(a) Scope. Sections 230.52, 230.56, and 230.65 of Title 56 of the Oklahoma Statutes and Section 608 of Title 42 of the United States Code address Temporary Assistance for Needy Families (TANF) recipients' responsibility to immunize their children. Immunization of minor children two months of age and older is a variable condition of eligibility that must be addressed before certification and at renewal. The parent or caretaker relative must provide proof that each child is current on age-appropriate immunizations within 90-calendar days of certification and when additional immunizations become due in the future unless he or she requests and, is approved for a good cause exemption, per (b) of this Section. Refer to the Oklahoma State Department of Health (OSDH) website at www.ok.gov/health/ for current immunization schedules and vaccination information. • 1 Proof of immunization includes providing a copy of the vaccination record issued by the local health official or a licensed physician. • 2
(1) When the minor child attends a licensed child care center or home or a parochial, private, or public school, proof of current immunization is not required as each of these entities require proof of immunization or a signed OSDH Form 216-A, Certificate of Exemption, on file with OSDH as a condition of attendance.
(2) When the child does not attend a facility, per (a)(1) of this Section and the client fails to provide proof of current immunization within 90-calendar days without good cause, the worker reduces the TANF cash assistance by 25 percent of the payment standard, per Oklahoma Administrative Code 340:10-3-57(g). • 3 The worker removes the 25 percent penalty the next effective date after the client provides proof of current immunization. • 4
(b) Good cause. The client may claim a good cause exemption because of the child's medical condition, the immunizations are contrary to the child's religion, or the client's personal objection. To claim a good cause exemption, the client must return a completed Form 08TA017E, Immunization Certificate of Exemption, signed by: • 5
(1) a physician, certifying that there is a medical contraindication;
(2) a religious leader, parent, or caretaker relative, certifying that immunizations are contrary to the teachings of the child's religion; or
(3) the parent or caretaker relative, certifying that immunizations are contrary to the parent's or care relative's beliefs.
1. A hyperlink is available to the Oklahoma State Department of Health (OSDH) "Information about Vaccines for Children, Adolescents, and Adults" page under Temporary Assistance for Needy Families (TANF)/Immunization Schedule on the Adult and Family Services Job Function page. Included on the page is the current Childhood Immunization Schedule showing at what ages vaccinations are due, the Recommended Immunizations for Children 7-18 Years Old, information about vaccines, and the laws regarding vaccination.
2. When the worker determines that a child does not have the required immunizations or is not current, he or she refers the parent or caretaker relative to the child's primary care provider or to the local county health department. OSDH has outreach workers to assist families and can provide immunizations without charge.
3. Upon certification, the worker enters a "Y" for "immunizations current," an "N" for "immunizations not current," or a "P" for "immunizations pending," in the immunizations field of the Household tab in the Family Assistance/Client Services (FACS) and documents each child's status in FACS case notes.
(1) The worker uses the "P" code, when the:
(A) child is scheduled or will be scheduled to have his or her immunizations updated within the next 90-calendar days;
(B) client is staggering the child's immunizations over a longer period of time to prevent the possibility of a vaccine injury. In this instance, the client must provide documentation from the child's doctor verifying this plan and a schedule detailing when the child's immunizations are expected to be current;
(C) client is delaying the child's immunizations because another household member has a serious illness and immunizing the child could compromise the household member's health. In this instance, the client must provide documentation from the household member's doctor verifying this situation and when it might be safe to immunize the child; or
(D) client requests good cause and is in the process of getting a physician or religious leader's signature on Form 08TA017E, Immunization Certificate of Exemption.
(2) The worker uses the "N" code when:
(A) the child's immunizations are not up-to-date;
(B) an appointment is not set to update immunizations; and
(C) criteria per (1)(A) of this instruction does not apply.
(3) All children coded "P" for immunization or good cause pending or "N" for immunizations not current are shown on the worker's County Worker Activity (CWA) report 62 until the worker changes the immunization code to "Y" for immunization current or "G" for good cause exemption paperwork received. The worker must complete a renewal at six-month intervals when required immunizations are pending or are not current, per Oklahoma Administrative Code (OAC) 340:65-3-8.
5. OSDH only processes good cause exemption requests for schools and child care facilities. To claim a good cause exemption when the child does not attend one of these facilities, the client must return a completed Form 08TA017E, signed by a:
(1) physician certifying that there is a medical contraindication;
(2) religious leader, parent, or caretaker relative certifying that immunizations are contrary to the teachings of the child's religion; or
(3) parent or caretaker relative certifying that immunizations are contrary to the parent or caretaker's beliefs.
6. Once the worker receives a completed and signed Form 08TA017E, the worker:
(1) updates the immunization field to "G" for good cause exemption paperwork received;
(2) images a copy to the case record; and
(3) enters a Family Assistance/Client Services (FACS) case note.