college or little one care.
  • When the following catch-up vaccine dose comes due, the mother or father or guardian should flip in documentation inside 30 days of the vaccination due date. Legitimate documentation contains medical data displaying vaccination, proof of immunity to the illness in query, or a accomplished Certificates of Exemption (COE) kind.

 

What does “any the vaccine doses they’re eligible to obtain” imply?

Youngsters are due for various vaccines relying on their age. “Any doses the kid is eligible to obtain” means all the required vaccine doses the kid is sufficiently old to obtain and the really useful time interval from the earlier dose of that vaccine has been met in accordance with the nationwide immunization catch-up schedule. For instance:

  • A toddler getting into kindergarten has had no vaccines:
    • The kid should get one dose of every of the required vaccines (Hepatitis B, DTaP, IPV, MMR and Varicella) earlier than beginning college. They’re then in conditional standing till the following vaccine is due plus 30 calendar days to show in documentation that they’ve gotten the vaccine. Conditional standing then continues as described till all the vaccine sequence are full.
  • A toddler getting into kindergarten has had all vaccines besides MMR dose 2. MMR dose one was administered 1 week earlier than the beginning of faculty:
    • The kid can begin college in conditional standing for 3 weeks (ready for MMR dose 2 minimal legitimate date) plus an extra 30 calendar days during which to get the dose and switch in documentation to the college.
  • A toddler getting into kindergarten has all the early childhood vaccines however is lacking their age 4 – 6yr vaccines required for kindergarten entry:
    • The kid should get the lacking DTaP, IPV, MMR and varicella earlier than beginning college. Then they’ve accomplished the vaccinations wanted for his or her grade. They don’t want conditional standing attendance.
  • A pupil getting into seventh grade has not had their required Tdap booster:
    • The scholar should get the Tdap vaccine earlier than beginning college. Then they’ve accomplished the vaccinations wanted for his or her grade. They don’t want conditional standing attendance.
What occurs if documentation isn’t turned in throughout the 30 day time interval?

If the 30 day conditional interval, after the following vaccine dose comes due, expires and documentation has not been given to the college or little one care, then the coed have to be excluded from additional attendance, per RCW 28A.210.120. Legitimate documentation contains medical data displaying vaccination, proof of immunity to the illness in query, or a accomplished certificates of exemption (COE) kind.

 

When does a baby enter conditional standing and for a way lengthy?

The commonest state of affairs happens when a baby arrives on their first day of faculty lacking required immunizations. The kid should get any of the doses they’re eligible to obtain earlier than beginning college. If further doses are wanted to finish the vaccine sequence then they’ll begin college on the situation that they proceed to get the remaining doses primarily based on the nationwide immunization catch-up schedule. They have to get remaining doses inside 30 calendar days following the really useful date of the following dose wanted in accordance with the nationwide schedule. A toddler additionally enters conditional standing when a short lived medical exemption expires. On this case, the kid has 30 calendar days from the expiration date of the medical exemption to get the lacking immunization(s) or one other exemption.

 

Who grants conditional standing?

The varsity or little one care workers decide if the situations for conditional standing have been met.

 

Does conditional standing solely apply to college students attending a brand new college or district?

No, conditional standing applies to any little one with out an exemption attending college or little one care who’s lacking immunizations and ready for the really useful date of the following vaccine dose wanted in accordance with the nationwide schedule.

 

How do the conditional standing guidelines apply to youngsters in navy households?

Youngsters of active-duty navy mother and father or guardians should flip in documentation of immunization standing on or earlier than the primary day of attendance. In the event that they want further vaccine doses to satisfy state necessities, they’ve 30 days from enrollment to take action.

 

Does conditional standing apply to youngsters in little one care?

Licensed little one day care facilities should comply with the immunization requirement legal guidelines and guidelines. This contains all private and non-private little one cares licensed by the Division of Youngsters, Youth, and Households to supply early childhood schooling and early studying providers for a gaggle of kids for durations of lower than twenty-four hours.

 

How do the principles apply to youngsters who’re homeless or in foster care?

There’s an exception for college students who’re thought of homeless in accordance with the McKinney-Vento Act or in foster care. They have to be allowed to enroll, attend lessons, and take part totally. They can’t be excluded for being out of compliance with the immunization necessities. College and little one care workers ought to work with the Homeless Liaison or Foster Care Caseworker to deliver the kid into compliance. Each foster little one/youth in out-of-home placement ought to obtain an EPSDT/Effectively-Youngster examination, which incorporates immunizations if wanted, inside 30 days of getting into any foster or relative placement. For extra info see the Immunization Handbook for Colleges, Preschools, and Youngster Care Services.

 

What’s the WA Administrative Code (WAC) that talks about conditional standing?

It’s: WAC 246-105-020, WAC 246-105-050 and WAC 246-105-060

 

Is there a requirement to make a couple of mother or father contact by letter or telephone to allow them to know their little one is in conditional standing, or simply the discover of exclusion required in RCW 28A.210.120?

No further necessities exist past the RCW and WAC procedures for excluding college students. Regardless that not specified within the regulation, it’s best apply to ship a written discover to oldsters concerning the pupil’s conditional standing.

 

Does DOH have pattern letters for college students in conditional standing or who must be excluded?

Pattern letters can be found within the Conditional Standing Attendance and Excluding Youngsters Out-of-Compliance with Immunization Necessities sections of the College and Youngster Care Immunization web page www.doh.wa.gov/SCCI.

 

Illness Outbreaks
Why would college students or workers be excluded from college throughout illness outbreaks?
Excluding individuals who had been doubtlessly uncovered or recognized to be vulnerable to a illness may also help cease an outbreak for some illnesses.
Why is exclusion finished for some illnesses and never for others?
Exclusion is believed to lower the unfold of some illnesses greater than others. The native well being officer makes the dedication if excluding individuals vulnerable to the illness throughout an outbreak is warranted.
Who decides if college students or workers will probably be excluded in an outbreak scenario?

The County’s native well being officer has the authority to exclude college students, workers, and volunteers in faculties or childcare facilities if they’re infectious, uncovered, or vulnerable to the illness. See WAC 246-110-020 for extra info.

What documentation is required within the occasion of an outbreak at a faculty or little one care?
The native well being officer will decide what documentation is suitable. For example, in accordance with the Facilities for Illness Management and Prevention acceptable documentation of measles immunity contains one of many following; 1) date of delivery earlier than 1957. 2) file of age-appropriate measles vaccination with a dwell measles virus-containing vaccine. This implies two doses for anybody 4 years and older, or one dose for adults, verified by a licensed well being care supplier. 3) A letter from a licensed well being care supplier documenting an infection with and full restoration from earlier measles sickness. 4) A letter from a licensed well being care supplier that confirms a blood take a look at displaying measles immunity. Proof of immunity needs to be previous to a illness publicity. These workers and college students who obtain vaccination after publicity should still must be excluded.
How lengthy can college students and workers be excluded?
This will probably be decided by the native well being officer. The scholar and workers exclusion time depends upon the publicity interval and the incubation time of the particular illness. For example, exclusion for measles lasts till 21 days have handed for the reason that date of final recognized potential publicity. That is in accordance with WAC 246-105-040. This exclusion time could also be prolonged if one other case happens.
Are workers required to make use of their sick go away or trip if they’re excluded?
This may depend upon the kid care, district or college’s coverage and procedures.
Worker and Volunteer MMR Requirement
What’s the MMR requirement for little one care workers and volunteers?

The regulation requires all little one care workers and volunteers to have documentation of vaccination with the MMR (measles, mumps and rubella) vaccine or have proof of immunity to measles.

 

Do little one care workers and volunteers have to supply documentation of vaccination standing to the state or to their employer?

Youngster care workers and volunteers have to supply documentation to their employer and will probably be saved onsite of their personnel file. It will likely be checked by little one care licensors at their monitoring visits. It might even be accessed by the native well being officer if there’s an outbreak of measles or different vaccine-preventable illness. For additional questions on this subject, contact the Department of Children, Youth, and Families.

How does a baby care workers particular person or volunteer adjust to the requirement?

The regulation requires that workers and volunteers at licensed little one care amenities present one in every of these choices:

  • Immunization data displaying they’ve acquired the MMR vaccine.
  • Proof of immunity to measles by means of documented lab proof of antibody titer.
  • A healthcare supplier’s attestation of the particular person’s historical past of measles enough to supply immunity in opposition to measles. (The supplier might contemplate CDC guidance for proof of immunity, together with for these born earlier than 1957.)
  • Written certification, signed by a Washington-licensed MD, ND, DO, ARNP, or PA, that the MMR vaccine isn’t advisable for that particular person.
What little one care suppliers need to adjust to the workers and volunteer MMR regulation?

All private and non-private little one cares licensed to supply early childhood schooling and early studying providers for a gaggle of kids for durations of lower than twenty-four hours. This portion of the regulation will probably be applied by the state Department of Children, Youth and Families (DCYF). The brand new regulation provides a brand new part to RCW 43.216, which DCYF has authority over.

Will Okay-12 college workers and volunteers have to supply documentation of MMR vaccination standing to the state or to their employer?

The regulation doesn’t embrace language requiring college workers and volunteers to supply documentation of immunity to MMR illness until they’re supervising youngsters in an early studying program. Nonetheless, the Division of Well being encourages anybody who’s round youngsters to be immunized in opposition to contagious illnesses and updated with any really useful vaccines. For extra details about vaccines really useful for adults, see web page 28 of the Immunization Handbook for Colleges, Preschools, and Youngster Care Services (PDF).

If little one care workers or volunteers suppose that they had the MMR vaccine up to now and might’t discover their data is it secure to get one other one?

Usually, the Facilities for Illness Management and Prevention recommends repeating the vaccine if there is no such thing as a medically verified file that the shot was given. If that’s not an choice, a titer take a look at is offered to test whether or not you might be resistant to measles. Seek the advice of together with your healthcare supplier for the most suitable choice for you.

If an worker or volunteer was vaccinated for measles however they didn’t get the MMR vaccine, is that enough, or do they should get the complete MMR vaccine?

If they’re offering documentation of being vaccinated, it wants to incorporate vaccination in opposition to all three diseases-measles, mumps and rubella. If they’re offering lab proof of immunity (also called a blood take a look at or titer), it solely must be for measles.

Can a baby care workers particular person or volunteer flip in an exemption to the requirement?

Employees and volunteers will not be exempted from the requirement to supply documentation of immunity for private and non secular causes. Solely written certification signed by a well being care practitioner, licensed in WA State, (medical physician (MD), naturopathic physician (ND), osteopathic physician (DO), superior registered nurse practitioner (ARNP) or a doctor’s assistant (PA)) that the measles, mumps, and rubella vaccine is, within the practitioner’s judgment, not advisable for the particular person can be utilized as a substitute of the required documentation of immunity.

What if little one care workers or volunteers want extra time to acquire and supply the wanted data?

The kid care heart might enable an individual to be employed or volunteer on the premises for as much as thirty calendar days in the event that they signal a written assertion that they’ve acquired the MMR vaccine or are immune from measles, however require further time to acquire and supply the data.

Does the regulation pertain to after-school applications at little one care facilities (just like the YMCA)?

Sure. This is applicable to all licensed little one care settings.

What a few non-public college that operates a baby care heart on website? Does the regulation apply to Kindergarten by means of fifth grade lecturers since they’re in the identical facility and/or might have some interplay with the kid care youngsters?

The regulation applies to all workers and volunteers of licensed little one day care facilities, together with “nonemployees who present care and supervision to youngsters on the little one day care heart.” If that applies to these lecturers or different workers or volunteers, then sure. The Division of Well being encourages anybody who’s round youngsters to be immunized in opposition to contagious illnesses and updated with any really useful vaccines.

Does the regulation apply to impartial contractors? Examples embrace early intervention suppliers visiting campus, house guests, social staff, speech pathologists or employed photographers.

Unbiased contractors usually are not thought of workers or volunteers, so the brand new regulation doesn’t apply to them. Nonetheless, an company can encourage impartial contractors to maintain updated on their immunizations

Does the regulation apply to household house care websites?

No, however household house care facilities are allowed to set their very own insurance policies for his or her staff, volunteers, and attendees. Within the occasion of a vaccine-preventable illness outbreak just like the measles, the native well being officer can require the household house care website to supply immunization standing info for all workers and attendees. If no documentation is supplied, the well being officer can require people to avoid the positioning.

I am a baby care employee/volunteer and have to get my MMR vaccine. Will I’ve to pay for it?

Most individuals can get the vaccine for free of charge or low price. MMR vaccine is roofed by most insurance coverage corporations, together with Medicare and Apple Well being (Medicaid). The state offers vaccine for free of charge to these youthful than 19. Discover out extra about protection for grownup vaccines right here.

Normal
How can I entry my immunization file within the state registry?

This web site has details about find out how to entry your vaccination data within the state registry referred to as the WA Immunization Data System, together with accessing MyIR.

What immunization documentation does a faculty or little one care want so a baby can attend?

Youngsters are required to have documentation of full immunization or an exemption once they begin college or little one care. A Certificates of Immunization Standing (CIS) kind displaying that the coed is totally immunized or is catching-up with the vaccine sequence, or a Certificates of Exemption (COE) kind have to be turned in on or earlier than the coed’s first day of attendance (per RCW 28A.210-080). There’s an exception for college students who’re thought of homeless in accordance with the McKinney-Vento Act or in foster care. They have to be allowed to enroll, attend lessons, and take part totally. They can’t be excluded for being out of compliance with the immunization necessities. College and little one care workers ought to work with the Homeless Liaison or Foster Care Caseworker to deliver the kid into compliance.

Do the immunization necessities apply to each private and non-private faculties?
Sure, the immunization legal guidelines apply to each private and non-private college college students.
Do college students who attend on-line college or different different applications want to satisfy the immunization necessities?

College students enrolled at a public or non-public college taking part in different college applications should comply with the identical immunization guidelines as all different college students. They want a accomplished Certificates of Immunization Standing (CIS) and/or Certificates of Exemption (COE) on file on the college or district program. Discover extra info within the Immunization Handbook for Colleges, Preschools, and Youngster Cares.

Do college students with an IEP (Individualized Training Program) have totally different immunization necessities than these with out?

There are not any particular provisions or exceptions for college students being served underneath particular schooling. Immunization compliance for varsity attendance is printed in state law. Colleges are inspired to work with households to make sure that college students proceed to obtain obligatory providers recognized of their IEP.

Do worldwide college students have to comply with the immunization necessities?

Worldwide college students, even these solely attending college for a short while, should adjust to the immunization necessities and have a CIS and/or Certificates of Exemption (COE) on file on the college.

How do the immunization necessities have an effect on faculties and universities?

Washington has no state regulation requiring immunizations for post-high college schooling establishments. Every school or college has their very own coverage relating to immunization necessities for college students. Verify together with your school or college to seek out out if they’ve immunization necessities. Lots of them clarify their immunization coverage on their web site.

How can I entry my kid’s immunization file within the state registry?

This web site has details about find out how to entry your kid’s vaccination data within the state registry referred to as the WA Immunization Data System, together with accessing MyIR.

Is there a technique to request vaccination data from different states?

This Facilities for Illness Management and Prevention web site has contact info for every of the US immunization registries.

Why do not I/my little one have a state immunization file?

The Washington Immunization Data System (WA IIS) began about 25 years in the past and it’s utilized by nearly all suppliers who give childhood vaccines. It’s particular to Washington state. In case your are unable to seek out the file you might be on the lookout for, please test together with your healthcare supplier to see if they’re placing info into the WA IIS. You probably have medically verified vaccination data from one other state or nation or from earlier than the system was in use, deliver these data to your healthcare supplier. Medically verified data could be added to the WA IIS by your healthcare supplier so will probably be simpler to seek out them sooner or later.

Does my little one or do I’ve to get a vaccine once more if I can not discover the file?

Usually, the Facilities for Illness Management and Prevention recommends repeating the vaccine if there is no such thing as a medically verified file that the vaccine was given. If that’s not an choice, a titer take a look at could also be accessible to test whether or not you might be resistant to the illness. Seek the advice of together with your healthcare supplier for the most suitable choice for you.

What’s an antibody titer take a look at?

An antibody titer take a look at is a lab take a look at (blood draw) that may test if a person has immunity to a illness. Not all vaccine-preventable illnesses have a titer accessible. For those who really feel you or your little one are already are resistant to the illness by means of having the illness or by means of vaccination, your healthcare supplier can talk about if a titer take a look at is the precise choice for you. Relying on the illness, the supplier might advocate getting the vaccination as a substitute. Verify together with your insurance coverage supplier to seek out out whether or not the price of a titer is roofed by insurance coverage.

Which illnesses can have immunity documented by blood antibody titers?

All illnesses can have immunity by blood antibody exams documented by a well being care supplier (HCP) aside from pertussis, pneumococcal (PCV) and Haemophilus influenzae kind b (Hib). The HCP should state on the CIS or in a letter that the kid has blood antibody titer ranges enough for immunity. If the HCP is documenting immunity to polio, blood antibody titer testing should present immunity for all three kinds of polioviruses.

Are there dangers if I determine to not vaccinate my little one?

It is simple to miss the advantages of vaccination after we not often see individuals sick with a few of the illnesses that vaccines forestall. However the determination to not immunize a baby entails danger. Selecting to not immunize places the kid and others liable to getting a harmful illness that could possibly be lethal. Immunization is the one most vital means mother and father can shield their youngsters in opposition to severe illnesses, and it is affordable to ask questions on it. You probably have questions or issues about immunizations, you will need to discuss together with your kid’s healthcare supplier. You too can study extra about vaccination and the dangers and advantages of each decisions in Plain Speak About Childhood Immunization (PDF).

The place can mother or father go for present info on immunization?

An excellent place for fogeys and guardians to seek out trusted and dependable info on immunizations is www.doh.wa.gov/immunization.

I’ve questions concerning the college and little one care immunization guidelines. Whom do I contact?

You probably have questions concerning the immunization necessities you possibly can e-mail [email protected]

 

I need to discuss to the State Board of Well being about college immunization guidelines. Whom do I contact?

Discover the Board of Well being’s contact info on their web site, sboh.wa.gov.

I need to discuss to DCYF about little one care immunization guidelines. Whom do I contact?

If you’re a mother or father with questions on immunizations in your little one care heart, contact your licensor. For basic little one care questions, contact Jennifer Helseth at [email protected]

Can a non-public college set immunization insurance policies which might be stricter than the state’s necessities?

If the administration of a non-public college want to set immunization insurance policies stricter than the state’s necessities, they need to seek the advice of with their authorized counsel. The Division of Well being can’t give authorized recommendation. Discover state immunization legal guidelines throughout the Revised Code of Washington (RCW) sections 28A.210.060, 28A.210.080, and 28A.210.090.

Can a non-public little one care set immunization insurance policies which might be stricter than the state’s necessities?

For questions on little one care necessities, please contact Jennifer Helseth of the Division of Youngsters, Youth, and Households at [email protected]

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