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General Assembly Committee Bill No. 568
January Session, 2021
LCO No. 6219
Referred to Committee on PUBLIC HEALTH
Introduced by:
(PH)
AN ACT ELIMINATING THE NONMEDICAL EXEMPT ION TO THE
IMMUNIZATION REQUIREMENT.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. Section 10-204a of the general statutes is repealed and the 1
following is substituted in lieu thereof (Effective from passage): 2
(a) Each local or regional board of education, or similar body 3
governing a nonpublic school or schools, shall require each child to be 4
protected by adequate immunization against diphtheria, pertussis, 5
tetanus, poliomyelitis, measles, mumps, rubella, [hemophilus] 6
haemophilus influenzae type B and any other vaccine required by the 7
schedule for active immunization adopted pursuant to section 19a-7f 8
before being permitted to enroll in any program operated by a public or 9
nonpublic school under its jurisdiction. Before being permitted to enter 10
seventh grade, a child shall receive a second immunization against 11
measles. Any such child who (1) presents a certificate from a physician, 12
physician assistant, advanced practice registered nurse or local health 13
agency stating that initial immunizations have been given to such child 14
and additional immunizations are in process (A) under guidelines and 15
schedules specified by the Commissioner of Public Health, or (B) in the 16
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case of a child enrolled in sixth grade or below who, prior to the effective 17
date of this section, was exempt from the appropriate provisions of this 18
section upon presentation of a statement that such immunizations 19
would be contrary to the religious beliefs of such child or the parents or 20
guardian of such child, as such additional immunizations are 21
recommended, in a written declaration, in a form prescribed by the 22
Commissioner of Public Health, for such child by a physician, a 23
physician assistant or an advanced practice registered nurse; or (2) 24
presents a certificate, in a form prescribed by the commissioner 25
pursuant to section 7 of this act, from a physician, physician assistant or 26
advanced practice registered nurse stating that in the opinion of such 27
physician, physician assistant or advanced practice registered nurse 28
such immunization is medically contraindicated because of the physical 29
condition of such child; [or (3) presents a statement from the parents or 30
guardian of such child that such immunization would be contrary to the 31
religious beliefs of such child or the parents or guardian of such child, 32
which statement shall be acknowledged, in accordance with the 33
provisions of sections 1-32, 1-34 and 1-35, by (A) a judge of a court of 34
record or a family support magistrate, (B) a clerk or deputy clerk of a 35
court having a seal, (C) a town clerk, (D) a notary public, (E) a justice of 36
the peace, (F) an attorney admitted to the bar of this state, or (G) 37
notwithstanding any provision of chapter 6, a school nurse;] or [(4)] (3) 38
in the case of measles, mumps or rubella, presents a certificate from a 39
physician, physician assistant or advanced practice registered nurse or 40
from the director of health in such child's present or previous town of 41
residence, stating that the child has had a confirmed case of such 42
disease; or [(5)] (4) in the case of [hemophilus] haemophilus influenzae 43
type B has passed [his] such child's fifth birthday; or [(6)] (5) in the case 44
of pertussis, has passed [his] such child's sixth birthday, shall be exempt 45
from the appropriate provisions of this section. [If the parents or 46
guardians of any child are unable to pay for such immunizations, the 47
expense of such immunizations shall, on the recommendations of such 48
board of education, be paid by the town. Before being permitted to enter 49
seventh grade, the parents or guardian of any child who is exempt on 50
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religious grounds from the immunization requirements of this section, 51
pursuant to subdivision (3) of this subsection, shall present to such 52
school a statement that such immunization requirements are contrary to 53
the religious beliefs of such child or the parents or guardian of such 54
child, which statement shall be acknowledged, in accordance with the 55
provisions of sections 1-32, 1-34 and 1-35, by (A) a judge of a court of 56
record or a family support magistrate, (B) a clerk or deputy clerk of a 57
court having a seal, (C) a town clerk, (D) a notary public, (E) a justice of 58
the peace, (F) an attorney admitted to the bar of this state, or (G) 59
notwithstanding any provision of chapter 6, a school nurse.] The 60
statement described in subparagraph (B) of subdivision (1) of this 61
subsection shall be acknowledged, in accordance with the provisions of 62
sections 1-32, 1-34 and 1-35, by a judge of a court of record or a family 63
support magistrate, a clerk or deputy clerk of a court having a seal, a 64
town clerk, a notary public, a justice of the peace, an attorney admitted 65
to the bar of this state, or notwithstanding any provision of chapter 6, a 66
school nurse. 67
(b) The immunization requirements provided for in subsection (a) of 68
this section shall not apply to any child who is enrolled in seventh grade 69
through twelfth grade on or before the effective date of this section if 70
such child presented a statement, prior to the effective date of this 71
section, from the parents or guardians of such child that such 72
immunization is contrary to the religious beliefs of such child or the 73
parents or guardian of such child, and such statement was 74
acknowledged, in accordance with the provisions of sections 1-32, 1-34 75
and 1-35, by (1) a judge of a court of record or a family support 76
magistrate, (2) a clerk or deputy clerk of a court having a seal, (3) a town 77
clerk, (4) a notary public, (5) a justice of the peace, (6) an attorney 78
admitted to the bar of this state, or (7) notwithstanding any provision of 79
chapter 6, a school nurse. 80
(c) Any child who is enrolled in sixth grade or below prior to the 81
effective date of this section who presented a statement, prior to the 82
effective date of this section, from the parents or guardians of such child 83
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that the immunization is contrary to the religious beliefs of such child 84
or the parents or guardian of such child, which statement was 85
acknowledged, in accordance with the provisions of sections 1-32, 1-34 86
and 1-35, by (1) a judge of a court of record or a family support 87
magistrate, (2) a clerk or deputy clerk of a court having a seal, (3) a town 88
clerk, (4) a notary public, (5) a justice of the peace, (6) an attorney 89
admitted to the bar of this state, or (7) notwithstanding any provision of 90
chapter 6, a school nurse, but did not present a written declaration from 91
a physician, a physician assistant or an advanced practice registered 92
nurse stating that additional immunizations are in process as 93
recommended by such physician, physician assistant or advanced 94
practice registered nurse, rather than as recommended under guidelines 95
and schedules specified by the Commissioner of Public Health, shall 96
comply with the immunization requirements provided for in 97
subparagraph (A) of subdivision (1) of subsection (a) of this section on 98
or before September 1, 2022, or not later than fourteen days after 99
transferring to a program operated by a public or nonpublic school 100
under the jurisdiction of a local or regional board of education or similar 101
body governing a nonpublic school or schools, whichever is later. 102
(d) If the parents or guardians of any child are unable to pay for any 103
immunization required by subsection (a) of this section, the expense of 104
such immunization shall, on the recommendation of such child's local 105
or regional board of education, or similar body governing a nonpublic 106
school or schools, be paid by the town. 107
[(b)] (e) The definitions of adequate immunization shall reflect the 108
schedule for active immunization adopted pursuant to section 19a-7f 109
and be established by regulation adopted in accordance with the 110
provisions of chapter 54 by the Commissioner of Public Health, who 111
shall also be responsible for providing procedures under which [said] 112
such boards and [said] such similar governing bodies shall collect and 113
report immunization data on each child to the Department of Public 114
Health for (1) compilation and analysis by [said] the department, and 115
(2) release by the department of annual immunization rates for each 116
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public and nonpublic school in the state, provided such immunization 117
data may not contain information that identifies a specific individual. 118
[(c)] (f) The Commissioner of Public Health may issue a temporary 119
waiver to the schedule for active immunization for any vaccine if the 120
National Centers for Disease Control and Prevention recognizes a 121
nation-wide shortage of supply for such vaccine. 122
Sec. 2. Section 19a-25 of the general statutes is repealed and the 123
following is substituted in lieu thereof (Effective from passage): 124
(a) All information, records of interviews, written reports, statements, 125
notes, memoranda or other data, including personal data as defined in 126
subdivision (9) of section 4-190, procured by: [the] (1) The Department 127
of Public Health, by staff committees of facilities accredited by the 128
Department of Public Health or the maternity mortality review 129
committee, established pursuant to section 19a-59i, in connection with 130
studies of morbidity and mortality conducted by the Department of 131
Public Health, such staff committees or the maternal mortality review 132
committee, or carried on by said department, such staff committees or 133
the maternal mortality review committee jointly with other persons, 134
agencies or organizations, [or procured by] (2) the directors of health of 135
towns, cities or boroughs or the Department of Public Health pursuant 136
to section 19a-215, or [procured by] (3) such other persons, agencies or 137
organizations, for the purpose of reducing the morbidity or mortality 138
from any cause or condition, shall be confidential and shall be used 139
solely for the purposes of medical or scientific research and, for 140
information obtained pursuant to section 19a-215, disease prevention 141
and control by the local director of health and the Department of Public 142
Health. Such information, records, reports, statements, notes, 143
memoranda or other data shall not be admissible as evidence in any 144
action of any kind in any court or before any other tribunal, board, 145
agency or person, nor shall it be exhibited or its contents disclosed in 146
any way, in whole or in part, by any officer or representative of the 147
Department of Public Health or of any such facility, by any person 148
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participating in such a research project or by any other person, except 149
as may be necessary for the purpose of furthering the research project to 150
which it relates. 151
(b) Notwithstanding the provisions of chapter 55, the Department of 152
Public Health may exchange personal data for the purpose of medical 153
or scientific research, with any other governmental agency or private 154
research organization; provided such state, governmental agency or 155
private research organization shall not further disclose such personal 156
data. The Commissioner of Public Health shall adopt regulations, in 157
accordance with the provisions of chapter 54, consistent with the 158
purposes of this section to establish the procedures to ensure the 159
confidentiality of such disclosures. The furnishing of such information 160
to the Department of Public Health or its authorized representative, or 161
to any other agency cooperating in such a research project, shall not 162
subject any person, hospital, [sanitarium] behavioral health facility, rest 163
home, nursing home or other person or agency furnishing such 164
information to any action for damages or other relief because of such 165
disclosure. [This section shall not be deemed to affect disclosure.] 166
(c) The provisions of this section shall not affect: (1) Disclosure of 167
regular hospital and medical records made in the course of the regular 168
notation of the care and treatment of any patient, but only records or 169
notations by [such] the staff committees described in subsection (a) of 170
this section pursuant to their work, or (2) release by the Department of 171
Public Health of annual immunization rates for each public and 172
nonpublic school in the state pursuant to section 10-204a, as amended 173
by this act. 174
Sec. 3. Section 10a-155 of the general statutes is repealed and the 175
following is substituted in lieu thereof (Effective from passage): 176
(a) Each institution of higher education shall require each full-time or 177
matriculating student born after December 31, 1956, to provide proof of 178
adequate immunization against measles, rubella, [and on and after 179
August 1, 2010, to provide proof of adequate immunization against] 180
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mumps and varicella as recommended by the national Advisory 181
Committee for Immunization Practices before permitting such student 182
to enroll in such institution. [Any such] 183
(b) Notwithstanding the provisions of subsection (a) of this section, 184
any student who (1) presents a certificate, in a form prescribed by the 185
Commissioner of Public Health pursuant to section 7 of this act, from a 186
physician, a physician assistant or an advanced practice registered nurse 187
stating that in the opinion of such physician, physician assistant or 188
advanced practice registered nurse such immunization is medically 189
contraindicated, (2) [provides] prior to the effective date of this section, 190
provided a statement that such immunization [would be] is contrary to 191
his or her religious beliefs, (3) presents a certificate from a physician, a 192
physician assistant, an advanced practice registered nurse or the 193
director of health in the student's present or previous town of residence, 194
stating that the student has had a confirmed case of such disease, (4) is 195
enrolled exclusively in a program for which students do not congregate 196
on campus for classes or to participate in institutional-sponsored events, 197
such as students enrolled in distance learning programs for 198
individualized home study or programs conducted entirely through 199
electronic media in a setting without other students present, or (5) 200
graduated from a public or nonpublic high school in this state in 1999 or 201
later and was not exempt from the measles, rubella and [on and after 202
August 1, 2010, the] mumps vaccination requirement pursuant to 203
subdivision (2) or (3) of subsection (a) of section 10-204a, as amended by 204
this act, shall be exempt from the appropriate provisions of this section. 205
[(b)] (c) Each institution of higher education shall keep uniform 206
records of the immunizations and immunization status of each student, 207
based on the certificate of immunization or other evidence acceptable 208
pursuant to subsection [(a)] (b) of this section. The record shall be part 209
of the student's permanent record. By November first of each year, the 210
chief administrative officer of each institution of higher education shall 211
cause to be submitted to the Commissioner of Public Health, on a form 212
provided by the commissioner, a summary report of the immunization 213
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status of all students enrolling in such institution. 214
Sec. 4. Subsection (a) of section 10a-155b of the general statutes is 215
repealed and the following is substituted in lieu thereof (Effective from 216
passage): 217
(a) For students who first enroll in the 2014-2015 school year, and first 218
enroll in each school year thereafter, each public or private college or 219
university in this state shall require that each student who resides in on-220
campus housing be vaccinated against meningitis and submit evidence 221
of having received a meningococcal conjugate vaccine not more than 222
five years before enrollment as a condition of such residence. The 223
provisions of this subsection shall not apply to any such student who (1) 224
presents a certificate, in a form prescribed by the Commissioner of 225
Public Health pursuant to section 7 of this act, from a physician, an 226
advanced practice registered nurse or a physician assistant stating that, 227
in the opinion of such physician, advanced practice registered nurse or 228
physician assistant, such vaccination is medically contraindicated 229
because of the physical condition of such student, or (2) [presents] prior 230
to the effective date of this section, presented a statement that such 231
vaccination [would be] is contrary to the religious beliefs of such 232
student. 233
Sec. 5. Section 19a-79 of the general statutes is repealed and the 234
following is substituted in lieu thereof (Effective from passage): 235
(a) The Commissioner of Early Childhood shall adopt regulations, in 236
accordance with the provisions of chapter 54, to carry out the purposes 237
of sections 19a-77 to 19a-80, inclusive, and 19a-82 to 19a-87, inclusive, 238
and to assure that child care centers and group child care homes meet 239
the health, educational and social needs of children utilizing such child 240
care centers and group child care homes. Such regulations shall (1) 241
specify that before being permitted to attend any child care center or 242
group child care home, each child shall be protected as age-appropriate 243
by adequate immunization against diphtheria, pertussis, tetanus, 244
poliomyelitis, measles, mumps, rubella, [hemophilus] haemophilus 245
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influenzae type B and any other vaccine required by the schedule of 246
active immunization adopted pursuant to section 19a-7f, [including 247
appropriate exemptions for children for whom such immunization is 248
medically contraindicated and for children whose parent or guardian 249
objects to such immunization on religious grounds, and that any 250
objection by a parent or a guardian to immunization of a child on 251
religious grounds shall be accompanied by a statement from such parent 252
or guardian that such immunization would be contrary to the religious 253
beliefs of such child or the parent or guardian of such child, which 254
statement shall be acknowledged, in accordance with the provisions of 255
sections 1-32, 1-34 and 1-35, by (A) a judge of a court of record or a family 256
support magistrate, (B) a clerk or deputy clerk of a court having a seal, 257
(C) a town clerk, (D) a notary public, (E) a justice of the peace, or (F) an 258
attorney admitted to the bar of this state,] (2) specify conditions under 259
which child care center directors and teachers and group child care 260
home providers may administer tests to monitor glucose levels in a child 261
with diagnosed diabetes mellitus, and administer medicinal 262
preparations, including controlled drugs specified in the regulations by 263
the commissioner, to a child receiving child care services at such child 264
care center or group child care home pursuant to the written order of a 265
physician licensed to practice medicine or a dentist licensed to practice 266
dental medicine in this or another state, or an advanced practice 267
registered nurse licensed to prescribe in accordance with section 20-94a, 268
or a physician assistant licensed to prescribe in accordance with section 269
20-12d, and the written authorization of a parent or guardian of such 270
child, (3) specify that an operator of a child care center or group child 271
care home, licensed before January 1, 1986, or an operator who receives 272
a license after January 1, 1986, for a facility licensed prior to January 1, 273
1986, shall provide a minimum of thirty square feet per child of total 274
indoor usable space, free of furniture except that needed for the 275
children's purposes, exclusive of toilet rooms, bathrooms, coatrooms, 276
kitchens, halls, isolation room or other rooms used for purposes other 277
than the activities of the children, (4) specify that a child care center or 278
group child care home licensed after January 1, 1986, shall provide 279
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thirty-five square feet per child of total indoor usable space, (5) establish 280
appropriate child care center staffing requirements for employees 281
certified in cardiopulmonary resuscitation by the American Red Cross, 282
the American Heart Association, the National Safety Council, American 283
Safety and Health Institute, Medic First Aid International, Inc. or an 284
organization using guidelines for cardiopulmonary resuscitation and 285
emergency cardiovascular care published by the American Heart 286
Association and International Liaison Committee on Resuscitation, (6) 287
specify that [on and after January 1, 2003,] a child care center or group 288
child care home (A) shall not deny services to a child on the basis of a 289
child's known or suspected allergy or because a child has a prescription 290
for an automatic prefilled cartridge injector or similar automatic 291
injectable equipment used to treat an allergic reaction, or for injectable 292
equipment used to administer glucagon, (B) shall, not later than three 293
weeks after such child's enrollment in such a center or home, have staff 294
trained in the use of such equipment on-site during all hours when such 295
a child is on-site, (C) shall require such child's parent or guardian to 296
provide the injector or injectable equipment and a copy of the 297
prescription for such medication and injector or injectable equipment 298
upon enrollment of such child, and (D) shall require a parent or 299
guardian enrolling such a child to replace such medication and 300
equipment prior to its expiration date, (7) specify that [on and after 301
January 1, 2005,] a child care center or group child care home (A) shall 302
not deny services to a child on the basis of a child's diagnosis of asthma 303
or because a child has a prescription for an inhalant medication to treat 304
asthma, and (B) shall, not later than three weeks after such child's 305
enrollment in such a center or home, have staff trained in the 306
administration of such medication on-site during all hours when such a 307
child is on-site, and (8) establish physical plant requirements for 308
licensed child care centers and licensed group child care homes that 309
exclusively serve school-age children. When establishing such 310
requirements, the Office of Early Childhood shall give consideration to 311
child care centers and group child care homes that are located in private 312
or public school buildings. With respect to this subdivision only, the 313
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commissioner shall implement policies and procedures necessary to 314
implement the physical plant requirements established pursuant to this 315
subdivision while in the process of adopting such policies and 316
procedures in regulation form. Until replaced by policies and 317
procedures implemented pursuant to this subdivision, any physical 318
plant requirement specified in the office's regulations that is generally 319
applicable to child care centers and group child care homes shall 320
continue to be applicable to such centers and homes that exclusively 321
serve school-age children. The commissioner shall [print] post notice of 322
the intent to adopt regulations pursuant to this subdivision on the 323
eRegulations System not later than twenty days after the date of 324
implementation of such policies and procedures. Policies and 325
procedures implemented pursuant to this subdivision shall be valid 326
until the time final regulations are adopted. 327
(b) Any child who (1) presents a certificate, in a form prescribed by 328
the Commissioner of Public Health pursuant to section 7 of this act, 329
signed by a physician, a physician assistant or an advanced practice 330
registered nurse stating that, in the opinion of such physician, physician 331
assistant or advanced practice registered nurse, the immunizations 332
required pursuant to regulations adopted pursuant to subdivision (1) of 333
subsection (a) of this section are medically contraindicated, (2) in the 334
case of a child who is enrolled in seventh grade through twelfth grade, 335
presented a statement, prior to the effective date of this section, that such 336
immunizations are contrary to the religious beliefs of such child or the 337
parents or guardians of such child, or (3) in the case of a child who is 338
enrolled in sixth grade or below, (A) presented a statement, prior to the 339
effective date of this section, that such immunizations are contrary to 340
the religious beliefs of such child or the parents or guardian of such 341
child, and (B) presents a written declaration, in a form prescribed by the 342
Commissioner of Public Health, from a physician, a physician assistant 343
or an advanced practice registered nurse stating that an immunization 344
against diphtheria, pertussis, tetanus, poliomyelitis, measles, mumps, 345
rubella, haemophilus influenzae type B and any other vaccine required 346
by the schedule of active immunization adopted pursuant to section 347
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19a-7f has been given to such child and that any additional necessary 348
immunizations of such student against diphtheria, pertussis, tetanus, 349
poliomyelitis, measles, mumps, rubella, haemophilus influenzae type B 350
and any other vaccine required by such schedule of active immunization 351
are in process under guidelines specified by the Commissioner of Public 352
Health or as recommended for the child by the physician, physician 353
assistant or advanced practice registered nurse, shall be exempt from 354
the immunization requirements set forth in such regulations. The 355
statement described in subparagraph (A) of subdivision (3) of this 356
subsection shall be acknowledged, in accordance with the provisions of 357
sections 1-32, 1-34 and 1-35, by a judge of a court of record or a family 358
support magistrate, a clerk or deputy clerk of a court having a seal, a 359
town clerk, a notary public, a justice of the peace, or an attorney 360
admitted to the bar of this state. 361
(c) Any child who is enrolled in sixth grade or below on or before the 362
effective date of this section who presented, prior to the effective date of 363
this section, the statement described in subparagraph (A) of subdivision 364
(3) of subsection (b) of this section, but did not present the written 365
declaration described in subparagraph (B) of subdivision (3) of 366
subsection (b) of this section, shall comply, on or before September 1, 367
2022, or not later than fourteen days after applying to enroll in the child 368
care center or group child care home, whichever is later, with the 369
immunization requirements set forth in the regulations adopted 370
pursuant to subdivision (1) of subsection (a) of this section. 371
[(b)] (d) The commissioner may adopt regulations, pursuant to 372
chapter 54, to establish civil penalties of not more than one hundred 373
dollars per day for each day of violation and other disciplinary remedies 374
that may be imposed, following a contested-case hearing, upon the 375
holder of a license issued under section 19a-80 to operate a child care 376
center or group child care home or upon the holder of a license issued 377
under section 19a-87b, as amended by this act, to operate a family child 378
care home. 379
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[(c)] (e) The commissioner shall exempt Montessori schools 380
accredited by the American Montessori Society or the Association 381
Montessori Internationale from any provision in regulations adopted 382
pursuant to subsection (a) of this section which sets requirements on 383
group size or child to staff ratios or the provision of cots. 384
[(d)] (f) Upon the declaration by the Governor of a civil preparedness 385
emergency pursuant to section 28-9 or a public health emergency 386
pursuant to section 19a-131a, the commissioner may waive the 387
provisions of any regulation adopted pursuant to this section if the 388
commissioner determines that such waiver would not endanger the life, 389
safety or health of any child. The commissioner shall prescribe the 390
duration of such waiver, provided such waiver shall not extend beyond 391
the duration of the declared emergency. The commissioner shall 392
establish the criteria by which a waiver request shall be made and the 393
conditions for which a waiver will be granted or denied. The provisions 394
of section 19a-84 shall not apply to a denial of a waiver request under 395
this subsection. 396
[(e)] (g) Any child care center or group child care home may provide 397
child care services to homeless children and youths, as defined in 42 398
USC 11434a, as amended from time to time, for a period not to exceed 399
ninety days without complying with any provision in regulations 400
adopted pursuant to this section relating to immunization and physical 401
examination requirements. Any child care center or group child care 402
home that provides child care services to homeless children and youths 403
at such center or home under this subsection shall maintain a record on 404
file of all homeless children and youths who have attended such center 405
or home for a period of two years after such homeless children or youths 406
are no longer receiving child care services at such center or home. 407
[(f)] (h) Any child care center or group child care home may provide 408
child care services to a foster child for a period not to exceed forty-five 409
days without complying with any provision in regulations adopted 410
pursuant to this section relating to immunization and physical 411
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examination requirements. Any child care center or group child care 412
home that provides child care services to a foster child at such center or 413
home under this subsection shall maintain a record on file of such foster 414
child for a period of two years after such foster child is no longer 415
receiving child care services at such center or home. For purposes of this 416
subsection, "foster child" means a child who is in the care and custody 417
of the Commissioner of Children and Families and placed in a foster 418
home licensed pursuant to section 17a-114, foster home approved by a 419
child-placing agency licensed pursuant to section 17a-149, facility 420
licensed pursuant to section 17a-145 or with a relative or fictive kin 421
caregiver pursuant to section 17a-114. 422
Sec. 6. Section 19a-87b of the general statutes is repealed and the 423
following is substituted in lieu thereof (Effective from passage): 424
(a) No person, group of persons, association, organization, 425
corporation, institution or agency, public or private, shall maintain a 426
family child care home, as defined in section 19a-77, without a license 427
issued by the Commissioner of Early Childhood. Licensure forms shall 428
be obtained from the Office of Early Childhood. Applications for 429
licensure shall be made to the commissioner on forms provided by the 430
office and shall contain the information required by regulations adopted 431
under this section. The licensure and application forms shall contain a 432
notice that false statements made therein are punishable in accordance 433
with section 53a-157b. Applicants shall state, in writing, that they are in 434
compliance with the regulations adopted by the commissioner pursuant 435
to subsection (f) of this section. Before a family child care home license 436
is granted, the office shall make an inquiry and investigation which shall 437
include a visit and inspection of the premises for which the license is 438
requested. Any inspection conducted by the office shall include an 439
inspection for evident sources of lead poisoning. The office shall provide 440
for a chemical analysis of any paint chips found on such premises. 441
Neither the commissioner nor the commissioner's designee shall require 442
an annual inspection for homes seeking license renewal or for licensed 443
homes, except that the commissioner or the commissioner's designee 444
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shall make an unannounced visit, inspection or investigation of each 445
licensed family child care home at least once every year. A licensed 446
family child care home shall not be subject to any conditions on the 447
operation of such home by local officials, other than those imposed by 448
the office pursuant to this subsection, if the home complies with all local 449
codes and ordinances applicable to single and multifamily dwellings. 450
(b) No person shall act as an assistant or substitute staff member to a 451
person or entity maintaining a family child care home, as defined in 452
section 19a-77, without an approval issued by the commissioner. Any 453
person seeking to act as an assistant or substitute staff member in a 454
family child care home shall submit an application for such approval to 455
the office. Applications for approval shall: (1) Be made to the 456
commissioner on forms provided by the office, (2) contain the 457
information required by regulations adopted under this section, and (3) 458
be accompanied by a fee of fifteen dollars. The approval application 459
forms shall contain a notice that false statements made in such form are 460
punishable in accordance with section 53a-157b. 461
(c) The commissioner, within available appropriations, shall require 462
each initial applicant or prospective employee of a family child care 463
home in a position requiring the provision of care to a child, including 464
an assistant or substitute staff member and each household member 465
who is sixteen years of age or older, to submit to comprehensive 466
background checks, including state and national criminal history 467
records checks. The criminal history records checks required pursuant 468
to this subsection shall be conducted in accordance with section 29-17a. 469
The commissioner shall also request a check of the state child abuse 470
registry established pursuant to section 17a-101k. The commissioner 471
shall notify each licensee of the provisions of this subsection. For 472
purposes of this subsection, "household member" means any person, 473
other than the person who is licensed to conduct, operate or maintain a 474
family child care home, who resides in the family child care home, such 475
as the licensee's spouse or children, tenants and any other occupant. 476
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(d) An application for initial licensure pursuant to this section shall 477
be accompanied by a fee of forty dollars and such license shall be issued 478
for a term of four years. An application for renewal of a license issued 479
pursuant to this section shall be accompanied by a fee of forty dollars 480
and a certification from the licensee that any child enrolled in the family 481
child care home has received age-appropriate immunizations in 482
accordance with regulations adopted pursuant to subsection (f) of this 483
section. A license issued pursuant to this section shall be renewed for a 484
term of four years. In the case of an applicant submitting an application 485
for renewal of a license that has expired, and who has ceased operations 486
of a family child care home due to such expired license, the 487
commissioner may renew such expired license within thirty days of the 488
date of such expiration upon receipt of an application for renewal that 489
is accompanied by such fee and such certification. 490
(e) An application for initial staff approval or renewal of staff 491
approval shall be accompanied by a fee of fifteen dollars. Such 492
approvals shall be issued or renewed for a term of two years. 493
(f) The commissioner shall adopt regulations, in accordance with the 494
provisions of chapter 54, to assure that family child care homes, as 495
defined in section 19a-77, meet the health, educational and social needs 496
of children utilizing such homes. Such regulations shall ensure that the 497
family child care home is treated as a residence, and not an institutional 498
facility. Such regulations shall specify that each child be protected as 499
age-appropriate by adequate immunization against diphtheria, 500
pertussis, tetanus, poliomyelitis, measles, mumps, rubella, 501
[hemophilus] haemophilus influenzae type B and any other vaccine 502
required by the schedule of active immunization adopted pursuant to 503
section 19a-7f. [Such regulations shall provide appropriate exemptions 504
for children for whom such immunization is medically contraindicated 505
and for children whose parents or guardian objects to such 506
immunization on religious grounds and require that any such objection 507
be accompanied by a statement from such parents or guardian that such 508
immunization would be contrary to the religious beliefs of such child or 509
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the parents or guardian of such child, which statement shall be 510
acknowledged, in accordance with the provisions of sections 1-32, 1-34 511
and 1-35, by (1) a judge of a court of record or a family support 512
magistrate, (2) a clerk or deputy clerk of a court having a seal, (3) a town 513
clerk, (4) a notary public, (5) a justice of the peace, or (6) an attorney 514
admitted to the bar of this state.] Such regulations shall also specify 515
conditions under which family child care home providers may 516
administer tests to monitor glucose levels in a child with diagnosed 517
diabetes mellitus, and administer medicinal preparations, including 518
controlled drugs specified in the regulations by the commissioner, to a 519
child receiving child care services at a family child care home pursuant 520
to a written order of a physician licensed to practice medicine in this or 521
another state, an advanced practice registered nurse licensed to 522
prescribe in accordance with section 20-94a or a physician assistant 523
licensed to prescribe in accordance with section 20-12d, and the written 524
authorization of a parent or guardian of such child. Such regulations 525
shall specify appropriate standards for extended care and intermittent 526
short-term overnight care. The commissioner shall inform each licensee, 527
by way of a plain language summary provided not later than sixty days 528
after the regulation's effective date, of any new or changed regulations 529
adopted under this subsection with which a licensee must comply. 530
(g) Any child who (1) presents a certificate, in a form prescribed by 531
the Commissioner of Public Health pursuant to section 7 of this act, 532
signed by a physician, a physician assistant or an advanced practice 533
registered nurse stating that, in the opinion of such physician, physician 534
assistant or advanced practice registered nurse, the immunizations 535
required pursuant to regulations adopted pursuant to subsection (f) of 536
this section are medically contraindicated, (2) in the case of a child who 537
is enrolled in seventh grade through twelfth grade, presented a 538
statement, prior to the effective date of this section, that such 539
immunizations are contrary to the religious beliefs of such child or the 540
parents or guardians of such child, or (3) in the case of a child who is 541
enrolled in sixth grade or below, (A) presented a statement, prior to the 542
effective date of this section, that such immunizations are contrary to 543
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the religious beliefs of such child or the parents or guardians of such 544
child, and (B) presents a written declaration, in a form prescribed by the 545
Commissioner of Public Health, from a physician, physician assistant or 546
advanced practice registered nurse stating that an immunization against 547
diphtheria, pertussis, tetanus, poliomyelitis, measles, mumps, rubella, 548
haemophilus influenzae type B and any other vaccine required by the 549
schedule of active immunization adopted pursuant to section 19a-7f has 550
been given to such child and that any additional necessary 551
immunizations of such student against diphtheria, pertussis, tetanus, 552
poliomyelitis, measles, mumps, rubella, haemophilus influenzae type B 553
and any other vaccine required by such schedule of active immunization 554
are in process under guidelines specified by the Commissioner of Public 555
Health or as recommended for the child by the physician, physician 556
assistant or advanced practice registered nurse, shall be exempt from 557
the immunization requirements set forth in such regulations. The 558
statement described in subparagraph (A) of subdivision (3) of this 559
subsection shall be acknowledged, in accordance with the provisions of 560
sections 1-32, 1-34 and 1-35, by (i) a judge of a court of record or a family 561
support magistrate, (ii) a clerk or deputy clerk of a court having a seal, 562
(iii) a town clerk, (iv) a notary public, (v) a justice of the peace, or (vi) an 563
attorney admitted to the bar of this state. 564
(h) Any child who is enrolled in sixth grade or below on or before the 565
effective date of this section who presented, prior to the effective date of 566
this section, the statement described in subparagraph (A) of subdivision 567
(3) of subsection (g) of this section, but did not present the written 568
declaration described in subparagraph (B) of subdivision (3) of 569
subsection (g) of this section shall comply, on or before September 1, 570
2022, or not later than fourteen days after applying to enroll in the family 571
child care home, whichever is later, with the immunization 572
requirements set forth in the regulations adopted pursuant to subsection 573
(f) of this section. 574
[(g)] (i) Upon the declaration by the Governor of a civil preparedness 575
emergency pursuant to section 28-9 or a public health emergency 576
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pursuant to section 19a-131a, the commissioner may waive the 577
provisions of any regulation adopted pursuant to this section if the 578
commissioner determines that such waiver would not endanger the life, 579
safety or health of any child. The commissioner shall prescribe the 580
duration of such waiver, provided such waiver shall not extend beyond 581
the duration of the declared emergency. The commissioner shall 582
establish the criteria by which a waiver request shall be made and the 583
conditions for which a waiver will be granted or denied. The provisions 584
of section 19a-84 shall not apply to a denial of a waiver request under 585
this subsection. 586
[(h)] (j) Any family child care home may provide child care services 587
to homeless children and youths, as defined in 42 USC 11434a, as 588
amended from time to time, for a period not to exceed ninety days 589
without complying with any provision in regulations adopted pursuant 590
to this section relating to immunization and physical examination 591
requirements. Any family child care home that provides child care 592
services to homeless children and youths at such home under this 593
subsection shall maintain a record on file of all homeless children and 594
youths who have attended such home for a period of two years after 595
such homeless children or youths are no longer receiving child care 596
services at such home. 597
[(i)] (k) Any family child care home may provide child care services 598
to a foster child for a period not to exceed forty-five days without 599
complying with any provision in regulations adopted pursuant to this 600
section relating to immunization and physical examination 601
requirements. Any family child care home that provides child care 602
services to a foster child at such home under this subsection shall 603
maintain a record on file of such foster child for a period of two years 604
after such foster child is no longer receiving child care services at such 605
home. For purposes of this subsection, "foster child" means a child who 606
is in the care and custody of the Commissioner of Children and Families 607
and placed in a foster home licensed pursuant to section 17a-114, foster 608
home approved by a child-placing agency licensed pursuant to section 609
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17a-149, facility licensed pursuant to section 17a-145 or with a relative 610
or fictive kin caregiver pursuant to section 17a-114. 611
Sec. 7. (NEW) (Effective from passage) On or before October 1, 2021, the 612
Commissioner of Public Health shall develop and make available on the 613
Internet web site of the Department of Public Health a certificate for use 614
by a physician, physician assistant or advanced practice registered 615
nurse stating that, in the opinion of such physician, physician assistant 616
or advanced practice registered nurse, a vaccination required by the 617
general statutes is medically contraindicated for a person because of the 618
physical condition of such person. The certificate shall include (1) 619
definitions of the terms "contraindication" and "precaution", (2) a list of 620
contraindications and precautions recognized by the National Centers 621
for Disease Control and Prevention for each of the statutorily required 622
vaccinations, from which the physician, physician assistant or advanced 623
practice registered nurse may select the relevant contraindication or 624
precaution on behalf of such person, (3) a section in which the physician, 625
physician assistant or advanced practice registered nurse may record a 626
contraindication or precaution that is not recognized by the National 627
Centers for Disease Control and Prevention, but in his or her discretion, 628
results in the vaccination being medically contraindicated, including, 629
but not limited to, any autoimmune disorder, family history of any 630
autoimmune disorder, family history of any reaction to a vaccination, 631
genetic predisposition to any reaction to a vaccination as determined 632
through genetic testing and a previous documented reaction of a person 633
that is correlated to a vaccination, (4) a section in which the physician, 634
physician assistant or advanced practice registered nurse may include a 635
written explanation for the exemption from any statutorily required 636
vaccinations, (5) a section requiring the signature of the physician, 637
physician assistant or advanced practice registered nurse, (6) a 638
requirement that the physician, physician assistant or advanced practice 639
registered nurse attach such person's most current immunization 640
record, and (7) a synopsis of the grounds for any order of quarantine or 641
isolation pursuant to section 19a-131b of the general statutes. 642
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Sec. 8. (NEW) (Effective from passage) (a) There is established an 643
Advisory Committee on Medically Contraindicated Vaccinations within 644
the Department of Public Health for the purpose of advising the 645
Commissioner of Public Health on issues concerning exemptions from 646
state or federal requirements for vaccinations that result from a 647
physician, physician assistant or advanced practice registered nurse 648
stating that a vaccination is medically contraindicated for a person due 649
to the medical condition of such person. Said advisory committee shall 650
not be responsible for confirming or denying any determination by a 651
physician, physician assistant or advanced practice registered nurse that 652
a vaccination is medically contraindicated for a specific individual. In 653
order to carry out its duties, the advisory committee shall (1) have access 654
to the childhood immunization registry established by the department 655
pursuant to section 19a-7h of the general statutes, (2) evaluate the 656
process used by the department in collecting data concerning 657
exemptions resulting from a vaccination b eing medically 658
contraindicated and whether the department should have any oversight 659
over such exemptions, (3) examine whether enrollment of an 660
unvaccinated child into a program operated by a public or nonpublic 661
school, institution of higher education, child care center or group child 662
care home should be conditioned upon the child meeting certain 663
criteria, (4) calculate the ratio of school nurses to students in each public 664
and nonpublic school in the state and the funding issues surrounding 665
such ratio, (5) assess whether immunizations should be required more 666
frequently than prior to enrollment into a program operated by a public 667
or nonpublic school and prior to entering seventh grade, and (6) 668
determine whether (A) there are any discrepancies in the issuance of 669
certificates stating that a vaccine is medically contraindicated, and (B) to 670
recommend continuing education of physicians, physician assistants or 671
advanced practice registered nurses in vaccine contraindications and 672
precautions. All information obtained by the advisory committee from 673
such registry shall be confidential pursuant to section 19a-25 of the 674
general statutes, as amended by this act. 675
(b) The advisory committee shall consist of the following members: 676
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(1) Two appointed by the speaker of the House of Representatives, 677
one of whom shall be a physician licensed pursuant to chapter 370 of the 678
general statutes who is a pediatrician, and one of whom shall be a 679
member of the public; 680
(2) Two appointed by the president pro tempore of the Senate, one of 681
whom shall be a physician licensed pursuant to chapter 370 of the 682
general statutes who has expertise in the efficacy of vaccines, and one of 683
whom shall be a member of the public; 684
(3) One appointed by the majority leader of the House of 685
Representatives, who shall be a school nurse; 686
(4) One appointed by the majority leader of the Senate, who shall be 687
a physician assistant licensed pursuant to chapter 370 of the general 688
statutes who has experience in the administration of vaccines; 689
(5) One appointed by the minority leader of the House of 690
Representatives, who shall be an advanced practice registered nurse 691
licensed pursuant to chapter 378 of the general statutes who has 692
experience in the administration of vaccines; 693
(6) One appointed by the minority leader of the Senate, who shall be 694
a representative of the Connecticut Chapter of the American Academy 695
of Pediatrics; 696
(7) The Commissioner of Public Health, or the commissioner's 697
designee; 698
(8) The Commissioner of Education, or the commissioner's designee; 699
and 700
(9) The Commissioner of Early Childhood, or the commissioner's 701
designee. 702
(c) The members of the advisory committee shall elect a chairperson 703
of the advisory committee from among its members. Such chairperson 704
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shall schedule the first meeting of the advisory committee, which shall 705
be held not later than October 1, 2021. The advisory committee shall 706
meet not less than biannually. On or before January 1, 2022, and 707
annually thereafter, the committee shall report, in accordance with the 708
provisions of section 11-4a of the general statutes, on its activities and 709
findings to the joint standing committee of the General Assembly 710
having cognizance of matters relating to public health. 711
Sec. 9. (NEW) (Effective from passage) The Department of Public 712
Health, in collaboration with the state Department of Education and the 713
Office of Early Childhood, shall evaluate all of the data collected by said 714
departments concerning exemptions from immunization requirements. 715
Not later than January 1, 2022, and annually thereafter, the 716
Commissioners of Public Health, Education and Early Childhood shall 717
jointly report, in accordance with the provisions of section 11-4a of the 718
general statutes, to the joint standing committees of the General 719
Assembly having cognizance of matters relating to public health and 720
education regarding the evaluation of such data. 721
Sec. 10. Subsection (a) of section 38a-492r of the general statutes is 722
repealed and the following is substituted in lieu thereof (Effective January 723
1, 2022): 724
(a) Each individual health insurance policy providing coverage of the 725
type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 726
delivered, issued for delivery, renewed, amended or continued in this 727
state that provides coverage for prescription drugs shall provide 728
[coverage for] (1) coverage for immunizations recommended by the 729
American Academy of Pediatrics, American Academy of Family 730
Physicians and the American College of Obstetricians and 731
Gynecologists, and (2) with respect to immunizations that have in effect 732
a recommendation from the Advisory Committee on Immunization 733
Practices of the Centers for Disease Control and Prevention with respect 734
to the individual involved, coverage for such immunizations and at least 735
a twenty-minute consultation between such individual and a health care 736
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LCO No. 6219 24 of 25
provider authorized to prescribe such immunizations to such 737
individual. 738
Sec. 11. Subsection (a) of section 38a-518r of the general statutes is 739
repealed and the following is substituted in lieu thereof (Effective January 740
1, 2022): 741
(a) Each group health insurance policy providing coverage of the type 742
specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 743
delivered, issued for delivery, renewed, amended or continued in this 744
state that provides coverage for prescription drugs shall provide 745
[coverage for] (1) coverage for immunizations recommended by the 746
American Academy of Pediatrics, American Academy of Family 747
Physicians and the American College of Obstetricians and 748
Gynecologists, and (2) with respect to immunizations that have in effect 749
a recommendation from the Advisory Committee on Immunization 750
Practices of the Centers for Disease Control and Prevention with respect 751
to the individual involved, coverage for such immunizations and at least 752
a twenty-minute consultation between such individual and a health care 753
provider authorized to prescribe such immunizations to such 754
individual. 755
This act shall take effect as follows and shall amend the following
sections:
Section 1 from passage 10-204a
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
Sec. 10 January 1, 2022 38a-492r(a)
Sec. 11 January 1, 2022 38a-518r(a)
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Statement of Purpose:
To eliminate the nonmedical exemption to the immunization
requirement for individuals attending public or private school from
prekindergarten through grade twelve, individuals in higher education
and children in day care settings.
[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except
that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not
underlined.]
Co-Sponsors: SEN. DAUGHERTY ABRAMS, 13th Dist.; SEN. DUFF, 25th Dist.
REP. ELLIOTT, 88th Dist.; REP. PALM, 36th Dist.
S.B. 568