Monthly Archives: September 2013

May I Refuse to Care for a Child Who is Not Immunized?

A parent who wants to enroll in your family child care program tells you she refuses to immunize her child. What do you do?

The following Tom Copeland article covers all the variables that you need to take into consideration.  As he said, “The answer is not simple”, and it’s not!  As a general rule, you can exclude any child you want from your program – UNLESS …

Your response needs to take into consideration your state health laws, your state child care licensing rules and anti-discrimination laws.

Immunization of preschool children will help them from contracting and spreading vaccine-preventable disease. These diseases include polio, diphtheria, tetanus, pertussis, haemophilus, influenzae, hepatitis, pneumococcal, chickenpox, measles, mumps and rubella.

Obviously your concern is the health and safety of the child admitted into your program as well as the other children already in your program. Accepting a non-immunized child puts this at risk.

Most states (through health or child care regulations) require the administration of immunizations to combat these diseases.

Does this mean you can refuse to accept a child who is not immunized?


As a general rule you can exclude children from your program for any reason, unless you are unlawfully discriminating based on a protected class: race, sex, religion, disability, or national orgin. A non immunized child is not a protected class.

All states allow parents to be exempted from the requirement that their child be immunized if their refusal is based on medical reasons.

All states, except Mississippi and West Virginia allow religious exemptions.

Twenty states allow an exemption for philosophical reasons: Arizon, Arkansas, California, Colorado, Idaho, Louisiana, Maine, Michigan, Minnesota, Missouri, New Mexico, North Dakota, Ohio, Oklahoma, Pennsylvania, Texas, Utah, Vermont, Washington, and Wisconsin.

These exemptions mean that parents don’t have to immunize their child under certain conditions, but this does not mean you have to accept nonimmunized children into your program. Under federal law you can refuse to provide care for children based on the fact that they are not immunized.

Increasingly parents are refusing to immunize their children because of religious objections. If this happens, do not challenge the parent’s religious beliefs or their sincerity. Questioning their motives is likely to create more trouble.

What if a parent argues that you are discriminating against her religion if you refuse to provide care for her child because of the parent’s religious objection to immunization? Religious discrimination is a protected class.

The answer is not simple. It can vary depending on the state you are in. Because of the health risks involved, I recommend asking your licensor for advice. If they tell you that you must accept the child, ask for a copy of the law or rule they are citing as authority for their position. If necessary, ask you state licensing office for guidance.

Dealing with this issue can be difficult. Parents in your program may want to know if other children are not immunized. You should not share this information because you want to protect the privacy of all families.

If you do decide to accept children into your program who are not immunized, I recommend getting these parents to sign a statement indicating their reasons for not immunizing their children. Your licensor or state may have a particular form to use in this situation.

Immunization Notice

You can educate parents about the importance of immunizations and create an immunization notice for all families when they enroll in your program. This notice should:

* Describe the importance and benefits of immunization.

* Explain to parents who choose not to immunize their children the potential consequences of this decision, including contracting a disease, transmitting it to others, and being quanantined if there is an outbreak.

* State that there may be immunized, underimmunized, or nonimmunized children in your program, and because of confidentiality rules you will not be able to provide any information about the immunization status of the other children in your program.

* Inform parents that exposing their children to others who aren’t immunized may increase their risk of contracting disease.

This is an issue where you should also seek guidance from your licensor or your state department of health. If they say you must enroll their child, follow their direction. In some states they will have a form for parents to fill out indicating their objections to immunization.

Can you be sued by a parent if their child contracts a disease in your program from an unimmunized child? You can always be sued, but the chances of winning are remote, particularly if they have received an immunization notice from you. Check with your business liability insurance agent to see if your policy covers you against such a lawsuit.

Tom Copeland –

Child Care Advocacy and Policymakers

Congress will be back in session September 9. Some members take recess as an opportunity to re-engage with their community and the constituents they serve. But how well do you connect with your representatives the other months of the year.    Foster and cultivate those important relationships with your Senators and Representative, as well as their key staff so that when they are in town, on the next recess, you can continue the conversation, in person.  Print out these basic suggestions and  keep handy for the next time Congress goes on recess.  You want them to know who you are and what issues you care about –early learning, child care, resource and referral services, etc., and how those issues are affecting your local community and your state.

CA Child Care Resource & Referral SnippetIn order to ensure you get the most out of your elected officials, here are 5 tips for  success:

1. Schedule a visit/meeting.  Go to our congressional directory to look up the contact information for your Member’s district office(s).  Call the office or send an email requesting a meeting, and be sure to briefly mention the purpose of the meeting.

2. Do your research before your meeting.  You can make the most of your meeting time by being prepared and knowing your audience.  Learn about your Member of Congress: is she/he a Democrat or a Republican? Is your Member on Facebook or Twitter? What committees is she/he on? Do those committees work on child care issues?  You should also know whether the Member supports an increased investment in child care and early learning (and has voted accordingly). Visit the Core Issues page to get background on the issues.

3. Invite your elected officials to your child care program. Reach out to district staff or ask during a meeting with staff or your Member if they would like to visit your child care program: if you’re representing a child care resource and referral agency, you may have a recommendation of a place to visit. This is a great way for Members to connect what you do with what children need, and why investments in child care and early learning programs are so important. Members and their staff get a firsthand look at why quality child care is a necessity for any thriving community.

4. Attend scheduled town halls. Another great way to engage with your elected officials during recess is to attend a town hall meeting (or two!).  Check your policymaker’s website to find out the date and location of any upcoming town hall meetings. In preparation for the meeting, write down–at most–two questions: you will not have a lot of time so make sure your questions are specific and straight to the point.  Read our town hall tips sheet for more information.

5. Follow up. If you were able to get a meeting, attend a town hall, and/or host a Member at your early learning program, send a thank you note to your Member and their staff.  Thank them for taking the time out to meet with you/have the town hall meeting/visit your program, and gently remind them why they should continue to support child care. Be sure to follow up on any requests you made at the meeting as well as any information they may have asked for.  A few words of appreciation will have a lasting impact on your relationship with your elected officials and your long term advocacy efforts.