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General Assembly Substitute Bill No. 5044
February Session, 2020
AN ACT CONCERNING IM MUNIZATIONS.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. Subsections (a) and (b) of section 10-204a of the general 1
statutes are repealed and the following is substituted in lieu thereof 2
(Effective from passage): 3
(a) Each local or regional board of education, or similar body 4
governing a nonpublic school or schools, shall require each child to be 5
protected by adequate immunization against diphtheria, pertussis, 6
tetanus, poliomyelitis, measles, mumps, rubella, [hemophilus] 7
haemophilus influenzae type B and any other vaccine required by the 8
schedule for active immunization adopted pursuant to section 19a-7f 9
before being permitted to enroll in any program operated by a public or 10
nonpublic school under its jurisdiction. Before being permitted to enter 11
seventh grade, a child shall receive a second immunization against 12
measles. Any such child who (1) presents a certificate from a physician, 13
physician assistant, advanced practice registered nurse or local health 14
agency stating that initial immunizations have been given to such child 15
and additional immunizations are in process under guidelines and 16
schedules specified by the Commissioner of Public Health; or (2) 17
presents a certificate, in a form prescribed by the commissioner 18
pursuant to section 7 of this act, from a physician, physician assistant or 19
advanced practice registered nurse stating that in the opinion of such 20
physician, physician assistant or advanced practice registered nurse 21 Substitute Bill No. 5044
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such immunization is medically contraindicated because of the physical 22
condition of such child; or (3) prior to the effective date of this section, 23
presents a statement from the parents or guardian of such child that 24
such immunization would be contrary to the religious beliefs of such 25
child or the parents or guardian of such child, which statement shall be 26
acknowledged, in accordance with the provisions of sections 1-32, 1-34 27
and 1-35, by (A) a judge of a court of record or a family support 28
magistrate, (B) a clerk or deputy clerk of a court having a seal, (C) a town 29
clerk, (D) a notary public, (E) a justice of the peace, (F) an attorney 30
admitted to the bar of this state, or (G) notwithstanding any provision 31
of chapter 6, a school nurse; or (4) in the case of measles, mumps or 32
rubella, presents a certificate from a physician, physician assistant or 33
advanced practice registered nurse or from the director of health in such 34
child's present or previous town of residence, stating that the child has 35
had a confirmed case of such disease; or (5) in the case of [hemophilus] 36
haemophilus influenzae type B has passed [his] such child's fifth 37
birthday; or (6) in the case of pertussis, has passed [his] such child's sixth 38
birthday, shall be exempt from the appropriate provisions of this 39
section. If the parents or guardians of any child are unable to pay for 40
such immunizations, the expense of such immunizations shall, on the 41
recommendations of such board of education, be paid by the town. 42
Before being permitted to enter seventh grade, the parents or guardian 43
of any child who is exempt on religious grounds from the immunization 44
requirements of this section, pursuant to subdivision (3) of this 45
subsection, shall present to such school a statement that such 46
immunization requirements are contrary to the religious beliefs of such 47
child or the parents or guardian of such child, which statement shall be 48
acknowledged, in accordance with the provisions of sections 1-32, 1-34 49
and 1-35, by (A) a judge of a court of record or a family support 50
magistrate, (B) a clerk or deputy clerk of a court having a seal, (C) a town 51
clerk, (D) a notary public, (E) a justice of the peace, (F) an attorney 52
admitted to the bar of this state, or (G) notwithstanding any provision 53
of chapter 6, a school nurse. 54
(b) The definitions of adequate immunization shall reflect the 55 Substitute Bill No. 5044
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schedule for active immunization adopted pursuant to section 19a-7f 56
and be established by regulation adopted in accordance with the 57
provisions of chapter 54 by the Commissioner of Public Health, who 58
shall also be responsible for providing procedures under which [said] 59
such boards and [said] such similar governing bodies shall collect and 60
report immunization data on each child to the Department of Public 61
Health for (1) compilation and analysis by [said] the department, and 62
(2) release by the department of annual immunization rates for each 63
public and nonpublic school in the state, provided such immunization 64
data may not contain information that identifies a specific individual. 65
Sec. 2. Section 19a-25 of the general statutes is repealed and the 66
following is substituted in lieu thereof (Effective from passage): 67
(a) All information, records of interviews, written reports, statements, 68
notes, memoranda or other data, including personal data as defined in 69
subdivision (9) of section 4-190, procured by: [the] (1) The Department 70
of Public Health, by staff committees of facilities accredited by the 71
Department of Public Health or the maternity mortality review 72
committee, established pursuant to section 19a-59i, in connection with 73
studies of morbidity and mortality conducted by the Department of 74
Public Health, such staff committees or the maternal mortality review 75
committee, or carried on by said department, such staff committees or 76
the maternal mortality review committee jointly with other persons, 77
agencies or organizations, [or procured by] (2) the directors of health of 78
towns, cities or boroughs or the Department of Public Health pursuant 79
to section 19a-215, or [procured by] (3) such other persons, agencies or 80
organizations, for the purpose of reducing the morbidity or mortality 81
from any cause or condition, shall be confidential and shall be used 82
solely for the purposes of medical or scientific research and, for 83
information obtained pursuant to section 19a-215, disease prevention 84
and control by the local director of health and the Department of Public 85
Health. Such information, records, reports, statements, notes, 86
memoranda or other data shall not be admissible as evidence in any 87
action of any kind in any court or before any other tribunal, board, 88 Substitute Bill No. 5044
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agency or person, nor shall it be exhibited or its contents disclosed in 89
any way, in whole or in part, by any officer or representative of the 90
Department of Public Health or of any such facility, by any person 91
participating in such a research project or by any other person, except 92
as may be necessary for the purpose of furthering the research project to 93
which it relates. 94
(b) Notwithstanding the provisions of chapter 55, the Department of 95
Public Health may exchange personal data for the purpose of medical 96
or scientific research, with any other governmental agency or private 97
research organization; provided such state, governmental agency or 98
private research organization shall not further disclose such personal 99
data. The Commissioner of Public Health shall adopt regulations, in 100
accordance with the provisions of chapter 54, consistent with the 101
purposes of this section to establish the procedures to ensure the 102
confidentiality of such disclosures. The furnishing of such information 103
to the Department of Public Health or its authorized representative, or 104
to any other agency cooperating in such a research project, shall not 105
subject any person, hospital, [sanitarium] behavioral health facility, rest 106
home, nursing home or other person or agency furnishing such 107
information to any action for damages or other relief because of such 108
disclosure. [This section shall not be deemed to affect disclosure] 109
(c) The provisions of this section shall not affect: (1) Disclosure of 110
regular hospital and medical records made in the course of the regular 111
notation of the care and treatment of any patient, but only records or 112
notations by [such] the staff committees described in subsection (a) of 113
this section pursuant to their work, or (2) release by the Department of 114
Public Health of annual immunization rates for each public and 115
nonpublic school in the state pursuant to section 10-204a, as amended 116
by this act. 117
Sec. 3. Section 10a-155 of the general statutes is repealed and the 118
following is substituted in lieu thereof (Effective from passage): 119
(a) Each institution of higher education shall require each full-time or 120 Substitute Bill No. 5044
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matriculating student born after December 31, 1956, to provide proof of 121
adequate immunization against measles, rubella, [and on and after 122
August 1, 2010, to provide proof of adequate immunization against] 123
mumps and varicella as recommended by the national Advisory 124
Committee for Immunization Practices before permitting such student 125
to enroll in such institution. [Any such] 126
(b) Notwithstanding the provisions of subsection (a) of this section, 127
any student who (1) presents a certificate, in a form prescribed by the 128
Commissioner of Public Health pursuant to section 7 of this act, from a 129
physician, physician assistant or an advanced practice registered nurse 130
stating that in the opinion of such physician, physician assistant or 131
advanced practice registered nurse such immunization is medically 132
contraindicated, (2) prior to the effective date of this section, provides a 133
statement that such immunization would be contrary to his or her 134
religious beliefs, (3) presents a certificate from a physician, physician 135
assistant, an advanced practice registered nurse or the director of health 136
in the student's present or previous town of residence, stating that the 137
student has had a confirmed case of such disease, (4) is enrolled 138
exclusively in a program for which students do not congregate on 139
campus for classes or to participate in institutional-sponsored events, 140
such as students enrolled in distance learning programs for 141
individualized home study or programs conducted entirely through 142
electronic media in a setting without other students present, or (5) 143
graduated from a public or nonpublic high school in this state in 1999 or 144
later and was not exempt from the measles, rubella, [and on and after 145
August 1, 2010, the] mumps and varicella vaccination requirement 146
pursuant to subdivision (2) or (3) of subsection (a) of section 10-204a 147
shall be exempt from the appropriate provisions of this section. 148
[(b)] (c) Each institution of higher education shall keep uniform 149
records of the immunizations and immunization status of each student, 150
based on the certificate of immunization or other evidence acceptable 151
pursuant to subsection (a) of this section. The record shall be part of the 152
student's permanent record. By November first of each year, the chief 153 Substitute Bill No. 5044
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administrative officer of each institution of higher education shall cause 154
to be submitted to the Commissioner of Public Health, on a form 155
provided by the commissioner, a summary report of the immunization 156
status of all students enrolling in such institution. 157
Sec. 4. Subsection (a) of section 10a-155b of the general statutes is 158
repealed and the following is substituted in lieu thereof (Effective from 159
passage): 160
(a) For students who first enroll in the 2014-2015 school year, and first 161
enroll in each school year thereafter, each public or private college or 162
university in this state shall require that each student who resides in on-163
campus housing be vaccinated against meningitis and submit evidence 164
of having received a meningococcal conjugate vaccine not more than 165
five years before enrollment as a condition of such residence. The 166
provisions of this subsection shall not apply to any such student who (1) 167
presents a certificate, in a form prescribed by the Commissioner of 168
Public Health pursuant to section 7 of this act, from a physician, an 169
advanced practice registered nurse or a physician assistant stating that, 170
in the opinion of such physician, advanced practice registered nurse or 171
physician assistant, such vaccination is medically contraindicated 172
because of the physical condition of such student, or (2) prior to the 173
effective date of this section, presents a statement that such vaccination 174
would be contrary to the religious beliefs of such student. 175
Sec. 5. Section 19a-79 of the 2020 supplement to the general statutes 176
is repealed and the following is substituted in lieu thereof (Effective from 177
passage): 178
(a) The Commissioner of Early Childhood shall adopt regulations, in 179
accordance with the provisions of chapter 54, to carry out the purposes 180
of sections 19a-77 to 19a-80, inclusive, and 19a-82 to 19a-87, inclusive, 181
and to assure that child care centers and group child care homes meet 182
the health, educational and social needs of children utilizing such child 183
care centers and group child care homes. Such regulations shall (1) 184
specify that before being permitted to attend any child care center or 185 Substitute Bill No. 5044
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group child care home, each child shall be protected as age-appropriate 186
by adequate immunization against diphtheria, pertussis, tetanus, 187
poliomyelitis, measles, mumps, rubella, [hemophilus] haemophilus 188
influenzae type B and any other vaccine required by the schedule of 189
active immunization adopted pursuant to section 19a-7f, [including 190
appropriate exemptions for children for whom such immunization is 191
medically contraindicated and for children whose parent or guardian 192
objects to such immunization on religious grounds, and that any 193
objection by a parent or a guardian to immunization of a child on 194
religious grounds shall be accompanied by a statement from such parent 195
or guardian that such immunization would be contrary to the religious 196
beliefs of such child or the parent or guardian of such child, which 197
statement shall be acknowledged, in accordance with the provisions of 198
sections 1-32, 1-34 and 1-35, by (A) a judge of a court of record or a family 199
support magistrate, (B) a clerk or deputy clerk of a court having a seal, 200
(C) a town clerk, (D) a notary public, (E) a justice of the peace, or (F) an 201
attorney admitted to the bar of this state,] (2) specify conditions under 202
which child care center directors and teachers and group child care 203
home providers may administer tests to monitor glucose levels in a child 204
with diagnosed diabetes mellitus, and administer medicinal 205
preparations, including controlled drugs specified in the regulations by 206
the commissioner, to a child receiving child care services at such child 207
care center or group child care home pursuant to the written order of a 208
physician licensed to practice medicine or a dentist licensed to practice 209
dental medicine in this or another state, or an advanced practice 210
registered nurse licensed to prescribe in accordance with section 20-94a, 211
or a physician assistant licensed to prescribe in accordance with section 212
20-12d, and the written authorization of a parent or guardian of such 213
child, (3) specify that an operator of a child care center or group child 214
care home, licensed before January 1, 1986, or an operator who receives 215
a license after January 1, 1986, for a facility licensed prior to January 1, 216
1986, shall provide a minimum of thirty square feet per child of total 217
indoor usable space, free of furniture except that needed for the 218
children's purposes, exclusive of toilet rooms, bathrooms, coatrooms, 219
kitchens, halls, isolation room or other rooms used for purposes other 220 Substitute Bill No. 5044
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than the activities of the children, (4) specify that a child care center or 221
group child care home licensed after January 1, 1986, shall provide 222
thirty-five square feet per child of total indoor usable space, (5) establish 223
appropriate child care center staffing requirements for employees 224
certified in cardiopulmonary resuscitation by the American Red Cross, 225
the American Heart Association, the National Safety Council, American 226
Safety and Health Institute, Medic First Aid International, Inc. or an 227
organization using guidelines for cardiopulmonary resuscitation and 228
emergency cardiovascular care published by the American Heart 229
Association and International Liaison Committee on Resuscitation, (6) 230
specify that [on and after January 1, 2003,] a child care center or group 231
child care home (A) shall not deny services to a child on the basis of a 232
child's known or suspected allergy or because a child has a prescription 233
for an automatic prefilled cartridge injector or similar automatic 234
injectable equipment used to treat an allergic reaction, or for injectable 235
equipment used to administer glucagon, (B) shall, not later than three 236
weeks after such child's enrollment in such a center or home, have staff 237
trained in the use of such equipment on-site during all hours when such 238
a child is on-site, (C) shall require such child's parent or guardian to 239
provide the injector or injectable equipment and a copy of the 240
prescription for such medication and injector or injectable equipment 241
upon enrollment of such child, and (D) shall require a parent or 242
guardian enrolling such a child to replace such medication and 243
equipment prior to its expiration date, (7) specify that [on and after 244
January 1, 2005,] a child care center or group child care home (A) shall 245
not deny services to a child on the basis of a child's diagnosis of asthma 246
or because a child has a prescription for an inhalant medication to treat 247
asthma, and (B) shall, not later than three weeks after such child's 248
enrollment in such a center or home, have staff trained in the 249
administration of such medication on-site during all hours when such a 250
child is on-site, and (8) establish physical plant requirements for 251
licensed child care centers and licensed group child care homes that 252
exclusively serve school-age children. When establishing such 253
requirements, the Office of Early Childhood shall give consideration to 254
child care centers and group child care homes that are located in private 255 Substitute Bill No. 5044
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or public school buildings. With respect to this subdivision only, the 256
commissioner shall implement policies and procedures necessary to 257
implement the physical plant requirements established pursuant to this 258
subdivision while in the process of adopting such policies and 259
procedures in regulation form. Until replaced by policies and 260
procedures implemented pursuant to this subdivision, any physical 261
plant requirement specified in the office's regulations that is generally 262
applicable to child care centers and group child care homes shall 263
continue to be applicable to such centers and homes that exclusively 264
serve school-age children. The commissioner shall print notice of the 265
intent to adopt regulations pursuant to this subdivision on the 266
eRegulations System not later than twenty days after the date of 267
implementation of such policies and procedures. Policies and 268
procedures implemented pursuant to this subdivision shall be valid 269
until the time final regulations are adopted. 270
(b) Any child who (1) presents a certificate, in a form prescribed by 271
the Commissioner of Public Health pursuant to section 7 of this act, 272
signed by a physician, physician assistant or advanced practice 273
registered nurse stating that, in the opinion of such physician, physician 274
assistant or advanced practice registered nurse, the immunizations 275
required pursuant to regulations adopted pursuant to subdivision (1) of 276
subsection (a) of this section are medically contraindicated, or (2) prior 277
to the effective date of this section, presents a statement that such 278
immunizations would be contrary to the religious beliefs of such child 279
or the parents or guardians of such child, shall be exempt from the 280
immunization requirements set forth in such regulations. Such 281
statement shall be acknowledged, in accordance with the provisions of 282
sections 1-32, 1-34 and 1-35, by (A) a judge of a court of record or a family 283
support magistrate, (B) a clerk or deputy clerk of a court having a seal, 284
(C) a town clerk, (D) a notary public, (E) a justice of the peace, or (F) an 285
attorney admitted to the bar of this state. 286
[(b)] (c) The commissioner may adopt regulations, pursuant to 287
chapter 54, to establish civil penalties of not more than one hundred 288 Substitute Bill No. 5044
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dollars per day for each day of violation and other disciplinary remedies 289
that may be imposed, following a contested-case hearing, upon the 290
holder of a license issued under section 19a-80 to operate a child care 291
center or group child care home or upon the holder of a license issued 292
under section 19a-87b, as amended by this act, to operate a family child 293
care home. 294
[(c)] (d) The commissioner shall exempt Montessori schools 295
accredited by the American Montessori Society or the Association 296
Montessori Internationale from any provision in regulations adopted 297
pursuant to subsection (a) of this section which sets requirements on 298
group size or child to staff ratios or the provision of cots. 299
[(d)] (e) Upon the declaration by the Governor of a civil preparedness 300
emergency pursuant to section 28-9 or a public health emergency 301
pursuant to section 19a-131a, the commissioner may waive the 302
provisions of any regulation adopted pursuant to this section if the 303
commissioner determines that such waiver would not endanger the life, 304
safety or health of any child. The commissioner shall prescribe the 305
duration of such waiver, provided such waiver shall not extend beyond 306
the duration of the declared emergency. The commissioner shall 307
establish the criteria by which a waiver request shall be made and the 308
conditions for which a waiver will be granted or denied. The provisions 309
of section 19a-84 shall not apply to a denial of a waiver request under 310
this subsection. 311
[(e)] (f) Any child care center or group child care home may provide 312
child care services to homeless children and youths, as defined in 42 313
USC 11434a, as amended from time to time, for a period not to exceed 314
ninety days without complying with any provision in regulations 315
adopted pursuant to this section relating to immunization and physical 316
examination requirements. Any child care center or group child care 317
home that provides child care services to homeless children and youths 318
at such center or home under this subsection shall maintain a record on 319
file of all homeless children and youths who have attended such center 320
or home for a period of two years after such homeless children or youths 321 Substitute Bill No. 5044
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are no longer receiving child care services at such center or home. 322
[(f)] (g) Any child care center or group child care home may provide 323
child care services to a foster child for a period not to exceed forty-five 324
days without complying with any provision in regulations adopted 325
pursuant to this section relating to immunization and physical 326
examination requirements. Any child care center or group child care 327
home that provides child care services to a foster child at such center or 328
home under this subsection shall maintain a record on file of such foster 329
child for a period of two years after such foster child is no longer 330
receiving child care services at such center or home. For purposes of this 331
subsection, "foster child" means a child who is in the care and custody 332
of the Commissioner of Children and Families and placed in a foster 333
home licensed pursuant to section 17a-114, foster home approved by a 334
child-placing agency licensed pursuant to section 17a-149, facility 335
licensed pursuant to section 17a-145 or with a relative or fictive kin 336
caregiver pursuant to section 17a-114. 337
Sec. 6. Section 19a-87b of the 2020 supplement to the general statutes 338
is repealed and the following is substituted in lieu thereof (Effective from 339
passage): 340
(a) No person, group of persons, association, organization, 341
corporation, institution or agency, public or private, shall maintain a 342
family child care home, as defined in section 19a-77, without a license 343
issued by the Commissioner of Early Childhood. Licensure forms shall 344
be obtained from the Office of Early Childhood. Applications for 345
licensure shall be made to the commissioner on forms provided by the 346
office and shall contain the information required by regulations adopted 347
under this section. The licensure and application forms shall contain a 348
notice that false statements made therein are punishable in accordance 349
with section 53a-157b. Applicants shall state, in writing, that they are in 350
compliance with the regulations adopted by the commissioner pursuant 351
to subsection (f) of this section. Before a family child care home license 352
is granted, the office shall make an inquiry and investigation which shall 353
include a visit and inspection of the premises for which the license is 354 Substitute Bill No. 5044
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requested. Any inspection conducted by the office shall include an 355
inspection for evident sources of lead poisoning. The office shall provide 356
for a chemical analysis of any paint chips found on such premises. 357
Neither the commissioner nor the commissioner's designee shall require 358
an annual inspection for homes seeking license renewal or for licensed 359
homes, except that the commissioner or the commissioner's designee 360
shall make an unannounced visit, inspection or investigation of each 361
licensed family child care home at least once every year. A licensed 362
family child care home shall not be subject to any conditions on the 363
operation of such home by local officials, other than those imposed by 364
the office pursuant to this subsection, if the home complies with all local 365
codes and ordinances applicable to single and multifamily dwellings. 366
(b) No person shall act as an assistant or substitute staff member to a 367
person or entity maintaining a family child care home, as defined in 368
section 19a-77, without an approval issued by the commissioner. Any 369
person seeking to act as an assistant or substitute staff member in a 370
family child care home shall submit an application for such approval to 371
the office. Applications for approval shall: (1) Be made to the 372
commissioner on forms provided by the office, (2) contain the 373
information required by regulations adopted under this section, and (3) 374
be accompanied by a fee of fifteen dollars. The approval application 375
forms shall contain a notice that false statements made in such form are 376
punishable in accordance with section 53a-157b. 377
(c) The commissioner, within available appropriations, shall require 378
each initial applicant or prospective employee of a family child care 379
home in a position requiring the provision of care to a child, including 380
an assistant or substitute staff member and each household member 381
who is sixteen years of age or older, to submit to comprehensive 382
background checks, including state and national criminal history 383
records checks. The criminal history records checks required pursuant 384
to this subsection shall be conducted in accordance with section 29-17a. 385
The commissioner shall also request a check of the state child abuse 386
registry established pursuant to section 17a-101k. The commissioner 387 Substitute Bill No. 5044
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shall notify each licensee of the provisions of this subsection. For 388
purposes of this subsection, "household member" means any person, 389
other than the person who is licensed to conduct, operate or maintain a 390
family child care home, who resides in the family child care home, such 391
as the licensee's spouse or children, tenants and any other occupant. 392
(d) An application for initial licensure pursuant to this section shall 393
be accompanied by a fee of forty dollars and such license shall be issued 394
for a term of four years. An application for renewal of a license issued 395
pursuant to this section shall be accompanied by a fee of forty dollars 396
and a certification from the licensee that any child enrolled in the family 397
child care home has received age-appropriate immunizations in 398
accordance with regulations adopted pursuant to subsection (f) of this 399
section. A license issued pursuant to this section shall be renewed for a 400
term of four years. In the case of an applicant submitting an application 401
for renewal of a license that has expired, and who has ceased operations 402
of a family child care home due to such expired license, the 403
commissioner may renew such expired license within thirty days of the 404
date of such expiration upon receipt of an application for renewal that 405
is accompanied by such fee and such certification. 406
(e) An application for initial staff approval or renewal of staff 407
approval shall be accompanied by a fee of fifteen dollars. Such 408
approvals shall be issued or renewed for a term of two years. 409
(f) The commissioner shall adopt regulations, in accordance with the 410
provisions of chapter 54, to assure that family child care homes, as 411
defined in section 19a-77, meet the health, educational and social needs 412
of children utilizing such homes. Such regulations shall ensure that the 413
family child care home is treated as a residence, and not an institutional 414
facility. Such regulations shall specify that each child be protected as 415
age-appropriate by adequate immunization against diphtheria, 416
pertussis, tetanus, poliomyelitis, measles, mumps, rubella, 417
[hemophilus] haemophilus influenzae type B and any other vaccine 418
required by the schedule of active immunization adopted pursuant to 419
section 19a-7f. [Such regulations shall provide appropriate exemptions 420 Substitute Bill No. 5044
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for children for whom such immunization is medically contraindicated 421
and for children whose parents or guardian objects to such 422
immunization on religious grounds and require that any such objection 423
be accompanied by a statement from such parents or guardian that such 424
immunization would be contrary to the religious beliefs of such child or 425
the parents or guardian of such child, which statement shall be 426
acknowledged, in accordance with the provisions of sections 1-32, 1-34 427
and 1-35, by (1) a judge of a court of record or a family support 428
magistrate, (2) a clerk or deputy clerk of a court having a seal, (3) a town 429
clerk, (4) a notary public, (5) a justice of the peace, or (6) an attorney 430
admitted to the bar of this state.] Such regulations shall also specify 431
conditions under which family child care home providers may 432
administer tests to monitor glucose levels in a child with diagnosed 433
diabetes mellitus, and administer medicinal preparations, including 434
controlled drugs specified in the regulations by the commissioner, to a 435
child receiving child care services at a family child care home pursuant 436
to a written order of a physician licensed to practice medicine in this or 437
another state, an advanced practice registered nurse licensed to 438
prescribe in accordance with section 20-94a or a physician assistant 439
licensed to prescribe in accordance with section 20-12d, and the written 440
authorization of a parent or guardian of such child. Such regulations 441
shall specify appropriate standards for extended care and intermittent 442
short-term overnight care. The commissioner shall inform each licensee, 443
by way of a plain language summary provided not later than sixty days 444
after the regulation's effective date, of any new or changed regulations 445
adopted under this subsection with which a licensee must comply. 446
(g) Any child who (1) presents a certificate, in a form prescribed by 447
the Commissioner of Public Health pursuant to section 7 of this act, 448
signed by a physician, physician assistant or advanced practice 449
registered nurse stating that, in the opinion of such physician, physician 450
assistant or advanced practice registered nurse, the immunizations 451
required pursuant to regulations adopted pursuant to subsection (f) of 452
this section are medically contraindicated, or (2) prior to the effective 453
date of this section, presents a statement that such immunizations 454 Substitute Bill No. 5044
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would be contrary to the religious beliefs of such child or the parents or 455
guardians of such child, shall be exempt from the immunization 456
requirements set forth in such regulations. Such statement shall be 457
acknowledged, in accordance with the provisions of sections 1-32, 1-34 458
and 1-35, by (A) a judge of a court of record or a family support 459
magistrate, (B) a clerk or deputy clerk of a court having a seal, (C) a town 460
clerk, (D) a notary public, (E) a justice of the peace, or (F) an attorney 461
admitted to the bar of this state. 462
[(g)] (h) Upon the declaration by the Governor of a civil preparedness 463
emergency pursuant to section 28-9 or a public health emergency 464
pursuant to section 19a-131a, the commissioner may waive the 465
provisions of any regulation adopted pursuant to this section if the 466
commissioner determines that such waiver would not endanger the life, 467
safety or health of any child. The commissioner shall prescribe the 468
duration of such waiver, provided such waiver shall not extend beyond 469
the duration of the declared emergency. The commissioner shall 470
establish the criteria by which a waiver request shall be made and the 471
conditions for which a waiver will be granted or denied. The provisions 472
of section 19a-84 shall not apply to a denial of a waiver request under 473
this subsection. 474
[(h)] (i) Any family child care home may provide child care services 475
to homeless children and youths, as defined in 42 USC 11434a, as 476
amended from time to time, for a period not to exceed ninety days 477
without complying with any provision in regulations adopted pursuant 478
to this section relating to immunization and physical examination 479
requirements. Any family child care home that provides child care 480
services to homeless children and youths at such home under this 481
subsection shall maintain a record on file of all homeless children and 482
youths who have attended such home for a period of two years after 483
such homeless children or youths are no longer receiving child care 484
services at such home. 485
[(i)] (j) Any family child care home may provide child care services to 486
a foster child for a period not to exceed forty-five days without 487 Substitute Bill No. 5044
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complying with any provision in regulations adopted pursuant to this 488
section relating to immunization and physical examination 489
requirements. Any family child care home that provides child care 490
services to a foster child at such home under this subsection shall 491
maintain a record on file of such foster child for a period of two years 492
after such foster child is no longer receiving child care services at such 493
home. For purposes of this subsection, "foster child" means a child who 494
is in the care and custody of the Commissioner of Children and Families 495
and placed in a foster home licensed pursuant to section 17a-114, foster 496
home approved by a child-placing agency licensed pursuant to section 497
17a-149, facility licensed pursuant to section 17a-145 or with a relative 498
or fictive kin caregiver pursuant to section 17a-114. 499
Sec. 7. (Effective from passage) On or before October 1, 2020, the 500
Commissioner of Public Health shall develop and make available on the 501
Internet web site of the Department of Public Health a certificate for use 502
by a physician, physician assistant or advanced practice registered 503
nurse stating that, in the opinion of such physician, physician assistant 504
or advanced practice registered nurse, a vaccination required by the 505
general statutes is medically contraindicated for a person because of the 506
physical condition of such person. The certificate shall include (1) 507
definitions of the terms "contraindication" and "precaution", (2) a list of 508
contraindications and precautions recognized by the National Centers 509
for Disease Control and Prevention for each of the statutorily required 510
vaccinations, from which the physician, physician assistant or advanced 511
practice registered nurse may select the relevant contraindication or 512
precaution on behalf of such person, (3) a section in which the physician, 513
physician assistant or advanced practice registered nurse may record a 514
contraindication or precaution that is not recognized by the National 515
Centers for Disease Control and Prevention, but in his or her discretion, 516
results in the vaccination being medically contraindicated, including, 517
but not limited to, any autoimmune disorder or family history of any 518
autoimmune disorder, (4) a section in which the physician, physician 519
assistant or advanced practice registered nurse may include a written 520
explanation for the exemption from any statutorily required 521 Substitute Bill No. 5044
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vaccinations, (5) a section requiring the signature of the physician, 522
physician assistant or advanced practice registered nurse, (6) a 523
requirement that the physician, physician assistant or advanced practice 524
registered nurse attach such person's most current immunization 525
record, and (7) a synopsis of the grounds for any order of quarantine or 526
isolation pursuant to section 19a-131b of the general statutes. 527
Sec. 8. (NEW) (Effective from passage) (a) There is established an 528
Advisory Committee on Medically Contraindicated Vaccinations within 529
the Department of Public Health for the purpose of advising the 530
Commissioner of Public Health on issues concerning exemptions from 531
state or federal requirements for vaccinations that result from a 532
physician, physician assistant or advanced practice registered nurse 533
stating that a vaccination is medically contraindicated for a person due 534
to the medical condition of such person. For the purpose of performing 535
its function, the advisory committee shall (1) have access to the 536
childhood immunization registry established by the department 537
pursuant to section 19a-7h of the general statutes, (2) evaluate the 538
process used by the Department of Public Health in collecting data 539
concerning exemptions resulting from a vaccination being medically 540
contraindicated and whether the department should have any oversight 541
over such exemptions, (3) examine whether enrollment of an 542
unvaccinated child into a program operated by a public or nonpublic 543
school, institution of higher education, child care center or group child 544
care home should be conditioned upon the child meeting certain 545
criteria, (4) calculate the ratio of school nurses to students in each public 546
and nonpublic school in the state and the funding issues surrounding 547
such ratio, (5) assess whether immunizations should be required more 548
frequently than prior to enrollment into a program operated by a public 549
or nonpublic school and prior to entering seventh grade, and (6) 550
determine whether (A) there are any discrepancies in the issuance of 551
certificates stating that a vaccine is medically contraindicated, and (B) to 552
recommend continuing education of physicians, physician assistants or 553
advanced practice registered nurses in vaccine contraindications and 554
precautions. All information obtained by the advisory committee from 555 Substitute Bill No. 5044
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such registry shall be confidential pursuant to section 19a-25 of the 556
general statutes, as amended by this act. 557
(b) The advisory committee shall consist of the following members: 558
(1) Two appointed by the speaker of the House of Representatives, 559
one of whom shall be a physician licensed pursuant to chapter 370 of the 560
general statutes who is a pediatrician, and one of whom shall be a 561
member of the public; 562
(2) Two appointed by the president pro tempore of the Senate, one of 563
whom shall be a physician licensed pursuant to chapter 370 of the 564
general statutes who has expertise in the efficacy of vaccines, and one of 565
whom shall be a member of the public; 566
(3) One appointed by the majority leader of the House of 567
Representatives, who shall be a school nurse; 568
(4) One appointed by the majority leader of the Senate, who shall be 569
a physician assistant licensed pursuant to chapter 370 of the general 570
statutes who has experience in the administration of vaccines; 571
(5) One appointed by the minority leader of the House of 572
Representatives, who shall be an advanced practice registered nurse 573
licensed pursuant to chapter 378 of the general statutes who has 574
experience in the administration of vaccines; 575
(6) One appointed by the minority leader of the Senate, who shall be 576
a representative of the Connecticut Chapter of the American Academy 577
of Pediatrics; 578
(7) The Commissioner of Public Health, or the commissioner's 579
designee; 580
(8) The Commissioner of Education, or the commissioner's designee; 581
and 582
(9) The Commissioner of Early Childhood, or the commissioner's 583 Substitute Bill No. 5044
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designee. 584
(c) The advisory committee shall meet not less than biannually. On or 585
before January 1, 2021, and annually thereafter, the committee shall 586
report, in accordance with the provisions of section 11-4a of the general 587
statutes, on its activities and findings to the joint standing committee of 588
the General Assembly having cognizance of matters relating to public 589
health. 590
Sec. 9. (NEW) (Effective from passage) The Department of Public 591
Health, in collaboration with the State Department of Education and the 592
Office of Early Childhood, shall evaluate all of the data collected by said 593
departments concerning exemptions from immunization requirements. 594
Not later than January 1, 2021, and annually thereafter, the 595
Commissioners of Public Health, Education and Early Childhood shall 596
jointly report, in accordance with the provisions of section 11-4a of the 597
general statutes, to the joint standing committee of the General 598
Assembly having cognizance of matters relating to public health 599
regarding the evaluation of such data. 600
This act shall take effect as follows and shall amend the following
sections:
Section 1 from passage 10-204a(a) and (b)
Sec. 2 from passage 19a-25
Sec. 3 from passage 10a-155
Sec. 4 from passage 10a-155b(a)
Sec. 5 from passage 19a-79
Sec. 6 from passage 19a-87b
Sec. 7 from passage New section
Sec. 8 from passage New section
Sec. 9 from passage New section
Statement of Legislative Commissioners:
In Section 1(a)(2), ", in a form prescribed by the commissioner pursuant
to section 7 of this act," was added for consistency.
PH Joint Favorable Subst.