Connecticut 2021 Regular Session

Connecticut Senate Bill SB00568 Compare Versions

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Version 2 (New)

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7		-	General Assembly Substitute Bill No. 568
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	6	+	General Assembly Committee Bill No. 568
8	7		January Session, 2021
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	11	+	Referred to Committee on PUBLIC HEALTH
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	13	+
	14	+	Introduced by:
	15	+	(PH)
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12	19		AN ACT ELIMINATING THE NONMEDICAL EXEMPT ION TO THE
13	20		IMMUNIZATION REQUIREMENT.
14	21		Be it enacted by the Senate and House of Representatives in General
15	22		Assembly convened:
16	23
17	24		Section 1. Section 10-204a of the general statutes is repealed and the 1
18	25		following is substituted in lieu thereof (Effective from passage): 2
19	26		(a) Each local or regional board of education, or similar body 3
20	27		governing a nonpublic school or schools, shall require each child to be 4
21	28		protected by adequate immunization against diphtheria, pertussis, 5
22	29		tetanus, poliomyelitis, measles, mumps, rubella, [hemophilus] 6
23	30		haemophilus influenzae type B and any other vaccine required by the 7
24	31		schedule for active immunization adopted pursuant to section 19a-7f 8
25	32		before being permitted to enroll in any program operated by a public or 9
26	33		nonpublic school under its jurisdiction. Before being permitted to enter 10
27	34		seventh grade, a child shall receive a second immunization against 11
28	35		measles. Any such child who (1) presents a certificate from a physician, 12
29	36		physician assistant, advanced practice registered nurse or local health 13
30	37		agency stating that initial immunizations have been given to such child 14
31	38		and additional immunizations are in process (A) under guidelines and 15
32	39		schedules specified by the Commissioner of Public Health, or (B) in the 16
	40	+	Committee Bill No. 568
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33	45		case of a child enrolled in sixth grade or below who, prior to the effective 17
34	46		date of this section, was exempt from the appropriate provisions of this 18
35		-	section upon presentation of a statement that such immunizations 19 Substitute Bill No. 568
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	47	+	section upon presentation of a statement that such immunizations 19
42	48		would be contrary to the religious beliefs of such child or the parents or 20
43	49		guardian of such child, as such additional immunizations are 21
44	50		recommended, in a written declaration, in a form prescribed by the 22
45	51		Commissioner of Public Health, for such child by a physician, a 23
46	52		physician assistant or an advanced practice registered nurse; or (2) 24
47	53		presents a certificate, in a form prescribed by the commissioner 25
48	54		pursuant to section 7 of this act, from a physician, physician assistant or 26
49	55		advanced practice registered nurse stating that in the opinion of such 27
50	56		physician, physician assistant or advanced practice registered nurse 28
51	57		such immunization is medically contraindicated because of the physical 29
52	58		condition of such child; [or (3) presents a statement from the parents or 30
53	59		guardian of such child that such immunization would be contrary to the 31
54	60		religious beliefs of such child or the parents or guardian of such child, 32
55	61		which statement shall be acknowledged, in accordance with the 33
56	62		provisions of sections 1-32, 1-34 and 1-35, by (A) a judge of a court of 34
57	63		record or a family support magistrate, (B) a clerk or deputy clerk of a 35
58	64		court having a seal, (C) a town clerk, (D) a notary public, (E) a justice of 36
59	65		the peace, (F) an attorney admitted to the bar of this state, or (G) 37
60	66		notwithstanding any provision of chapter 6, a school nurse;] or [(4)] (3) 38
61	67		in the case of measles, mumps or rubella, presents a certificate from a 39
62	68		physician, physician assistant or advanced practice registered nurse or 40
63	69		from the director of health in such child's present or previous town of 41
64	70		residence, stating that the child has had a confirmed case of such 42
65	71		disease; or [(5)] (4) in the case of [hemophilus] haemophilus influenzae 43
66	72		type B has passed [his] such child's fifth birthday; or [(6)] (5) in the case 44
67	73		of pertussis, has passed [his] such child's sixth birthday, shall be exempt 45
68	74		from the appropriate provisions of this section. [If the parents or 46
69	75		guardians of any child are unable to pay for such immunizations, the 47
70	76		expense of such immunizations shall, on the recommendations of such 48
71	77		board of education, be paid by the town. Before being permitted to enter 49
72	78		seventh grade, the parents or guardian of any child who is exempt on 50
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73	84		religious grounds from the immunization requirements of this section, 51
74	85		pursuant to subdivision (3) of this subsection, shall present to such 52
75	86		school a statement that such immunization requirements are contrary to 53
76		-	the religious beliefs of such child or the parents or guardian of such 54 Substitute Bill No. 568
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	87	+	the religious beliefs of such child or the parents or guardian of such 54
83	88		child, which statement shall be acknowledged, in accordance with the 55
84	89		provisions of sections 1-32, 1-34 and 1-35, by (A) a judge of a court of 56
85	90		record or a family support magistrate, (B) a clerk or deputy clerk of a 57
86	91		court having a seal, (C) a town clerk, (D) a notary public, (E) a justice of 58
87	92		the peace, (F) an attorney admitted to the bar of this state, or (G) 59
88	93		notwithstanding any provision of chapter 6, a school nurse.] The 60
89	94		statement described in subparagraph (B) of subdivision (1) of this 61
90	95		subsection shall be acknowledged, in accordance with the provisions of 62
91	96		sections 1-32, 1-34 and 1-35, by a judge of a court of record or a family 63
92	97		support magistrate, a clerk or deputy clerk of a court having a seal, a 64
93	98		town clerk, a notary public, a justice of the peace, an attorney admitted 65
94		-	to the bar of this state, or, notwithstanding any provision of chapter 6, a 66
	99	+	to the bar of this state, or notwithstanding any provision of chapter 6, a 66
95	100		school nurse. 67
96	101		(b) The immunization requirements provided for in subsection (a) of 68
97	102		this section shall not apply to any child who is enrolled in seventh grade 69
98	103		through twelfth grade on or before the effective date of this section if 70
99	104		such child presented a statement, prior to the effective date of this 71
100		-	section, from the parents or ~~guardian~~ of such child that such 72
	105	+	section, from the parents or guardians of such child that such 72
101	106		immunization is contrary to the religious beliefs of such child or the 73
102	107		parents or guardian of such child, and such statement was 74
103	108		acknowledged, in accordance with the provisions of sections 1-32, 1-34 75
104	109		and 1-35, by (1) a judge of a court of record or a family support 76
105	110		magistrate, (2) a clerk or deputy clerk of a court having a seal, (3) a town 77
106	111		clerk, (4) a notary public, (5) a justice of the peace, (6) an attorney 78
107	112		admitted to the bar of this state, or (7) notwithstanding any provision of 79
108	113		chapter 6, a school nurse. 80
109	114		(c) Any child who is enrolled in sixth grade or below prior to the 81
110	115		effective date of this section who presented a statement, prior to the 82
111		-	effective date of this section, from the parents or guardian of such child 83
	116	+	effective date of this section, from the parents or guardians of such child 83
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112	122		that the immunization is contrary to the religious beliefs of such child 84
113	123		or the parents or guardian of such child, which statement was 85
114	124		acknowledged, in accordance with the provisions of sections 1-32, 1-34 86
115		-	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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	125	+	and 1-35, by (1) a judge of a court of record or a family support 87
122	126		magistrate, (2) a clerk or deputy clerk of a court having a seal, (3) a town 88
123	127		clerk, (4) a notary public, (5) a justice of the peace, (6) an attorney 89
124	128		admitted to the bar of this state, or (7) notwithstanding any provision of 90
125	129		chapter 6, a school nurse, but did not present a written declaration from 91
126	130		a physician, a physician assistant or an advanced practice registered 92
127	131		nurse stating that additional immunizations are in process as 93
128	132		recommended by such physician, physician assistant or advanced 94
129	133		practice registered nurse, rather than as recommended under guidelines 95
130	134		and schedules specified by the Commissioner of Public Health, shall 96
131	135		comply with the immunization requirements provided for in 97
132	136		subparagraph (A) of subdivision (1) of subsection (a) of this section on 98
133	137		or before September 1, 2022, or not later than fourteen days after 99
134	138		transferring to a program operated by a public or nonpublic school 100
135	139		under the jurisdiction of a local or regional board of education or similar 101
136	140		body governing a nonpublic school or schools, whichever is later. 102
137		-	(d) If the parents or ~~guardian~~ of any child are unable to pay for any 103
	141	+	(d) If the parents or guardians of any child are unable to pay for any 103
138	142		immunization required by subsection (a) of this section, the expense of 104
139	143		such immunization shall, on the recommendation of such child's local 105
140	144		or regional board of education, or similar body governing a nonpublic 106
141	145		school or schools, be paid by the town. 107
142	146		[(b)] (e) The definitions of adequate immunization shall reflect the 108
143	147		schedule for active immunization adopted pursuant to section 19a-7f 109
144	148		and be established by regulation adopted in accordance with the 110
145	149		provisions of chapter 54 by the Commissioner of Public Health, who 111
146	150		shall also be responsible for providing procedures under which [said] 112
147	151		such boards and [said] such similar governing bodies shall collect and 113
148	152		report immunization data on each child to the Department of Public 114
149	153		Health for (1) compilation and analysis by [said] the department, and 115
150	154		(2) release by the department of annual immunization rates for each 116
	155	+	Committee Bill No. 568
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151	160		public and nonpublic school in the state, provided such immunization 117
152	161		data may not contain information that identifies a specific individual. 118
153	162		[(c)] (f) The Commissioner of Public Health may issue a temporary 119
154		-	waiver to the schedule for active immunization for any vaccine if the 120 Substitute Bill No. 568
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	163	+	waiver to the schedule for active immunization for any vaccine if the 120
161	164		National Centers for Disease Control and Prevention recognizes a 121
162	165		nation-wide shortage of supply for such vaccine. 122
163	166		Sec. 2. Section 19a-25 of the general statutes is repealed and the 123
164	167		following is substituted in lieu thereof (Effective from passage): 124
165	168		(a) All information, records of interviews, written reports, statements, 125
166	169		notes, memoranda or other data, including personal data as defined in 126
167	170		subdivision (9) of section 4-190, procured by: [the] (1) The Department 127
168	171		of Public Health, by staff committees of facilities accredited by the 128
169	172		Department of Public Health or the maternity mortality review 129
170	173		committee, established pursuant to section 19a-59i, in connection with 130
171	174		studies of morbidity and mortality conducted by the Department of 131
172	175		Public Health, such staff committees or the maternal mortality review 132
173	176		committee, or carried on by said department, such staff committees or 133
174	177		the maternal mortality review committee jointly with other persons, 134
175	178		agencies or organizations, [or procured by] (2) the directors of health of 135
176	179		towns, cities or boroughs or the Department of Public Health pursuant 136
177	180		to section 19a-215, or [procured by] (3) such other persons, agencies or 137
178	181		organizations, for the purpose of reducing the morbidity or mortality 138
179	182		from any cause or condition, shall be confidential and shall be used 139
180	183		solely for the purposes of medical or scientific research and, for 140
181	184		information obtained pursuant to section 19a-215, disease prevention 141
182	185		and control by the local director of health and the Department of Public 142
183	186		Health. Such information, records, reports, statements, notes, 143
184	187		memoranda or other data shall not be admissible as evidence in any 144
185	188		action of any kind in any court or before any other tribunal, board, 145
186	189		agency or person, nor shall it be exhibited or its contents disclosed in 146
187	190		any way, in whole or in part, by any officer or representative of the 147
188	191		Department of Public Health or of any such facility, by any person 148
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189	197		participating in such a research project or by any other person, except 149
190	198		as may be necessary for the purpose of furthering the research project to 150
191	199		which it relates. 151
192	200		(b) Notwithstanding the provisions of chapter 55, the Department of 152
193		-	Public Health may exchange personal data for the purpose of medical 153 Substitute Bill No. 568
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	201	+	Public Health may exchange personal data for the purpose of medical 153
200	202		or scientific research, with any other governmental agency or private 154
201	203		research organization; provided such state, governmental agency or 155
202	204		private research organization shall not further disclose such personal 156
203	205		data. The Commissioner of Public Health shall adopt regulations, in 157
204	206		accordance with the provisions of chapter 54, consistent with the 158
205	207		purposes of this section to establish the procedures to ensure the 159
206	208		confidentiality of such disclosures. The furnishing of such information 160
207	209		to the Department of Public Health or its authorized representative, or 161
208	210		to any other agency cooperating in such a research project, shall not 162
209	211		subject any person, hospital, [sanitarium] behavioral health facility, rest 163
210	212		home, nursing home or other person or agency furnishing such 164
211	213		information to any action for damages or other relief because of such 165
212	214		disclosure. [This section shall not be deemed to affect disclosure.] 166
213	215		(c) The provisions of this section shall not affect: (1) Disclosure of 167
214	216		regular hospital and medical records made in the course of the regular 168
215	217		notation of the care and treatment of any patient, but only records or 169
216	218		notations by [such] the staff committees described in subsection (a) of 170
217	219		this section pursuant to their work, or (2) release by the Department of 171
218	220		Public Health of annual immunization rates for each public and 172
219	221		nonpublic school in the state pursuant to section 10-204a, as amended 173
220	222		by this act. 174
221	223		Sec. 3. Section 10a-155 of the general statutes is repealed and the 175
222	224		following is substituted in lieu thereof (Effective from passage): 176
223	225		(a) Each institution of higher education shall require each full-time or 177
224	226		matriculating student born after December 31, 1956, to provide proof of 178
225	227		adequate immunization against measles, rubella, [and on and after 179
226	228		August 1, 2010, to provide proof of adequate immunization against] 180
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227	234		mumps and varicella as recommended by the national Advisory 181
228	235		Committee for Immunization Practices before permitting such student 182
229	236		to enroll in such institution. [Any such] 183
230	237		(b) Notwithstanding the provisions of subsection (a) of this section, 184
231		-	any student who (1) presents a certificate, in a form prescribed by the 185 Substitute Bill No. 568
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	238	+	any student who (1) presents a certificate, in a form prescribed by the 185
238	239		Commissioner of Public Health pursuant to section 7 of this act, from a 186
239	240		physician, a physician assistant or an advanced practice registered nurse 187
240	241		stating that in the opinion of such physician, physician assistant or 188
241	242		advanced practice registered nurse such immunization is medically 189
242	243		contraindicated, (2) [provides] prior to the effective date of this section, 190
243	244		provided a statement that such immunization [would be] is contrary to 191
244	245		his or her religious beliefs, (3) presents a certificate from a physician, a 192
245	246		physician assistant, an advanced practice registered nurse or the 193
246	247		director of health in the student's present or previous town of residence, 194
247	248		stating that the student has had a confirmed case of such disease, (4) is 195
248	249		enrolled exclusively in a program for which students do not congregate 196
249	250		on campus for classes or to participate in institutional-sponsored events, 197
250	251		such as students enrolled in distance learning programs for 198
251	252		individualized home study or programs conducted entirely through 199
252	253		electronic media in a setting without other students present, or (5) 200
253	254		graduated from a public or nonpublic high school in this state in 1999 or 201
254	255		later and was not exempt from the measles, rubella and [on and after 202
255	256		August 1, 2010, the] mumps vaccination requirement pursuant to 203
256		-	subdivision (2) [or (3)] of subsection (a) of section 10-204a, as amended 204
257		-	by this act, shall be exempt from the appropriate provisions of this 205
258		-	section. 206
259		-	[(b)] (c) Each institution of higher education shall keep uniform 207
260		-	records of the immunizations and immunization status of each student, 208
261		-	based on the certificate of immunization or other evidence acceptable 209
262		-	pursuant to subsection [(a)] (b) of this section. The record shall be part 210
263		-	of the student's permanent record. By November first of each year, the 211
264		-	chief administrative officer of each institution of higher education shall 212
265		-	cause to be submitted to the Commissioner of Public Health, on a form 213
266		-	provided by the commissioner, a summary report of the immunization 214
267		-	status of all students enrolling in such institution. 215
268		-	Sec. 4. Subsection (a) of section 10a-155b of the general statutes is 216
269		-	repealed and the following is substituted in lieu thereof (Effective from 217
270		-	passage): 218 Substitute Bill No. 568
	257	+	subdivision (2) or (3) of subsection (a) of section 10-204a, as amended by 204
	258	+	this act, shall be exempt from the appropriate provisions of this section. 205
	259	+	[(b)] (c) Each institution of higher education shall keep uniform 206
	260	+	records of the immunizations and immunization status of each student, 207
	261	+	based on the certificate of immunization or other evidence acceptable 208
	262	+	pursuant to subsection [(a)] (b) of this section. The record shall be part 209
	263	+	of the student's permanent record. By November first of each year, the 210
	264	+	chief administrative officer of each institution of higher education shall 211
	265	+	cause to be submitted to the Commissioner of Public Health, on a form 212
	266	+	provided by the commissioner, a summary report of the immunization 213
	267	+	Committee Bill No. 568
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277		-	~~(a) For~~ students ~~who first enroll~~ in ~~the 2014-2015~~ ~~school year, and first 219~~
278		-	~~enroll in each school year thereafter,~~ ~~each public or private college or 220~~
279		-	~~university~~ in ~~this state shall require that each student who resides in on-221~~
280		-	~~campus housing be vaccinated against meningitis and submit evidence 222~~
281		-	~~of having received a meningococcal conjugate vaccine not more than 223~~
282		-	~~five years before enrollment as a condition of such residence.~~ ~~The 224~~
283		-	~~provisions of~~ this ~~subsection~~ shall ~~not apply to any such~~ student who ~~(1) 225~~
284		-	~~presents a certificate,~~ ~~in a form prescribed by the Commissioner of 226~~
285		-	~~Public Health pursuant to section 7~~ of ~~this act, from~~ a ~~physician, an 227~~
286		-	~~advanced practice registered nurse or~~ a ~~physician assistant stating that,~~ ~~228~~
287		-	~~in the opinion~~ of such ~~physician, advanced practice registered nurse or 229~~
288		-	~~physician assistant~~, ~~such vaccination is medically contraindicated 230~~
289		-	~~because~~ of ~~the physical condition of such student~~, ~~or (2) [presents] prior 231~~
290		-	~~to the effective date of this section, presented~~ a ~~statement~~ that ~~such 232~~
291		-	~~vaccination [would be] is contrary to~~ the ~~religious beliefs~~ of such ~~233~~
292		-	~~student. 234~~
293		-	~~Sec. 5. Section 19a-79~~ of the ~~general statutes is repealed and the 235~~
294		-	~~following is substituted in lieu thereof (~~Effective ~~from passage): 236~~
295		-	~~(a)~~ The ~~Commissioner~~ of ~~Early Childhood shall adopt regulations, in 237~~
296		-	~~accordance with the provisions of chapter 54, to carry out the purposes 238~~
297		-	~~of sections~~ 19a-~~77 to 19a-80, inclusive,~~ and ~~19a-82 to 19a-87, inclusive, 239~~
298		-	~~and to assure that child care centers and group child care homes meet 240~~
299		-	the ~~health, educational and social needs~~ of ~~children utilizing such child 241~~
300		-	~~care centers and group child care homes.~~ ~~Such regulations shall (1) 242~~
301		-	~~specify that before being permitted~~ to ~~attend any child care center or 243~~
302		-	group child care ~~home, each child shall be protected as age-appropriate 244~~
303		-	~~by adequate immunization against diphtheria~~, ~~pertussis, tetanus,~~ ~~245~~
304		-	~~poliomyelitis, measles,~~ ~~mumps, rubella,~~ ~~[hemophilus] haemophilus 246~~
305		-	~~influenzae type B and~~ any ~~other vaccine required by the schedule of 247~~
306		-	~~active immunization adopted pursuant to section 19a-7f~~, ~~[including 248~~
307		-	~~appropriate exemptions for children for whom such~~ immunization ~~is 249~~
308		-	~~medically contraindicated and for children whose parent or guardian 250~~
309		-	~~objects to such immunization on religious grounds, and that any 251 Substitute~~ Bill No. 568
	272	+	status of all students enrolling in such institution. 214
	273	+	Sec. 4. Subsection (a) of section 10a-155b of the general statutes is 215
	274	+	repealed and the following is substituted in lieu thereof (Effective from 216
	275	+	passage): 217
	276	+	(a) For students who first enroll in the 2014-2015 school year, and first 218
	277	+	enroll in each school year thereafter, each public or private college or 219
	278	+	university in this state shall require that each student who resides in on-220
	279	+	campus housing be vaccinated against meningitis and submit evidence 221
	280	+	of having received a meningococcal conjugate vaccine not more than 222
	281	+	five years before enrollment as a condition of such residence. The 223
	282	+	provisions of this subsection shall not apply to any such student who (1) 224
	283	+	presents a certificate, in a form prescribed by the Commissioner of 225
	284	+	Public Health pursuant to section 7 of this act, from a physician, an 226
	285	+	advanced practice registered nurse or a physician assistant stating that, 227
	286	+	in the opinion of such physician, advanced practice registered nurse or 228
	287	+	physician assistant, such vaccination is medically contraindicated 229
	288	+	because of the physical condition of such student, or (2) [presents] prior 230
	289	+	to the effective date of this section, presented a statement that such 231
	290	+	vaccination [would be] is contrary to the religious beliefs of such 232
	291	+	student. 233
	292	+	Sec. 5. Section 19a-79 of the general statutes is repealed and the 234
	293	+	following is substituted in lieu thereof (Effective from passage): 235
	294	+	(a) The Commissioner of Early Childhood shall adopt regulations, in 236
	295	+	accordance with the provisions of chapter 54, to carry out the purposes 237
	296	+	of sections 19a-77 to 19a-80, inclusive, and 19a-82 to 19a-87, inclusive, 238
	297	+	and to assure that child care centers and group child care homes meet 239
	298	+	the health, educational and social needs of children utilizing such child 240
	299	+	care centers and group child care homes. Such regulations shall (1) 241
	300	+	specify that before being permitted to attend any child care center or 242
	301	+	group child care home, each child shall be protected as age-appropriate 243
	302	+	by adequate immunization against diphtheria, pertussis, tetanus, 244
	303	+	poliomyelitis, measles, mumps, rubella, [hemophilus] haemophilus 245
	304	+	Committee Bill No. 568
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315	308
316		-	~~objection~~ by ~~a parent or a guardian to immunization~~ of ~~a child on 252~~
317		-	~~religious grounds shall be accompanied by a statement from such parent 253~~
318		-	~~or guardian that~~ such immunization ~~would be contrary to the religious 254~~
319		-	~~beliefs of such child or the~~ parent or guardian ~~of such child, which 255~~
320		-	~~statement shall be acknowledged~~, ~~in accordance with the provisions of 256~~
321		-	~~sections 1-32, 1-34 and 1-35,~~ by (A) a ~~judge~~ of a ~~court of record or a family 257~~
322		-	~~support magistrate,~~ ~~(B)~~ a ~~clerk or deputy clerk of a court having a seal, 258~~
323		-	~~(C) a town clerk,~~ ~~(D) a notary public,~~ ~~(E) a justice of~~ the ~~peace, or (F) an 259~~
324		-	~~attorney admitted to~~ the ~~bar~~ of ~~this state~~,~~] (2) specify conditions under 260~~
325		-	~~which child care center directors and teachers and group child care 261~~
326		-	~~home providers may administer tests to monitor glucose levels in~~ a ~~child 262~~
327		-	~~with diagnosed diabetes mellitus~~, ~~and administer medicinal 263~~
328		-	~~preparations~~, ~~including controlled drugs specified in~~ the ~~regulations by 264~~
329		-	~~the commissioner,~~ to ~~a child receiving child care services at such child 265~~
330		-	care center or group child care ~~home pursuant to the written order of a 266~~
331		-	~~physician licensed~~ to ~~practice medicine or~~ a ~~dentist licensed to practice 267~~
332		-	~~dental medicine in this or another state~~, ~~or an advanced practice 268~~
333		-	~~registered nurse licensed to prescribe~~ in ~~accordance with section 20-94a, 269~~
334		-	or a ~~physician assistant licensed to prescribe in accordance with section 270~~
335		-	~~20-12d, and~~ the written ~~authorization~~ of a ~~parent or guardian of such 271~~
336		-	~~child, (3) specify that an operator of~~ a ~~child care center or group child 272~~
337		-	~~care home,~~ ~~licensed before January 1,~~ ~~1986~~, or an ~~operator who receives 273~~
338		-	~~a license after January 1, 1986, for a facility~~ licensed ~~prior~~ to ~~January 1~~, ~~274~~
339		-	~~1986, shall provide~~ a ~~minimum of thirty square feet per child of total 275~~
340		-	~~indoor usable space~~, ~~free~~ of ~~furniture except that needed for the 276~~
341		-	~~children's purposes~~, ~~exclusive~~ of ~~toilet rooms,~~ ~~bathrooms, coatrooms,~~ ~~277~~
342		-	~~kitchens~~, ~~halls~~, ~~isolation room~~ or ~~other rooms used for purposes other 278~~
343		-	~~than the activities of the children~~, ~~(4) specify that~~ a ~~child care center or 279~~
344		-	~~group child care home licensed after January 1,~~ 1986, shall provide ~~280~~
345		-	~~thirty-five square feet per child of total~~ indoor usable space, ~~(5) establish 281~~
346		-	~~appropriate child care center staffing requirements for employees 282~~
347		-	~~certified in cardiopulmonary resuscitation by the American Red Cross~~, ~~283~~
348		-	~~the American Heart Association,~~ the ~~National Safety Council~~, ~~American 284~~
349		-	~~Safety and Health Institute~~, ~~Medic First Aid International~~, ~~Inc. or an 285~~
350		-	~~organization using guidelines for cardiopulmonary resuscitation and 286 Substitute~~ Bill No. 568
	309	+	influenzae type B and any other vaccine required by the schedule of 246
	310	+	active immunization adopted pursuant to section 19a-7f, [including 247
	311	+	appropriate exemptions for children for whom such immunization is 248
	312	+	medically contraindicated and for children whose parent or guardian 249
	313	+	objects to such immunization on religious grounds, and that any 250
	314	+	objection by a parent or a guardian to immunization of a child on 251
	315	+	religious grounds shall be accompanied by a statement from such parent 252
	316	+	or guardian that such immunization would be contrary to the religious 253
	317	+	beliefs of such child or the parent or guardian of such child, which 254
	318	+	statement shall be acknowledged, in accordance with the provisions of 255
	319	+	sections 1-32, 1-34 and 1-35, by (A) a judge of a court of record or a family 256
	320	+	support magistrate, (B) a clerk or deputy clerk of a court having a seal, 257
	321	+	(C) a town clerk, (D) a notary public, (E) a justice of the peace, or (F) an 258
	322	+	attorney admitted to the bar of this state,] (2) specify conditions under 259
	323	+	which child care center directors and teachers and group child care 260
	324	+	home providers may administer tests to monitor glucose levels in a child 261
	325	+	with diagnosed diabetes mellitus, and administer medicinal 262
	326	+	preparations, including controlled drugs specified in the regulations by 263
	327	+	the commissioner, to a child receiving child care services at such child 264
	328	+	care center or group child care home pursuant to the written order of a 265
	329	+	physician licensed to practice medicine or a dentist licensed to practice 266
	330	+	dental medicine in this or another state, or an advanced practice 267
	331	+	registered nurse licensed to prescribe in accordance with section 20-94a, 268
	332	+	or a physician assistant licensed to prescribe in accordance with section 269
	333	+	20-12d, and the written authorization of a parent or guardian of such 270
	334	+	child, (3) specify that an operator of a child care center or group child 271
	335	+	care home, licensed before January 1, 1986, or an operator who receives 272
	336	+	a license after January 1, 1986, for a facility licensed prior to January 1, 273
	337	+	1986, shall provide a minimum of thirty square feet per child of total 274
	338	+	indoor usable space, free of furniture except that needed for the 275
	339	+	children's purposes, exclusive of toilet rooms, bathrooms, coatrooms, 276
	340	+	kitchens, halls, isolation room or other rooms used for purposes other 277
	341	+	than the activities of the children, (4) specify that a child care center or 278
	342	+	group child care home licensed after January 1, 1986, shall provide 279
	343	+	Committee Bill No. 568
351	344
352	345
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356	347
357		-	~~emergency cardiovascular care published by the American Heart 287~~
358		-	~~Association and International Liaison Committee on Resuscitation,~~ ~~(6) 288~~
359		-	~~specify that [on~~ ~~and after January 1~~, ~~2003,] a child care center or group 289~~
360		-	~~child care home (A) shall not deny services to a child on~~ the ~~basis of a 290~~
361		-	~~child's known~~ or ~~suspected allergy or because a child has a prescription 291~~
362		-	for ~~an automatic prefilled cartridge injector or similar automatic 292~~
363		-	~~injectable equipment used to treat an allergic reaction,~~ ~~or for injectable 293~~
364		-	~~equipment used to administer glucagon~~, (B) ~~shall, not later than three 294~~
365		-	~~weeks~~ after ~~such~~ child~~'s enrollment in such a~~ center or ~~home, have staff 295~~
366		-	~~trained in~~ the ~~use~~ of ~~such equipment on-site during all hours when such 296~~
367		-	a child ~~is on-site, (C) shall require such child's parent or guardian to 297~~
368		-	~~provide the~~ injector or ~~injectable equipment and a copy of the 298~~
369		-	~~prescription for such medication and injector or~~ injectable equipment ~~299~~
370		-	~~upon enrollment of such child~~, ~~and~~ (D) shall ~~require a parent or 300~~
371		-	~~guardian enrolling~~ such a ~~child to replace such medication and 301~~
372		-	equipment ~~prior to its expiration date,~~ ~~(7) specify that [on and after 302~~
373		-	~~January 1, 2005,]~~ a child ~~care center or group child care home~~ (A) shall ~~303~~
374		-	~~not deny services to~~ a ~~child on~~ the ~~basis of a child's diagnosis of asthma 304~~
375		-	~~or because a child has a~~ prescription for ~~an inhalant~~ medication ~~to treat 305~~
376		-	~~asthma~~, and (B) shall~~, not later than three weeks after such child's 306~~
377		-	~~enrollment in~~ such a ~~center or home,~~ ~~have staff trained in the 307~~
378		-	~~administration of such medication~~ on~~-site during all hours when such a 308~~
379		-	child ~~is on-site, and~~ (8) ~~establish physical plant requirements for 309~~
380		-	~~licensed~~ child ~~care centers and licensed group~~ child ~~care homes that 310~~
381		-	~~exclusively serve school-age~~ ~~children. When establishing such 311~~
382		-	~~requirements~~, ~~the Office of Early Childhood~~ shall ~~give consideration to 312~~
383		-	~~child care centers and group child care homes that are located~~ in ~~private 313~~
384		-	~~or public school buildings.~~ ~~With respect to this subdivision only,~~ ~~the 314~~
385		-	~~commissioner shall implement policies~~ and ~~procedures necessary to 315~~
386		-	~~implement the physical plant requirements established pursuant to this 316~~
387		-	~~subdivision while in the process of adopting~~ such ~~policies and 317~~
388		-	~~procedures in regulation form.~~ ~~Until replaced by policies and 318~~
389		-	~~procedures implemented pursuant to this subdivision,~~ ~~any physical 319~~
390		-	~~plant requirement specified in~~ the ~~office's regulations that is generally 320~~
391		-	~~applicable to child care centers and group child care homes shall 321 Substitute~~ Bill No. 568
	348	+	thirty-five square feet per child of total indoor usable space, (5) establish 280
	349	+	appropriate child care center staffing requirements for employees 281
	350	+	certified in cardiopulmonary resuscitation by the American Red Cross, 282
	351	+	the American Heart Association, the National Safety Council, American 283
	352	+	Safety and Health Institute, Medic First Aid International, Inc. or an 284
	353	+	organization using guidelines for cardiopulmonary resuscitation and 285
	354	+	emergency cardiovascular care published by the American Heart 286
	355	+	Association and International Liaison Committee on Resuscitation, (6) 287
	356	+	specify that [on and after January 1, 2003,] a child care center or group 288
	357	+	child care home (A) shall not deny services to a child on the basis of a 289
	358	+	child's known or suspected allergy or because a child has a prescription 290
	359	+	for an automatic prefilled cartridge injector or similar automatic 291
	360	+	injectable equipment used to treat an allergic reaction, or for injectable 292
	361	+	equipment used to administer glucagon, (B) shall, not later than three 293
	362	+	weeks after such child's enrollment in such a center or home, have staff 294
	363	+	trained in the use of such equipment on-site during all hours when such 295
	364	+	a child is on-site, (C) shall require such child's parent or guardian to 296
	365	+	provide the injector or injectable equipment and a copy of the 297
	366	+	prescription for such medication and injector or injectable equipment 298
	367	+	upon enrollment of such child, and (D) shall require a parent or 299
	368	+	guardian enrolling such a child to replace such medication and 300
	369	+	equipment prior to its expiration date, (7) specify that [on and after 301
	370	+	January 1, 2005,] a child care center or group child care home (A) shall 302
	371	+	not deny services to a child on the basis of a child's diagnosis of asthma 303
	372	+	or because a child has a prescription for an inhalant medication to treat 304
	373	+	asthma, and (B) shall, not later than three weeks after such child's 305
	374	+	enrollment in such a center or home, have staff trained in the 306
	375	+	administration of such medication on-site during all hours when such a 307
	376	+	child is on-site, and (8) establish physical plant requirements for 308
	377	+	licensed child care centers and licensed group child care homes that 309
	378	+	exclusively serve school-age children. When establishing such 310
	379	+	requirements, the Office of Early Childhood shall give consideration to 311
	380	+	child care centers and group child care homes that are located in private 312
	381	+	or public school buildings. With respect to this subdivision only, the 313
	382	+	Committee Bill No. 568
392	383
393	384
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397	386
398		-	continue to be applicable to such centers and homes that exclusively 322
399		-	serve school-age children. The commissioner shall [print] post notice of 323
400		-	the intent to adopt regulations pursuant to this subdivision on the 324
401		-	eRegulations System not later than twenty days after the date of 325
402		-	implementation of such policies and procedures. Policies and 326
403		-	procedures implemented pursuant to this subdivision shall be valid 327
404		-	until the time final regulations are adopted. 328
405		-	(b) Any child who (1) presents a certificate, in a form prescribed by 329
406		-	the Commissioner of Public Health pursuant to section 7 of this act, 330
407		-	signed by a physician, a physician assistant or an advanced practice 331
408		-	registered nurse stating that, in the opinion of such physician, physician 332
409		-	assistant or advanced practice registered nurse, the immunizations 333
410		-	required pursuant to regulations adopted pursuant to subdivision (1) of 334
411		-	subsection (a) of this section are medically contraindicated, (2) in the 335
412		-	case of a child who is enrolled in seventh grade through twelfth grade, 336
413		-	presented a statement, prior to the effective date of this section, that such 337
414		-	immunizations are contrary to the religious beliefs of such child or the 338
415		-	parents or guardian of such child, or (3) in the case of a child who is 339
416		-	enrolled in sixth grade or below, (A) presented a statement, prior to the 340
417		-	effective date of this section, that such immunizations are contrary to 341
418		-	the religious beliefs of such child or the parents or guardian of such 342
419		-	child, and (B) presents a written declaration, in a form prescribed by the 343
420		-	Commissioner of Public Health, from a physician, a physician assistant 344
421		-	or an advanced practice registered nurse stating that an immunization 345
422		-	against diphtheria, pertussis, tetanus, poliomyelitis, measles, mumps, 346
423		-	rubella, haemophilus influenzae type B and any other vaccine required 347
424		-	by the schedule of active immunization adopted pursuant to section 348
425		-	19a-7f has been given to such child and that any additional necessary 349
426		-	immunizations of such student against diphtheria, pertussis, tetanus, 350
427		-	poliomyelitis, measles, mumps, rubella, haemophilus influenzae type B 351
428		-	and any other vaccine required by such schedule of active immunization 352
429		-	are in process under guidelines specified by the Commissioner of Public 353
430		-	Health or as recommended for the child by the physician, physician 354
431		-	assistant or advanced practice registered nurse, shall be exempt from 355 Substitute Bill No. 568
	387	+	commissioner shall implement policies and procedures necessary to 314
	388	+	implement the physical plant requirements established pursuant to this 315
	389	+	subdivision while in the process of adopting such policies and 316
	390	+	procedures in regulation form. Until replaced by policies and 317
	391	+	procedures implemented pursuant to this subdivision, any physical 318
	392	+	plant requirement specified in the office's regulations that is generally 319
	393	+	applicable to child care centers and group child care homes shall 320
	394	+	continue to be applicable to such centers and homes that exclusively 321
	395	+	serve school-age children. The commissioner shall [print] post notice of 322
	396	+	the intent to adopt regulations pursuant to this subdivision on the 323
	397	+	eRegulations System not later than twenty days after the date of 324
	398	+	implementation of such policies and procedures. Policies and 325
	399	+	procedures implemented pursuant to this subdivision shall be valid 326
	400	+	until the time final regulations are adopted. 327
	401	+	(b) Any child who (1) presents a certificate, in a form prescribed by 328
	402	+	the Commissioner of Public Health pursuant to section 7 of this act, 329
	403	+	signed by a physician, a physician assistant or an advanced practice 330
	404	+	registered nurse stating that, in the opinion of such physician, physician 331
	405	+	assistant or advanced practice registered nurse, the immunizations 332
	406	+	required pursuant to regulations adopted pursuant to subdivision (1) of 333
	407	+	subsection (a) of this section are medically contraindicated, (2) in the 334
	408	+	case of a child who is enrolled in seventh grade through twelfth grade, 335
	409	+	presented a statement, prior to the effective date of this section, that such 336
	410	+	immunizations are contrary to the religious beliefs of such child or the 337
	411	+	parents or guardians of such child, or (3) in the case of a child who is 338
	412	+	enrolled in sixth grade or below, (A) presented a statement, prior to the 339
	413	+	effective date of this section, that such immunizations are contrary to 340
	414	+	the religious beliefs of such child or the parents or guardian of such 341
	415	+	child, and (B) presents a written declaration, in a form prescribed by the 342
	416	+	Commissioner of Public Health, from a physician, a physician assistant 343
	417	+	or an advanced practice registered nurse stating that an immunization 344
	418	+	against diphtheria, pertussis, tetanus, poliomyelitis, measles, mumps, 345
	419	+	rubella, haemophilus influenzae type B and any other vaccine required 346
	420	+	by the schedule of active immunization adopted pursuant to section 347
	421	+	Committee Bill No. 568
432	422
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437	425
438		-	the immunization requirements set forth in such regulations. The 356
439		-	statement described in subparagraph (A) of subdivision (3) of this 357
440		-	subsection shall be acknowledged, in accordance with the provisions of 358
441		-	sections 1-32, 1-34 and 1-35, by a judge of a court of record or a family 359
442		-	support magistrate, a clerk or deputy clerk of a court having a seal, a 360
443		-	town clerk, a notary public, a justice of the peace, or an attorney 361
444		-	admitted to the bar of this state. 362
445		-	(c) Any child who is enrolled in sixth grade or below on or before the 363
446		-	effective date of this section who presented, prior to the effective date of 364
447		-	this section, the statement described in subparagraph (A) of subdivision 365
448		-	(3) of subsection (b) of this section, but did not present the written 366
449		-	declaration described in subparagraph (B) of subdivision (3) of 367
450		-	subsection (b) of this section, shall comply, on or before September 1, 368
451		-	2022, or not later than fourteen days after applying to enroll in the child 369
452		-	care center or group child care home, whichever is later, with the 370
453		-	immunization requirements set forth in the regulations adopted 371
454		-	pursuant to subdivision (1) of subsection (a) of this section. 372
455		-	[(b)] (d) The commissioner may adopt regulations, pursuant to 373
456		-	chapter 54, to establish civil penalties of not more than one hundred 374
457		-	dollars per day for each day of violation and other disciplinary remedies 375
458		-	that may be imposed, following a contested-case hearing, upon the 376
459		-	holder of a license issued under section 19a-80 to operate a child care 377
460		-	center or group child care home or upon the holder of a license issued 378
461		-	under section 19a-87b, as amended by this act, to operate a family child 379
462		-	care home. 380
463		-	[(c)] (e) The commissioner shall exempt Montessori schools 381
464		-	accredited by the American Montessori Society or the Association 382
465		-	Montessori Internationale from any provision in regulations adopted 383
466		-	pursuant to subsection (a) of this section which sets requirements on 384
467		-	group size or child to staff ratios or the provision of cots. 385
468		-	[(d)] (f) Upon the declaration by the Governor of a civil preparedness 386
469		-	emergency pursuant to section 28-9 or a public health emergency 387 Substitute Bill No. 568
	426	+	19a-7f has been given to such child and that any additional necessary 348
	427	+	immunizations of such student against diphtheria, pertussis, tetanus, 349
	428	+	poliomyelitis, measles, mumps, rubella, haemophilus influenzae type B 350
	429	+	and any other vaccine required by such schedule of active immunization 351
	430	+	are in process under guidelines specified by the Commissioner of Public 352
	431	+	Health or as recommended for the child by the physician, physician 353
	432	+	assistant or advanced practice registered nurse, shall be exempt from 354
	433	+	the immunization requirements set forth in such regulations. The 355
	434	+	statement described in subparagraph (A) of subdivision (3) of this 356
	435	+	subsection shall be acknowledged, in accordance with the provisions of 357
	436	+	sections 1-32, 1-34 and 1-35, by a judge of a court of record or a family 358
	437	+	support magistrate, a clerk or deputy clerk of a court having a seal, a 359
	438	+	town clerk, a notary public, a justice of the peace, or an attorney 360
	439	+	admitted to the bar of this state. 361
	440	+	(c) Any child who is enrolled in sixth grade or below on or before the 362
	441	+	effective date of this section who presented, prior to the effective date of 363
	442	+	this section, the statement described in subparagraph (A) of subdivision 364
	443	+	(3) of subsection (b) of this section, but did not present the written 365
	444	+	declaration described in subparagraph (B) of subdivision (3) of 366
	445	+	subsection (b) of this section, shall comply, on or before September 1, 367
	446	+	2022, or not later than fourteen days after applying to enroll in the child 368
	447	+	care center or group child care home, whichever is later, with the 369
	448	+	immunization requirements set forth in the regulations adopted 370
	449	+	pursuant to subdivision (1) of subsection (a) of this section. 371
	450	+	[(b)] (d) The commissioner may adopt regulations, pursuant to 372
	451	+	chapter 54, to establish civil penalties of not more than one hundred 373
	452	+	dollars per day for each day of violation and other disciplinary remedies 374
	453	+	that may be imposed, following a contested-case hearing, upon the 375
	454	+	holder of a license issued under section 19a-80 to operate a child care 376
	455	+	center or group child care home or upon the holder of a license issued 377
	456	+	under section 19a-87b, as amended by this act, to operate a family child 378
	457	+	care home. 379
	458	+	Committee Bill No. 568
470	459
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475	462
476		-	~~pursuant to section 19a-131a,~~ the commissioner ~~may waive the 388~~
477		-	~~provisions of any regulation adopted pursuant to this section if~~ the ~~389~~
478		-	~~commissioner determines that such waiver would not endanger the life, 390~~
479		-	~~safety or health~~ of ~~any child.~~ ~~The commissioner shall prescribe the 391~~
480		-	~~duration~~ of ~~such waiver,~~ ~~provided such waiver shall not extend beyond 392~~
481		-	the ~~duration~~ of ~~the declared emergency.~~ ~~The commissioner shall 393~~
482		-	~~establish the criteria by which~~ a ~~waiver request shall be made and the 394~~
483		-	~~conditions for which a waiver will be granted or denied.~~ The ~~provisions 395~~
484		-	of section ~~19a-84 shall not apply to a denial of a waiver request under 396~~
485		-	~~this subsection.~~ ~~397~~
486		-	~~[(e)] (g)~~ Any child ~~care center or group child care home may provide 398~~
487		-	~~child care services to homeless children and youths~~, ~~as defined in 42 399~~
488		-	~~USC 11434a,~~ ~~as amended from time to time,~~ ~~for a period not to exceed 400~~
489		-	~~ninety days without complying with any provision in regulations 401~~
490		-	~~adopted pursuant to this section relating to immunization and physical 402~~
491		-	~~examination requirements.~~ ~~Any child care center or group child care 403~~
492		-	~~home that provides child care services to homeless children and youths 404~~
493		-	~~at such~~ center or home ~~under this subsection shall maintain a record on 405~~
494		-	~~file of all~~ homeless children and youths ~~who have attended such center 406~~
495		-	~~or home~~ for a period ~~of two years after such homeless children or youths 407~~
496		-	~~are no longer receiving child care services at such center or home. 408~~
497		-	~~[(f)] (h) Any child care center or group child care home may provide 409~~
498		-	child care ~~services to a foster~~ child ~~for a period not to exceed forty-five 410~~
499		-	~~days without complying with any provision in regulations adopted 411~~
500		-	~~pursuant to~~ this ~~section relating to immunization and physical 412~~
501		-	~~examination requirements.~~ ~~Any child care~~ center ~~or group child care 413~~
502		-	home ~~that provides child care services to~~ a ~~foster child at~~ such ~~center~~ or ~~414~~
503		-	~~home under this subsection shall maintain a record on file of~~ such ~~foster 415~~
504		-	~~child for a period of two years after such foster~~ child ~~is no longer 416~~
505		-	~~receiving~~ child care services ~~at such center or home.~~ For ~~purposes of this 417~~
506		-	~~subsection, "foster~~ ~~child" means a child who is~~ in ~~the care and custody 418~~
507		-	~~of the Commissioner of Children~~ and ~~Families and placed in a foster 419~~
508		-	~~home licensed pursuant to section 17a-114, foster home approved by a 420 Substitute~~ Bill No. 568
	463	+	[(c)] (e) The commissioner shall exempt Montessori schools 380
	464	+	accredited by the American Montessori Society or the Association 381
	465	+	Montessori Internationale from any provision in regulations adopted 382
	466	+	pursuant to subsection (a) of this section which sets requirements on 383
	467	+	group size or child to staff ratios or the provision of cots. 384
	468	+	[(d)] (f) Upon the declaration by the Governor of a civil preparedness 385
	469	+	emergency pursuant to section 28-9 or a public health emergency 386
	470	+	pursuant to section 19a-131a, the commissioner may waive the 387
	471	+	provisions of any regulation adopted pursuant to this section if the 388
	472	+	commissioner determines that such waiver would not endanger the life, 389
	473	+	safety or health of any child. The commissioner shall prescribe the 390
	474	+	duration of such waiver, provided such waiver shall not extend beyond 391
	475	+	the duration of the declared emergency. The commissioner shall 392
	476	+	establish the criteria by which a waiver request shall be made and the 393
	477	+	conditions for which a waiver will be granted or denied. The provisions 394
	478	+	of section 19a-84 shall not apply to a denial of a waiver request under 395
	479	+	this subsection. 396
	480	+	[(e)] (g) Any child care center or group child care home may provide 397
	481	+	child care services to homeless children and youths, as defined in 42 398
	482	+	USC 11434a, as amended from time to time, for a period not to exceed 399
	483	+	ninety days without complying with any provision in regulations 400
	484	+	adopted pursuant to this section relating to immunization and physical 401
	485	+	examination requirements. Any child care center or group child care 402
	486	+	home that provides child care services to homeless children and youths 403
	487	+	at such center or home under this subsection shall maintain a record on 404
	488	+	file of all homeless children and youths who have attended such center 405
	489	+	or home for a period of two years after such homeless children or youths 406
	490	+	are no longer receiving child care services at such center or home. 407
	491	+	[(f)] (h) Any child care center or group child care home may provide 408
	492	+	child care services to a foster child for a period not to exceed forty-five 409
	493	+	days without complying with any provision in regulations adopted 410
	494	+	pursuant to this section relating to immunization and physical 411
	495	+	Committee Bill No. 568
509	496
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514	499
515		-	child-placing agency licensed pursuant to section 17a-149, facility 421
516		-	licensed pursuant to section 17a-145 or with a relative or fictive kin 422
517		-	caregiver pursuant to section 17a-114. 423
518		-	Sec. 6. Section 19a-87b of the general statutes is repealed and the 424
519		-	following is substituted in lieu thereof (Effective from passage): 425
520		-	(a) No person, group of persons, association, organization, 426
521		-	corporation, institution or agency, public or private, shall maintain a 427
522		-	family child care home, as defined in section 19a-77, without a license 428
523		-	issued by the Commissioner of Early Childhood. Licensure forms shall 429
524		-	be obtained from the Office of Early Childhood. Applications for 430
525		-	licensure shall be made to the commissioner on forms provided by the 431
526		-	office and shall contain the information required by regulations adopted 432
527		-	under this section. The licensure and application forms shall contain a 433
528		-	notice that false statements made therein are punishable in accordance 434
529		-	with section 53a-157b. Applicants shall state, in writing, that they are in 435
530		-	compliance with the regulations adopted by the commissioner pursuant 436
531		-	to subsection (f) of this section. Before a family child care home license 437
532		-	is granted, the office shall make an inquiry and investigation which shall 438
533		-	include a visit and inspection of the premises for which the license is 439
534		-	requested. Any inspection conducted by the office shall include an 440
535		-	inspection for evident sources of lead poisoning. The office shall provide 441
536		-	for a chemical analysis of any paint chips found on such premises. 442
537		-	Neither the commissioner nor the commissioner's designee shall require 443
538		-	an annual inspection for homes seeking license renewal or for licensed 444
539		-	homes, except that the commissioner or the commissioner's designee 445
540		-	shall make an unannounced visit, inspection or investigation of each 446
541		-	licensed family child care home at least once every year. A licensed 447
542		-	family child care home shall not be subject to any conditions on the 448
543		-	operation of such home by local officials, other than those imposed by 449
544		-	the office pursuant to this subsection, if the home complies with all local 450
545		-	codes and ordinances applicable to single and multifamily dwellings. 451
546		-	(b) No person shall act as an assistant or substitute staff member to a 452
547		-	person or entity maintaining a family child care home, as defined in 453 Substitute Bill No. 568
	500	+	examination requirements. Any child care center or group child care 412
	501	+	home that provides child care services to a foster child at such center or 413
	502	+	home under this subsection shall maintain a record on file of such foster 414
	503	+	child for a period of two years after such foster child is no longer 415
	504	+	receiving child care services at such center or home. For purposes of this 416
	505	+	subsection, "foster child" means a child who is in the care and custody 417
	506	+	of the Commissioner of Children and Families and placed in a foster 418
	507	+	home licensed pursuant to section 17a-114, foster home approved by a 419
	508	+	child-placing agency licensed pursuant to section 17a-149, facility 420
	509	+	licensed pursuant to section 17a-145 or with a relative or fictive kin 421
	510	+	caregiver pursuant to section 17a-114. 422
	511	+	Sec. 6. Section 19a-87b of the general statutes is repealed and the 423
	512	+	following is substituted in lieu thereof (Effective from passage): 424
	513	+	(a) No person, group of persons, association, organization, 425
	514	+	corporation, institution or agency, public or private, shall maintain a 426
	515	+	family child care home, as defined in section 19a-77, without a license 427
	516	+	issued by the Commissioner of Early Childhood. Licensure forms shall 428
	517	+	be obtained from the Office of Early Childhood. Applications for 429
	518	+	licensure shall be made to the commissioner on forms provided by the 430
	519	+	office and shall contain the information required by regulations adopted 431
	520	+	under this section. The licensure and application forms shall contain a 432
	521	+	notice that false statements made therein are punishable in accordance 433
	522	+	with section 53a-157b. Applicants shall state, in writing, that they are in 434
	523	+	compliance with the regulations adopted by the commissioner pursuant 435
	524	+	to subsection (f) of this section. Before a family child care home license 436
	525	+	is granted, the office shall make an inquiry and investigation which shall 437
	526	+	include a visit and inspection of the premises for which the license is 438
	527	+	requested. Any inspection conducted by the office shall include an 439
	528	+	inspection for evident sources of lead poisoning. The office shall provide 440
	529	+	for a chemical analysis of any paint chips found on such premises. 441
	530	+	Neither the commissioner nor the commissioner's designee shall require 442
	531	+	an annual inspection for homes seeking license renewal or for licensed 443
	532	+	homes, except that the commissioner or the commissioner's designee 444
	533	+	Committee Bill No. 568
548	534
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553	537
554		-	~~section 19a-77, without~~ an ~~approval issued by the commissioner.~~ ~~Any 454~~
555		-	~~person seeking to act as an assistant or substitute staff member in~~ a ~~455~~
556		-	family child care home shall ~~submit an application for such approval~~ to ~~456~~
557		-	~~the office.~~ ~~Applications for approval shall:~~ ~~(1) Be made to the 457~~
558		-	~~commissioner on forms provided by~~ the ~~office, (2) contain the 458~~
559		-	~~information required by regulations adopted under this section,~~ and ~~(3) 459~~
560		-	~~be accompanied by~~ a ~~fee of fifteen dollars. The approval application 460~~
561		-	~~forms shall contain~~ a ~~notice that false statements made~~ in ~~such form are 461~~
562		-	~~punishable in accordance with~~ section ~~53a-157b~~. ~~462~~
563		-	~~(c) The commissioner,~~ ~~within available appropriations,~~ ~~shall require 463~~
564		-	~~each initial applicant or prospective employee of a~~ family child care ~~464~~
565		-	~~home in a position requiring~~ the ~~provision of care to a child, including 465~~
566		-	~~an assistant or substitute staff member and each household member 466~~
567		-	~~who is sixteen years of age or older~~, ~~to submit to comprehensive 467~~
568		-	~~background checks,~~ ~~including state and national criminal history 468~~
569		-	~~records checks.~~ ~~The criminal history records checks required pursuant 469~~
570		-	~~to this subsection shall be conducted~~ in accordance with section ~~29-17a~~. ~~470~~
571		-	The commissioner shall ~~also request a check of the state child abuse 471~~
572		-	~~registry established pursuant to section 17a-101k. The commissioner 472~~
573		-	~~shall notify each licensee~~ of ~~the provisions of this subsection.~~ ~~For 473~~
574		-	~~purposes of this subsection,~~ "household member~~" means any person, 474~~
575		-	~~other than the person~~ who is ~~licensed~~ to ~~conduct, operate or maintain a 475~~
576		-	~~family child care home~~, ~~who resides in the family child care home, such 476~~
577		-	as the ~~licensee's spouse or children,~~ ~~tenants and any other occupant. 477~~
578		-	~~(d) An application for initial licensure pursuant~~ to this ~~section~~ shall ~~478~~
579		-	~~be accompanied by~~ a ~~fee~~ of ~~forty dollars and such license shall be issued 479~~
580		-	~~for a term of four years~~. ~~An application for renewal of a license issued 480~~
581		-	~~pursuant to~~ this ~~section shall be accompanied by a fee of forty dollars 481~~
582		-	~~and a certification from the licensee that~~ any ~~child enrolled in the family 482~~
583		-	~~child care home has received age-appropriate~~ ~~immunizations in 483~~
584		-	~~accordance with regulations adopted pursuant to subsection (f) of this 484~~
585		-	~~section~~. ~~A license issued pursuant to this section shall be renewed for a 485~~
586		-	~~term of four years. In the case of an applicant submitting an application 486 Substitute~~ Bill No. 568
	538	+	shall make an unannounced visit, inspection or investigation of each 445
	539	+	licensed family child care home at least once every year. A licensed 446
	540	+	family child care home shall not be subject to any conditions on the 447
	541	+	operation of such home by local officials, other than those imposed by 448
	542	+	the office pursuant to this subsection, if the home complies with all local 449
	543	+	codes and ordinances applicable to single and multifamily dwellings. 450
	544	+	(b) No person shall act as an assistant or substitute staff member to a 451
	545	+	person or entity maintaining a family child care home, as defined in 452
	546	+	section 19a-77, without an approval issued by the commissioner. Any 453
	547	+	person seeking to act as an assistant or substitute staff member in a 454
	548	+	family child care home shall submit an application for such approval to 455
	549	+	the office. Applications for approval shall: (1) Be made to the 456
	550	+	commissioner on forms provided by the office, (2) contain the 457
	551	+	information required by regulations adopted under this section, and (3) 458
	552	+	be accompanied by a fee of fifteen dollars. The approval application 459
	553	+	forms shall contain a notice that false statements made in such form are 460
	554	+	punishable in accordance with section 53a-157b. 461
	555	+	(c) The commissioner, within available appropriations, shall require 462
	556	+	each initial applicant or prospective employee of a family child care 463
	557	+	home in a position requiring the provision of care to a child, including 464
	558	+	an assistant or substitute staff member and each household member 465
	559	+	who is sixteen years of age or older, to submit to comprehensive 466
	560	+	background checks, including state and national criminal history 467
	561	+	records checks. The criminal history records checks required pursuant 468
	562	+	to this subsection shall be conducted in accordance with section 29-17a. 469
	563	+	The commissioner shall also request a check of the state child abuse 470
	564	+	registry established pursuant to section 17a-101k. The commissioner 471
	565	+	shall notify each licensee of the provisions of this subsection. For 472
	566	+	purposes of this subsection, "household member" means any person, 473
	567	+	other than the person who is licensed to conduct, operate or maintain a 474
	568	+	family child care home, who resides in the family child care home, such 475
	569	+	as the licensee's spouse or children, tenants and any other occupant. 476
	570	+	Committee Bill No. 568
587	571
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592	574
593		-	for renewal of a license that has expired, and who has ceased operations 487
594		-	of a family child care home due to such expired license, the 488
595		-	commissioner may renew such expired license within thirty days of the 489
596		-	date of such expiration upon receipt of an application for renewal that 490
597		-	is accompanied by such fee and such certification. 491
598		-	(e) An application for initial staff approval or renewal of staff 492
599		-	approval shall be accompanied by a fee of fifteen dollars. Such 493
600		-	approvals shall be issued or renewed for a term of two years. 494
601		-	(f) The commissioner shall adopt regulations, in accordance with the 495
602		-	provisions of chapter 54, to assure that family child care homes, as 496
603		-	defined in section 19a-77, meet the health, educational and social needs 497
604		-	of children utilizing such homes. Such regulations shall ensure that the 498
605		-	family child care home is treated as a residence, and not an institutional 499
606		-	facility. Such regulations shall specify that each child be protected as 500
607		-	age-appropriate by adequate immunization against diphtheria, 501
608		-	pertussis, tetanus, poliomyelitis, measles, mumps, rubella, 502
609		-	[hemophilus] haemophilus influenzae type B and any other vaccine 503
610		-	required by the schedule of active immunization adopted pursuant to 504
611		-	section 19a-7f. [Such regulations shall provide appropriate exemptions 505
612		-	for children for whom such immunization is medically contraindicated 506
613		-	and for children whose parents or guardian objects to such 507
614		-	immunization on religious grounds and require that any such objection 508
615		-	be accompanied by a statement from such parents or guardian that such 509
616		-	immunization would be contrary to the religious beliefs of such child or 510
617		-	the parents or guardian of such child, which statement shall be 511
618		-	acknowledged, in accordance with the provisions of sections 1-32, 1-34 512
619		-	and 1-35, by (1) a judge of a court of record or a family support 513
620		-	magistrate, (2) a clerk or deputy clerk of a court having a seal, (3) a town 514
621		-	clerk, (4) a notary public, (5) a justice of the peace, or (6) an attorney 515
622		-	admitted to the bar of this state.] Such regulations shall also specify 516
623		-	conditions under which family child care home providers may 517
624		-	administer tests to monitor glucose levels in a child with diagnosed 518
625		-	diabetes mellitus, and administer medicinal preparations, including 519 Substitute Bill No. 568
	575	+	(d) An application for initial licensure pursuant to this section shall 477
	576	+	be accompanied by a fee of forty dollars and such license shall be issued 478
	577	+	for a term of four years. An application for renewal of a license issued 479
	578	+	pursuant to this section shall be accompanied by a fee of forty dollars 480
	579	+	and a certification from the licensee that any child enrolled in the family 481
	580	+	child care home has received age-appropriate immunizations in 482
	581	+	accordance with regulations adopted pursuant to subsection (f) of this 483
	582	+	section. A license issued pursuant to this section shall be renewed for a 484
	583	+	term of four years. In the case of an applicant submitting an application 485
	584	+	for renewal of a license that has expired, and who has ceased operations 486
	585	+	of a family child care home due to such expired license, the 487
	586	+	commissioner may renew such expired license within thirty days of the 488
	587	+	date of such expiration upon receipt of an application for renewal that 489
	588	+	is accompanied by such fee and such certification. 490
	589	+	(e) An application for initial staff approval or renewal of staff 491
	590	+	approval shall be accompanied by a fee of fifteen dollars. Such 492
	591	+	approvals shall be issued or renewed for a term of two years. 493
	592	+	(f) The commissioner shall adopt regulations, in accordance with the 494
	593	+	provisions of chapter 54, to assure that family child care homes, as 495
	594	+	defined in section 19a-77, meet the health, educational and social needs 496
	595	+	of children utilizing such homes. Such regulations shall ensure that the 497
	596	+	family child care home is treated as a residence, and not an institutional 498
	597	+	facility. Such regulations shall specify that each child be protected as 499
	598	+	age-appropriate by adequate immunization against diphtheria, 500
	599	+	pertussis, tetanus, poliomyelitis, measles, mumps, rubella, 501
	600	+	[hemophilus] haemophilus influenzae type B and any other vaccine 502
	601	+	required by the schedule of active immunization adopted pursuant to 503
	602	+	section 19a-7f. [Such regulations shall provide appropriate exemptions 504
	603	+	for children for whom such immunization is medically contraindicated 505
	604	+	and for children whose parents or guardian objects to such 506
	605	+	immunization on religious grounds and require that any such objection 507
	606	+	be accompanied by a statement from such parents or guardian that such 508
	607	+	immunization would be contrary to the religious beliefs of such child or 509
	608	+	Committee Bill No. 568
626	609
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631	612
632		-	controlled drugs specified in the regulations by the commissioner, to a 520
633		-	child receiving child care services at a family child care home pursuant 521
634		-	to a written order of a physician licensed to practice medicine in this or 522
635		-	another state, an advanced practice registered nurse licensed to 523
636		-	prescribe in accordance with section 20-94a or a physician assistant 524
637		-	licensed to prescribe in accordance with section 20-12d, and the written 525
638		-	authorization of a parent or guardian of such child. Such regulations 526
639		-	shall specify appropriate standards for extended care and intermittent 527
640		-	short-term overnight care. The commissioner shall inform each licensee, 528
641		-	by way of a plain language summary provided not later than sixty days 529
642		-	after the regulation's effective date, of any new or changed regulations 530
643		-	adopted under this subsection with which a licensee must comply. 531
644		-	(g) Any child who (1) presents a certificate, in a form prescribed by 532
645		-	the Commissioner of Public Health pursuant to section 7 of this act, 533
646		-	signed by a physician, a physician assistant or an advanced practice 534
647		-	registered nurse stating that, in the opinion of such physician, physician 535
648		-	assistant or advanced practice registered nurse, the immunizations 536
649		-	required pursuant to regulations adopted pursuant to subsection (f) of 537
650		-	this section are medically contraindicated, (2) in the case of a child who 538
651		-	is enrolled in seventh grade through twelfth grade, presented a 539
652		-	statement, prior to the effective date of this section, that such 540
653		-	immunizations are contrary to the religious beliefs of such child or the 541
654		-	parents or guardian of such child, or (3) in the case of a child who is 542
655		-	enrolled in sixth grade or below, (A) presented a statement, prior to the 543
656		-	effective date of this section, that such immunizations are contrary to 544
657		-	the religious beliefs of such child or the parents or guardian of such 545
658		-	child, and (B) presents a written declaration, in a form prescribed by the 546
659		-	Commissioner of Public Health, from a physician, physician assistant or 547
660		-	advanced practice registered nurse stating that an immunization against 548
661		-	diphtheria, pertussis, tetanus, poliomyelitis, measles, mumps, rubella, 549
662		-	haemophilus influenzae type B and any other vaccine required by the 550
663		-	schedule of active immunization adopted pursuant to section 19a-7f has 551
664		-	been given to such child and that any additional necessary 552
665		-	immunizations of such student against diphtheria, pertussis, tetanus, 553 Substitute Bill No. 568
	613	+	the parents or guardian of such child, which statement shall be 510
	614	+	acknowledged, in accordance with the provisions of sections 1-32, 1-34 511
	615	+	and 1-35, by (1) a judge of a court of record or a family support 512
	616	+	magistrate, (2) a clerk or deputy clerk of a court having a seal, (3) a town 513
	617	+	clerk, (4) a notary public, (5) a justice of the peace, or (6) an attorney 514
	618	+	admitted to the bar of this state.] Such regulations shall also specify 515
	619	+	conditions under which family child care home providers may 516
	620	+	administer tests to monitor glucose levels in a child with diagnosed 517
	621	+	diabetes mellitus, and administer medicinal preparations, including 518
	622	+	controlled drugs specified in the regulations by the commissioner, to a 519
	623	+	child receiving child care services at a family child care home pursuant 520
	624	+	to a written order of a physician licensed to practice medicine in this or 521
	625	+	another state, an advanced practice registered nurse licensed to 522
	626	+	prescribe in accordance with section 20-94a or a physician assistant 523
	627	+	licensed to prescribe in accordance with section 20-12d, and the written 524
	628	+	authorization of a parent or guardian of such child. Such regulations 525
	629	+	shall specify appropriate standards for extended care and intermittent 526
	630	+	short-term overnight care. The commissioner shall inform each licensee, 527
	631	+	by way of a plain language summary provided not later than sixty days 528
	632	+	after the regulation's effective date, of any new or changed regulations 529
	633	+	adopted under this subsection with which a licensee must comply. 530
	634	+	(g) Any child who (1) presents a certificate, in a form prescribed by 531
	635	+	the Commissioner of Public Health pursuant to section 7 of this act, 532
	636	+	signed by a physician, a physician assistant or an advanced practice 533
	637	+	registered nurse stating that, in the opinion of such physician, physician 534
	638	+	assistant or advanced practice registered nurse, the immunizations 535
	639	+	required pursuant to regulations adopted pursuant to subsection (f) of 536
	640	+	this section are medically contraindicated, (2) in the case of a child who 537
	641	+	is enrolled in seventh grade through twelfth grade, presented a 538
	642	+	statement, prior to the effective date of this section, that such 539
	643	+	immunizations are contrary to the religious beliefs of such child or the 540
	644	+	parents or guardians of such child, or (3) in the case of a child who is 541
	645	+	enrolled in sixth grade or below, (A) presented a statement, prior to the 542
	646	+	effective date of this section, that such immunizations are contrary to 543
	647	+	Committee Bill No. 568
666	648
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671	651
672		-	poliomyelitis, measles, mumps, rubella, haemophilus influenzae type B 554
673		-	and any other vaccine required by such schedule of active immunization 555
674		-	are in process under guidelines specified by the Commissioner of Public 556
675		-	Health or as recommended for the child by the physician, physician 557
676		-	assistant or advanced practice registered nurse, shall be exempt from 558
677		-	the immunization requirements set forth in such regulations. The 559
678		-	statement described in subparagraph (A) of subdivision (3) of this 560
679		-	subsection shall be acknowledged, in accordance with the provisions of 561
680		-	sections 1-32, 1-34 and 1-35, by (i) a judge of a court of record or a family 562
681		-	support magistrate, (ii) a clerk or deputy clerk of a court having a seal, 563
682		-	(iii) a town clerk, (iv) a notary public, (v) a justice of the peace, or (vi) an 564
683		-	attorney admitted to the bar of this state. 565
684		-	(h) Any child who is enrolled in sixth grade or below on or before the 566
685		-	effective date of this section who presented, prior to the effective date of 567
686		-	this section, the statement described in subparagraph (A) of subdivision 568
687		-	(3) of subsection (g) of this section, but did not present the written 569
688		-	declaration described in subparagraph (B) of subdivision (3) of 570
689		-	subsection (g) of this section shall comply, on or before September 1, 571
690		-	2022, or not later than fourteen days after applying to enroll in the family 572
691		-	child care home, whichever is later, with the immunization 573
692		-	requirements set forth in the regulations adopted pursuant to subsection 574
693		-	(f) of this section. 575
694		-	[(g)] (i) Upon the declaration by the Governor of a civil preparedness 576
695		-	emergency pursuant to section 28-9 or a public health emergency 577
696		-	pursuant to section 19a-131a, the commissioner may waive the 578
697		-	provisions of any regulation adopted pursuant to this section if the 579
698		-	commissioner determines that such waiver would not endanger the life, 580
699		-	safety or health of any child. The commissioner shall prescribe the 581
700		-	duration of such waiver, provided such waiver shall not extend beyond 582
701		-	the duration of the declared emergency. The commissioner shall 583
702		-	establish the criteria by which a waiver request shall be made and the 584
703		-	conditions for which a waiver will be granted or denied. The provisions 585
704		-	of section 19a-84 shall not apply to a denial of a waiver request under 586 Substitute Bill No. 568
	652	+	the religious beliefs of such child or the parents or guardians of such 544
	653	+	child, and (B) presents a written declaration, in a form prescribed by the 545
	654	+	Commissioner of Public Health, from a physician, physician assistant or 546
	655	+	advanced practice registered nurse stating that an immunization against 547
	656	+	diphtheria, pertussis, tetanus, poliomyelitis, measles, mumps, rubella, 548
	657	+	haemophilus influenzae type B and any other vaccine required by the 549
	658	+	schedule of active immunization adopted pursuant to section 19a-7f has 550
	659	+	been given to such child and that any additional necessary 551
	660	+	immunizations of such student against diphtheria, pertussis, tetanus, 552
	661	+	poliomyelitis, measles, mumps, rubella, haemophilus influenzae type B 553
	662	+	and any other vaccine required by such schedule of active immunization 554
	663	+	are in process under guidelines specified by the Commissioner of Public 555
	664	+	Health or as recommended for the child by the physician, physician 556
	665	+	assistant or advanced practice registered nurse, shall be exempt from 557
	666	+	the immunization requirements set forth in such regulations. The 558
	667	+	statement described in subparagraph (A) of subdivision (3) of this 559
	668	+	subsection shall be acknowledged, in accordance with the provisions of 560
	669	+	sections 1-32, 1-34 and 1-35, by (i) a judge of a court of record or a family 561
	670	+	support magistrate, (ii) a clerk or deputy clerk of a court having a seal, 562
	671	+	(iii) a town clerk, (iv) a notary public, (v) a justice of the peace, or (vi) an 563
	672	+	attorney admitted to the bar of this state. 564
	673	+	(h) Any child who is enrolled in sixth grade or below on or before the 565
	674	+	effective date of this section who presented, prior to the effective date of 566
	675	+	this section, the statement described in subparagraph (A) of subdivision 567
	676	+	(3) of subsection (g) of this section, but did not present the written 568
	677	+	declaration described in subparagraph (B) of subdivision (3) of 569
	678	+	subsection (g) of this section shall comply, on or before September 1, 570
	679	+	2022, or not later than fourteen days after applying to enroll in the family 571
	680	+	child care home, whichever is later, with the immunization 572
	681	+	requirements set forth in the regulations adopted pursuant to subsection 573
	682	+	(f) of this section. 574
	683	+	[(g)] (i) Upon the declaration by the Governor of a civil preparedness 575
	684	+	emergency pursuant to section 28-9 or a public health emergency 576
	685	+	Committee Bill No. 568
705	686
706	687
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709		-	19 of 24
	688	+	LCO No. 6219 19 of 25
710	689
711		-	this subsection. 587
712		-	[(h)] (j) Any family child care home may provide child care services 588
713		-	to homeless children and youths, as defined in 42 USC 11434a, as 589
714		-	amended from time to time, for a period not to exceed ninety days 590
715		-	without complying with any provision in regulations adopted pursuant 591
716		-	to this section relating to immunization and physical examination 592
717		-	requirements. Any family child care home that provides child care 593
718		-	services to homeless children and youths at such home under this 594
719		-	subsection shall maintain a record on file of all homeless children and 595
720		-	youths who have attended such home for a period of two years after 596
721		-	such homeless children or youths are no longer receiving child care 597
722		-	services at such home. 598
723		-	[(i)] (k) Any family child care home may provide child care services 599
724		-	to a foster child for a period not to exceed forty-five days without 600
725		-	complying with any provision in regulations adopted pursuant to this 601
726		-	section relating to immunization and physi cal examination 602
727		-	requirements. Any family child care home that provides child care 603
728		-	services to a foster child at such home under this subsection shall 604
729		-	maintain a record on file of such foster child for a period of two years 605
730		-	after such foster child is no longer receiving child care services at such 606
731		-	home. For purposes of this subsection, "foster child" means a child who 607
732		-	is in the care and custody of the Commissioner of Children and Families 608
733		-	and placed in a foster home licensed pursuant to section 17a-114, foster 609
734		-	home approved by a child-placing agency licensed pursuant to section 610
735		-	17a-149, facility licensed pursuant to section 17a-145 or with a relative 611
736		-	or fictive kin caregiver pursuant to section 17a-114. 612
737		-	Sec. 7. (NEW) (Effective from passage) On or before October 1, 2021, the 613
738		-	Commissioner of Public Health shall develop and make available on the 614
739		-	Internet web site of the Department of Public Health a certificate for use 615
740		-	by a physician, physician assistant or advanced practice registered 616
741		-	nurse stating that, in the opinion of such physician, physician assistant 617
742		-	or advanced practice registered nurse, a vaccination required by the 618
743		-	general statutes is medically contraindicated for a person because of the 619 Substitute Bill No. 568
	690	+	pursuant to section 19a-131a, the commissioner may waive the 577
	691	+	provisions of any regulation adopted pursuant to this section if the 578
	692	+	commissioner determines that such waiver would not endanger the life, 579
	693	+	safety or health of any child. The commissioner shall prescribe the 580
	694	+	duration of such waiver, provided such waiver shall not extend beyond 581
	695	+	the duration of the declared emergency. The commissioner shall 582
	696	+	establish the criteria by which a waiver request shall be made and the 583
	697	+	conditions for which a waiver will be granted or denied. The provisions 584
	698	+	of section 19a-84 shall not apply to a denial of a waiver request under 585
	699	+	this subsection. 586
	700	+	[(h)] (j) Any family child care home may provide child care services 587
	701	+	to homeless children and youths, as defined in 42 USC 11434a, as 588
	702	+	amended from time to time, for a period not to exceed ninety days 589
	703	+	without complying with any provision in regulations adopted pursuant 590
	704	+	to this section relating to immunization and physical examination 591
	705	+	requirements. Any family child care home that provides child care 592
	706	+	services to homeless children and youths at such home under this 593
	707	+	subsection shall maintain a record on file of all homeless children and 594
	708	+	youths who have attended such home for a period of two years after 595
	709	+	such homeless children or youths are no longer receiving child care 596
	710	+	services at such home. 597
	711	+	[(i)] (k) Any family child care home may provide child care services 598
	712	+	to a foster child for a period not to exceed forty-five days without 599
	713	+	complying with any provision in regulations adopted pursuant to this 600
	714	+	section relating to immunization and physical examination 601
	715	+	requirements. Any family child care home that provides child care 602
	716	+	services to a foster child at such home under this subsection shall 603
	717	+	maintain a record on file of such foster child for a period of two years 604
	718	+	after such foster child is no longer receiving child care services at such 605
	719	+	home. For purposes of this subsection, "foster child" means a child who 606
	720	+	is in the care and custody of the Commissioner of Children and Families 607
	721	+	and placed in a foster home licensed pursuant to section 17a-114, foster 608
	722	+	home approved by a child-placing agency licensed pursuant to section 609
	723	+	Committee Bill No. 568
744	724
745	725
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748		-	20 of 24
	726	+	LCO No. 6219 20 of 25
749	727
750		-	~~physical condition of such person.~~ ~~The certificate shall include (1) 620~~
751		-	~~definitions of the terms "contraindication" and "precaution"; (2) a list of 621~~
752		-	~~contraindications and precautions recognized by~~ the ~~National Centers 622~~
753		-	~~for Disease Control~~ and ~~Prevention for each of~~ the ~~statutorily required 623~~
754		-	~~vaccinations, from which~~ the ~~physician, physician assistant or advanced 624~~
755		-	practice registered ~~nurse may select the relevant contraindication or 625~~
756		-	~~precaution on behalf~~ of such ~~person; (3) a section in which the~~ physician, ~~626~~
757		-	~~physician assistant~~ or advanced practice registered nurse ~~may record~~ a ~~627~~
758		-	~~contraindication or precaution that~~ is ~~not recognized by~~ the ~~National 628~~
759		-	~~Centers for Disease Control and Prevention,~~ ~~but in his or her discretion, 629~~
760		-	~~results in~~ the ~~vaccination being medically contraindicated~~, ~~including, 630~~
761		-	~~but not limited to,~~ ~~any autoimmune disorder,~~ ~~family history of any 631~~
762		-	~~autoimmune disorder,~~ ~~family history~~ of ~~any reaction to a vaccination, 632~~
763		-	~~genetic predisposition to any reaction to a vaccination as determined 633~~
764		-	~~through genetic testing and a previous documented reaction of a person 634~~
765		-	~~that is correlated to a vaccination;~~ (4) a section in which the physician, ~~635~~
766		-	physician assistant or advanced practice registered nurse may ~~include~~ a ~~636~~
767		-	~~written explanation for~~ the ~~exemption from any statutorily required 637~~
768		-	~~vaccinations; (5) a section requiring the signature of the physician~~, ~~638~~
769		-	~~physician assistant or advanced practice registered nurse;~~ ~~(6) a 639~~
770		-	~~requirement that the physician~~, ~~physician assistant or advanced practice 640~~
771		-	~~registered nurse attach such person's most current immunization 641~~
772		-	~~record; and (7)~~ a ~~synopsis of the grounds for any order of quarantine or 642~~
773		-	~~isolation pursuant to section 19a-131b~~ of ~~the general statutes.~~ ~~643~~
774		-	~~Sec. 8. (NEW) (Effective from passage) (a) There~~ is ~~established an 644~~
775		-	~~Advisory Committee on Medically Contraindicated Vaccinations within 645~~
776		-	~~the Department of Public Health~~ for the ~~purpose of advising the 646~~
777		-	~~Commissioner~~ of ~~Public Health on issues concerning exemptions from 647~~
778		-	~~state~~ or ~~federal requirements for vaccinations that result from~~ a ~~648~~
779		-	physician, physician assistant or advanced practice ~~registered nurse 649~~
780		-	~~stating that a vaccination is medically contraindicated for a~~ person ~~due 650~~
781		-	to the ~~medical condition~~ of ~~such person.~~ ~~Said advisory committee shall 651~~
782		-	~~not be responsible for confirming or denying any determination by a 652~~
783		-	~~physician, physician assistant or advanced practice registered nurse that 653 Substitute~~ Bill No. 568
	728	+	17a-149, facility licensed pursuant to section 17a-145 or with a relative 610
	729	+	or fictive kin caregiver pursuant to section 17a-114. 611
	730	+	Sec. 7. (NEW) (Effective from passage) On or before October 1, 2021, the 612
	731	+	Commissioner of Public Health shall develop and make available on the 613
	732	+	Internet web site of the Department of Public Health a certificate for use 614
	733	+	by a physician, physician assistant or advanced practice registered 615
	734	+	nurse stating that, in the opinion of such physician, physician assistant 616
	735	+	or advanced practice registered nurse, a vaccination required by the 617
	736	+	general statutes is medically contraindicated for a person because of the 618
	737	+	physical condition of such person. The certificate shall include (1) 619
	738	+	definitions of the terms "contraindication" and "precaution", (2) a list of 620
	739	+	contraindications and precautions recognized by the National Centers 621
	740	+	for Disease Control and Prevention for each of the statutorily required 622
	741	+	vaccinations, from which the physician, physician assistant or advanced 623
	742	+	practice registered nurse may select the relevant contraindication or 624
	743	+	precaution on behalf of such person, (3) a section in which the physician, 625
	744	+	physician assistant or advanced practice registered nurse may record a 626
	745	+	contraindication or precaution that is not recognized by the National 627
	746	+	Centers for Disease Control and Prevention, but in his or her discretion, 628
	747	+	results in the vaccination being medically contraindicated, including, 629
	748	+	but not limited to, any autoimmune disorder, family history of any 630
	749	+	autoimmune disorder, family history of any reaction to a vaccination, 631
	750	+	genetic predisposition to any reaction to a vaccination as determined 632
	751	+	through genetic testing and a previous documented reaction of a person 633
	752	+	that is correlated to a vaccination, (4) a section in which the physician, 634
	753	+	physician assistant or advanced practice registered nurse may include a 635
	754	+	written explanation for the exemption from any statutorily required 636
	755	+	vaccinations, (5) a section requiring the signature of the physician, 637
	756	+	physician assistant or advanced practice registered nurse, (6) a 638
	757	+	requirement that the physician, physician assistant or advanced practice 639
	758	+	registered nurse attach such person's most current immunization 640
	759	+	record, and (7) a synopsis of the grounds for any order of quarantine or 641
	760	+	isolation pursuant to section 19a-131b of the general statutes. 642
	761	+	Committee Bill No. 568
784	762
785	763
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788		-	21 of 24
	764	+	LCO No. 6219 21 of 25
789	765
790		-	a vaccination is medically contraindicated for a specific individual. In 654
791		-	order to carry out its duties, the advisory committee shall (1) have access 655
792		-	to the childhood immunization registry established by the department 656
793		-	pursuant to section 19a-7h of the general statutes; (2) evaluate the 657
794		-	process used by the department in collecting data concerning 658
795		-	exemptions resulting from a vaccination being medically 659
796		-	contraindicated and whether the department should have any oversight 660
797		-	over such exemptions; (3) examine whether enrollment of an 661
798		-	unvaccinated child into a program operated by a public or nonpublic 662
799		-	school, institution of higher education, child care center or group child 663
800		-	care home should be conditioned upon the child meeting certain 664
801		-	criteria; (4) calculate the ratio of school nurses to students in each public 665
802		-	and nonpublic school in the state and the funding issues surrounding 666
803		-	such ratio; (5) assess whether immunizations should be required more 667
804		-	frequently than prior to enrollment into a program operated by a public 668
805		-	or nonpublic school and prior to entering seventh grade; and (6) 669
806		-	determine whether (A) there are any discrepancies in the issuance of 670
807		-	certificates stating that a vaccine is medically contraindicated, and (B) to 671
808		-	recommend continuing education of physicians, physician assistants or 672
809		-	advanced practice registered nurses in vaccine contraindications and 673
810		-	precautions. All information obtained by the advisory committee from 674
811		-	such registry shall be confidential pursuant to section 19a-25 of the 675
812		-	general statutes, as amended by this act. 676
813		-	(b) The advisory committee shall consist of the following members: 677
814		-	(1) Two appointed by the speaker of the House of Representatives, 678
815		-	one of whom shall be a physician licensed pursuant to chapter 370 of the 679
816		-	general statutes who is a pediatrician, and one of whom shall be a 680
817		-	member of the public; 681
818		-	(2) Two appointed by the president pro tempore of the Senate, one of 682
819		-	whom shall be a physician licensed pursuant to chapter 370 of the 683
820		-	general statutes who has expertise in the efficacy of vaccines, and one of 684
821		-	whom shall be a member of the public; 685 Substitute Bill No. 568
	766	+	Sec. 8. (NEW) (Effective from passage) (a) There is established an 643
	767	+	Advisory Committee on Medically Contraindicated Vaccinations within 644
	768	+	the Department of Public Health for the purpose of advising the 645
	769	+	Commissioner of Public Health on issues concerning exemptions from 646
	770	+	state or federal requirements for vaccinations that result from a 647
	771	+	physician, physician assistant or advanced practice registered nurse 648
	772	+	stating that a vaccination is medically contraindicated for a person due 649
	773	+	to the medical condition of such person. Said advisory committee shall 650
	774	+	not be responsible for confirming or denying any determination by a 651
	775	+	physician, physician assistant or advanced practice registered nurse that 652
	776	+	a vaccination is medically contraindicated for a specific individual. In 653
	777	+	order to carry out its duties, the advisory committee shall (1) have access 654
	778	+	to the childhood immunization registry established by the department 655
	779	+	pursuant to section 19a-7h of the general statutes, (2) evaluate the 656
	780	+	process used by the department in collecting data concerning 657
	781	+	exemptions resulting from a vaccination b eing medically 658
	782	+	contraindicated and whether the department should have any oversight 659
	783	+	over such exemptions, (3) examine whether enrollment of an 660
	784	+	unvaccinated child into a program operated by a public or nonpublic 661
	785	+	school, institution of higher education, child care center or group child 662
	786	+	care home should be conditioned upon the child meeting certain 663
	787	+	criteria, (4) calculate the ratio of school nurses to students in each public 664
	788	+	and nonpublic school in the state and the funding issues surrounding 665
	789	+	such ratio, (5) assess whether immunizations should be required more 666
	790	+	frequently than prior to enrollment into a program operated by a public 667
	791	+	or nonpublic school and prior to entering seventh grade, and (6) 668
	792	+	determine whether (A) there are any discrepancies in the issuance of 669
	793	+	certificates stating that a vaccine is medically contraindicated, and (B) to 670
	794	+	recommend continuing education of physicians, physician assistants or 671
	795	+	advanced practice registered nurses in vaccine contraindications and 672
	796	+	precautions. All information obtained by the advisory committee from 673
	797	+	such registry shall be confidential pursuant to section 19a-25 of the 674
	798	+	general statutes, as amended by this act. 675
	799	+	(b) The advisory committee shall consist of the following members: 676
	800	+	Committee Bill No. 568
822	801
823	802
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826		-	22 of 24
	803	+	LCO No. 6219 22 of 25
827	804
828		-	(3) ~~One~~ appointed by the ~~majority leader~~ of the House of ~~686~~
829		-	~~Representatives, who~~ shall be a ~~school nurse;~~ ~~687~~
830		-	~~(4)~~ One ~~appointed by the majority leader~~ of ~~the Senate, who~~ shall be ~~688~~
831		-	~~a physician assistant licensed pursuant to chapter 370~~ of the ~~general 689~~
832		-	~~statutes who has experience in~~ the ~~administration~~ of ~~vaccines; 690~~
833		-	~~(5) One appointed by the minority leader~~ of the ~~House of 691~~
834		-	~~Representatives,~~ who ~~shall be an advanced practice registered nurse 692~~
835		-	~~licensed pursuant to chapter 378~~ of the ~~general statutes who has 693~~
836		-	~~experience in~~ the ~~administration~~ of ~~vaccines; 694~~
837		-	~~(6) One appointed by the minority leader of the Senate~~, who shall be ~~695~~
838		-	~~a representative~~ of the ~~Connecticut Chapter of the American Academy 696~~
839		-	of ~~Pediatrics; 697~~
840		-	~~(7)~~ The ~~Commissioner~~ of ~~Public Health,~~ ~~or the commissioner's 698~~
841		-	~~designee; 699~~
842		-	~~(8) The Commissioner of Education~~, ~~or the commissioner's designee;~~ ~~700~~
843		-	~~and 701~~
844		-	~~(9)~~ The ~~Commissioner~~ of ~~Early Childhood,~~ ~~or the commissioner's 702~~
845		-	~~designee. 703~~
846		-	~~(c) The members~~ of the ~~advisory committee shall elect a chairperson 704~~
847		-	of ~~the advisory committee from among its members. Such chairperson 705~~
848		-	~~shall schedule~~ the ~~first meeting~~ of the ~~advisory committee,~~ ~~which shall 706~~
849		-	~~be held not later than October 1, 2021. The advisory committee shall 707~~
850		-	~~meet not less than biannually. On~~ or ~~before January 1,~~ ~~2022, and 708~~
851		-	~~annually thereafter,~~ ~~the committee shall report, in accordance with the 709~~
852		-	~~provisions~~ of ~~section 11-4a~~ of the ~~general statutes,~~ ~~on its activities and 710~~
853		-	~~findings to the joint standing committee of the General Assembly 711~~
854		-	~~having cognizance~~ of ~~matters relating to public health.~~ ~~712~~
855		-	~~Sec. 9.~~ ~~(NEW) (Effective~~ from ~~passage) The Department of Public 713~~
856		-	~~Health, in collaboration with the state Department of Education and the 714 Substitute~~ Bill No. 568
	805	+	(1) Two appointed by the speaker of the House of Representatives, 677
	806	+	one of whom shall be a physician licensed pursuant to chapter 370 of the 678
	807	+	general statutes who is a pediatrician, and one of whom shall be a 679
	808	+	member of the public; 680
	809	+	(2) Two appointed by the president pro tempore of the Senate, one of 681
	810	+	whom shall be a physician licensed pursuant to chapter 370 of the 682
	811	+	general statutes who has expertise in the efficacy of vaccines, and one of 683
	812	+	whom shall be a member of the public; 684
	813	+	(3) One appointed by the majority leader of the House of 685
	814	+	Representatives, who shall be a school nurse; 686
	815	+	(4) One appointed by the majority leader of the Senate, who shall be 687
	816	+	a physician assistant licensed pursuant to chapter 370 of the general 688
	817	+	statutes who has experience in the administration of vaccines; 689
	818	+	(5) One appointed by the minority leader of the House of 690
	819	+	Representatives, who shall be an advanced practice registered nurse 691
	820	+	licensed pursuant to chapter 378 of the general statutes who has 692
	821	+	experience in the administration of vaccines; 693
	822	+	(6) One appointed by the minority leader of the Senate, who shall be 694
	823	+	a representative of the Connecticut Chapter of the American Academy 695
	824	+	of Pediatrics; 696
	825	+	(7) The Commissioner of Public Health, or the commissioner's 697
	826	+	designee; 698
	827	+	(8) The Commissioner of Education, or the commissioner's designee; 699
	828	+	and 700
	829	+	(9) The Commissioner of Early Childhood, or the commissioner's 701
	830	+	designee. 702
	831	+	(c) The members of the advisory committee shall elect a chairperson 703
	832	+	of the advisory committee from among its members. Such chairperson 704
	833	+	Committee Bill No. 568
857	834
858	835
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861		-	23 of 24
	836	+	LCO No. 6219 23 of 25
862	837
863		-	Office of Early Childhood, shall evaluate all of the data collected by said 715
864		-	departments concerning exemptions from immunization requirements. 716
865		-	Not later than January 1, 2022, and annually thereafter, the 717
866		-	Commissioners of Public Health, Education and Early Childhood shall 718
867		-	jointly report, in accordance with the provisions of section 11-4a of the 719
868		-	general statutes, to the joint standing committees of the General 720
869		-	Assembly having cognizance of matters relating to public health and 721
870		-	education regarding the evaluation of such data. 722
871		-	Sec. 10. Subsection (a) of section 38a-492r of the general statutes is 723
872		-	repealed and the following is substituted in lieu thereof (Effective January 724
873		-	1, 2022): 725
874		-	(a) Each individual health insurance policy providing coverage of the 726
875		-	type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 727
876		-	delivered, issued for delivery, renewed, amended or continued in this 728
877		-	state that provides coverage for prescription drugs shall provide 729
878		-	[coverage for] (1) coverage for immunizations recommended by the 730
879		-	American Academy of Pediatrics, American Academy of Family 731
880		-	Physicians and the American College of Obstetrician s and 732
881		-	Gynecologists, and (2) with respect to immunizations that have in effect 733
882		-	a recommendation from the Advisory Committee on Immunization 734
883		-	Practices of the Centers for Disease Control and Prevention with respect 735
884		-	to the individual involved, coverage for such immunizations and at least 736
885		-	a twenty-minute consultation between such individual and a health care 737
886		-	provider authorized to administer such immunizations to such 738
887		-	individual. 739
888		-	Sec. 11. Subsection (a) of section 38a-518r of the general statutes is 740
889		-	repealed and the following is substituted in lieu thereof (Effective January 741
890		-	1, 2022): 742
891		-	(a) Each group health insurance policy providing coverage of the type 743
892		-	specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 744
893		-	delivered, issued for delivery, renewed, amended or continued in this 745
894		-	state that provides coverage for prescription drugs shall provide 746 Substitute Bill No. 568
	838	+	shall schedule the first meeting of the advisory committee, which shall 705
	839	+	be held not later than October 1, 2021. The advisory committee shall 706
	840	+	meet not less than biannually. On or before January 1, 2022, and 707
	841	+	annually thereafter, the committee shall report, in accordance with the 708
	842	+	provisions of section 11-4a of the general statutes, on its activities and 709
	843	+	findings to the joint standing committee of the General Assembly 710
	844	+	having cognizance of matters relating to public health. 711
	845	+	Sec. 9. (NEW) (Effective from passage) The Department of Public 712
	846	+	Health, in collaboration with the state Department of Education and the 713
	847	+	Office of Early Childhood, shall evaluate all of the data collected by said 714
	848	+	departments concerning exemptions from immunization requirements. 715
	849	+	Not later than January 1, 2022, and annually thereafter, the 716
	850	+	Commissioners of Public Health, Education and Early Childhood shall 717
	851	+	jointly report, in accordance with the provisions of section 11-4a of the 718
	852	+	general statutes, to the joint standing committees of the General 719
	853	+	Assembly having cognizance of matters relating to public health and 720
	854	+	education regarding the evaluation of such data. 721
	855	+	Sec. 10. Subsection (a) of section 38a-492r of the general statutes is 722
	856	+	repealed and the following is substituted in lieu thereof (Effective January 723
	857	+	1, 2022): 724
	858	+	(a) Each individual health insurance policy providing coverage of the 725
	859	+	type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 726
	860	+	delivered, issued for delivery, renewed, amended or continued in this 727
	861	+	state that provides coverage for prescription drugs shall provide 728
	862	+	[coverage for] (1) coverage for immunizations recommended by the 729
	863	+	American Academy of Pediatrics, American Academy of Family 730
	864	+	Physicians and the American College of Obstetricians and 731
	865	+	Gynecologists, and (2) with respect to immunizations that have in effect 732
	866	+	a recommendation from the Advisory Committee on Immunization 733
	867	+	Practices of the Centers for Disease Control and Prevention with respect 734
	868	+	to the individual involved, coverage for such immunizations and at least 735
	869	+	a twenty-minute consultation between such individual and a health care 736
	870	+	Committee Bill No. 568
895	871
896	872
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899		-	24 of 24
	873	+	LCO No. 6219 24 of 25
900	874
901		-	[coverage for] (1) coverage for immunizations recommended by the 747
902		-	American Academy of Pediatrics, American Academy of Family 748
903		-	Physicians and the American C ollege of Obstetricians and 749
904		-	Gynecologists, and (2) with respect to immunizations that have in effect 750
905		-	a recommendation from the Advisory Committee on Immunization 751
906		-	Practices of the Centers for Disease Control and Prevention with respect 752
907		-	to the individual involved, coverage for such immunizations and at least 753
908		-	a twenty-minute consultation between such individual and a health care 754
909		-	provider authorized to administer such immunizations to such 755
910		-	individual. 756
	875	+	provider authorized to prescribe such immunizations to such 737
	876	+	individual. 738
	877	+	Sec. 11. Subsection (a) of section 38a-518r of the general statutes is 739
	878	+	repealed and the following is substituted in lieu thereof (Effective January 740
	879	+	1, 2022): 741
	880	+	(a) Each group health insurance policy providing coverage of the type 742
	881	+	specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 743
	882	+	delivered, issued for delivery, renewed, amended or continued in this 744
	883	+	state that provides coverage for prescription drugs shall provide 745
	884	+	[coverage for] (1) coverage for immunizations recommended by the 746
	885	+	American Academy of Pediatrics, American Academy of Family 747
	886	+	Physicians and the American College of Obstetricians and 748
	887	+	Gynecologists, and (2) with respect to immunizations that have in effect 749
	888	+	a recommendation from the Advisory Committee on Immunization 750
	889	+	Practices of the Centers for Disease Control and Prevention with respect 751
	890	+	to the individual involved, coverage for such immunizations and at least 752
	891	+	a twenty-minute consultation between such individual and a health care 753
	892	+	provider authorized to prescribe such immunizations to such 754
	893	+	individual. 755
911	894		This act shall take effect as follows and shall amend the following
912	895		sections:
913	896
914	897		Section 1 from passage 10-204a
915	898		Sec. 2 from passage 19a-25
916	899		Sec. 3 from passage 10a-155
917	900		Sec. 4 from passage 10a-155b(a)
918	901		Sec. 5 from passage 19a-79
919	902		Sec. 6 from passage 19a-87b
920	903		Sec. 7 from passage New section
921	904		Sec. 8 from passage New section
922	905		Sec. 9 from passage New section
923	906		Sec. 10 January 1, 2022 38a-492r(a)
924	907		Sec. 11 January 1, 2022 38a-518r(a)
925	908
926		-	Statement of Legislative Commissioners:
927		-	In Sections 1(b), 1(c), 1(d), 5(b) and 6(g), references to "guardians" were
928		-	changed to "guardian" for consistency, in Section 3(b), "subdivision (2)
929		-	or (3)" was changed to "subdivision (2) [or (3)]" for accuracy and in
930		-	Sections 10 and 11, "prescribe" was changed to "administer" for clarity.
	909	+	Committee Bill No. 568
931	910
932		-	PH Joint Favorable Subst. -LCO
	911	+
	912	+	LCO No. 6219 25 of 25
	913	+
	914	+	Statement of Purpose:
	915	+	To eliminate the nonmedical exemption to the immunization
	916	+	requirement for individuals attending public or private school from
	917	+	prekindergarten through grade twelve, individuals in higher education
	918	+	and children in day care settings.
	919	+	[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except
	920	+	that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not
	921	+	underlined.]
	922	+
	923	+	Co-Sponsors: SEN. DAUGHERTY ABRAMS, 13th Dist.; SEN. DUFF, 25th Dist.
	924	+	REP. ELLIOTT, 88th Dist.; REP. PALM, 36th Dist.
	925	+
	926	+	S.B. 568
	927	+
933	928