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General Assembly Substitute Bill No. 568
January Session, 2021
AN ACT ELIMINATING THE NONMEDICAL EXEMPT ION TO THE
IMMUNIZATION REQUIRE MENT.
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 Section 10-204a of the general statutes is repealed and the 1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
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 Substitute Bill No. 568
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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
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 Substitute Bill No. 568
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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 guardian 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 guardian of such child 83
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 Substitute Bill No. 568
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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 guardian 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
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 Substitute Bill No. 568
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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
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 Substitute Bill No. 568
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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
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 Substitute Bill No. 568
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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 204
by this act, shall be exempt from the appropriate provisions of this 205
section. 206
[(b)] (c) Each institution of higher education shall keep uniform 207
records of the immunizations and immunization status of each student, 208
based on the certificate of immunization or other evidence acceptable 209
pursuant to subsection [(a)] (b) of this section. The record shall be part 210
of the student's permanent record. By November first of each year, the 211
chief administrative officer of each institution of higher education shall 212
cause to be submitted to the Commissioner of Public Health, on a form 213
provided by the commissioner, a summary report of the immunization 214
status of all students enrolling in such institution. 215
Sec. 4. Subsection (a) of section 10a-155b of the general statutes is 216
repealed and the following is substituted in lieu thereof (Effective from 217
passage): 218 Substitute Bill No. 568
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(a) For students who first enroll in the 2014-2015 school year, and first 219
enroll in each school year thereafter, each public or private college or 220
university in this state shall require that each student who resides in on-221
campus housing be vaccinated against meningitis and submit evidence 222
of having received a meningococcal conjugate vaccine not more than 223
five years before enrollment as a condition of such residence. The 224
provisions of this subsection shall not apply to any such student who (1) 225
presents a certificate, in a form prescribed by the Commissioner of 226
Public Health pursuant to section 7 of this act, from a physician, an 227
advanced practice registered nurse or a physician assistant stating that, 228
in the opinion of such physician, advanced practice registered nurse or 229
physician assistant, such vaccination is medically contraindicated 230
because of the physical condition of such student, or (2) [presents] prior 231
to the effective date of this section, presented a statement that such 232
vaccination [would be] is contrary to the religious beliefs of such 233
student. 234
Sec. 5. Section 19a-79 of the general statutes is repealed and the 235
following is substituted in lieu thereof (Effective from passage): 236
(a) The Commissioner of Early Childhood shall adopt regulations, in 237
accordance with the provisions of chapter 54, to carry out the purposes 238
of sections 19a-77 to 19a-80, inclusive, and 19a-82 to 19a-87, inclusive, 239
and to assure that child care centers and group child care homes meet 240
the health, educational and social needs of children utilizing such child 241
care centers and group child care homes. Such regulations shall (1) 242
specify that before being permitted to attend any child care center or 243
group child care home, each child shall be protected as age-appropriate 244
by adequate immunization against diphtheria, pertussis, tetanus, 245
poliomyelitis, measles, mumps, rubella, [hemophilus] haemophilus 246
influenzae type B and any other vaccine required by the schedule of 247
active immunization adopted pursuant to section 19a-7f, [including 248
appropriate exemptions for children for whom such immunization is 249
medically contraindicated and for children whose parent or guardian 250
objects to such immunization on religious grounds, and that any 251 Substitute Bill No. 568
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objection by a parent or a guardian to immunization of a child on 252
religious grounds shall be accompanied by a statement from such parent 253
or guardian that such immunization would be contrary to the religious 254
beliefs of such child or the parent or guardian of such child, which 255
statement shall be acknowledged, in accordance with the provisions of 256
sections 1-32, 1-34 and 1-35, by (A) a judge of a court of record or a family 257
support magistrate, (B) a clerk or deputy clerk of a court having a seal, 258
(C) a town clerk, (D) a notary public, (E) a justice of the peace, or (F) an 259
attorney admitted to the bar of this state,] (2) specify conditions under 260
which child care center directors and teachers and group child care 261
home providers may administer tests to monitor glucose levels in a child 262
with diagnosed diabetes mellitus, and administer medicinal 263
preparations, including controlled drugs specified in the regulations by 264
the commissioner, to a child receiving child care services at such child 265
care center or group child care home pursuant to the written order of a 266
physician licensed to practice medicine or a dentist licensed to practice 267
dental medicine in this or another state, or an advanced practice 268
registered nurse licensed to prescribe in accordance with section 20-94a, 269
or a physician assistant licensed to prescribe in accordance with section 270
20-12d, and the written authorization of a parent or guardian of such 271
child, (3) specify that an operator of a child care center or group child 272
care home, licensed before January 1, 1986, or an operator who receives 273
a license after January 1, 1986, for a facility licensed prior to January 1, 274
1986, shall provide a minimum of thirty square feet per child of total 275
indoor usable space, free of furniture except that needed for the 276
children's purposes, exclusive of toilet rooms, bathrooms, coatrooms, 277
kitchens, halls, isolation room or other rooms used for purposes other 278
than the activities of the children, (4) specify that a child care center or 279
group child care home licensed after January 1, 1986, shall provide 280
thirty-five square feet per child of total indoor usable space, (5) establish 281
appropriate child care center staffing requirements for employees 282
certified in cardiopulmonary resuscitation by the American Red Cross, 283
the American Heart Association, the National Safety Council, American 284
Safety and Health Institute, Medic First Aid International, Inc. or an 285
organization using guidelines for cardiopulmonary resuscitation and 286 Substitute Bill No. 568
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emergency cardiovascular care published by the American Heart 287
Association and International Liaison Committee on Resuscitation, (6) 288
specify that [on and after January 1, 2003,] a child care center or group 289
child care home (A) shall not deny services to a child on the basis of a 290
child's known or suspected allergy or because a child has a prescription 291
for an automatic prefilled cartridge injector or similar automatic 292
injectable equipment used to treat an allergic reaction, or for injectable 293
equipment used to administer glucagon, (B) shall, not later than three 294
weeks after such child's enrollment in such a center or home, have staff 295
trained in the use of such equipment on-site during all hours when such 296
a child is on-site, (C) shall require such child's parent or guardian to 297
provide the injector or injectable equipment and a copy of the 298
prescription for such medication and injector or injectable equipment 299
upon enrollment of such child, and (D) shall require a parent or 300
guardian enrolling such a child to replace such medication and 301
equipment prior to its expiration date, (7) specify that [on and after 302
January 1, 2005,] a child care center or group child care home (A) shall 303
not deny services to a child on the basis of a child's diagnosis of asthma 304
or because a child has a prescription for an inhalant medication to treat 305
asthma, and (B) shall, not later than three weeks after such child's 306
enrollment in such a center or home, have staff trained in the 307
administration of such medication on-site during all hours when such a 308
child is on-site, and (8) establish physical plant requirements for 309
licensed child care centers and licensed group child care homes that 310
exclusively serve school-age children. When establishing such 311
requirements, the Office of Early Childhood shall give consideration to 312
child care centers and group child care homes that are located in private 313
or public school buildings. With respect to this subdivision only, the 314
commissioner shall implement policies and procedures necessary to 315
implement the physical plant requirements established pursuant to this 316
subdivision while in the process of adopting such policies and 317
procedures in regulation form. Until replaced by policies and 318
procedures implemented pursuant to this subdivision, any physical 319
plant requirement specified in the office's regulations that is generally 320
applicable to child care centers and group child care homes shall 321 Substitute Bill No. 568
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continue to be applicable to such centers and homes that exclusively 322
serve school-age children. The commissioner shall [print] post notice of 323
the intent to adopt regulations pursuant to this subdivision on the 324
eRegulations System not later than twenty days after the date of 325
implementation of such policies and procedures. Policies and 326
procedures implemented pursuant to this subdivision shall be valid 327
until the time final regulations are adopted. 328
(b) Any child who (1) presents a certificate, in a form prescribed by 329
the Commissioner of Public Health pursuant to section 7 of this act, 330
signed by a physician, a physician assistant or an advanced practice 331
registered nurse stating that, in the opinion of such physician, physician 332
assistant or advanced practice registered nurse, the immunizations 333
required pursuant to regulations adopted pursuant to subdivision (1) of 334
subsection (a) of this section are medically contraindicated, (2) in the 335
case of a child who is enrolled in seventh grade through twelfth grade, 336
presented a statement, prior to the effective date of this section, that such 337
immunizations are contrary to the religious beliefs of such child or the 338
parents or guardian of such child, or (3) in the case of a child who is 339
enrolled in sixth grade or below, (A) presented a statement, prior to the 340
effective date of this section, that such immunizations are contrary to 341
the religious beliefs of such child or the parents or guardian of such 342
child, and (B) presents a written declaration, in a form prescribed by the 343
Commissioner of Public Health, from a physician, a physician assistant 344
or an advanced practice registered nurse stating that an immunization 345
against diphtheria, pertussis, tetanus, poliomyelitis, measles, mumps, 346
rubella, haemophilus influenzae type B and any other vaccine required 347
by the schedule of active immunization adopted pursuant to section 348
19a-7f has been given to such child and that any additional necessary 349
immunizations of such student against diphtheria, pertussis, tetanus, 350
poliomyelitis, measles, mumps, rubella, haemophilus influenzae type B 351
and any other vaccine required by such schedule of active immunization 352
are in process under guidelines specified by the Commissioner of Public 353
Health or as recommended for the child by the physician, physician 354
assistant or advanced practice registered nurse, shall be exempt from 355 Substitute Bill No. 568
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the immunization requirements set forth in such regulations. The 356
statement described in subparagraph (A) of subdivision (3) of this 357
subsection shall be acknowledged, in accordance with the provisions of 358
sections 1-32, 1-34 and 1-35, by a judge of a court of record or a family 359
support magistrate, a clerk or deputy clerk of a court having a seal, a 360
town clerk, a notary public, a justice of the peace, or an attorney 361
admitted to the bar of this state. 362
(c) Any child who is enrolled in sixth grade or below on or before the 363
effective date of this section who presented, prior to the effective date of 364
this section, the statement described in subparagraph (A) of subdivision 365
(3) of subsection (b) of this section, but did not present the written 366
declaration described in subparagraph (B) of subdivision (3) of 367
subsection (b) of this section, shall comply, on or before September 1, 368
2022, or not later than fourteen days after applying to enroll in the child 369
care center or group child care home, whichever is later, with the 370
immunization requirements set forth in the regulations adopted 371
pursuant to subdivision (1) of subsection (a) of this section. 372
[(b)] (d) The commissioner may adopt regulations, pursuant to 373
chapter 54, to establish civil penalties of not more than one hundred 374
dollars per day for each day of violation and other disciplinary remedies 375
that may be imposed, following a contested-case hearing, upon the 376
holder of a license issued under section 19a-80 to operate a child care 377
center or group child care home or upon the holder of a license issued 378
under section 19a-87b, as amended by this act, to operate a family child 379
care home. 380
[(c)] (e) The commissioner shall exempt Montessori schools 381
accredited by the American Montessori Society or the Association 382
Montessori Internationale from any provision in regulations adopted 383
pursuant to subsection (a) of this section which sets requirements on 384
group size or child to staff ratios or the provision of cots. 385
[(d)] (f) Upon the declaration by the Governor of a civil preparedness 386
emergency pursuant to section 28-9 or a public health emergency 387 Substitute Bill No. 568
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pursuant to section 19a-131a, the commissioner may waive the 388
provisions of any regulation adopted pursuant to this section if the 389
commissioner determines that such waiver would not endanger the life, 390
safety or health of any child. The commissioner shall prescribe the 391
duration of such waiver, provided such waiver shall not extend beyond 392
the duration of the declared emergency. The commissioner shall 393
establish the criteria by which a waiver request shall be made and the 394
conditions for which a waiver will be granted or denied. The provisions 395
of section 19a-84 shall not apply to a denial of a waiver request under 396
this subsection. 397
[(e)] (g) Any child care center or group child care home may provide 398
child care services to homeless children and youths, as defined in 42 399
USC 11434a, as amended from time to time, for a period not to exceed 400
ninety days without complying with any provision in regulations 401
adopted pursuant to this section relating to immunization and physical 402
examination requirements. Any child care center or group child care 403
home that provides child care services to homeless children and youths 404
at such center or home under this subsection shall maintain a record on 405
file of all homeless children and youths who have attended such center 406
or home for a period of two years after such homeless children or youths 407
are no longer receiving child care services at such center or home. 408
[(f)] (h) Any child care center or group child care home may provide 409
child care services to a foster child for a period not to exceed forty-five 410
days without complying with any provision in regulations adopted 411
pursuant to this section relating to immunization and physical 412
examination requirements. Any child care center or group child care 413
home that provides child care services to a foster child at such center or 414
home under this subsection shall maintain a record on file of such foster 415
child for a period of two years after such foster child is no longer 416
receiving child care services at such center or home. For purposes of this 417
subsection, "foster child" means a child who is in the care and custody 418
of the Commissioner of Children and Families and placed in a foster 419
home licensed pursuant to section 17a-114, foster home approved by a 420 Substitute Bill No. 568
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child-placing agency licensed pursuant to section 17a-149, facility 421
licensed pursuant to section 17a-145 or with a relative or fictive kin 422
caregiver pursuant to section 17a-114. 423
Sec. 6. Section 19a-87b of the general statutes is repealed and the 424
following is substituted in lieu thereof (Effective from passage): 425
(a) No person, group of persons, association, organization, 426
corporation, institution or agency, public or private, shall maintain a 427
family child care home, as defined in section 19a-77, without a license 428
issued by the Commissioner of Early Childhood. Licensure forms shall 429
be obtained from the Office of Early Childhood. Applications for 430
licensure shall be made to the commissioner on forms provided by the 431
office and shall contain the information required by regulations adopted 432
under this section. The licensure and application forms shall contain a 433
notice that false statements made therein are punishable in accordance 434
with section 53a-157b. Applicants shall state, in writing, that they are in 435
compliance with the regulations adopted by the commissioner pursuant 436
to subsection (f) of this section. Before a family child care home license 437
is granted, the office shall make an inquiry and investigation which shall 438
include a visit and inspection of the premises for which the license is 439
requested. Any inspection conducted by the office shall include an 440
inspection for evident sources of lead poisoning. The office shall provide 441
for a chemical analysis of any paint chips found on such premises. 442
Neither the commissioner nor the commissioner's designee shall require 443
an annual inspection for homes seeking license renewal or for licensed 444
homes, except that the commissioner or the commissioner's designee 445
shall make an unannounced visit, inspection or investigation of each 446
licensed family child care home at least once every year. A licensed 447
family child care home shall not be subject to any conditions on the 448
operation of such home by local officials, other than those imposed by 449
the office pursuant to this subsection, if the home complies with all local 450
codes and ordinances applicable to single and multifamily dwellings. 451
(b) No person shall act as an assistant or substitute staff member to a 452
person or entity maintaining a family child care home, as defined in 453 Substitute Bill No. 568
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section 19a-77, without an approval issued by the commissioner. Any 454
person seeking to act as an assistant or substitute staff member in a 455
family child care home shall submit an application for such approval to 456
the office. Applications for approval shall: (1) Be made to the 457
commissioner on forms provided by the office, (2) contain the 458
information required by regulations adopted under this section, and (3) 459
be accompanied by a fee of fifteen dollars. The approval application 460
forms shall contain a notice that false statements made in such form are 461
punishable in accordance with section 53a-157b. 462
(c) The commissioner, within available appropriations, shall require 463
each initial applicant or prospective employee of a family child care 464
home in a position requiring the provision of care to a child, including 465
an assistant or substitute staff member and each household member 466
who is sixteen years of age or older, to submit to comprehensive 467
background checks, including state and national criminal history 468
records checks. The criminal history records checks required pursuant 469
to this subsection shall be conducted in accordance with section 29-17a. 470
The commissioner shall also request a check of the state child abuse 471
registry established pursuant to section 17a-101k. The commissioner 472
shall notify each licensee of the provisions of this subsection. For 473
purposes of this subsection, "household member" means any person, 474
other than the person who is licensed to conduct, operate or maintain a 475
family child care home, who resides in the family child care home, such 476
as the licensee's spouse or children, tenants and any other occupant. 477
(d) An application for initial licensure pursuant to this section shall 478
be accompanied by a fee of forty dollars and such license shall be issued 479
for a term of four years. An application for renewal of a license issued 480
pursuant to this section shall be accompanied by a fee of forty dollars 481
and a certification from the licensee that any child enrolled in the family 482
child care home has received age-appropriate immunizations in 483
accordance with regulations adopted pursuant to subsection (f) of this 484
section. A license issued pursuant to this section shall be renewed for a 485
term of four years. In the case of an applicant submitting an application 486 Substitute Bill No. 568
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for renewal of a license that has expired, and who has ceased operations 487
of a family child care home due to such expired license, the 488
commissioner may renew such expired license within thirty days of the 489
date of such expiration upon receipt of an application for renewal that 490
is accompanied by such fee and such certification. 491
(e) An application for initial staff approval or renewal of staff 492
approval shall be accompanied by a fee of fifteen dollars. Such 493
approvals shall be issued or renewed for a term of two years. 494
(f) The commissioner shall adopt regulations, in accordance with the 495
provisions of chapter 54, to assure that family child care homes, as 496
defined in section 19a-77, meet the health, educational and social needs 497
of children utilizing such homes. Such regulations shall ensure that the 498
family child care home is treated as a residence, and not an institutional 499
facility. Such regulations shall specify that each child be protected as 500
age-appropriate by adequate immunization against diphtheria, 501
pertussis, tetanus, poliomyelitis, measles, mumps, rubella, 502
[hemophilus] haemophilus influenzae type B and any other vaccine 503
required by the schedule of active immunization adopted pursuant to 504
section 19a-7f. [Such regulations shall provide appropriate exemptions 505
for children for whom such immunization is medically contraindicated 506
and for children whose parents or guardian objects to such 507
immunization on religious grounds and require that any such objection 508
be accompanied by a statement from such parents or guardian that such 509
immunization would be contrary to the religious beliefs of such child or 510
the parents or guardian of such child, which statement shall be 511
acknowledged, in accordance with the provisions of sections 1-32, 1-34 512
and 1-35, by (1) a judge of a court of record or a family support 513
magistrate, (2) a clerk or deputy clerk of a court having a seal, (3) a town 514
clerk, (4) a notary public, (5) a justice of the peace, or (6) an attorney 515
admitted to the bar of this state.] Such regulations shall also specify 516
conditions under which family child care home providers may 517
administer tests to monitor glucose levels in a child with diagnosed 518
diabetes mellitus, and administer medicinal preparations, including 519 Substitute Bill No. 568
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controlled drugs specified in the regulations by the commissioner, to a 520
child receiving child care services at a family child care home pursuant 521
to a written order of a physician licensed to practice medicine in this or 522
another state, an advanced practice registered nurse licensed to 523
prescribe in accordance with section 20-94a or a physician assistant 524
licensed to prescribe in accordance with section 20-12d, and the written 525
authorization of a parent or guardian of such child. Such regulations 526
shall specify appropriate standards for extended care and intermittent 527
short-term overnight care. The commissioner shall inform each licensee, 528
by way of a plain language summary provided not later than sixty days 529
after the regulation's effective date, of any new or changed regulations 530
adopted under this subsection with which a licensee must comply. 531
(g) Any child who (1) presents a certificate, in a form prescribed by 532
the Commissioner of Public Health pursuant to section 7 of this act, 533
signed by a physician, a physician assistant or an advanced practice 534
registered nurse stating that, in the opinion of such physician, physician 535
assistant or advanced practice registered nurse, the immunizations 536
required pursuant to regulations adopted pursuant to subsection (f) of 537
this section are medically contraindicated, (2) in the case of a child who 538
is enrolled in seventh grade through twelfth grade, presented a 539
statement, prior to the effective date of this section, that such 540
immunizations are contrary to the religious beliefs of such child or the 541
parents or guardian of such child, or (3) in the case of a child who is 542
enrolled in sixth grade or below, (A) presented a statement, prior to the 543
effective date of this section, that such immunizations are contrary to 544
the religious beliefs of such child or the parents or guardian of such 545
child, and (B) presents a written declaration, in a form prescribed by the 546
Commissioner of Public Health, from a physician, physician assistant or 547
advanced practice registered nurse stating that an immunization against 548
diphtheria, pertussis, tetanus, poliomyelitis, measles, mumps, rubella, 549
haemophilus influenzae type B and any other vaccine required by the 550
schedule of active immunization adopted pursuant to section 19a-7f has 551
been given to such child and that any additional necessary 552
immunizations of such student against diphtheria, pertussis, tetanus, 553 Substitute Bill No. 568
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poliomyelitis, measles, mumps, rubella, haemophilus influenzae type B 554
and any other vaccine required by such schedule of active immunization 555
are in process under guidelines specified by the Commissioner of Public 556
Health or as recommended for the child by the physician, physician 557
assistant or advanced practice registered nurse, shall be exempt from 558
the immunization requirements set forth in such regulations. The 559
statement described in subparagraph (A) of subdivision (3) of this 560
subsection shall be acknowledged, in accordance with the provisions of 561
sections 1-32, 1-34 and 1-35, by (i) a judge of a court of record or a family 562
support magistrate, (ii) a clerk or deputy clerk of a court having a seal, 563
(iii) a town clerk, (iv) a notary public, (v) a justice of the peace, or (vi) an 564
attorney admitted to the bar of this state. 565
(h) Any child who is enrolled in sixth grade or below on or before the 566
effective date of this section who presented, prior to the effective date of 567
this section, the statement described in subparagraph (A) of subdivision 568
(3) of subsection (g) of this section, but did not present the written 569
declaration described in subparagraph (B) of subdivision (3) of 570
subsection (g) of this section shall comply, on or before September 1, 571
2022, or not later than fourteen days after applying to enroll in the family 572
child care home, whichever is later, with the immunization 573
requirements set forth in the regulations adopted pursuant to subsection 574
(f) of this section. 575
[(g)] (i) Upon the declaration by the Governor of a civil preparedness 576
emergency pursuant to section 28-9 or a public health emergency 577
pursuant to section 19a-131a, the commissioner may waive the 578
provisions of any regulation adopted pursuant to this section if the 579
commissioner determines that such waiver would not endanger the life, 580
safety or health of any child. The commissioner shall prescribe the 581
duration of such waiver, provided such waiver shall not extend beyond 582
the duration of the declared emergency. The commissioner shall 583
establish the criteria by which a waiver request shall be made and the 584
conditions for which a waiver will be granted or denied. The provisions 585
of section 19a-84 shall not apply to a denial of a waiver request under 586 Substitute Bill No. 568
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this subsection. 587
[(h)] (j) Any family child care home may provide child care services 588
to homeless children and youths, as defined in 42 USC 11434a, as 589
amended from time to time, for a period not to exceed ninety days 590
without complying with any provision in regulations adopted pursuant 591
to this section relating to immunization and physical examination 592
requirements. Any family child care home that provides child care 593
services to homeless children and youths at such home under this 594
subsection shall maintain a record on file of all homeless children and 595
youths who have attended such home for a period of two years after 596
such homeless children or youths are no longer receiving child care 597
services at such home. 598
[(i)] (k) Any family child care home may provide child care services 599
to a foster child for a period not to exceed forty-five days without 600
complying with any provision in regulations adopted pursuant to this 601
section relating to immunization and physi cal examination 602
requirements. Any family child care home that provides child care 603
services to a foster child at such home under this subsection shall 604
maintain a record on file of such foster child for a period of two years 605
after such foster child is no longer receiving child care services at such 606
home. For purposes of this subsection, "foster child" means a child who 607
is in the care and custody of the Commissioner of Children and Families 608
and placed in a foster home licensed pursuant to section 17a-114, foster 609
home approved by a child-placing agency licensed pursuant to section 610
17a-149, facility licensed pursuant to section 17a-145 or with a relative 611
or fictive kin caregiver pursuant to section 17a-114. 612
Sec. 7. (NEW) (Effective from passage) On or before October 1, 2021, the 613
Commissioner of Public Health shall develop and make available on the 614
Internet web site of the Department of Public Health a certificate for use 615
by a physician, physician assistant or advanced practice registered 616
nurse stating that, in the opinion of such physician, physician assistant 617
or advanced practice registered nurse, a vaccination required by the 618
general statutes is medically contraindicated for a person because of the 619 Substitute Bill No. 568
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physical condition of such person. The certificate shall include (1) 620
definitions of the terms "contraindication" and "precaution"; (2) a list of 621
contraindications and precautions recognized by the National Centers 622
for Disease Control and Prevention for each of the statutorily required 623
vaccinations, from which the physician, physician assistant or advanced 624
practice registered nurse may select the relevant contraindication or 625
precaution on behalf of such person; (3) a section in which the physician, 626
physician assistant or advanced practice registered nurse may record a 627
contraindication or precaution that is not recognized by the National 628
Centers for Disease Control and Prevention, but in his or her discretion, 629
results in the vaccination being medically contraindicated, including, 630
but not limited to, any autoimmune disorder, family history of any 631
autoimmune disorder, family history of any reaction to a vaccination, 632
genetic predisposition to any reaction to a vaccination as determined 633
through genetic testing and a previous documented reaction of a person 634
that is correlated to a vaccination; (4) a section in which the physician, 635
physician assistant or advanced practice registered nurse may include a 636
written explanation for the exemption from any statutorily required 637
vaccinations; (5) a section requiring the signature of the physician, 638
physician assistant or advanced practice registered nurse; (6) a 639
requirement that the physician, physician assistant or advanced practice 640
registered nurse attach such person's most current immunization 641
record; and (7) a synopsis of the grounds for any order of quarantine or 642
isolation pursuant to section 19a-131b of the general statutes. 643
Sec. 8. (NEW) (Effective from passage) (a) There is established an 644
Advisory Committee on Medically Contraindicated Vaccinations within 645
the Department of Public Health for the purpose of advising the 646
Commissioner of Public Health on issues concerning exemptions from 647
state or federal requirements for vaccinations that result from a 648
physician, physician assistant or advanced practice registered nurse 649
stating that a vaccination is medically contraindicated for a person due 650
to the medical condition of such person. Said advisory committee shall 651
not be responsible for confirming or denying any determination by a 652
physician, physician assistant or advanced practice registered nurse that 653 Substitute Bill No. 568
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a vaccination is medically contraindicated for a specific individual. In 654
order to carry out its duties, the advisory committee shall (1) have access 655
to the childhood immunization registry established by the department 656
pursuant to section 19a-7h of the general statutes; (2) evaluate the 657
process used by the department in collecting data concerning 658
exemptions resulting from a vaccination being medically 659
contraindicated and whether the department should have any oversight 660
over such exemptions; (3) examine whether enrollment of an 661
unvaccinated child into a program operated by a public or nonpublic 662
school, institution of higher education, child care center or group child 663
care home should be conditioned upon the child meeting certain 664
criteria; (4) calculate the ratio of school nurses to students in each public 665
and nonpublic school in the state and the funding issues surrounding 666
such ratio; (5) assess whether immunizations should be required more 667
frequently than prior to enrollment into a program operated by a public 668
or nonpublic school and prior to entering seventh grade; and (6) 669
determine whether (A) there are any discrepancies in the issuance of 670
certificates stating that a vaccine is medically contraindicated, and (B) to 671
recommend continuing education of physicians, physician assistants or 672
advanced practice registered nurses in vaccine contraindications and 673
precautions. All information obtained by the advisory committee from 674
such registry shall be confidential pursuant to section 19a-25 of the 675
general statutes, as amended by this act. 676
(b) The advisory committee shall consist of the following members: 677
(1) Two appointed by the speaker of the House of Representatives, 678
one of whom shall be a physician licensed pursuant to chapter 370 of the 679
general statutes who is a pediatrician, and one of whom shall be a 680
member of the public; 681
(2) Two appointed by the president pro tempore of the Senate, one of 682
whom shall be a physician licensed pursuant to chapter 370 of the 683
general statutes who has expertise in the efficacy of vaccines, and one of 684
whom shall be a member of the public; 685 Substitute Bill No. 568
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(3) One appointed by the majority leader of the House of 686
Representatives, who shall be a school nurse; 687
(4) One appointed by the majority leader of the Senate, who shall be 688
a physician assistant licensed pursuant to chapter 370 of the general 689
statutes who has experience in the administration of vaccines; 690
(5) One appointed by the minority leader of the House of 691
Representatives, who shall be an advanced practice registered nurse 692
licensed pursuant to chapter 378 of the general statutes who has 693
experience in the administration of vaccines; 694
(6) One appointed by the minority leader of the Senate, who shall be 695
a representative of the Connecticut Chapter of the American Academy 696
of Pediatrics; 697
(7) The Commissioner of Public Health, or the commissioner's 698
designee; 699
(8) The Commissioner of Education, or the commissioner's designee; 700
and 701
(9) The Commissioner of Early Childhood, or the commissioner's 702
designee. 703
(c) The members of the advisory committee shall elect a chairperson 704
of the advisory committee from among its members. Such chairperson 705
shall schedule the first meeting of the advisory committee, which shall 706
be held not later than October 1, 2021. The advisory committee shall 707
meet not less than biannually. On or before January 1, 2022, and 708
annually thereafter, the committee shall report, in accordance with the 709
provisions of section 11-4a of the general statutes, on its activities and 710
findings to the joint standing committee of the General Assembly 711
having cognizance of matters relating to public health. 712
Sec. 9. (NEW) (Effective from passage) The Department of Public 713
Health, in collaboration with the state Department of Education and the 714 Substitute Bill No. 568
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Office of Early Childhood, shall evaluate all of the data collected by said 715
departments concerning exemptions from immunization requirements. 716
Not later than January 1, 2022, and annually thereafter, the 717
Commissioners of Public Health, Education and Early Childhood shall 718
jointly report, in accordance with the provisions of section 11-4a of the 719
general statutes, to the joint standing committees of the General 720
Assembly having cognizance of matters relating to public health and 721
education regarding the evaluation of such data. 722
Sec. 10. Subsection (a) of section 38a-492r of the general statutes is 723
repealed and the following is substituted in lieu thereof (Effective January 724
1, 2022): 725
(a) Each individual health insurance policy providing coverage of the 726
type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 727
delivered, issued for delivery, renewed, amended or continued in this 728
state that provides coverage for prescription drugs shall provide 729
[coverage for] (1) coverage for immunizations recommended by the 730
American Academy of Pediatrics, American Academy of Family 731
Physicians and the American College of Obstetrician s and 732
Gynecologists, and (2) with respect to immunizations that have in effect 733
a recommendation from the Advisory Committee on Immunization 734
Practices of the Centers for Disease Control and Prevention with respect 735
to the individual involved, coverage for such immunizations and at least 736
a twenty-minute consultation between such individual and a health care 737
provider authorized to administer such immunizations to such 738
individual. 739
Sec. 11. Subsection (a) of section 38a-518r of the general statutes is 740
repealed and the following is substituted in lieu thereof (Effective January 741
1, 2022): 742
(a) Each group health insurance policy providing coverage of the type 743
specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 744
delivered, issued for delivery, renewed, amended or continued in this 745
state that provides coverage for prescription drugs shall provide 746 Substitute Bill No. 568
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[coverage for] (1) coverage for immunizations recommended by the 747
American Academy of Pediatrics, American Academy of Family 748
Physicians and the American C ollege of Obstetricians and 749
Gynecologists, and (2) with respect to immunizations that have in effect 750
a recommendation from the Advisory Committee on Immunization 751
Practices of the Centers for Disease Control and Prevention with respect 752
to the individual involved, coverage for such immunizations and at least 753
a twenty-minute consultation between such individual and a health care 754
provider authorized to administer such immunizations to such 755
individual. 756
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)
Statement of Legislative Commissioners:
In Sections 1(b), 1(c), 1(d), 5(b) and 6(g), references to "guardians" were
changed to "guardian" for consistency, in Section 3(b), "subdivision (2)
or (3)" was changed to "subdivision (2) [or (3)]" for accuracy and in
Sections 10 and 11, "prescribe" was changed to "administer" for clarity.
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