GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 1999

SESSION LAW 2000-112
SENATE BILL 1234

AN ACT TO REQUIRE THAT ADULT CARE HOMES AND NURSING HOMES ENSURE THAT RESIDENTS AND EMPLOYEES ARE IMMUNIZED AGAINST INFLUENZA VIRUS AND THAT RESIDENTS ARE ALSO IMMUNIZED AGAINST PNEUMOCOCCAL DISEASE.

The General Assembly of North Carolina enacts:

Section 1. Effective September 1, 2000, Article 1 of Chapter 131D of the General Statutes is amended by adding the following new section to read:
"§ 131D-9. Immunization of residents of adult care homes.
(a)	Except as provided in subsection (e) of this section, an adult care home licensed under this Article shall require residents to be immunized against pneumococcal disease.
(b)	Upon admission, an adult care home shall notify the resident of the immunization requirements of this section and shall request that the resident agree to be immunized against pneumococcal disease.
(c)	An adult care home shall document the immunization against pneumococcal disease for each resident.  Upon finding that a resident is lacking the immunization, or if the adult care home is unable to verify that the individual has received the required immunization, the adult care home shall provide or arrange for immunization.  The immunization and documentation required shall occur not later than November 30 of each year.
(d)	For an individual who becomes a resident of the adult care home after November 30 but before March 30 of the following year, the adult care home shall determine the individual's status for the immunization required under this section, and if found to be deficient, the adult care home shall provide the immunization.
(e)	No individual shall be required to receive vaccine under this section if the vaccine is medically contraindicated, or if the vaccine is against the individual's religious beliefs, or if the individual refuses the vaccine after being fully informed of the health risks of not being immunized.
(f)	Notwithstanding any other provision of law to the contrary, the Health Services Commission shall have the authority to adopt rules to implement the immunization requirements of this section."
Section 2. Effective September 1, 2001, G.S. 131D-9, as enacted by Section 1 of this act, reads as rewritten:
"§ 131D-9. Immunization of employees and residents of adult care homes.
(a)	Except as provided in subsection (e) of this section, an adult care home licensed under this Article shall require residents and employees to be immunized annually against influenza virus and shall require residents to also be immunized against pneumococcal disease.
(b)	Upon admission, an adult care home shall notify the resident of the immunization requirements of this section and shall request that the resident agree to be immunized against influenza virus and pneumococcal disease.
(b1)	An adult care home shall notify every employee of the immunization requirements of this section and shall request that the employee agree to be immunized against the influenza virus.
(c)	An adult care home shall document the annual immunization against influenza virus and the immunization against  pneumococcal disease for each resident and each employee, as required under this section.  Upon finding that a resident is lacking one or both of these immunizations or that an employee has not been immunized against influenza virus, or if the adult care home is unable to verify that the individual has received the required immunization, the adult care home shall provide or arrange for immunization.  The immunization and documentation required shall occur not later than November 30 of each year.
(d)	For an individual who becomes a resident of or who is newly employed by the adult care home after November 30 but before March 30 of the following year, the adult care home shall determine the individual's status for the immunizations required under this section, and if found to be deficient, the adult care home shall provide the immunization.
(e)	No individual shall be required to receive vaccine under this section if the vaccine is medically contraindicated, or if the vaccine is against the individual's religious beliefs, or if the individual refuses the vaccine after being fully informed of the health risks of not being immunized.
(f)	Notwithstanding any other provision of law to the contrary, the Health Services Commission shall have the authority to adopt rules to implement the immunization requirements of this section.
(g)	As used in this section, 'employee' means an individual who is a part-time or full-time employee of the adult care home."
Section 3. Effective September 1, 2000, Part A of Article 6 of Chapter 131E of the General Statutes is amended by adding the following new section to read:
"§ 131E-113. Immunization of residents.
(a)	Except as provided in subsection (e) of this section, a nursing home licensed under this Part shall require residents to be immunized against pneumococcal disease.
(b)	Upon admission, a nursing home shall notify the resident of the immunization requirements of this section and shall request that the resident agree to be immunized against pneumococcal disease.
(c)	A nursing home shall document the immunization against pneumococcal disease for each resident.  Upon finding that a resident is lacking the immunization, or if the nursing home is unable to verify that the individual has received the required immunization, the nursing home shall provide or arrange for immunization.  The immunization and documentation required shall occur not later than November 30 of each year.
(d)	For an individual who becomes a resident of the nursing home after November 30 but before March 30 of the following year, the nursing home shall determine the individual's status for the immunization required under this section, and if found to be deficient, the nursing home shall provide the immunization.
(e)	No individual shall be required to receive vaccine under this section if the vaccine is medically contraindicated, or if the vaccine is against the individual's religious beliefs, or if the individual refuses the vaccine after being fully informed of the health risks of not being immunized.
(f)	Notwithstanding any other provision of law to the contrary, the Health Services Commission shall have the authority to adopt rules to implement the immunization requirements of this section."
Section 4. Effective September 1, 2001, G.S. 131E-113, as enacted by Section 3 of this act, reads as rewritten:
"§ 131E-113. Immunization of employees and residents.
(a)	Except as provided in subsection (e) of this section, a nursing home licensed under this Part shall require residents and employees to be immunized against influenza virus and shall require residents to also be immunized against pneumococcal disease.
(b)	Upon admission, a nursing home shall notify the resident of the immunization requirements of this section and shall request that the resident agree to be immunized against influenza virus and pneumococcal disease.
(b1)	A nursing home shall notify every employee of the immunization requirements of this section and shall request that the employee agree to be immunized against influenza virus.
(c)	A nursing home shall document the annual immunization against influenza virus and the immunization against pneumococcal disease for each resident and each employee, as required under this section.  Upon finding that a resident is lacking one or both of these immunizations or that an employee has not been immunized against influenza virus, or if the nursing home is unable to verify that the individual has received the required immunization, the nursing home shall provide or arrange for immunization.  The immunization and documentation required shall occur not later than November 30 of each year.
(d)	For an individual who becomes a resident of or who is newly employed by the nursing home after November 30 but before March 30 of the following year, the nursing home shall determine the individual's status for the immunizations required under this section, and if found to be deficient, the nursing home shall provide the immunization.
(e)	No individual shall be required to receive vaccine under this section if the vaccine is medically contraindicated, or if the vaccine is against the individual's religious beliefs, or if the individual refuses the vaccine after being fully informed of the health risks of not being immunized.
(f)	Notwithstanding any other provision of law to the contrary, the Health Services Commission shall have the authority to adopt rules to implement the immunization requirements of this section.
(g)	As used in this section, 'employee' means an individual who is a part-time or full-time employee of the nursing home."
Section 5. The Department of Health and Human Services shall make available to nursing homes and adult care homes educational and informational materials pertaining to vaccinations required under this act.
Section 6.  G.S. 130A-29(c) is amended by adding the following new subdivision to read:
"(9)	Implementing immunization requirements for adult care homes as provided in G.S. 131D-9 and for nursing homes as provided in G.S. 131E-113."
Section 7. This act is effective when it becomes law.
In the General Assembly read three times and ratified this the 4th day of July, 2000.

s/	Marc Basnight
President Pro Tempore of the Senate

s/	Joe Hackney
Speaker Pro Tempore of the House of Representatives

s/	James B. Hunt, Jr.
Governor

Approved 8:34 a.m. this 14th day of July, 2000