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					 1 COMMITTEE REPORT
 2 April 11, 2007
 3
 4                                                        H. 3136
 5
 6   Introduced by Reps. Brady, Scarborough, Cobb-Hunter,
 7   Funderburk, Miller, Harvin, Ceips, Parks, Neilson, Haley, Knight,
 8   Viers, Vick, Whitmire, Brantley, Allen, Davenport, Hardwick,
 9   Scott, Anthony, Gullick, Breeland, Mack, Battle, Williams,
10   Sandifer, R. Brown, Govan, Hosey, Edge, McLeod, Hart, Hayes,
11   Jennings, Agnew, Gambrell, J.H. Neal, Weeks, Harrison, Spires,
12   Moss, Rutherford, Bales, Branham, Mitchell, F.N. Smith,
13   Jefferson, Merrill, Anderson, Herbkersman, Pinson, Taylor,
14   Huggins, Mahaffey, Alexander, Clyburn, Phillips, Lowe, Dantzler,
15   Witherspoon, Whipper, Coleman, Stavrinakis and Barfield
16
17   S. Printed 4/11/07--H.
18   Read the first time January 9, 2007.
19
20
21                THE COMMITTEE ON MEDICAL,
22        MILITARY, PUBLIC AND MUNICIPAL AFFAIRS
23      To whom was referred a Bill (H. 3136) to enact the “Cervical
24   Cancer Prevention Act” so as to amend the Code of Laws of South
25   Carolina, 1976, by adding Section 44-29-187 so as to provide, etc.,
26   respectfully
27                              REPORT:
28      That they have duly and carefully considered the same and
29   recommend that the same do pass with amendment:
30
31      Amend the bill, as and if amended, by deleting Section
32   44-29-187 and inserting:
33      /Section 44-29-187. (A)(1) Beginning with the 2009-2010
34   school year, the Department of Health and Environmental Control
35   shall include the cervical cancer vaccination series as a required
36   vaccination in accordance with Section 44-29-180 for female
37   students enrolling in the seventh grade in any school, public or
38   private, in this State. However, if a student has not attained the
39   age of eleven by the time of enrollment in the seventh grade, the
40   student is not required to have the cervical cancer vaccination
41   series before enrolling in the seventh grade but must have received


     [3136-1]
 1   the vaccination series to enroll in the grade following her eleventh
 2   birthday.
 3         (2) Notwithstanding subsection (A)(1), a female student is
 4   not required to comply with subsection (A)(1) if:
 5           (a) the student‟s parent or guardian has signed and
 6   submitted the appropriate form, as provided by the department, to
 7   the school indicating that the parent or guardian has received the
 8   informational brochure provided for in subsection (B) and that the
 9   parent or guardian has elected for the student not to receive the
10   cervical cancer vaccination; or
11           (b) the student has obtained an exemption in accordance
12   with regulation 61-8 „Vaccination, Screening and Immunization
13   Regarding Contagious Diseases‟, which includes, but is not limited
14   to, religious and medical exemptions.
15      (B)(1) The department shall develop and provide to each school
16   district informational brochures concerning the cervical cancer
17   vaccination series and the requirements and exemptions provided
18   for in this section.
19         (2) At the beginning of the school year each school district
20   shall provide these informational brochures to the parents or
21   guardians of all female students in the sixth grade.
22      (C) For the purposes of this section „cervical cancer vaccination
23   series‟ means the human papillomavirus vaccination series.
24      (D) Implementation of this section is contingent upon the
25   appropriation of state and federal funding to the department to
26   fully cover the costs of providing this vaccine to eligible female
27   students./
28      Renumber sections to conform.
29      Amend title to conform.
30
31   LEON HOWARD for Committee.
32
33
34        STATEMENT OF ESTIMATED FISCAL IMPACT
35       ESTIMATED FISCAL IMPACT ON GENERAL FUND
36                          EXPENDITURES:
37               A Cost to the General Fund (See Below)
38      ESTIMATED FISCAL IMPACT ON FEDERAL & OTHER
39                      FUND EXPENDITURES:
40        $0 (No additional expenditures or savings are expected)




     [3136-2]
 1   EXPLANATION OF IMPACT:
 2   Department of Health and Environmental Control (DHEC)
 3      Based on 2007 data and current federal assistance levels, the
 4   department estimates an additional $1,728,000 is needed to
 5   purchase HPV vaccine for those children who are not eligible to
 6   receive it under the Federal Vaccines for Children (FVC)
 7   Entitlement Program (i.e., Medicaid, Uninsured, American Indian,
 8   Alaska Native) or whose insurance will not cover the cost of
 9   vaccinations. The cost of immunization assumes 20% of the
10   State‟s 30,000 11-year old females are underinsured or otherwise
11   ineligible for the federally assisted vaccinations. Cost estimates
12   are also based on a series of 3 injections and a per injection cost of
13   $96. DHEC indicates enactment would require additional staff
14   time to administer the increased number of vaccinations and
15   maintain records. The department estimates additional salaries,
16   fringe and other operating costs to be an estimated $304,440
17   depending on staffing levels at the time of implementation in 2010
18   (see Special Notes below).
19      It is anticipated that in FY 2007, the FVC program will provide
20   DHEC with enough HPV vaccine to immunize all the FVC-
21   eligible female adolescents ages 9 to 18. However, under federal
22   FVC guidelines, the vaccine must be made available to all eligible
23   females in this age group and DHEC cannot target 11-year olds
24   only. It should be noted that the level of federal FVC program
25   funding, as well as the cost of HPV vaccine, could vary from year
26   to year. Additionally, any actions taken by the insurance industry
27   to cover the cost of HPV vaccinations could reduce DHEC‟s cost.
28   Consequently, the impact on the state general fund necessary to
29   cover the gap in coverage would vary accordingly.
30   State Department of Education (SDE)
31      The department indicates this bill would have a minimal impact
32   on that agency‟s expenditures. SDE indicates there would be a
33   cost to the school districts associated with verification of
34   vaccination and notification of non-compliance as needed.
35   Average cost is approximately $7,000 per district.
36   SPECIAL NOTES:
37      The House of Representative Way and Means version of the FY
38   2007-08 Appropriation Act contains funding for Vaccine
39   Purchases for under-insured Children and adolescents, which
40   includes 8.00 additional FTEs. No additional FTEs would be
41   needed for implementation of this bill in 2010 if these FTEs along
42   with salary and fringe benefits are contained in the FY 2007-08
43   Appropriation Act.

     [3136-3]
 1      Section 2(D) of the bill provides that implementation of this
 2   “section” is contingent upon the appropriation of funding adequate
 3   to cover the costs of providing this vaccine to eligible female
 4   students. The General Assembly may wish to clarify if this
 5   provision is intended to include both DHEC‟s responsibility to
 6   vaccinate and the general requirement that all 11-year old females
 7   must receive the HPV vaccination before they can enroll in school.
 8
 9                                    Approved By:
10                                    Don Addy
11                                    Office of State Budget
12




     [3136-4]
 1
 2
 3
 4
 5
 6
 7
 8
 9                              A BILL
10
11   TO ENACT THE “CERVICAL CANCER PREVENTION ACT”
12   SO AS TO AMEND THE CODE OF LAWS OF SOUTH
13   CAROLINA, 1976, BY ADDING SECTION 44-29-187 SO AS
14   TO PROVIDE THAT BEGINNING WITH THE 2009-2010
15   SCHOOL YEAR, THE DEPARTMENT OF HEALTH AND
16   ENVIRONMENTAL CONTROL SHALL REQUIRE FEMALE
17   STUDENTS ENROLLING IN THE SEVENTH GRADE TO
18   HAVE RECEIVED THE CERVICAL CANCER VACCINE
19   SERIES AND TO AUTHORIZE DELAYING THE
20   REQUIREMENT FOR STUDENTS WHO ARE NOT ELEVEN
21   YEARS OLD AT ENROLLMENT INTO THE SEVENTH
22   GRADE; TO APPLY THE DEPARTMENT‟S IMMUNIZATION
23   AND VACCINATION EXEMPTIONS, AS PROVIDED FOR IN
24   REGULATION, INCLUDING, BUT NOT LIMITED TO, A
25   RELIGIOUS EXEMPTION; AND TO PROVIDE THAT
26   IMPLEMENTATION OF THIS SECTION IS CONTINGENT
27   UPON STATE AND FEDERAL FUNDING.
28
29   Whereas, the American Cancer Society estimates that over 9,700
30   new cervical cancer cases will be diagnosed in the United States
31   this year and that more than 3,700 women will die this year of
32   cervical cancer; and
33
34   Whereas, infections caused by two strains of the human
35   papillomavirus (HPV) are the leading cause of cervical cancer and
36   account for seventy percent of all cervical cancer cases; and
37
38   Whereas, South Carolina ranks third in the country in the incidence
39   of cervical cancer and the death rate for cervical cancer in South
40   Carolina exceeds the national death rate;
41


     [3136]                           1
 1   Whereas, data from the South Carolina Department of Health and
 2   Environmental Control indicates that approximately two hundred
 3   new cases of cervical cancer are diagnosed annually in South
 4   Carolina. Additionally, more than $25 million is expended
 5   annually in South Carolina to treat HPV related conditions; and
 6
 7   Whereas, the Food and Drug Administration recently approved the
 8   use of the HPV vaccine, a vaccine for the prevention of cervical
 9   cancer, a groundbreaking development in medical history in that
10   this is the first vaccine specifically developed to prevent a type of
11   cancer; and
12
13   Whereas, clinical trials to date have found that this cervical cancer
14   vaccine is extremely safe and highly effective in preventing
15   infection of the two strains of the human papillomavirus, which
16   cause seventy percent of cervical cancer; and
17
18   Whereas, the Centers for Disease Control Advisory Committee on
19   Immunization Practices recommends, in conjunction with the
20   federal Vaccine for Children Program, that females between the
21   ages of nine and eighteen receive the cervical cancer vaccine, with
22   11 years of age being the recommended age for being vaccinated;
23   and
24
25   Whereas, this recommendation of the Centers for Disease Control
26   Advisory Committee on Immunization Practices has been endorsed
27   by the American Academy of Pediatrics, the American College of
28   Obstetricians and Gynecologists, the American Academy of
29   Family Physicians, and the American Medical Association; and
30
31   Whereas, in this State, as well as throughout the country,
32   recommendations of the Advisory Committee on Immunization
33   Practices are the basis for vaccination requirements set by law for
34   school attendance. Now therefore,
35
36   Be it enacted by the General Assembly of the State of South
37   Carolina:
38
39   SECTION 1. This act may be cited as “The Cervical Cancer
40   Prevention Act”.
41
42   SECTION 2. Chapter 29, Title 44 of the 1976 Code is amended
43   by adding:

     [3136]                            2
 1      “Section 44-29-187. (A)(1) Beginning with the 2009-2010
 2   school year, the Department of Health and Environmental Control
 3   shall include the cervical cancer vaccination series as a required
 4   vaccination in accordance with Section 44-29-180 for female
 5   students enrolling in the seventh grade in any school, public or
 6   private, in this State.
 7         (2) Notwithstanding subsection (A)(1), a female student is
 8   not required to comply with subsection (A)(1) if the student has
 9   not attained the age of eleven by the time of enrollment in the
10   seventh grade. However, the student must have received the
11   cervical cancer vaccination series to enroll in the grade following
12   her eleventh birthday.
13      (B) Regulation 61-8, as amended, „Vaccination, Screening and
14   Immunization Regarding Contagious Diseases‟, and its exemptions
15   apply to this section including, but not limited to, a religious
16   exemption in which the parents, parent, guardian, or person in loco
17   parentis may sign the appropriate section of the South Carolina
18   Certificate of Religious Exemption, as provided by the department,
19   stating they are members of a recognized religious denomination in
20   which the tenets and practices of the religious denomination
21   conflict with immunizations.
22      (C) For purposes of this section, „cervical cancer vaccination
23   series‟ means the human papillomavirus vaccination series.
24      (D) Implementation of this section is contingent upon the
25   appropriation of state and federal funding to the department to
26   cover the costs of providing this vaccine to eligible female
27   students.”
28
29   SECTION 2. This act takes effect upon approval by the Governor.
30                            ----XX----
31




     [3136]                           3

				
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