AN ACT ESTABLISHING CONNECTICUT VACCINE STANDARDS.

Substitute House Bill No. 5044

Public Act No. 26-3

AN ACT ESTABLISHING CONNECTICUT VACCINE STANDARDS.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:

Section 1. Subsection (a) of section 19a-7f of the general statutes is
repealed and the following is substituted in lieu thereof ( Effective from
passage):
(a) The Commissioner of Public Health shall [determine] establish the
standard of care for immunization for [the children ] residents of this
state. The standard of care for immunization shall (1) be based on a
consideration of the recommended schedules for [active] immunization
for [normal] adults, infants and children published by the National
Centers for Disease Control and Prevention Advisory Committee on
Immunization Practices, the American Academy of Pediatrics , the
American College of Obstetrics and Gynecology and the American
Academy of Family Physicians , and (2) include schedules
recommended by the commissioner for immunization and
contraindications to administration of vaccines in accordance with such
schedules. The commissioner shall establish, within available
appropriations, an immunization program [which] that shall: [(1)] (A)
Provide [vaccine] vaccines at no cost t o health care providers in
Connecticut to administer to children so that cost of [vaccine] vaccines
will not be a barrier to age-appropriate vaccination in this state; [(2)] (B)
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with the assistance of hospital maternity programs, provide all parents
in this state with the recommended immunization schedule for [normal]
infants and children, a booklet to record immunizations at the time of
the infant's discharge from the hospital nursery and a list of sites where
immunization may be provided; [(3)] (C) inform in a timely manner all
health care providers of changes in the recommended immunization
schedule; [(4)] (D) assist hospitals, local health providers and local
health departments to develop and implement record -keeping and
outreach programs to identify and immunize those children who have
fallen behind the recommended immunization schedule or who lack
access to regular preventative health care and have the authority to
gather such data as may be needed to evaluate such efforts; [(5)] (E)
assist in the development of a program to assess the vaccination status
of children who are clients of state and federal programs serving the
health and welfare of children and make provision for v accination of
those who are behind the recommended immunization schedule; [(6)]
(F) access available state and federal funds , including, but not limited
to, any funds available through the federal Childhood Immunization
Reauthorization or any funds available through the Medicaid program;
[(7)] (G) solicit, receive and expend funds from any public or private
source; and [(8)] (H) develop and make available to parents and health
care providers public health educational materials about the benefits of
timely immunization.
Sec. 2. Subparagraph (B) of subdivision (3) of subsection (b) of section
19a-7f of the general statutes is repealed and the following is substituted
in lieu thereof (Effective from passage):
(B) [Commencing January 1, 2013, (i) any ] Any health care provider
who administers vaccines to children (i) under the federal Vaccines For
Children immunization program that is operated by the Department of
Public Health under authority of 42 USC 1396s shall utilize, and the
department shall provide, any vaccine licensed by the federal Food and
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Drug Administration, including any combination vaccine and dosage
form, that is (I) recommended by the National Centers for Disease
Control and Prevention Advisory Committee on Immunization
Practices, and (II) made available to the department by the National
Centers for Disease Control and Prevention, and (ii) [any health care
provider who administers vaccines to children ] shall utilize, and the
department shall provide, subject to inclusion in such program due to
available appropriations, any vaccine licen sed by the federal Food and
Drug Administration, including any combination vaccine and dosage
form, that is (I) [recommended by the National Centers for Disease
Control and Prevention Advisory Committee on Immunization
Practices] set forth in the schedules for immunization included in the
standard of care for immunization established pursuant to subsection
(a) of this section, (II) made available to the department by the National
Centers for Disease Control and Prevention or by other means of
procurement, provided such procurement conforms with practices
designed to reduce state procurement costs and results in more efficient
state procurement , and (III) equivalent, as determined by the
commissioner, to the cost for vaccine series completion of comparable
available licensed vaccines.
Sec. 3. Subsection (a) of section 19a -7j of the general statutes is
repealed and the following is substituted in lieu thereof ( Effective from
passage):
(a) Not later than September first, annually, the Secretary of the Office
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 distr ibute vaccines for
routine immunizations [included] for infants and children set forth in
the [schedule] schedules for [active] immunization [required by ]
included in the standard of care for immunization established pursuant
to section 19a -7f, as amended by this act ; (B) to purchase, store and
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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 ] schedules
for immunization included in the standard of care for immunization
established pursuant to section 19a -7f, as amended by this act , (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 treatment of patients in
communicable disease control clinics, as defined in section 19a-216a; (C)
to administer the immunization program for infants and children
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 immunization information
system, established pursuant to section 19a -7h, (2) calculate the
difference between the amount expended in the prior fiscal year for the
purposes set forth in subdivision (1) of t his subsection and the amount
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. Section 19a -522 of the general statutes is repealed and the
following is substituted in lieu thereof (Effective from passage):
(a) The [commissioner] Commissioner of Public Health, in
consultation with the Commissioner of Social Services, shall adopt
regulations, in accordance with chapter 54, concerning the health, safety
and welfare of patients in nursing home facilities, classification of
violations relating to such facilities, medical staff qualifications, record-
keeping, nursing servi ce, dietary service, personnel qualifications and
general operational conditions. The regulations shall: (1) [Assure]
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Ensure that each patient admitted to a nursing home facility is protected
by adequate immunization against respiratory viral diseases, including,
but not limited to, influenza and pneumococcal disease in accordance
with the [recommendations of the National Advisory Committee on
Immunization Practices, established by the Secretary of Health and
Human Services] schedules for immunization included in the standard
of care for immunization established pursuant to section 19a -7f, as
amended by this act; (2) specify that each patient be protected annually
against influenza and be vaccinated against pneumonia in accordance
with the [recommendations of the National Advisory Committee on
Immunization] standard of care for immunization established pursuant
to section 19a -7f, as amended by this act ; and (3) provide appropriate
exemptions for patients for whom such immunizations are medically
contraindicated and for patients who object to such immunization on
religious grounds.
(b) The Commissioner of Public Health may implement policies and
procedures necessary to administer the provisions of this section
concerning the protection of patients by adequate immunization against
respiratory viral diseases while in the process of adopting such policies
and procedures as regulations, provided notice of intent to adopt
regulations is published on the eRegulations System not later than
twenty days after the date of implementation. Policies and procedures
implemented pursuant to this sect ion shall be valid until the time final
regulations are adopted.
[(b)] (c) Nursing home facilities or residential care homes may not
charge the family or estate of a deceased self -pay patient beyond the
date on which such patient dies. Nursing home facilities or residential
care homes shall reimburse the estate of a deceased self -pay patient,
within sixty days after the death of such patient, for any advance
payments made by or on behalf of the patient covering any period
beyond the date of death. Interest, in accordance with subsection (a) of
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section 37-1, on such reimbursement shall begin to accrue from the date
of such patient's death.
Sec. 5. Section 19a -7q of the general statutes is repealed and the
following is substituted in lieu thereof (Effective from passage):
[On or before October 1, 2021, the ] The Commissioner of Public
Health shall develop and make available on the Internet web site of the
Department of Public Health a certificate for use, in a form and manner
prescribed by the commissioner, by a licensed physician, licensed
physician assistant or licensed advanced practice registered nurse
stating that, in the opinion of such physician, physician assistant or
advanced practice registered nurse, a vaccination required by the
general statutes is medically contraindicated for a person because of the
physical condition of such person. The certificate shall include (1)
definitions of the terms "contraindication" and "precaution", (2) a list of
contraindications and precautions [recognized by the National Centers
for Disease Control and Prevention] included in the standard of care for
immunization established pursuant to section 19a -7f, as amended by
this act, for each of the statutorily required vaccinations, from which the
physician, physician assistant or advanced practice registered nurse
may select the relevant contraindication or precaution on behalf of such
person, (3) a section in which the physician, physician assistant or
advanced practice registered nurse may record a contraindication or
precaution that is not [recognized by the National Centers for Disease
Control and Prevention ] included in the standard of care for
immunization established pursuant to section 19a -7f, as amended by
this act , but in his or her discretion, results in the vaccination being
medically contraindicated, including, but not limited to, any
autoimmune disorder, family history of any autoimmune disorder,
family history of any reaction to a vaccination, genetic predisposition to
any reaction to a vaccination as determined through genetic testing and
a previous documented rea ction of a person that is correlated to a
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vaccination, (4) a section in which the physician, physician assistant or
advanced practice registered nurse may include a written explanation
for the exemption from any statutorily required vaccinations, (5) a
section requiring the signature of the physic ian, physician assistant or
advanced practice registered nurse, (6) a requirement that the physician,
physician assistant or advanced practice registered nurse attach such
person's most current immunization record, and (7) a synopsis of the
grounds for any order of quarantine or isolation pursuant to section 19a-
131b.
Sec. 6. Section 10 -204a of the general statutes is repealed and the
following is substituted in lieu thereof (Effective from passage):
(a) Each local or regional board of education, or similar body
governing a nonpublic school or schools, shall require each child to be
protected by adequate immunization against diphtheria, pertussis,
tetanus, poliomyelitis, measles, mumps, rubella, haemop hilus
influenzae type B and any other vaccine required by the schedule for
[active] immunization adopted pursuant to section 19a -7f, as amended
by this act, before being permitted to enroll in any program operated by
a public or nonpublic school under its jurisdiction. Before being
permitted to enter seventh grade, a child shall receive a second
immunization against measles. Any such child who (1) presents a
certificate from a physician, physician assistant, advanced practice
registered nurse or local healt h 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 of a
child enrolled in a preschool p rogram or other prekindergarten
program who, prior to April 28, 2021, was exempt from the appropriate
provisions of this section upon presentation of a statement that such
immunizations would be contrary to the religious beliefs of such child
or the parent s or guardian of such child, as such additional
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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 (2) presents a certificate, in a form pres cribed by the
commissioner pursuant to section 19a-7q, as amended by this act, from
a physician, physician assistant or advanced practice registered nurse
stating that in the opinion of such physician, physician assistant or
advanced practice registered nu rse such immunization is medically
contraindicated because of the physical condition of such child; or (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; or (4) in the case of haemophilus influenzae type B has passed
such child's fifth birthday; 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 notw ithstanding 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
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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 bel iefs 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 lat er 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 g overning a nonpublic
school or schools, be paid by the town.
(e) The definitions of adequate immunization shall reflect the
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[schedule] schedules for [active] immunization [adopted] included in
the standard of care for immunization established pursuant to section
19a-7f, as amended by this act, 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 such boards and such similar governing bodies shall
collect and report immunization data on each child to the Department
of Public Health for (1) compilation and analysis by 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.
(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.
Sec. 7. Subsection (a) of section 10a -155 of the general statutes is
repealed and the following is substituted in lieu thereof ( Effective from
passage):
(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 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.
Sec. 8. Subsection (a) of section 19a -131a of the general statutes is
repealed and the following is substituted in lieu thereof ( Effective from
passage):
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(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: (1) Order the
commissioner to implement all or a portion of the public health
emergency response plan developed pursuant to section 19a -131g; (2)
authorize the commissioner to isolate or quarantine persons in
accordance with section 19a -131b; ( 3) order the commissioner to
vaccinate persons in accordance with section 19a-131e; (4) apply for and
receive federal assistance; [or] (5) order the commissioner to suspend
certain license renewal and inspection functions during the period of the
emergency and during the six -month period following the date the
emergency is declared to be over; or (6) authorize the commissioner, or
the commissioner's designee, to issue a standing order to permit medical
interventions, including vaccination, necessary to respond to the public
health emergency. As used in this subsection, "standing order" means a
nonpatient specific regimen applicable state wide that (A) includes, but
is not limited to, a prescription or order that is issued by a physician
licensed pursuant to chapter 370 allowing licensed health care 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.
Sec. 9. (NEW) ( Effective from passage ) (a) As used in this section,
"eligible health care provider" means a free clinic, as defined in section
19a-630 of the general statutes, municipal health authority established
under chapter 368e of the general statutes, district department of health
established under chapter 368f of the general statutes and any other
health care provider, as determined by the Commissioner of Public
Health, who is licensed as a health care provider in the state and
provides vaccinations for persons nineteen years of age or older.
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(b) There is established, within available appropriations, a vaccines
for adults program to be administered by the Department of Public
Health. The program shall provide for the department to purchase and
distribute vaccines to eligible health care providers. 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
preventing serious disease and death in the adult population and the
eligible health care provide rs to whom such vaccines shall be
distributed. In making such determination regarding the vaccines to be
purchased, the commissioner may consult with the advisory committee
established pursuant to section 19a -131n of the general statutes. An
eligible health care provider may administer a vaccine provided under
the program to a patient only if such vaccine is not a covered benefit for
the patient under any self-funded employee health benefits plan, health
benefit plan, as defined in section 38a -1080 of the g eneral statutes,
Medicaid, as defined in section 19a-508c of the general statutes, the state
employee plan, as defined in section 3-123aaa of the general statutes, or
a payment plan entered into between the health care provider and the
patient for health care services provided by such health care provider to
such patient. The list of vaccines for purchase and distribution and the
eligibility requirements for eligible health care providers determined by
the commissioner pursuant to this subsection shall not be considered
regulations of Connecticut state agencies, as defined in section 4 -166 of
the general statutes.
Sec. 10. Subsection (d) of section 4-186 of the 2026 supplement to the
general statutes is repealed and the following is substituted in lieu
thereof (Effective from passage):
(d) The provisions of this chapter shall not apply to: (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,
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(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 of this act.
Sec. 11. Subsection (a) of section 38a -492r of the general statutes is
repealed and the following is substituted in lieu thereof (Effective January
1, 2027):
(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 pres cription 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 a recommendation from the
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 b etween such individual and a health care provider
authorized to administer such immunizations to such individual , and
(3) coverage for immunizations within the schedules for immunization
included in the standard of care for immunization established pursuant
to section 19a-7f, as amended by this act.
Sec. 12. Subsection (a) of section 38a -518r of the general statutes is
repealed and the following is substituted in lieu thereof (Effective January
1, 2027):
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(a) Each group 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 prescript ion 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 a recommendation from the
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 betwee n such individual and a health care provider
authorized to administer such immunizations to such individual , and
(3) coverage for immunizations within the schedules for immunization
included in the standard of care for immunization established pursuant
to section 19a-7f, as amended by this act.
Sec. 13. Subdivision (1) of subsection (a) of section 20 -633 of the
general statutes is repealed and the following is substituted in lieu
thereof (Effective from passage):
(a) (1) Any person licensed as a pharmacist under part II of this
chapter may order, prescribe and administer any vaccine approved or
authorized by the United States Food and Drug Administration as
follows:
(A) Any such vaccine [, approved or authorized by the United States
Food and Drug Administration ] that is listed [on] in the National
Centers for Disease Control and Prevention's age -appropriate
immunization schedule or the schedules for immunization included in
the standard of care for immunization established pursuant to section
19a-7f, as amended by this act, to any patient who is: (i) Eighteen years
of age or older; 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
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guardian or other person having legal custody of such patient, or (II)
proof that such patient is an emancipated minor;
(B) Any such vaccine that is not [included on] listed in the National
Centers for Disease Control and Prevention's Adult Immunization
Schedule or in the schedules for immunization included in the standard
of care for immunization established pursuant to section 19a -7f, as
amended by this act, to any patient who is eighteen years of age or older;
[, provided the vaccine administration instructions for such vaccine are
available on the National Centers for Disease Control and Prevention's
Internet web site;] and
(C) Any such vaccine pursuant to a verbal or written prescription of
a prescribing practitioner for a specific patient.
Sec. 14. Section 52 -571b of the general statutes is repealed and the
following is substituted in lieu thereof ( Effective from passage and
applicable to any civil action pending on or filed after said date):
(a) The state or any political subdivision of the state shall not burden
a person's exercise of religion under section 3 of article first of the
Constitution of the state even if the burden results from a rule of general
applicability, except as provided in subsection (b) of this section.
(b) The state or any political subdivision of the state may burden a
person's exercise of religion only if it demonstrates that application of
the burden to the person (1) is in furtherance of a compelling
governmental interest, and (2) is the least restrictive means of furthering
that compelling governmental interest.
(c) A person whose exercise of religion has been burdened in
violation of the provisions of this section may assert that violation as a
claim or defense in a judicial proceeding and obtain appropriate relief
against the state or any political subdivision of the state.
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(d) Nothing in this section shall be construed to authorize the state or
any political subdivision of the state to burden any religious belief.
(e) Nothing in this section shall be construed to affect, interpret or in
any way address that portion of article seventh of the Constitution of
the state that prohibits any law giving a preference to any religious
society or denomination in the state. The gra nting of government
funding, benefits or exemptions, to the extent permissible under the
Constitution of the state, shall not constitute a violation of this section.
As used in this subsection, the term "granting" does not include the
denial of government funding, benefits or exemptions.
(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, subdivision (1) of subsection (a) and
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,
department, officer or employee of the state or any political subdivision
of the state, and "demonstrates" means meets the burdens o f going
forward with the evidence and of persuasion.
Sec. 15. Subsections (a) and (b) of section 19a -79 of the 2026
supplement to the general statutes are repealed and the following is
substituted in lieu thereof (Effective from passage):
(a) The Commissioner of Early 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
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care centers and group child care homes. 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, 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 , (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
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 2 0-12d, 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 fa cility
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, hal ls, 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 Institu te, Medic
First Aid International, Inc. or an organization using guidelines for
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cardiopulmonary resuscitation and 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 Sta tes Food and Drug Administration that is
used to treat an allergic reaction, or for injectable equipment, nasal spray
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 equip ment 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 car e 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 illnes s or injury, (ii) the date, time of occurrence
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and location of such 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 guardian of 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. When establishing such requirements, the Office of
Early Childhood shall give consideration to child care centers and group
child care homes that are located in private or public school buildings.
With respect to subd ivision (8) 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. Until replaced by policies and 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. The commissioner shall post 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. Policies and
procedures implemented pursuant to this subdivision shall be valid
until the time final regulations are adopted. For purposes of this
subsection, "illness" means fever, vomiting, diarrhea, ras h, headache,
persistent coughing, persistent crying or any other condition deemed an
illness by the Commissioner of Early Childhood.
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(b) Any child 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 pu rsuant 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. The statement descri bed in subparagraph (A) of
subdivision (3) 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
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court having a seal, a town clerk, a notary public, a justice of the peace,
or an attorney admitted to the bar of this state.
Sec. 16. Subsections (f) and (g) of section 19a -87b of the 2026
supplement to the general statutes are repealed and the following is
substituted in lieu thereof (Effective from passage):
(f) The commissioner shall adopt regulations, in accordance 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. Such regulations shall (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, poliomyeliti s, 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 in accordance with section 20-12d, and the
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 illnes s or injury, which shall, (A)
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include, but not be limited to, (i) a description of such illness or injury,
(ii) the date, time of occurrence and location of such illness or injury, (iii)
any responsive action taken by an employee of such home, and (iv)
whether such child was transporte d 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 guardian of such child not later
than the 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 the request of the Office of Early
Childhood. The commissioner shall inform each licensee, by way of a
plain language summary provided not later 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. For purposes
of this subsection, "illness" means fever, vomiting, diarrhea, rash,
headache, persistent coughing, persistent crying or any other condition
deemed an illness by the Commissioner of Early Childhood.
(g) Any child 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 pu rsuant to
subsection (f) 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 progr am or below, (A)
presented a statement, prior to April 28, 2021, that such immunizations
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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 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. The statement
described in subparagraph (A) of subdivision (3) of this subsection shall
be acknowledged, in accordance with the provisions of sections 1-32, 1-
34 and 1 -35, by (i) a judge of a co urt of record or a family support
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 peace, or (vi) an
attorney admitted to the bar of this state.

Governor's Action:
Approved April 27, 2026