In an effort to get more kids vaccinated on time, the state of California says that it will financially penalize schools that wrongly admitted a high percentage of kindergartners who were overdue for their second dose of the measles vaccine.
The state acted because its data analysis indicates that many schools are erroneously enrolling kindergartners who are overdue for one or more vaccinations and by law should be excluded from class until they're up to date with their shots.
Incoming kindergartners can be admitted as "conditional entrants" if they are not fully immunized but not overdue for any shots, or if they have a temporary medical exemption. Last fall, more than 24,000 kindergartners were conditional enrollees statewide, according to data released by the California Department of Public Health. Nearly half of them were in Los Angeles County schools.
Public Health says it analyzed a sampling of conditional entrants from the 2014-15 school year last spring, and found that nearly 94 percent had not received the minimum number of vaccine doses required for the "conditional" classification.
Under a new policy published in July, state auditors will now review schools with 2015-16 conditional kindergarten admission rates above 25 percent. The auditors will check whether these schools received state payment for attendance of students who should have been excluded from class for not meeting the conditional admission criteria.
If children entered school with only one of two required measles shots and had not received their second shot within three months, as required by state law, the guidelines require auditors to verify the students were excluded from class. If they were not excluded, the policy says the auditors should "disallow the [average daily attendance payment] for any days after three calendar months and ten days from the first dose until the date of the second dose."
For the Los Angeles Unified School District, for example, the average daily attendance payment for a kindergarten student is $58, according to district spokeswoman Ellen Morgan.
The California Department of Education says it will audit 166 schools statewide for having more than 25 percent of their kindergartners enrolled as conditional entrants; 107 are in the Los Angeles Unified School District.
Public Health is also helping local health departments educate school staff on the proper use of conditional entrance criteria for measles.
Officials say the new rules are partly a response to the measles outbreak that began at Disneyland in Dec. 2014. It sickened 131 Californians and shined a light on the low vaccination rates in some communities.
The number of conditional entrants statewide and in L.A. County were down by about one-third this fall from the 2014-15 school year. Public Health partly credits the threat of the financial penalties, first communicated to schools last summer, for the reduction.
Morgan, the L.A. Unified spokeswoman, denies that the new rules spurred the district to track conditional enrollments more carefully. Rather, "we have always strived to utilize all our resources to comply with immunization policies," she says, noting that district officials review vaccination records and "run bi-monthly immunization reports to keep track of when the next doses of immunization are due," among other tactics.
Morgan says the district is not concerned that the state's crackdown could reduce its attendance reimbursements.
"We are confident that we will be able to review student records and assist parents and guardians obtain the resources needed," she says.
While the overall number of conditional entrants is down, numerous L.A. Unified schools still enrolled a high percentage of conditionals for the 2015-16 academic year. At Union Avenue Elementary, 57 percent of the school's 236 kindergartens were classified as conditional. At Virginia Road Elementary, 55 percent of the school's 81 kindergartners were conditional. At Stanford Primary Center, which only has pre-kindergarten and kindergarten classes, 75 percent of the 170 kindergartners were conditional entrants.
KPCC and the Center for Health Reporting last year reported that while state law compels schools to track conditional entrants and exclude those who don’t get fully vaccinated, L.A. Unified was failing to track all of them. In the wake of KPCC's story, the school district said it was hiring more permanent and temporary nurses to bolster its tracking efforts.
This story has been updated to include the LAUSD’s ADA payment for kindergarten students.