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. 2019 Jan;109(1):96–101. doi: 10.2105/AJPH.2018.304768
We’re interested in understanding your experiences with the implementation of SB277. Can you talk a bit about how the roll out of SB277 has gone so far in your county?
 ▪ Are the schools having any issues with implementation?
 ▪ Are parents complaining or supportive of the new law?
 ▪ How are health care providers dealing with the change in exemption options?
Can you walk me through the process of how you are actually getting the medical exemption data from schools in your county?
 ▪ What types of information is the school collecting for medical exemptions?
 ▪ Are the data de-identified?
 ▪ Who in your office does any reviewing and verifying tasks?
If you notice a potentially invalid exemption, can you walk me through how you work with the school to figure out the next steps?
 ▪ Do you help the school reach out to the family?
 ▪ Do you contact the physician listed on the medical exemption?
 ▪ Does the child get excluded from school?
From your perspective, how do you feel the schools are handling medical exemptions under SB277?
 ▪ Are schools feeling prepared in terms of verifying medical exemptions?
 ▪ What have you heard from schools in terms of their level of comfort in tracking and verifying medical exemptions post-SB277?
 ▪ Are schools looking to you for guidance on enforcing SB277?
 ▪ Are schools doing an adequate job of reviewing and verifying medical exemptions?
What are the biggest challenges you face as a local health officer working under SB277?
 ▪ Enforcing the law?
 ▪ Getting information from the schools?
 ▪ Getting guidance from the state?
In your opinion, what do you think could be done better at the school level to enforce SB277?
In your opinion, what do you think could be done better at the local level to enforce SB277?

Note. SB277 = California Senate Bill 277.