HB 6423 — AN ACT CONCERNING IMMUNIZATIONS.

General Assembly Substitute House Bill No.

6423 JanuaryPublic Session,Act 2021No. AN ACT CONCERNING IMMUNIZATIONS.

21-6 AN ACT CONCERNING IMMUNIZATIONS.

Any such child who (1) presents a certificate from a physician, physician assistant, advanced practice registered nurse or local health agency stating that initial immunizations have been given to such child and additional immunizations are in process (A) under guidelines and schedules specified by the Commissioner of Public Health, or (B) in the case ofaof childenrolledinsixthgradeorbelowwho,a child enrolled in a preschool programor other prekindergarten program who, prior totheeffectiveto the effective date of this section, was exempt from the appropriate provisions of this section upon presentation of a statement that such immunizations LCO \\PRDFS1\HCOUSERS\BARRYJN\WS\2021HB-06423-R021 of 24 HB.docx Substitute House Bill No.

6423 statement that such immunizations would be contrary to the religious beliefs of such child or the parents or guardian of such child, as such additional immunizations are recommended, in a written declaration, in a form prescribed by the Commissioner of Public Health, for such child by a physician, a physician assistant or an advanced practice registered nurse;

[or (3) presents a statement from the parents or guardian of such child that such immunization would be contrary to the religious beliefs of such child or the parents or guardian of such child, which statement shall be acknowledged, in accordance with the provisions of sections 1-32, 1-34 and 1-35, by (A) a judge of a court of record or a family support magistrate, (B)(B)a aclerkor clerk or deputy clerk ofofacourt a court having aaseal,(C)atown seal, (C) a town clerk, (D) a notary public, (E) a justice of the peace, (F) an attorney admitted to the bar of this state, or (G) notwithstanding any provision of chapter 6, a school nurse;] or [(4)] (3) in the case of measles, mumps or rubella, presents a certificate from a physician, physician assistant or advanced practice registered nurse or from the director of health in such child's present or previous town of residence, stating that the child has had a confirmed case of such disease;

[If the parents or guardians of any child are unable to pay for such immunizations, the expense of such immunizations shall, on the recommendations of such board of education, bepaidbe paid by the town.

Before being permittedtopermitted to enter seventh grade, the parents or guardian of any child who is exempt on religious grounds from the immunization requirements of this section, pursuant toPublic subdivisionAct (3) of this subsection, shall present to such school a statement that such immunization requirements are contrary to the religious beliefs of such child or the parents or guardian of such LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2021HB-06422 of 24 R02-HB.docx } Substitute Bill No.

642321-6 child,2 which statement shall be acknowledged, in accordance with the provisions of sections26 1-32,Substitute 1-34House andBill 1-35,No. by (A) a judge of a court of record or a family support magistrate, (B) a clerk or deputy clerk of a court having a seal, (C) a town clerk, (D) a notary public, (E) a justice of the peace, (F) an attorney admitted to the bar of this state, or (G) notwithstanding any provision of chapter 6, a school nurse.] 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)6423 Theto immunizationsubdivision requirements(3) providedof forthis insubsection, subsectionshall (a)present ofto thissuch sectionschool shalla notstatement applythat such immunization requirements are contrary to anythe religious beliefs of such child whoor isthe enrolledparents inor seventhguardian gradeof throughsuch twelfthchild, gradewhich onstatement orshall beforebe theacknowledged, effectivein dateaccordance with the provisions of thissections section1-32, if1-34 suchand child1-35, presentedby (A) a statement,judge priorof toa thecourt effectiveof daterecord ofor thisa section,family fromsupport themagistrate, parents(B) a clerk or guardiandeputy clerk of sucha childcourt thathaving sucha immunizationseal, is(C) contrarya totown theclerk, religious(D) beliefsa notary public, (E) a justice of suchthe childpeace, or(F) an attorney admitted to the parentsbar of this state, or guardian(G) notwithstanding any provision of suchchapter child,6, anda suchschool nurse.] The statement wasdescribed 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 (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.

(c)(b) AnyThe immunization requirements provided for in subsection (a) of this section shall not apply to any child who is enrolled in sixthkindergarten gradethrough ortwelfth belowgrade prioron toor before the effective date of this section whoif such child presented a statement, prior to the effective date of this section, from the parents or guardian of such child that thesuch immunization is contrary to the religious beliefs of such child or the parents or guardian of such child, whichand 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 LCOmagistrate, {\\PRDFS1\HCOUSERS\BARRYJN\WS\2021HB-06423(2) a clerk or deputy clerk of 24a R02-HB.docxcourt }having Substitutea Billseal, No.(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.

6423(c) magistrate,Any (2)child awho clerkis orenrolled deputyin clerk of a courtpreschool havingprogram aor seal,other (3)prekindergarten aprogram townprior clerk, (4) a notary public, (5) a justice of the peace, (6) an attorney admitted to the bareffective ofdate 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, ratherthanasrecommendedunder 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 onwho orPublic beforeAct SeptemberNo. 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.

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6423 presented a statement, prior to the effective date of this section, 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, rather than as recommended 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.

[(b)] (e) The definitions of adequate immunization shall reflect the schedule for active immunization adopted pursuant to section 19a-7f and be established by regulation adopted in accordance with the provisions of chapter 54 by the Commissioner of Public Health, who shall also be responsible for providing procedures under which [said] such boards and [said] such similar governing bodies shall collect and report immunization data on each child to the Department of Public HealthAct forNo. (1) compilation and analysis by [said] the department, 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.

[(c)]21-6 (f)4 The Commissioner of Public26 Health may issue a temporary waiver to the schedule for active immunization for any vaccine if the LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2021HB-06424 of 24 R02-HB.docx } Substitute House Bill No.

6423 Nationalsuch Centersboards and [said] such similar governing bodies shall collect and report immunization data on each child to the Department of Public Health for Disease(1) Controlcompilation and Preventionanalysis recognizesby a[said] nation-widethe shortagedepartment, and (2) release by the department of supplyannual immunization rates for each public and nonpublic school in the state, provided such vaccine.immunization data may not contain information that identifies a specific individual.

[(c)] (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.

Such information, records, reports, statements, notes, memoranda or other data shall not be admissible as evidence in any action of any kind in any court or before any other tribunal, board, agency or person, nor shall it be exhibited or its contents disclosed in any way, in whole or in part, by any officer or representative of the Department of Public HealthAct orNo. of any such facility, by any person participating in such a research project or by any other person, except as may be necessary for the purpose of furthering the research project to which it relates.

(b)21-6 Notwithstanding5 the provisions of chapter26 55, the Department of Public Health may exchange personal data for the purpose of medical LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2021HB-06425 of 24 R02-HB.docx } Substitute House Bill No.

6423 memoranda or scientificother research,data withshall not be admissible as evidence in any action of any kind in any court or before any other governmentaltribunal, board, agency or privateperson, nor shall it be exhibited or its contents disclosed in any way, in whole or in part, by any officer or representative of the Department of Public Health or of any such facility, by any person participating in such a research organization;project or by any other person, except as may be necessary for the purpose of furthering the research project to which it relates.

(b) Notwithstanding the provisions of chapter 55, the Department of Public Health may exchange personal data for the purpose of medical or scientific research, with any other governmental agency or private research organization;

[This section shall not be deemed to affect disclosure.]disclosure] (c) The provisions of this section shall not affect:

Sec.Public Act No.

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6423 Sec.

[Any such] (b) Notwithstanding the provisions of subsection (a) of this section, any student who (1) presents a certificate, in a form prescribed by the LCOCommissioner {\\PRDFS1\HCOUSERS\BARRYJN\WS\2021HB-06426of Public Health pursuant to section 7 of 24this R02-HB.docxact, }from Substitutea Billphysician,aphysicianassistantoranadvancedpracticeregisterednurse stating that in the opinion of such physician, physician assistant or advanced practice registered nurse such immunization is medically contraindicated, (2) [provides] prior to the effective date of this section, provided a statement that such immunization [would be] is contrary to his or her religious beliefs, (3) presents a certificate from a physician, a physician assistant, an advanced practice registered nurse or the director of health in the student's present or previous town of residence, stating that the student has had a confirmed case of such disease, (4) is enrolled exclusively in a program for which students do not congregate oncampusfor classesor to participate ininstitutional-sponsoredevents, such as students enrolled in distance learning programs for individualized home study or programs conducted entirely through electronic media in a setting without other students present, or (5) graduated from a public or nonpublic high school in this state in 1999 or later and was not exempt from the measles, rubella and [on and after August 1, 2010, the] mumps vaccination requirement pursuant to subdivision (2) [or (3)] of subsection (a) of section 10-204a, as amended by this act, shall be exempt from the appropriate provisions of this Public Act No.

642321-6 Commissioner of Public Health pursuant to section 7 of this26 act,Substitute fromHouse aBill physician,aphysicianassistantoranadvancedpracticeregisterednurseNo. stating that in the opinion of such physician, physician assistant or advanced practice registered nurse such immunization is medically contraindicated, (2) [provides] prior to the effective date of this section, provided a statement that such immunization [would be] is contrary to his or her religious beliefs, (3) presents a certificate from a physician, a physician assistant, an advanced practice registered nurse or the director of health in the student's present or previous town of residence, stating that the student has had a confirmed case of such disease, (4) is enrolled exclusively in a program for which students do not congregate oncampusfor classesor to participate ininstitutional-sponsoredevents, such as students enrolled in distance learning programs for individualized home study or programs conducted entirely through electronic media in a setting without other students present, or (5) graduated from a public or nonpublic high school in this state in 1999 or later and was not exempt from the measles, rubella and [on and after August 1, 2010, the] mumps vaccination requirement pursuant to subdivision (2) [or (3)] of subsection (a) of section 10-204a, as amended by this act, shall be exempt from the appropriate provisions of this section.

6423 section.

LCO(a) {\\PRDFS1\HCOUSERS\BARRYJN\WS\2021HB-06427For students who first enroll in the 2014-2015 school year, and first enroll in each school year thereafter, each public or private college or university in this state shall require that each student who resides in on- campus housing be vaccinated against meningitis and submit evidence of 24having R02-HB.docxreceived }a Substitutemeningococcal Billconjugate No.vaccine not more than five years before enrollment as a condition of such residence.

6423 (a) For students who first enroll in the 2014-2015 school year,and first enroll in each school year thereafter, each public or private college or university in this state shall require that each student who resides in on- campus housing be vaccinated against meningitis and submit evidence of having received a meningococcal conjugate vaccine not more than five years before enrollment as a condition of such residence.

Section 19a-79 of the general statutes is repealed and the followingPublic isAct substitutedNo. in lieu thereof (Effective from passage):

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6423 following is substituted in lieu thereof (Effective from passage):

Such regulations shall (1) 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, [hemophilus] haemophilus influenzae type B and any other vaccine required by the schedule of active immunization adopted pursuant to section 19a-7f, [including appropriate exemptions for children for whom such immunization is medically contraindicated and for children whose parent or guardian objects to such immunization on religious grounds, and that any LCOobjection {\\PRDFS1\HCOUSERS\BARRYJN\WS\2021HB-064238by a parent or a guardian to immunization of 24a R02-HB.docxchild }on Substitutereligiousgroundsshallbeaccompaniedbyastatementfromsuchparent Billor guardian that such immunization would be contrary to the religious beliefs of such child or the parent or guardian of such child, which statement shall be acknowledged, in accordance with the provisions of sections1-32,1-34and1-35,by(A)ajudgeofacourtofrecordorafamily support magistrate, (B) a clerk or deputy clerk of a court having a seal, (C) a town clerk, (D) a notary public, (E) a justice of the peace, or (F) an attorney admitted to the bar of this state,] (2) specify conditions under which child care center directors and teachers and group child care homeprovidersmayadministerteststomonitorglucoselevelsinachild 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 such child care center or group child care home pursuant to the written order of a physician licensed to practice medicine or a dentist licensed to practice Public Act No.

642321-6 objection9 by a parent or a guardian to immunization of a26 childSubstitute onHouse religiousgroundsshallbeaccompaniedbyastatementfromsuchparentBill orNo. guardian that such immunization would be contrary to the religious beliefs of such child or the parent or guardian of such child, which statement shall be acknowledged, in accordance with the provisions of sections1-32,1-34and1-35,by(A)ajudgeofacourtofrecordorafamily support magistrate, (B) a clerk or deputy clerk of a court having a seal, (C) a town clerk, (D) a notary public, (E) a justice of the peace, or (F) an attorney admitted to the bar of this state,] (2) specify conditions under which child care center directors and teachers and group child care homeprovidersmayadministerteststomonitorglucoselevelsinachild 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 such child care center or group child care home pursuant to the written order of a physician licensed to practice medicine or a dentist 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 child of total indoor usable space, free of furniture 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.

6423 dental medicine in this or another state, or an organizationadvanced usingpractice guidelinesregistered 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 child of total indoor usable space, free of furniture 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 andby LCOthe {\\PRDFS1\HCOUSERS\BARRYJN\WS\2021HB-06429American ofRed 24Cross, R02-HB.docxthe }American SubstituteHeart BillAssociation, No.the National Safety Council, American Safety and Health Institute, Medic First Aid International, Inc.

6423or an organization using guidelines for cardiopulmonary resuscitation and emergency cardiovascular care published by the American Heart Association and International Liaison Committee on Resuscitation, (6) specify that [on and after January 1, 2003,] 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 used to treat an allergic reaction, or for injectable equipment 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 injector or injectable equipment and a copy of the prescription for such medication and injector or injectable equipment upon enrollment of such child, and (D) shall require a parent or guardianPublic enrollingAct suchNo. a child to replace such medication and equipment prior to its expiration date, (7) specify that [on and after January 1, 2005,] 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, and (8) establish physical plant requirements for licensed child care centers and licensed group child care homes that exclusively serve school-age children.

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6423 guardian enrolling such a child to replace such medication and equipment prior to its expiration date, (7) specify that [on and after January 1, 2005,] 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, and (8) establish physical plant requirements for licensed child care centers and licensed group child care homes that exclusively serve school-age children.