Fla. Admin. Code Ann. R. 65A-4.216 - Immunization Program

(1) A child whose needs have been removed from the temporary cash assistance grant due to failure of the recipient to provide verification of immunization(s) or exemption through good cause will remain eligible for Medicaid. The child's needs will be reinstated when the individual provides proof that the immunization sequence has started and is up-to-date or complete, or that good cause for failure to immunize exists. Examples of good cause exemptions from the immunization requirement include religious reasons or a permanent medical condition that prohibits immunization.
(2) Any written statement containing information that the immunizations are current, the date the next immunization is due and the dated signature of a health care professional licensed under Chapter 458, 459 or 460, F.S., or authorized designee is acceptable as verification for immunization requirements. DH Form 680, 11/96, Florida Certification of Immunization, incorporated by reference, is an example of acceptable verification. Oral verification through direct contact between departmental staff and the health care professional or their authorized designee is allowed when the participant is unable to obtain written verification. DH Form 680 when signed by a healthcare professional licensed under Chapter 458 or 459, F.S., also will be used as verification of good cause for failure to immunize a child due to a permanent medical condition. DH Form 681, 5/99, Religious Exemption from Immunization, incorporated by reference, signed by the county public health director or administrator is acceptable verification of good cause for failure to immunize a child because of religious beliefs.


Fla. Admin. Code Ann. R. 65A-4.216
Rulemaking Authority 120.54(1), 414.45 FS. Law Implemented 414.13 FS.
New 4-26-94, Formerly 10C-1.517, Amended 7-22-97, Formerly 65A-1.517, Amended 10-11-99.

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