text: SECTION 1. SHORT TITLE.
  
      This Act may be cited as the ``Child Immunization Incentive Act of 
  1993''.
  
  SEC. 2. AFDC BENEFITS DENIED FOR CHILDREN WHO HAVE NOT RECEIVED 
                PREVENTIVE HEALTH CARE OR IMMUNIZATIONS.
  
      Section 402(a) of the Social Security Act (42 U.S.C. 602(a)) is 
  amended--
              (1) by striking ``and'' at the end of paragraph (44);
              (2) by striking the period at the end of paragraph (45) and 
          inserting ``; and''; and
              (3) by inserting after paragraph (45) the following:
              ``(46) provide that--
                      ``(A) aid under the plan shall not be payable with 
                  respect to any child who has not attained the age of 6 
                  years, unless the State agency has received from 1 or 
                  more physicians written verification (on a form 
                  prescribed by the State)--
                              ``(i) that the child has been examined by a 
                          physician not less frequently than--
                                      ``(I) in the case of a child who 
                                  has not attained the age of 19 months, 
                                  every 6 months since the child was 
                                  born; and
                                      ``(II) in the case of any other 
                                  child, every 6 months until the child 
                                  attained the age of 19 months, and 
                                  every year thereafter;
                              ``(ii) that the child has been immunized in 
                          accordance with recommendations issued by the 
                          Surgeon General of the Public Health Service; 
                          and
                              ``(iii) of any contraindication which 
                          exempts the child from receiving an 
                          immunization;
                      ``(B) the State will conduct appropriate education 
                  and outreach activities designed to--
                              ``(i) increase public awareness of the 
                          importance of preventive health care and 
                          immunizations for pre-school children; and
                              ``(ii) inform the public about--
                                      ``(I) the availability of 
                                  preventive health care and immunization 
                                  services for pre-school children;
                                      ``(II) any transportation, child 
                                  care, or other support services that 
                                  may be available to assist parents in 
                                  obtaining such services for their 
                                  children; and
                                      ``(III) the clinics at which any 
                                  child may receive immunizations free or 
                                  at a reduced charge.''.
  
  SEC. 3. AMENDMENTS TO THE CHILD CARE AND DEVELOPMENT BLOCK GRANT.
  
      Section 658E(2) of the Child Care and Development Block Grant Act 
  (42 U.S.C. 9858c(2)) is amended--
              (1) in subparagraph (F)--
                      (A) in clause (ii) by striking ``and'' at the end,
                      (B) in clause (iii) by striking the period at the 
                  end and inserting ``; and'',
                      (C) by inserting after subclause (III), as so 
                  redesignated, the following:
                              ``(iv) a requirement that such providers 
                          require with respect to each child who receives 
                          child care services from any of such providers 
                          that certificates signed by a physician who 
                          verifies that such child has been immunized in 
                          accordance with recommendations issued by the 
                          Surgeon General of the Public Health Service be 
                          submitted, at required intervals and in 
                          accordance with rules issued by the Secretary, 
                          to the child care provider involved.'', and
                      (D) by striking the last sentence, and
              (2) in subparagraph (G&lt;plus-minus&gt;)--
                      (i) by inserting ``(i)'' before ``Provide'', and
                      (ii) by adding at the end the following:
                      ``(ii) For the purpose of enforcing the requirement 
                  described in subparagraph (F)(iv), such procedures 
                  shall ensure that each of such providers gives to 
                  parents of each child who receives child care services 
                  from the provider involved written notice of--
                              ``(I) each immunization requirement 
                          applicable to such child;
                              ``(II) an opportunity of not less than 30 
                          days, and not more than 45 days, to correct the 
                          failure to satisfy such requirement; and
                              ``(III) the fact that child care services 
                          for such child will be terminated for failure 
                          to satisfy such requirement before the 
                          expiration of the 45-day period beginning on 
                          the date such notice is received.''.
  
  SEC. 4. ISSUANCE OF IMMUNIZATION RECOMMENDATIONS BY THE SURGEON GENERAL 
                OF THE PUBLIC HEALTH SERVICE.
  
      After taking into consideration the then most recent report of the 
  Committee on Infectious Diseases of the American Academy of Pediatrics, 
  the Surgeon General of the Public Health Service shall issue, and 
  revise from time to time, recommendations for the immunization of 
  children under 6 years of age. With respect to each recommended 
  immunization, such recommendation shall include--
              (1) contraindications (if any) that should be identified to 
          exempt a child from receiving such immunization, and
              (2) remedial action that may be taken to minimize the 
          adverse effect of failure to administer such immunization to a 
          child at the recommended age.
  
  SEC. 5. EFFECTIVE DATES; APPLICATION OF AMENDMENTS.
  
      (a) Effective Date.--Except as provided in subsections (b) and (c), 
  this Act and the amendments made by this Act shall take effect on the 
  date of the enactment of this Act.
      (b) Application of Section 2 Amendments.--The amendments made by 
  section 2 shall apply, without regard to whether regulations to 
  implement the amendments have been promulgated, to--
              (1) payments to individuals under State plan approved under 
          part A of title IV of the Social Security Act, for months 
          ending after the 120-day period that begins with the date of 
          the enactment of this Act; and
              (2) payments to States under such part for calendar 
          quarters ending after such 120-day period.
      (c) Application of Section 3 Amendments.--The amendments made by 
  section 3 shall not apply with respect to fiscal years beginning before 
  the date of the enactment of this Act.
target: Child Immunization Incentive Act of 1993 - Amends part A (Aid to Families with Dependent Children) (AFDC) of title IV of the Social Security Act to:  (1) deny AFDC for children under six who have not received periodic examinations by a physician or immunizations; and (2) require State outreach activities with respect to preventive health care and immunizations for pre-school children. 
  Amends the Child Care and Development Block Grant Act to require providers assisted under such Act to require each child receiving their services to receive immunizations in accordance with the recommendations issued by the Surgeon General pursuant to this Act.
feat_title: Child Immunization Incentive Act of 1993