SB 457 — AN ACT CONCERNING CLINICAL MEDICAL ASSISTANTS.

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322 Practices, (II) made available to the department by the National Centers for Disease Control and Prevention, and (III) equivalent, as determined by the commissioner, to the cost for vaccine series completion of comparable available licensed vaccines.

(C) For purposes of subparagraphs (A)(ii) and (B)(ii) of this subdivision, "comparable" means a vaccine (i) protects a recipient against the same infection or infections, (ii) has similar safety and efficacy profiles, (iii) requires the same number of doses, and (iv) is recommended for similar populations by the National Centers for Disease Control and Prevention.

(D) On and after October 1, 2022, any health care provider that administers vaccines to children under the immunization program described in subparagraph (B) of this subdivision shall order such vaccines using the immunization information system in a form and manner prescribed by the Commissioner of Public Health.

(4) (A) The provisions of this subsection shall not apply in the event of a public health emergency, as defined in section 19a-131, or an attack, major disaster, emergency or disaster emergency, as those terms are defined in section 28-1.

(B) Nothing in this subsection shall require a health care provider to procure a vaccine from the Department of Public Health when such provider is directed by said department to procure such vaccine from another source, including, but not limited to, during a declared national or state vaccine shortage.

(C) Nothing in this subsection shall require a health care provider to utilize or administer a vaccine provided by said department if, based upon such provider's medical judgment, (i) administration of such vaccine is not medically appropriate, or (ii) the administration of another vaccine that said department is not authorized to supply under subdivision (3) of this subsection is more medically appropriate.

(5) No health care provider shall seek or receive remuneration for or sSB457 / File No.

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322 sell any vaccine serum provided by said department under this section.

Nothing in this section shall prohibit a health care provider from charging or billing for administering a vaccine.

(6) Not later than January 1, 2014, said department shall submit a report to the General Assembly, in accordance with section 11-4a, evaluating the effectiveness of implementing expanded vaccine choice and universal health care provider participation.

Sec.

3.

Subsection (a) of section 19a-7j of the general statutes is repealed andthefollowing issubstituted inlieuthereof(EffectiveOctober 1, 2022):

(a)NotlaterthanSeptemberfirst,annually,theSecretaryoftheOffice of Policy and Management, in consultation with the Commissioner of Public Health, shall (1) determine the amount appropriated for the following purposes:

(A) To purchase, store and distribute vaccines for routine immunizations included in the schedule for active immunization required by section 19a-7f, as amended by this act;

(B) to purchase, store and distribute (i) vaccines to prevent hepatitis A and B in persons of all ages, as recommended by the schedule for immunizations published by the National Advisory Committee for Immunization Practices, (ii) antibiotics necessary for the treatment of tuberculosis and biologics and antibiotics necessary for the detection and treatment of tuberculosis infections, and (iii) antibiotics to support treatmentofpatientsincommunicabledisease controlclinics,asdefined in section 19a-216a;

(C) to administer the immunization program described in section 19a-7f, as amended by this act;

and (D) to provide services needed to collect up-to-date information on childhood immunizations for all children enrolled in Medicaid who reach two years of age during the year preceding the current fiscal year, to incorporate such information into the [childhood immunization registry, as defined] immunization information system, established pursuant to section 19a-7h, as amended by this act, (2) calculate the difference between the amount expended in the prior fiscal year for the purposes set forth in subdivision (1) of this subsection and the amount sSB457 / File No.

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322 of the appropriation used for the purpose of the health and welfare fee established in subparagraph (A) of subdivision (2) of subsection (b) of this section in that same year, and (3) inform the Insurance Commissioner of such amounts.

Sec.

4.

Subsection (a) of section 19a-7r of the 2022 supplement to the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2022):

(a) There is established an Advisory Committee on Medically Contraindicated Vaccinations within the Department of Public Health for thepurpose ofadvising theCommissioner ofPublicHealthonissues concerning exemptions from state or federal requirements for vaccinations that result from a physician, physician assistant or advanced practice registered nurse stating that a vaccination is medically contraindicated for a person due to the medical condition of such person.

Said advisory committee shall not be responsible for confirming or denying any determination by a physician, physician assistant or advanced practice registered nurse that a vaccination is medically contraindicated for a specific individual.

In order to carry out its duties, the advisory committee shall (1) have access to the [childhood immunization registry] immunization information system established by the department pursuant to section 19a-7h, as amended by this act, (2) evaluate the process used by the department in collecting data concerning exemptions resulting from a vaccination being medically contraindicated and whether thedepartmentshould have any oversight over such exemptions, (3) examine whether enrollment of an unvaccinated child into a program operated by a public or nonpublic school, institution of higher education, child care center or group child care home should be conditioned upon the child meeting certain criteria, (4) calculate the ratio of school nurses to students in each public and nonpublic school in the state and the funding issues surrounding such ratio, (5) assess whether immunizations should be required more frequently than prior to enrollment into a program operated by a public or nonpublic school and prior to entering seventh grade, and (6) determine whether (A) there are any discrepancies in the issuance of sSB457 / File No.

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322 certificates stating that a vaccine is medically contraindicated, and (B) to recommend continuing education of physicians, physician assistants or advanced practice registered nurses in vaccine contraindications and precautions.

All information obtained by the advisory committee from such registry shall be confidential pursuant to section 19a-25.

Sec.

5.

Section 19a-7t of the 2022 supplement to the general statutes is repealed.

(Effective October 1, 2022) This act shall take effect as follows and shall amend the following sections:

Section 1 October 1, 2022 19a-7h Sec.

2 October 1, 2022 19a-7f(b) Sec.

3 October 1, 2022 19a-7j(a) Sec.

4 October 1, 2022 19a-7r(a) Sec.

5 October 1, 2022 Repealer section Statement of Legislative Commissioners:

In Section 1(a), "an advanced practice registered nurse, nurse midwife or registered nurse licensed pursuant to chapter 378" was changed to "a nurse-midwife licensed pursuant to chapter 377, an advanced practice registered nurse or registered nurse licensed pursuant to chapter 378" for accuracy and consistency with the general statutes;

and Sections 3 and 4 were added to conform with the changes being made in Section 1.

PH Joint Favorable Subst.

-LCO sSB457 / File No.

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322 The following Fiscal Impact Statement and Bill Analysis are prepared for the benefit of the members of the General Assembly, solely for purposes of information, summarization and explanation and do not represent the intent of the General Assembly or either chamber thereof for any purpose.

In general, fiscal impacts are based upon a variety of informational sources, including the analyst’s professional knowledge.

Whenever applicable, agency data is consulted as part of the analysis, however final products do not necessarily reflect an assessment from any specific department.

OFA Fiscal Note State Impact:

None Municipal Impact:

None Explanation This bill replaces the Department of Public Health’s (DPH) childhood immunization registry and tracking system (“CIRTS”) with an immunization information system (“CT WiZ”) that provides vaccine recipients of all ages, instead of only children under age 6, with access to their immunization records.

The bill requires, rather than allows, DPH to maintain the system and requires the system to include information to accurately identify a vaccine recipient and assess the recipient’s current immunization status.

Under the bill, vaccine recipients’ participation in CT WiZ is voluntary, and health care providers must provide a vaccine recipient, or the recipient’s legal guardian, information on how to opt out of enrolling in the system.

There is no fiscal impact for DPH to maintain an immunization registry and tracking system that has an enrollment "opt out" option.

The Out Years State Impact:

None Municipal Impact:

None sSB457 / File No.

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322 OLR Bill Analysis SB 457 AN ACT CONCERNING THE DEPARTMENT OF PUBLIC HEALTH'S RECOMMENDATIONS REGARDING CONNECTICUT'S IMMUNIZATION INFORMATION SYSTEM.

SUMMARY This bill replaces the Department of Public Health’s (DPH) childhood immunization registry and tracking system (“CIRTS”) with an immunization information system (“CT WiZ”) that provides vaccine recipients of all ages, instead of only children under age 6, with access to their immunization records.

The bill requires, rather than allows, DPH to maintain the system and requires the system to include information to accurately identify a vaccine recipient andassess therecipient’scurrent immunizationstatus.

Under the bill, vaccine recipients’ participation in CT WiZ is voluntary, and health care providers must provide a vaccine recipient, or the recipient’s legal guardian, conservator, or parent or guardian (if a minor) (hereafter “recipient’s representative”), information on how to opt out of enrolling in the system.

As under current law, all personal information in CT WiZ is confidential and cannot be disclosed without the consent of the vaccine recipient or the recipient’s representative.

Under the bill, healthcare providers:

1.

must order vaccines through CT WiZ when administering vaccines to children under the Connecticut Vaccine Program (see BACKGROUND);

2.

must report to DPH certain information regarding the vaccine sSB457 / File No.

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322 administration when they administer vaccines to residents;

and 3.

may use CT WiZ to access a person’s current immunization status to (a) determine whether the person requires immunizations or (b) officially document the person’s immunization status to meet childcare, school, or higher education immunization entry requirements.

The bill also imposes various requirements on CT WiZ and authorizes DPH to take specified actions, as follows:

1.

DPH must, upon request, provide a vaccine recipient, or the recipient’s representative, access to any information a health care provider gives to CT WiZ on the recipient’s vaccine status;

2.

DPH must, in consultation with the Office of Health Strategy (OHS), facilitate interoperability between CT WiZ and the Statewide Health Information Exchange;

3.

DPH must provide local and district health directors with sufficient information on residents who live in their jurisdiction and are listed in CT WiZ in order to address under-vaccinated communities and improve health equity;

4.

the DPH commissioner may use information in CT WiZ for medical or scientific research, disease control and prevention, and maintaining the state’s list of reportable diseases, emergency illnesses and health conditions, and lab findings (see BACKGROUND);

and 5.

DPH may exchange information in CT WiZ with federal agencies providing health care services and other states’ immunization information systems.

The bill also makes various related technical and conforming changes, including repealing a provision requiring DPH to provide COVID-19 vaccine recipients information on their vaccination status.

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322 EFFECTIVE DATE:

October 1, 2022 HEALTH CARE PROVIDER DEFINITION Under the bill, a health care provider is someone who:

1.

is a physician, physician assistant, nurse midwife, advanced practice registered nurse, registered nurse, pharmacist, or an individual authorized by state or federal law to administer a vaccine and 2.

has direct or supervisory responsibility for administering a vaccine or assessing a person’s immunization status.

REPORTING REQUIREMENTS The bill requires each health care provider who administers a vaccine to a resident to report, in a manner the DPH commissioner prescribes, the following information:

1.

the vaccine recipient’s name and date of birth;

2.

the name and date of each vaccine dose administered to the recipient;

3.

any other information the commissioner deems necessary;

and 4.

when appropriate, contraindications or exemptions to administering each vaccine dose.

INTEROPERABILITY WITH THE STATEWIDE HEALTH INFORMATION EXCHANGE The bill requires the DPH commissioner, in consultation with the Office of Health Strategy, to facilitate interoperability between the immunization information system and the Statewide Health Information Exchange.

It allows the commissioner to implement necessary policies and procedures while in the process of adopting regulations, provided she posts the policies and procedures on the eRegulationsSystembeforeadoptingthem.Thepoliciesandprocedures she implements are valid until the regulations are adopted.

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322 BACKGROUND Connecticut Vaccine Program The Connecticut Vaccine Program is a state and federally funded program that provides certain childhood vaccinations at no cost to health care providers.

The state-funded component is funded by an assessment on certain health insurers and third-party administrators.

DPH List of Reportable Diseases By law, DPH must annually issue a list of (1) reportable diseases, emergency illnesses, andhealthconditionsand(2)reportablelaboratory findings.

Health care providers and clinical laboratories must report findings of the diseases, illnesses, and conditions identified on this list within 12 hours and 48 hours, respectively.

COMMITTEE ACTION Public Health Committee Joint Favorable Yea 22 Nay 9 (03/23/2022) sSB457 / File No.

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