HB 5044 — AN ACT ESTABLISHING CONNECTICUT VACCINE STANDARDS.

or (5) in the case of pertussis, has passed such child's sixth birthday, shall be exempt from the appropriate provisions of this section.

The statement described in subparagraph (B) of subdivision (1) of this subsection shall be acknowledged, in accordance with the provisions of sections 1-32, 1-34 and 1-35, by a judge of a court of record or a family support magistrate, a clerk or deputy clerk of a court having a seal, a town clerk, a notary public, a justice of the peace, an attorney admitted to the bar of this state, or notwithstanding any provision of chapter 6, a school nurse.

(b) The immunization requirements provided for in subsection (a) of this section shall not apply to any child who is enrolled in kindergarten through twelfth grade on or before April 28, 2021, if such child presented a statement, prior to April 28, 2021, from the parents or guardian of such child that such immunization is contrary to the religious beliefs of such child or the parents or guardian of such child, and such statement was acknowledged, in accordance with the provisions of sections 1-32, 1-34 and 1-35, by (1) a judge of a court of record or a family support magistrate, (2) a clerk or deputy clerk of a Public Act No.

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5044 court having a seal, (3) a town clerk, (4) a notary public, (5) a justice of the peace, (6) an attorney admitted to the bar of this state, or (7) notwithstanding any provision of chapter 6, a school nurse.

(c) Any child who is enrolled in a preschool program or other prekindergarten program prior to April 28, 2021, who presented a statement, prior to April 28, 2021, from the parents or guardian of such child that the immunization is contrary to the religious beliefs of such child or the parents or guardian of such child, which statement was acknowledged, in accordance with the provisions of sections 1-32, 1-34 and 1-35, by (1) a judge of a court of record or a family support magistrate, (2) a clerk or deputy clerk of a court having a seal, (3) a town clerk, (4) a notary public, (5) a justice of the peace, (6) an attorney admitted to the bar of this state, or (7) notwithstanding any provision of chapter 6, a school nurse, but did not present a written declaration from a physician, a physician assistant or an advanced practice registered nurse stating that additional immunizations are in process as recommended by such physician, physician assistant or advanced practice registered nurse, ratherthanasrecommended under guidelines and schedules specified by the Commissioner of Public Health, shall comply with the immunization requirements provided for in subparagraph (A) of subdivision (1) of subsection (a) of this section on or before September 1, 2022, or not later than fourteen days after transferring to a program operated by a public or nonpublic school under the jurisdiction of a local or regional board of education or similar body governing a nonpublic school or schools, whichever is later.

(d) If the parents or guardian of any child are unable to pay for any immunization required by subsection (a) of this section, the expense of such immunization shall, on the recommendation of such child's local or regional board of education, or similar body governing a nonpublic school or schools, be paid by the town.

(e) The definitions of adequate immunization shall reflect the Public Act No.

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5044 [schedule] schedules for [active] immunization [adopted] included in the standard of care for immunization established pursuant to section 19a-7f, asamended by thisact, and beestablishedby regulationadopted in accordance with the provisions of chapter 54 by the Commissioner of Public Health, who shall also be responsible for providing procedures under which such boards and such similar governing bodies shall collect and report immunization data on each child to the Department ofPublicHealth for (1) compilationandanalysisby thedepartment,and (2) release by the department of annual immunization rates for each public and nonpublic school in the state, provided such immunization data may not contain information that identifies a specific individual.

(f) The Commissioner of Public Health may issue a temporary waiver to the schedule for [active] immunization for any vaccine if the National Centers for Disease Control and Prevention recognizes a nation-wide shortage of supply for such vaccine.

(a) Each institution of higher education shall require each full-time or matriculating student born after December 31, 1956, to provide proof of adequate immunization against measles, rubella, mumps and varicella, as [recommended by the national Advisory Committee for Immunization Practices] set forth in the schedules for active immunization included in the standard of care for immunization established pursuant to section 19a-7f, as amended by this act, before permitting such student to enroll in such institution.

(a)Public InAct the event of a state-wide or regional public health emergency, the Governor shall make a good faith effort to inform the legislative leaders specified in subsection (b) of this section before declaring that sHB5044 / File No.

40526-3 710 sHB5044of File23 Substitute House Bill No.

4055044 (a) In the event of a state-wide or regional public health emergency, the Governor shall make a good faith effort to inform the legislative leaders specified in subsection (b) of this section before declaring that the emergency exists and may do any of the following:

As used in this subsection, "standing order" means a nonpatient specific regimen applicable state-widestate wide that (A) includes, but is not limited to, a prescription or order that is issued by a physician licensed pursuant to chapter 370allowing licensedhealthcare providers to dispense or administer a medical intervention to control and prevent the spread of, mitigate or treat any infectious or noninfectious disease or threat to the public health, and (B) does not require any individual to receive or utilize such medical intervention.

(b) There is established, within available appropriations, a vaccines for adults program to be administered by the Department of Public Health.Act No.

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5044 (b) There is established, within available appropriations, a vaccines for adults program to be administered by the Department of Public Health.

The Commissioner of Public Health shall determine the vaccines to be purchased and distributed under the program based on the efficacy of such vaccines in sHB5044preventing /serious Filedisease No.and death in the adult population and the eligible health care providers to whom such vaccines shall be distributed.

405 8 sHB5044 File No.

405 preventing serious disease and death in the adult population and the eligible health care providers to whom such vaccines shall be distributed.

(1) [To procedures] Procedures followed or actions taken concerning the lower Connecticut River conservation zone described in chapter 477a and the upper Connecticut River conservation zone described in chapter 477c, (2) [to] the administrative determinations authorized by section 32-9r concerning manufacturing facilities in distressed municipalities, (3) [to] the rules made pursuant to section 9-436 for use of paper ballots, [and] (4) [to] guidelines established under section 22a-227 for development of a municipal solid waste management plan, and (5) the list of vaccines for purchase and distribution and eligibility requirements for health care providers determined by the Commissioner of Public HealthAct pursuantNo. to section 9 of this act.

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4055044 (2) [to] the administrative determinations authorized by section 32-9r concerning manufacturing facilities in distressed municipalities, (3) [to] the rules made pursuant to section 9-436 for use of paper ballots, [and] (4) [to] guidelines established under section 22a-227 for development of a municipal solid waste management plan, and (5) the list of vaccines for purchase and distribution and eligibility requirements for health care providers determined by the Commissioner of Public Health pursuant to section 9 sHB5044of Filethis No.act.

405 Sec.

(a) Each individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 delivered, issued for delivery, renewed, amended or continued in this state that provides coverage for prescription drugs shall provide (1) coverage for immunizations recommended by the American Academy of Pediatrics, American Academy of Family Physicians [and] or the American College of Obstetricians and Gynecologists, [and] (2) with respect to immunizations that have in effect arecommendation fromthe Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention with respect to the individual involved, coverage for such immunizations and at least a twenty-minute consultation between such individual and a health care provider authorized to administer such immunizations to such individual, and (3) coverage for immunizations within the schedules for active immunization included in the standard of care for immunization established pursuant to section 19a-7f, as amended by this act.

(a)EachgrouphealthinsurancepolicyprovidingcoverageofthetypePublic specifiedAct in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 delivered, issued for delivery, renewed, amended or continued in this state that provides coverage for prescription drugs shall provide (1) coverage for immunizations recommended by the American Academy of Pediatrics, American Academy of Family Physicians [and] or the American College of Obstetricians and Gynecologists, [and] (2) with respect to immunizations that have in effect arecommendation fromthe Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention with respect to the individual involved, coverage for such immunizations and at least a twenty-minute sHB5044 / File No.

40526-3 1013 sHB5044of File23 Substitute House Bill No.

4055044 (a)Eachgrouphealthinsurancepolicyprovidingcoverageofthetype specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 delivered, issued for delivery, renewed, amended or continued in this state that provides coverage for prescription drugs shall provide (1) coverage for immunizations recommended by the American Academy of Pediatrics, American Academy of Family Physicians [and] or the American College of Obstetricians and Gynecologists, [and] (2) with respect to immunizations that have in effect arecommendation fromthe Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention with respect to the individual involved, coverage for such immunizations and at least a twenty-minute consultation between such individual and a health care provider authorized to administer such immunizations to such individual, and (3) coverage for immunizations within the schedules for active immunization included in the standard of care for immunization established pursuant to section 19a-7f, as amended by this act.

or (ii) at least twelve years of age but younger than eighteen years of age with (I) the consent of such patient's parent, legal guardianPublic orAct otherNo. person having legal custody of such patient, or (II) proof that such patient is an emancipated minor;

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5044 guardian or other person having legal custody of such patient, or (II) proof that such patient is an emancipated minor;

sHB5044Sec. / File No.

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405 Sec.

(d)Public NothingAct inNo. this section shall be construed to authorize the state or any political subdivision of the state to burden any religious belief.

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5044 (d) Nothing in this section shall be construed to authorize the state or any political subdivision of the state to burden any religious belief.

(f) The provisions of this section shall not apply to the requirements set forth in sections 10-204a, as amended by this act, 10a-155, as amended by this act, and 10a-155b, 19a-79subdivision (1) of subsection (a) and 19a-87b.subsections (b) and (c) of section 19a-79, as amended by this act, and subdivision (2) of subsection (f) and subsections (g) and (h) of section 19a-87b, as amended by this act.

[(f)] (g) For the purposes of this section, "state or any political subdivision of the state" includes any agency, board, commission, sHB5044department, /officer Fileor No.employee of the state or any political subdivision of the state, and "demonstrates" means meets the burdens of going forward with the evidence and of persuasion.

405Sec. 12 sHB5044 File No.

40515. department, officer or employee of the state or any political subdivision of the state, and "demonstrates" means meets the burdens of going forward with the evidence and of persuasion.

ThisSubsections act(a) shalland take(b) effectof assection follows19a-79 andof shallthe amend2026 supplement to the general statutes are repealed and the following sections:is substituted in lieu thereof (Effective from passage):

Section(a) 1The fromCommissioner passageof 19a-7f(a)Early Sec.Childhood shall adopt regulations, in accordance with the provisions of chapter 54, to carry out the purposes of sections 19a-77 to 19a-80, inclusive, and 19a-82 to 19a-87, inclusive, and to assure that child care centers and group child care homes meet the health, educational and social needs of children utilizing such child Public Act No.

226-3 from16 passageof 19a-7f(b)(3)(B)23 Sec.Substitute House Bill No.

35044 fromcare passagecenters 19a-7j(a)and Sec.group child care homes.

4Such fromregulations passageshall 19a-522(1) Sec.specify that before being permitted to attend any child care center or group child care home, each child shall be protected as age-appropriate by adequate immunization against diphtheria, pertussis, tetanus, poliomyelitis, measles, mumps, rubella, haemophilus influenzae type B andanyothervaccinerequiredbythescheduleof[active]immunization adopted pursuant to section 19a-7f, as amended by this act, (2) specify conditions under which child care center directors and teachers and group child care home providers may administer tests to monitor glucose levels in a child with diagnosed diabetes mellitus, and administermedicinalpreparations,including controlleddrugsspecified in the regulations by the commissioner, to a child receiving child care services at such child care center or group child care home pursuant to thewrittenorderofaphysicianlicensedtopracticemedicineoradentist licensed to practice dental medicine in this or another state, or an advanced practice registered nurse licensed to prescribe in accordance with section 20-94a, or a physician assistant licensed to prescribe in accordance with section 20-12d, and the written authorization of a parent or guardian of such child, (3) specify that an operator of a child care center or group child care home, licensed before January 1, 1986, or an operator who receives a license after January 1, 1986, for a facility licensed prior to January 1, 1986, shall provide a minimum of thirty square feet per childof totalindoor usablespace, free offurniture except that needed for the children's purposes, exclusive of toilet rooms, bathrooms, coatrooms, kitchens, halls, isolation room or other rooms used for purposes other than the activities of the children, (4) specify that a child care center or group child care home licensed after January 1, 1986, shall provide thirty-five square feet per child of total indoor usable space, (5) establish appropriate child care center staffing requirements for employees certified in cardiopulmonary resuscitation by the American Red Cross, the American Heart Association, the National Safety Council, American Safety and Health Institute, Medic First Aid International, Inc.

5or froman passageorganization 19a-7qusing Sec.guidelines for Public Act No.

626-3 from17 passageof 10-204a(e)23 Sec.Substitute House Bill No.

75044 fromcardiopulmonary passageresuscitation 10a-155(a)and Sec.emergency cardiovascular care published by the American Heart Association and International Liaison Committee on Resuscitation, (6) specify that a child care center or group child care home (A) shall not deny services to a child on the basis of a child's known or suspected allergy or because a child has a prescription for an automatic prefilled cartridge injector or similar automatic injectable equipment, nasal spray or any other medical equipment approved by the United States Food and Drug Administration that is usedtotreatanallergicreaction,orforinjectableequipment,nasalspray or any other medical equipment approved by the United States Food and Drug Administration that is used to administer glucagon, (B) shall, not later than three weeks after such child's enrollment in such a center or home, have staff trained in the use of such equipment on-site during all hours when such a child is on-site, (C) shall require such child's parent or guardian to provide the equipment and a copy of the prescription for such medication upon enrollment of such child, and (D) shall require a parent or guardian enrolling such a child to replace such medication and equipment prior to its expiration date, (7) specify that a child care center or group child care home (A) shall not deny services to a child on the basis of a child's diagnosis of asthma or because a child has a prescription for an inhalant medication to treat asthma, and (B) shall, not later than three weeks after such child's enrollment in such a center or home, have staff trained in the administration of such medication on-site during all hours when such a child is on-site, (8) establish physical plant requirements for licensed child care centers and licensed group child care homes that exclusively serve school-age children, (9) specify that a child care center or group child care home shall immediately notify the parent or guardian of a child enrolled in such center or home if such child exhibits or develops an illness or is injured while in the care of such center or home, (10) specify that a child care center or group child care home shall create a written record of any such illness or injury, which shall, (A) include, but not be limited to, (i) a description of such illness or injury, (ii) the date, time of occurrence Public Act No.

826-3 from18 passageof 19a-131a(a)23 Sec.Substitute House Bill No.

95044 fromand passagelocation Newof sectionsuch Sec.illness or injury, (iii) any responsive action taken by an employee of such center or home, and (iv) whether such child was transported to a hospital emergency room, doctor's office or other medical facility as a result of such illness or injury, (B) be provided to the parent or guardianof such child not later than the next business day, and (C) be maintained by such center or home for a period of not less than two years and be made immediately available upon the request of the Office of Early Childhood, and (11) specify that a child care center or group child care home shall maintain any video recordings created at such center or home for a period of not less than thirty days, and make such recordings immediately available upon the request of the Office of Early Childhood.

10When fromestablishing passagesuch 4-186(d)requirements, Sec.the Office of Early Childhoodshallgive considerationto childcare centersandgroup child care homes that are located in private or public school buildings.

11With Januaryrespect 1,to 2027subdivision 38a-492r(a)(8) Sec.of this subsection, the commissioner shall implement policies and procedures necessary to implement the physical plant requirements established pursuant to this subdivision while in the process of adopting such policies and procedures in regulation form.

12Until Januaryreplaced 1,by 2027policies 38a-518r(a)and Sec.procedures implemented pursuant to this subdivision, any physical plant requirement specified in the office's regulations that is generally applicable to child care centers and group child care homes shall continue to be applicable to such centers and homes that exclusively serve school-age children.

13The fromcommissioner passageshall 20-633(a)(1)post Sec.notice of the intent to adopt regulations pursuant to this subdivision on the eRegulations System not later than twenty days after the date of implementation of such policies and procedures.

14Policies from passage and 52-571bprocedures applicableimplemented pursuant to anythis civilsubdivision actionshall pendingbe onvalid oruntil filedthe aftertime saidfinal dateregulations Statementare ofadopted. Legislative Commissioners:

InFor Sectionpurposes 5(3)of "recognizedthis bysubsection, the"illness" Nationalmeans Centersfever, forvomiting, Diseasediarrhea, Controlrash, andheadache, Prevention"persistent wascoughing, bracketedpersistent andcrying "includedor inany theother standardcondition ofdeemedan careillness for immunization established pursuant to section 19a-7f, as amended by this act" was inserted after the closingCommissioner bracket,of forEarly consistency.Childhood.

PHPublic JointAct FavorableNo. Subst.

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4055044 13(b) sHB5044Any Filechild No.who (1) presents a certificate, in a form prescribed by the Commissioner of Public Health pursuant to section 19a-7q, as amended by this act, signed by a physician, a physician assistant or an advanced practice registered nurse stating that, in the opinion of such physician, physician assistant or advanced practice registered nurse, the immunizations required pursuant to regulations adopted pursuant to subdivision (1) of subsection (a) of this section are medically contraindicated, (2) in the case of a child who is enrolled in kindergarten through twelfth grade, presented a statement, prior to April 28, 2021, that such immunizations are contrary to the religious beliefs of such child or the parents or guardian of such child, or (3) in the case of a child who is enrolled in a preschool program or other prekindergarten program or below, (A) presented a statement, prior to April 28, 2021, that such immunizations are contrary to the religious beliefs of such child or the parents or guardian of such child, and (B) presents a written declaration, in a form prescribed by the Commissioner of Public Health, from a physician, a physician assistant or an advanced practice registered nurse stating that an immunization against diphtheria, pertussis, tetanus, poliomyelitis,measles,mumps,rubella, haemophilus influenzae type B and any other vaccine required by the schedule of [active] immunization adopted pursuant to section 19a-7f, as amended by this act, has been given to such child and that any additional necessary immunizations of such student against diphtheria, pertussis, tetanus, poliomyelitis, measles, mumps, rubella, haemophilus influenzae type B and any other vaccine required by such schedule of [active] immunization are in process under guidelines specified by the Commissioner of Public Health or as recommended for the child by the physician, physician assistant or advanced practice registered nurse, shall be exempt from the immunization requirements set forth in such regulations.

405 The followingstatement Fiscaldescribed Impactin Statementsubparagraph and(A) Billof Analysissubdivision are(3) preparedof forthis thesubsection benefitshall ofbe theacknowledged, membersin ofaccordance with the Generalprovisions Assembly,of solelysections for1-32, purposes1-34 ofand information,1-35, summarizationby anda explanationjudge andof doa notcourt representof therecord intentor ofa thefamily Generalsupport Assemblymagistrate, a clerk or eitherdeputy chamberclerk thereofof fora anyPublic purpose.Act No.

In26-3 general,20 fiscal impacts are based upon a variety of informational23 sources,Substitute includingHouse theBill analyst’sNo. professional knowledge.

Whenever5044 applicable,court agencyhaving dataa isseal, consulteda astown partclerk, ofa thenotary analysis,public, howevera finaljustice productsof dothe notpeace, necessarilyor reflect an assessmentattorney fromadmitted anyto specificthe department.bar of this state.

OFASec. Fiscal Note State Impact:

Agency16. Affected Fund-Effect FY 27 $ FY 28 $ Public Health, Dept.

GFSubsections -(f) Potentialand See(g) Belowof Seesection Below19a-87b Savingsof Publicthe Health,2026 Dept.supplement to the general statutes are repealed and the following is substituted in lieu thereof (Effective from passage):

GF(f) -The Potentialcommissioner Seeshall Belowadopt Seeregulations, Belowin Costaccordance Note:with the provisions of chapter 54, to ensure that family child care homes, as described in section 19a-77, meet the health, educational and social needs of children utilizing such homes.

GF=GeneralSuch Fundregulations Municipalshall Impact:(1) ensure that the family child care home is treated as a residence, and not an institutional facility, (2) specify that each child be protected as age- appropriate by adequate immunization against diphtheria, pertussis, tetanus, poliomyelitis, measles, mumps, rubella, haemophilus influenzae type B and any other vaccine required by the schedule of [active] immunization adopted pursuant to section 19a-7f, as amended by this act, (3) specify conditions under which family child care home providers may administer tests to monitor glucose levels in a child with diagnosed diabetes mellitus, and administer medicinal preparations, including controlled drugs specified in the regulations by the commissioner, to a child receiving child care services at a family child care home pursuant to a written order of a physician licensed to practice medicine in this or another state, an advanced practice registered nurse licensed to prescribe in accordance with section 20-94a or a physician assistant licensed to prescribe inaccordance withsection20-12d,andthe written authorization of a parent or guardian of such child, (4) specify appropriate standards for extended care and intermittent short-term overnight care, (5) specify that a family child care home shall immediately notify the parent or guardian of a child enrolled in such home if such child exhibits or develops an illness or is injured while in the care of such home, (6) specify that a family child care home shall create a written record of any such illness or injury, which shall, (A) Public Act No.

Municipalities26-3 Effect21 FYof 2723 $Substitute FYHouse 28Bill $No. Various Municipalities Potential Potential Potential Savings Explanation The bill makes various changes to state laws on immunizations resulting in:

(1)5044 include, but not be limited to, (i) a potentialdescription costof such illness or injury, (ii) the date, time of occurrence and location ofsuch illness or injury, (iii) any responsive action taken by an employee of such home, and (iv) whether such child was transported to a hospital emergency room, doctor's office or other medical facility as a result of such illness or injury, (B) be provided to the Departmentparent or guardian of Publicsuch Healthchild (DPH)not beginninglater inthan FYthe 27;next business day, and (C) be maintained by such home for a period of not less than two years and be made immediately available upon the request of the Office of Early Childhood, and (7) specify that a family child care home shall maintain any video recordings created at such home for a period of not less than thirty days, and make such recordings immediately available upon therequest of the Office of Early Childhood.

andThe (2)commissioner potentialshall savingsinform toeach DPHlicensee, andby variousway municipalitiesof alsoa beginningplain inlanguage FYsummary 27,provided asnot describedlater below.than sixty days after the regulation's effective date, of any new or changed regulations adopted under this subsection with which a licensee must comply.

SectionFor 2purposes allowsof DPHthis tosubsection, purchase"illness" vaccines for the Connecticut Vaccine Program (CVP) by means otherfever, thanvomiting, throughdiarrhea, therash, Centersheadache, forpersistent Diseasecoughing, Controlpersistent andcrying Preventionor (CDC)any underother certaincondition conditions,deemed resultingan inillness potentialby savingsthe beginningCommissioner inof FYEarly 27Childhood. subject to available opportunities where alternative procurement options reduce state costs and increase efficiency.

Sections(g) 9Any andchild 10who establish(1) presents a state-fundedcertificate, Vaccinesin fora Adultsform Programprescribed toby providethe certainCommissioner vaccinesof atPublic noHealth costpursuant to underinsuredsection 19a-7q, as amended by this act, signed by a physician, a physician assistant or uninsuredan adults,advanced resultingpractice registered nurse stating that, in the opinion of such physician, physician assistant or advanced practice registered nurse, the immunizations required pursuant to regulations adopted pursuant to subsection(f)ofthissectionaremedicallycontraindicated,(2)inthecase of a potentialchild costwho is enrolled in kindergarten through twelfth grade, presented a statement, prior to DPHApril beginning28, 2021, that such immunizations are contrary to the religious beliefs of such child or the parents or guardian of such child, or (3) in FYthe sHB5044case /of Filea child who is enrolled in a preschool program or other prekindergarten program or below, (A) presented a statement, prior to April 28, 2021, that such immunizations Public Act No.

40526-3 1422 sHB5044of File23 Substitute House Bill No.

4055044 27.are contrary to the religious beliefs of such child or the parents or guardian of such child, and (B) presents a written declaration, in a form prescribed by the Commissioner of Public Health, from a physician, physician assistant or advanced practice registered nurse stating that an immunization against diphtheria, pertussis, tetanus, poliomyelitis, measles, mumps, rubella, haemophilus influenzae type B and any other vaccine required by the schedule of [active] immunization adopted pursuant to section 19a-7f, as amended by this act, has been given to such child and that any additional necessary immunizations of such student against diphtheria, pertussis, tetanus, poliomyelitis, measles, mumps, rubella, haemophilus influenzae type B and any other vaccine required bysuchschedule of [active]immunizationare inprocessunder guidelines specified by the Commissioner of Public Health or as recommended for the child by the physician, physician assistant or advanced practice registered nurse, shall be exempt from the immunization requirements set forth in such regulations.

The exactstatement costdescribed willin dependsubparagraph on(A) fundingof providedsubdivision and(3) of this subsection shall be acknowledged, in accordance with the numberprovisions of vaccinespurchasedsections as1-32, determinedby1- theCommissioner.DPHcurrentlyand operates1-35, by (i) a similar,judge moreof limiteda programcourt usingof federalrecord Sectionor 317a fundsfamily fromsupport magistrate, (ii) a clerk or deputy clerk of a court having a seal, (iii) a town clerk, (iv) a notary public, (v) a justice of the CDC.peace, or (vi) an attorney admitted to the bar of this state.

ThisGovernor's alsoAction: results in a potential savings to municipalities beginning in FY 27 to the extent:

(1)Approved DPHApril distributes27, vaccines2026 toPublic municipalAct healthNo. authorities;

and26-3 (2)23 in the absence of the23 bill, municipalities would have covered this cost.

Any savings to municipalities is dependent on which vaccine costs are covered by DPH.

The Out Years The annualized ongoing fiscal impact identified above would continue into the future subject to inflation.

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405 OLR Bill Analysis sHB 5044 AN ACT ESTABLISHING CONNECTICUT VACCINE STANDARDS.

SUMMARY This bill makes various changes to state laws on immunizations.

Principally, it:

1.

requires the Department of Public Health (DPH) commissioner to establish an immunization standard of care for adults, in addition to children as under current law, and authorizes her to consider recommended vaccine schedules from additional organizations when doing so (§§ 1, 3, & 5-7);

2.

requires the Connecticut Vaccine Program (CVP) to give all children’s vaccines included under DPH’s standard of care, instead of only those recommended by the CDC Advisory Committee on Immunization Practices (ACIP), and allows DPH to purchase the vaccines by means other than through the CDC under certain conditions (§ 2);

3.

requires DPH, in consultation with the Department of Social Services (DSS), to adopt regulations for nursing homes on immunization requirements for respiratory viral diseases (such as flu and pneumonia), according to DPH’s immunization standard ofcare instead oftheCDC recommendations asunder current law (and allows DPH to adopt related policies and procedures while in the process of adopting regulations) (§ 4);

4.

allows the governor, during a public health emergency, to authorize the DPH commissioner or her designee to issue a standing order to allow medical interventions (including vaccines) needed to respond to the emergency (§ 8);

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405 5.

establishes, within available appropriations, a DPH-administered Vaccines for Adults Program that purchases and distributes vaccines to eligible health care providers to administer to underinsured and uninsured adults ages 19 and older (§§ 9 & 10);

6.

requires health insurance policies that cover prescription drugs to also cover immunizations for children, adolescents, and adults included in DPH’s standards of care within the schedules the standards prescribe (§§ 11 & 12);

7.

authorizes licensed pharmacists to order, prescribe, and administer vaccines listed in DPH’s immunization standards of care, instead of CDC-recommended vaccines, for adult patients and patients between ages 12 and 18 (with parental consent or proof the minor is emancipated) (§ 13);

and 8.

expressly provides that the state’s Religious Freedom Restoration Act (RFRA) does not apply to school immunization requirements for (a) public and private schools, including higher education institutions and (b) child care centers and group and family day care homes (§ 14).

EFFECTIVE DATE:

Upon passage, except that provisions on (1) insurance coverage for vaccines take effect January 1, 2027, and (2) RFRA take effect upon passage and apply to any civil action pending or filed after that date.

§ § 1, 3 & 5-7 — EXPANDED IMMUNIZATION STANDARDS OF CARE Current law requires the DPH commissioner to establish an immunization standard of care for children based on the recommended vaccine schedules of ACIP, the American Academy of Pediatrics (AAP), and the American Academy of Family Physicians (AAFP).

The bill requires the commissioner to also establish an immunization standard of care for adults and, when setting any immunization standards, allows her to consider recommended immunization schedules from additional organizations, such as the American College sHB5044 / File No.

405 17 sHB5044 File No.

405 of Obstetrics and Gynecology (ACOG).

The standards of care must include immunization schedules for children and adults the commissioner recommends as well as any related contraindications.

The bill makes related conforming changes to provisions on (1) the health and welfare fee assessed against certain insurers to pay for the CVP (§ 3);

(2) medical exemption forms for state immunization requirements (§ 5);

and school immunization requirements, including for higher education institutions (§§ 6 & 7).

§ 2 — VACCINES FOR CHILDREN PROGRAM By law, DPH administers the CVP, which gives health care providers certain vaccines at no cost to administer to children under age 19, regardless of insurance status.

Under current law, the program only gives ACIP-recommended vaccines that DPH purchases through the CDC.

The bill instead requires the program to give all vaccines included in DPH’s recommended children’s vaccine schedule set under its standard of care.

It allows DPH to purchase the vaccines by means other than through the CDC, so long as the purchase conforms with practices designed to increase efficiency and reduce state costs.

§ 4 — NURSING HOME IMMUNIZATION REGULATIONS Current law requires the DPH commissioner to adopt nursing home regulations that generally require, among other things, residents to be adequately immunized against the flu and pneumonia according to ACIP recommendations.

The bill instead requires DPH to adopt immunization requirements for respiratory viral diseases, including the flu and pneumonia, based on DPH’s immunization standards and consult with the DSS commissioner when doing so.

Under the bill, the DPH commissioner may adopt policies and procedures needed to implement these immunization requirements while in the process of adopting regulations.

She must publish notice of her intent to adopt regulations on the eRegulations system within 20 days after implementing the policies and procedures, which are valid until final regulations are adopted.

sHB5044 / File No.

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405 § 8 — PUBLIC HEALTH EMERGENCIES The bill allows the governor, during a statewide or regional public health emergency, to authorize the DPH commissioner or her designee to issue a standing order to allow medical interventions (including vaccines) needed to respond to the emergency.

Under the bill, a standing order is a nonpatient-specific statewide order that (1) includes a prescription or order issued by a physician that allows licensed health care providers to dispense or administer medical interventions to treat, or control and prevent the spread of, a disease or public health threat and (2) does not require a person to receive or use these interventions.

§§ 9 & 10 — VACCINES FOR ADULTS PROGRAM The bill establishes, within available appropriations, a DPH- administered Vaccines for Adults Program.

Under the program, DPH must purchase and distribute vaccines to free clinics, municipal and district health departments, and other licensed health care providers determined by the commissioner who vaccinate adults ages 19 and older (“eligible health care providers”).

Under the bill, the commissioner must determine the (1) vaccines the program purchases and distributes based on their efficacy in preventing serious disease and death in adults and (2) eligible health care providers the program distributes the vaccines to.

When determining which vaccines to purchase, the commissioner may consult with DPH’s Federal Recommendations Advisory Committee (see BACKGROUND).

Thebillallowsaneligiblehealthcareprovidertoadministeravaccine provided under the program to a patient only if the vaccine is not already covered by (1) the patient’s public or private health insurance plan (if any) or (2) a payment plan the patient entered into with the provider for health care services.

Under the bill, the program’s vaccines and provider eligibility requirements the commissioner determines are not considered state regulationsandareexemptfromtheUniformAdministrativeProcedure sHB5044 / File No.

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405 Act’s regulatory process.

§§ 11 & 12 — INSURANCE COVERAGE FOR IMMUNIZATIONS The bill requires health insurance policies that cover prescription drugs to also cover immunizations for children, adolescents, and adults included in DPH standards of care based onthe schedules the standards set.

Existing law already requires these insurance policies to cover immunizations (1) recommended by the AAP, AAFP, or ACOG and (2) that have, in effect, a recommendation from ACIP for the person involved.

These include, for example, immunizations for influenza, meningitis, tetanus, HPV, hepatitis A and B, measles, mumps, rubella, and varicella.

For ACIP-recommended immunizations, existing law requires insurance policies to also cover a 20-minute immunization consultation between a patient and a provider authorized to administer them.

The bill applies to individual and group health insurance policies delivered, issued, renewed, amended, or continued in Connecticut that cover (1)basichospitalexpenses;(2)basicmedical-surgicalexpenses;(3) major medical expenses;

or (4) hospital or medical services, including those provided under an HMO plan.

Because of the federal Employee Retirement Income Security Act (ERISA), state insurance benefit mandates do not apply to self-insured benefit plans.

§ 13 — PHARMACISTS The bill authorizes licensed pharmacists to order, prescribe, and administer FDA-approved or authorized vaccines listed in DPH’s immunization standards of care, instead of only CDC-recommended vaccines, to adult patients and patients between ages 12 and 18 (with parental consent or proof the minor is emancipated).

Current law also allows pharmacists to order, prescribe, and administer to adult patients other vaccines that are (1) not on the immunization schedules, but for which there are administration instructions on CDC’s website or (2) prescribed (verbally or written) by a practitioner for a specific patient.

The bill specifies that these vaccines sHB5044 / File No.

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405 must be FDA-approved or authorized, and for vaccines that are not on the schedules, eliminates the condition that there must be instructions on the website.

§ 14 — RELIGIOUS FREEDOM RESTORATION ACT The Connecticut Constitution grants people the right to follow their religion and a state law commonly referred to as RFRA prohibits the state or any of its political subdivisions from placing any burden on this right, unless they can demonstrate that their actions are to further a compelling governmental interest and are the least restrictive way of doing so.

The bill expressly provides that RFRA does not apply to school immunization requirements for (1) public and private schools, including higher education institutions and (2) child care centers and group and family day care homes.

(A 2021 law eliminated the religious exemption from immunization requirements for people attending these facilities, and grandfathered people enrolled in grades kindergarten or higher who had already submitted the exemption.) BACKGROUND DPH Federal Recommendations Advisory Committee As authorized by law, the DPH commissioner has created a committee of experts to advise her on matters relating to CDC and FDA recommendations, using evidence-based data from peer-reviewed sources.

The committee must serve in a nonbinding advisory capacity, giving guidance only at thecommissioner’sdiscretion (CGS §19a-131n).

Related Bill sSB 450, favorably reported by the Public Health Committee, has identical provisions to the bill.

Related Case In 2022, parents from a few Connecticut municipalities filed a lawsuit against the governor and the education and public health commissionersclaimingthatthelegislature’s2021repealofthereligious sHB5044 / File No.

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405 exemption for school immunization requirements violated state and federal religious freedom protections.

In July 2024, the state Supreme Court dismissed the parents’ claims under the Connecticut and U.S.

constitutions but allowed their claims made under state statute (RFRA) to proceed (Spillane v.

Lamont, 350 Conn.

119 (2024)).

The case is currently pending in Connecticut Superior Court.

COMMITTEE ACTION Public Health Committee Joint Favorable Substitute Yea 21 Nay 10 (03/18/2026) sHB5044 / File No.

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