Chapter 1.6 - Influenza and Pneumococcal Immunizations

California Health and Safety Code — §§ 120392-120393

Sections (8)

§ 120392

Added by Stats. 2004, Ch. 36, Sec. 1. Effective January 1, 2005.

For purposes of this chapter, the following definitions apply:

(a)“Health care facility” means a skilled nursing facility as defined in subdivision (c) of Section 1250, an intermediate care facility as defined in subdivision (d) of Section 1250, or a nursing facility as defined in subdivision (k) of Section 1250. This chapter shall not apply to hospital-based skilled nursing facilities.

(b)“Medically contraindicated” means that the administration of the influenza or pneumococcal vaccines to a person, because of a medical condition of that person, would be detrimental to the person’s health if the person receives either or both of the vaccines.

§ 120392.2

Amended by Stats. 2025, Ch. 105, Sec. 33. (AB 144) Effective September 17, 2025.

(a)Each year, commencing October 1 to the following April 1, inclusive, every health care facility, as defined in subdivision (a) of Section 120392, shall offer, pursuant to Section 120392.4, immunizations for influenza and pneumococcal disease to residents, 65 years of age or older, receiving services at the facility consistent with recommendations adopted pursuant to Section 120164 and the latest recommendations of appropriate

entities for the prevention, detection, and control of influenza outbreaks in California long-term care facilities.

(b)Each health care facility, as defined in subdivision (a) of Section 120392, shall offer, pursuant to Section 120392.4, pneumococcal vaccine to all new admittees to the health care facility, consistent with the immunization recommendations adopted pursuant to Section 120164.

(c)The facility shall be reimbursed the standard Medi-Cal rate for an immunization provided to a Medi-Cal recipient, unless

the Medi-Cal recipient is also a Medicare recipient whose coverage includes reimbursement for the immunization.

§ 120392.3

Amended by Stats. 2025, Ch. 105, Sec. 34. (AB 144) Effective September 17, 2025.

(a)The department shall provide appropriate flu vaccine to local governmental or private, nonprofit agencies at no charge in order that the agencies may provide the vaccine, at a minimal cost, at accessible locations. The department and the California Department of Aging shall prepare, publish, and disseminate information regarding the immunization recommendations adopted pursuant to Section 120164 or other criteria in order to ensure that the vaccination program is efficient and effective in meeting public health goals. Any guidance issued pursuant to this subdivision shall be exempt from the rulemaking provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code). In the absence of guidance from the department, local agencies shall be guided by the influenza recommendations of the federal Centers for Disease Control and

Prevention’s Advisory Committee on Immunization Practices as of January 1, 2025, the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, or the American Academy of Family Physicians.

(b)The department may provide appropriate vaccine that prevents other respiratory infections to local governmental or private, nonprofit agencies at no charge in order that the agencies may provide the vaccine, at a minimal cost, at accessible locations for groups identified as high risk by the

department.

(c)The program shall be designed to use voluntary assistance from public or private sectors in administering the vaccines. However, local governmental or private, nonprofit agencies may charge and retain a fee not exceeding two dollars ($2) per person to offset administrative operating costs.

(d)Except when the department determines that it is not feasible to use federal funds due to excessive administrative costs, the department shall seek and use available federal funds to the maximum extent possible for the cost of the vaccine, the cost of administering the vaccine, and the minimal fee charged under this section, including reimbursement under the Medi-Cal program for persons eligible therefor to the extent permitted by federal law.

(e)A private, nonprofit volunteer agency whose involvement with an immunization program governed by this section is limited to the provision of a clinic site or promotional and logistical support pursuant to

subdivision (c), or any employee or member thereof, shall not be liable for any injury caused by an act or omission in the administration of the vaccine or other immunizing agent, if the immunization is performed pursuant to this section in conformity with applicable federal, state, or local governmental standards and the act or omission does not constitute willful misconduct or gross negligence. As used in this subdivision, “injury” includes the residual effects of the vaccine or other immunizing agent. It is the intent of the Legislature in adding this subdivision to affect only the liability of private, nonprofit volunteer agencies and their members that are not health facilities, as defined in Section 1250.

(f)This section shall not be construed to require the physical presence of a directing or supervising physician, or the examination by a physician of persons to be tested or immunized.

§ 120392.4

Added by Stats. 2004, Ch. 36, Sec. 1. Effective January 1, 2005.

(a)A resident who receives services at a health care facility during the period of October 1 to April 1 shall have his or her status for influenza and pneumococcal immunization determined by his or her physician or facility medical director, and, if appropriate, the facility shall offer to make the immunizations available, unless the facility, through written policies and procedures and using standardized nursing procedures, offers to make the immunizations available without limitation as to the period when the residents receive services at the facility.

(b)A health care facility shall obtain from a resident who requests immunization services, or, if the person lacks the capacity to make medical decisions, from the person legally authorized to make medical decisions on the resident’s behalf, informed consent for the resident to be immunized by vaccination against influenza or pneumococcal disease, or both, to be conducted by the facility while the resident is receiving services at the facility.

(c)A health care facility shall comply with Section 1418.8 with respect to a resident who lacks the capacity to make health care decisions, and there is no person with legal authority to make these decisions on behalf of the resident.

(d)The health care facility shall document in a resident’s medical record whether the resident has been offered the influenza vaccine or the pneumococcal vaccine.

§ 120392.6

Amended by Stats. 2025, Ch. 105, Sec. 35. (AB 144) Effective September 17, 2025.

No person who has been offered the vaccine as required under this chapter may receive either an influenza vaccine or pneumococcal vaccine pursuant to this chapter if any of the following conditions exists:

(a)The vaccine is medically contraindicated, as described in the product labeling approved by the federal Food and Drug Administration.

(b)Receipt of the vaccine is against the resident’s personal beliefs.

(c)Receipt of the vaccine is against the resident’s wishes, or, if the person lacks the capacity to make medical decisions, is against the wishes of the person legally authorized to make medical decisions on the resident’s behalf.

§ 120392.8

Added by Stats. 2004, Ch. 36, Sec. 1. Effective January 1, 2005.

(a)Notwithstanding any other provision of this chapter, a health care facility shall not be required to offer immunizations for influenza and pneumococcal disease under either of the following circumstances:

(1)The facility is unable to obtain the vaccine due to a shortage of the supply of vaccine.

(2)The resident refuses to pay for the vaccine and there is no other funding source available to pay for the cost of the vaccine.

(b)If a health care facility, as defined in subdivision (a) of Section 120392, fails to offer an immunization pursuant to this chapter due to lack of availability of vaccine, a physician’s refusal to assess the resident or cooperate with the recommendations of the provisions of this chapter, or lack of resident cooperation, the failure shall not be the basis for issuing a deficiency or citation against the facility’s license.

(c)This chapter is intended to encourage immunizations for residents in health care facilities, and the department shall consider a facility’s efforts to prevent a violation of this chapter prior to issuing a deficiency or citation. The department may issue a deficiency or citation for failure to comply with Section 120392.4.

§ 120392.9

Amended by Stats. 2025, Ch. 105, Sec. 36. (AB 144) Effective September 17, 2025.

Pursuant to its standardized procedures and if it has the vaccine in its possession, each year, commencing October 1 to the following April 1, inclusive, a general acute care hospital, as defined in subdivision (a) of Section 1250, shall offer, prior to discharge, immunizations for influenza and pneumococcal disease to inpatients, 65 years of age or older, consistent with recommendations adopted pursuant to Section 120164 or the recommendations of appropriate entities

for the prevention, detection, and control of influenza outbreaks in California general acute care hospitals.

§ 120393

Amended by Stats. 2025, Ch. 105, Sec. 37. (AB 144) Effective September 17, 2025.

(a)The State Department of Public Health shall post educational information, in accordance with the latest recommendations adopted pursuant to Section 120164, regarding influenza disease and the availability of influenza vaccinations on the department’s internet website. It is the intent of the Legislature to increase the average number of Californians who receive an

influenza vaccination.

(b)The educational information posted on the department’s internet website pursuant to subdivision (a) shall include, but not be limited to, all of the following:

(1)The health benefits of an influenza vaccination.

(2)That the influenza vaccination may be a covered benefit for those with health insurance coverage.

(3)That influenza vaccinations may be available for a minimal fee to those individuals who do not have health insurance coverage.

(4)The

locations where free or low-cost vaccinations are available.

(c)The department may use additional available resources to educate the public about the information described in subdivision (b), including public service announcements, media events, public outreach to individuals and groups who are susceptible to influenza, and any other preventive and wellness education efforts recommended by public health officials.