CT House Floor Session — 2026-04-21

All right. Good morning, everyone. Can we take a moment and do whatever is your custom? I ask that we just bow ever so slightly this morning. Gracious and Eternal God, we gather in this Chamber where decisions are made that shape the lives of your people. Decisions that touch classrooms and courtrooms, me/ak 2 kitchen tables and hospital beds, city streets and quiet rural roads, and so we pause. Not out of routine, but out of recognition that we do not lead well, unless we are first led by something greater than ourselves. O God, we ask for wisdom. Not the kind that simply wins arguments, but the kind that builds bridges, wisdom that listens deeply, before it speaks boldly, wisdom that remembers that every policy carries a human face. Grant these leaders clarity of mind at a time when confusion is loud. Grant them steadiness of spirit when pressure mounts and voices rise. And yes, O God, grant them courage. Courage to stand for what is right even when it is not popular, courage to reach across aisles when division feels easier than dialogue, courage to tell the truth, not just to one another, but even to themselves. We pray for their hearts, soften what has grown rigid, strengthen what has grown weary, awaken what has grown indifferent. Remind us all that behind every statistic is a story, behind every bill is a body, and behind every vote is a consequence that somebody, somewhere, will have to live with. me/ak 3 O God, at a time when our Nation wrestles with fear, uncertainty, and deep division, let this place be different. Let it be a place where justice is not a slogan, but a standard. Where equity is not an aspiration, but an action. Where service is not a stepping-stone, but a sacred calling. And when the days grow long, and the work grows heavy, remind them why they came here in the first place, not for title, not for power, but for people. And when this session is over, may it be said that something shifted, that wisdom prevailed, that courage stood tall, and that the work done here made life better for the people of Connecticut and the people across these United States. We all pray together. Amen and Amen. Thank you.

Let's do business on the clerk's desk. Okay?

Mr. Majority Leader? So let's just make a motion just in case the table for calendar --

me/ak 5 I don't see any objection. (gavel) So ordered.

Thank you, Mr. Clark. Announcements or introductions. Representative Santiago of the 84th city of Meriden, you have the floor, madam.

Okay, madam.

me/ak 7 Thank you, Representative Santiago. Oh, yes.

Thank you. And we welcome, and please enjoy our chamber. And I'm sure folks will wander up to the 3rd Floor because that's just what we need is more desserts. But thanks for being here. Representative Haddad of the 54th, you're joined by a few of our colleagues. You have the floor, sir.

Thank you to Representative Haddad for that. That's great. Representative Ackert, Representative Boyd. Who's from Oxford? Which one of you is from Oxford? My son Jack played so many baseball games at that field with the Blue Monster. Do you know what I'm talking about? I have spent more time in your town than Hartford for the last two summers, it feels like, where I'm from. So when I heard that, it just brought back memories of Little League. So then congratulations to all of you, and that is quite an accomplishment to raise $2.2 million for a wonderful hospital here in Downtown Hartford. So thank you. Representative Callahan of the 108th, for what purpose do you rise, sir?

You may proceed. me/ak 11

Congratulations. We're very proud of him now. His school of choice leaves a little bit to be desired. I was at that game, 62 to 48, just a few weeks ago, but, nonetheless, congratulations to him, and we're leaving tonight, so congratulations and enjoy. Representative Morrin Bello from Wethersfield of the 28th. What purpose do you rise, ma'am?

Good morning, Representative.

You may proceed, madam.

Thank you, Representative Morrin Bello. And I would note for all you kid mayors, and I know you had mayor Lester here as well, but representative Morrin Bello was also a mayor of your town. She much prefers being the state rep. It's a hard job being the mayor of any town. So, congratulations to our kid mayors here. Representative Buckbee of the 67th.

me/ak 14 Good morning.

Mr. Speaker, today starts a program for those of us in the nonprofit world called Give Local. Give Local is a 36-hour online donation platform where different nonprofits throughout Northwestern Connecticut and down into Waterbury as well. There's roughly 200 different nonprofits. If you make a donation to one of those nonprofits, you'll be met with an additional dollars. Sometimes 89% more, along with contests. So we always talk about giving. We talked about the money raised, which is great. 7:00 a.m. today through 7:00 p.m. tomorrow, 36 hours of Give Local online donation platform. me/ak 15 I highly recommend everyone try to take that look, find their favorite ones, and help out all those nonprofits directly. That's the first part, Mr. Speaker. The second part, I really wanted to mention that just a reminder, and thank you for your help with tomorrow -- New Milford Day is tomorrow, where we'll have baby goats and some ice cream and some great food here. Some wonderful people from the best town in the USA. Thank you, Mr. Speaker.

Thank you, Mr. Speaker. And just to make an announcement, And I'm so happy to visit and go to those communities that have a day here in the capitol. But I really wanted to prepare people for the April 27. me/ak 16 The April 27th is going to be Southeastern Connecticut Day. We will have multiple communities downstairs, and I just want to make sure that people get ready for Southeastern Connecticut Day, because we will be trying to top all days. Thank you, Mr. Speaker.

Thank you, Mr. Speaker. I just want to remind everybody that tomorrow night is our annual game tasting event. It'll be upstairs in the capitol in 310. Invite everybody to come out and try some of our tasty little treats.

Game tasting events.

No. Game tasting.

From 05:00 to 07:00. Excuse me. So please come out and join us. Thank you. me/ak 18

Page 23, Calendar 289. Substitute for House Bill Number 5044, AN ACT ESTABLISHING CONNECTICUT VACCINE STANDARDS. Favorable report of Public Health.

Thank you very much. Mr. Speaker, I move for acceptance to the joint committee's favorable report and passage of the bill.

Thank you very much, Mr. Speaker. Mr. Speaker, the bill before us is aiming to make sure that we have available, accessible, and affordable vaccines for residents in Connecticut, that we continue to protect our primary populations, our pediatric patients, our pregnant persons, and older adults, as well as those who are immunocompromised. That we here in Connecticut continue to rely on rigorous evidence-based review standards and retain the public regulations review process for any mandated schedules for schools and nursing homes. We're aiming to retain choice, access, and purchasing authority, and clarity and communication to the general public about recommended standards of care. We're seeking to maintain the status quo when it comes to religious exemptions adopted by the legislature in 2021, and we seek to maintain the high me/ak 20 vaccination rates that has prevented infection, disease, death in our most vulnerable populations. Mr. Speaker, what this bill does not do is create new mandates. Mr. Speaker, I'm going to take a few moments to outline what is contained within this bill. First, the bill has the commissioner and the Department of Public Health establish standards of care for immunization for both adults and children. This is taking into consideration the CDC's advisory committee for immunization practices and a number of other organizations. This is not a list of mandated vaccines. This bill allows the Department of Public Health to purchase vaccines included in that Connecticut standard of care rather than those recommended currently by the ACIP, which is the CDC group. Currently, Connecticut may only purchase vaccines for the Connecticut vaccine program through the CDC contract and only if they are recommended by ACIP. It allows the commissioner to create regulations for nursing homes regarding respiratory viral disease. It continues the process of the regulations review committee for any school-mandated vaccines in the school me/ak 21 vaccination schedule. During a declared public health emergency, the bill will allow the governor to designate the commissioner to create a standing order to allow medical interventions. This, again, does not create any new mandate. It establishes an adult vaccine program for underinsured individuals. It requires group and individual insurance policies to cover those vaccines that are recommended through the Connecticut standard of care. It continues to allow pharmacists to provide the vaccine again through the Connecticut standard of care. It provides that the state religious freedom restoration act does not apply to the school immunization requirements for public and private schools. Miss or Madam Speaker. Excuse me. Madam Speaker. Madam Speaker, the clerk is in possession of an amendment, LCO 4191. I ask that the amendment be called, and I be granted leave of the chamber to summarize.

House Amendment Schedule A, LCO Number 4191, offered by Representative McCarthy Vehey, Senator Anwar.

Thank you very much, Madam Speaker. Madam Speaker, the amendment before us makes two changes. It removes the word active as a descriptor to immunization in all relevant statutes. So there were some additions of words, but those are technical and conforming changes to that. It assures that we are able to provide all types of vaccines, whether active or what's called passive. And the other change that the bill makes is in Section 1, related to the standard of care that is being set by me/ak 23 the commissioner. It eliminates the words, including but not limited to.

Thank you very much. And, again, the second change in the amendment is eliminating the words in Section 1 that say including but not limited to. This will thereby limit the commissioner to only consider the groups that are explicitly named in the statute when setting that standard of care, which again is a recommendation, and I move adoption.

Thank you, Madam Speaker. I will speak on the amended bill once it is passed.

Thank you, Madam Chair. Nice to see you today.

me/ak 25 Through you, Madam Chair, I have a question about the change with the amendment with regard to the language, including but not limited to. Could the good chair of the Public Health Committee please explain what the ramifications are of that?

Thank you very much, Madam Speaker, and I thank the good representative for the question. Previously, the language said that the commissioner may consider a number of groups, including but not limited to. By deleting that language, we are limiting the number of groups and the groups that the commissioner may consider. So now the commissioner will be able to consider the groups who are listed here within the statute, which is the American Academy of Pediatrics, the American Academy of Family Physicians, the ACIP, the Advisory Committee for Immunization Practices, which is the CDC group, as well as, what the bill me/ak 26 does to add the American College of Obstetrics and Gynecology. So it's really limiting that look. Through you.

Thank you, Madam Chair. And through you, does that mean that there will be no acknowledgment of any other associations other than those listed through you, Madam Chair?

Thank you very much, Madam Speaker. That means that these are the groups that the commissioner will need to be looking at. In part, this was done because we know that these groups have a process for adopting a recommended schedule, some of me/ak 27 which, for example, the American Academy of Pediatrics, their process has been in place for 100 years. So we were looking for groups that did have such a process, rather than leaving it more open-ended. Through you.

Thank you, Madam Chair. And through you, I really encourage all of you to vote against this amendment. This amendment is limiting, limiting our options going forward, where we can't consider other associations and other accredited medical groups, including the federal CDC, by the way. I think this is not a good amendment. It's limiting, and if I'm incorrect, please, I want to give the good chair an opportunity to respond to that because it seems as though now we're limiting it to only certain associations. Can the good chair explain that? Through you. me/ak 28

Thank you. And I thank the good representative for the opportunity. We are retaining the advisory committee for immunization practices through the CDC as one of those groups that the commissioner shall consider. That is retained within this. Through you.

Thank you, Madam Speaker. And through you, does that still limit us from the ability to add others to that column of limited to, and no others will be able to be added to that? Through you, Madam Speaker.

Thank you very much, Madam Speaker. And I thank the good representative for the opportunity to have further conversation about this. The feedback that we had heard in committee and among members of the body was that there was a concern, and that was actually on both sides of the issue. People who are more in favor of the bill and people who were opposed to the bill, that it seemed a little bit too broad and not defined. So this was an effort to be responsive to that, to say, here we will make clear what this is. It's a little more transparent because now we all know that these are the groups that are being considered, and it's a little more defined and limited to those, again, that have a process in place for adopting a schedule through you.

Thank you, Madam Speaker. And I would just say that I'm still opposed to this amendment. I think we should always have our ear opened and have the ability to consider other associations, their findings, going forward. And this is very limiting, and I'm urging all of our colleagues to vote against this amendment. Thank you.

The House of Representatives is voting by roll, members to the chamber. The House of Representatives is voting by roll, members to the chamber.

House Amendment Schedule "A": Total number voting 140 Necessary for Passage 71 Those voting Yea 91 Those voting Nay 49 Absent not voting 11

Thank you, Madam Speaker.

I have a ton of comments and a ton of questions to talk about today to our good chair of the Public Health Committee. Madam Speaker, through you, this bill it's not about vaccines. It's not about whether you're pro or against vaccines. It's about the power, who has it, what they do with it, and who has the right to challenge it. Connecticut, as we know, has been watching what the federal delegation, the Trump administration, has been doing with the ACIP. And just to remind everybody, the ACIP is the Advisory Committee on Immunization Practices, and publicization of vaccines and the vaccine schedule. me/ak 33 So Madam Speaker, the answer from majority here today is to hand our own public health commissioner that same unchecked authority that we don't want to happen down in DC. One appointed official, no legislative vote required, no remedy for parents to go to court and sue. Because the bill doesn't just extend DPH authority. It eliminates Connecticut's RFRA, Religious Freedom Restoration Act. If this bill passes, a parent no longer has that right. Doesn't have that right, if they object to a vaccine that the DPH commissioner puts on the vaccine schedule, they can't go to court. Just can't. All done. Gets rid of it. And this RFRA protection has been in place to protect every resident of the state, regardless of their faith. It's gone. Again, gone for no purpose. It's not public health. It's a government ultimatum, and I urge everybody to listen to the debate here today. So through you, Madam Speaker, I have a few questions to the proponent of the bill.

Thank you, Madam Speaker. And through you, the word determined in the first section is replaced with established. What's the practical difference, and what's the reason for that change?

Thank you very much, Madam Speaker. Madam Speaker, I'm not sure if I'm going to give the best answer to the good representative that I could because I did not have an explicit conversation with our attorneys or with the department about this. But the change in this section of the statute is about the fact that previously or currently, in law, our commissioner determines the standard of care based on that federal group, the ACIP. And forgive me now to all in the chamber and all who are listening, we will continue to use alphabet soup here today. But me/ak 35 this is the shorthand for the Advisory Committee on Immunization Practices, which is the CDC body. Essentially, at this point, the commissioner is determining that schedule and that recommendation based on the ACIP. What we are doing now in this -- because of the changes at the federal level that the good representative referenced, because of the uncertainty, and there is a lawsuit right now that is occurring. What we are doing is we are asking our commissioner through the department to establish here in Connecticut those standards, and by looking at the groups that we talked about earlier with the amendment. And so it is current practice that, I would just say that I don't want to -- I don't want to use the term rubber stamp, but what I want to say is currently, it is determined through that federal recommendation. Through the change that we are making, we are allowing our commissioner in our state to establish that standard for us here in Connecticut by consulting those bodies that are listed in statute. Through you.

Thank you. And through you, Madam Chair, also in this section, we see, and we're starting to see the words, the phrase standard of care. Can you define what that is for this chamber?

Thank you very much, Madam Speaker. Madam Speaker, those who are immunization experts, as well as our attorneys that we've worked with, would use the phrase term of art for standard of care here in this section. We in the public health committee talk often about standards of care related to practice and liability. That is not what this term refers to. This is allowing us to have a set of recommendations that essentially allow us to communicate clearly me/ak 37 to the public and to providers what those recommended vaccines or what the recommended schedules are. Through you.

Thank you, Madam Speaker. And to add to the good chair's answer, will that standard of care be able to change, within the Department of Public Health, and the commissioner, as she sees fit?

Thank you very much, Madam Speaker. Madam Speaker, at this point, it is our commissioner who, again, is working with ACIP. That's current statute. And in this bill, this would be able to be changed and addressed. me/ak 38 And as does occur with those recommended schedules that come through that rigorous evidence-based process, if there was a change that needed to be made, or again, by considering these other bodies, it was prudent to make the commissioner would have the opportunity to do so. Through you.

And through you, Madam Speaker, currently, the commissioner can set the vaccine schedule through the recommendation of the CDC. Now that would change. Is that correct?

Thank you very much, Madam Speaker. And I appreciate the question from the good representative because, actually, our me/ak 39 current law does also include the American Academy of Pediatrics. It does also include the American Academy of Family Physicians. And to date, there hasn't really been daylight between the recommendations from ACIP and those other bodies. So that addition in this statute to add the American College of Obstetrics and Gynecology will allow for further expansion of looking at those evidence-based practices. Through you.

Thank you. And through you, Madam Speaker, does anything in this bill require legislative approval before the commissioner adds or, adds or subtracts any vaccines?

Thank you very much, Madam Speaker, for that question. Oftentimes, this section that we've been talking about, the standard of care, is -- there's an equivalency, a false equivalency between that and what we call our school vaccination schedule. Our school vaccination schedule is indeed a mandated schedule that must go through the regulations process. That schedule, which is where we require what vaccines are given to students in school, has to go through our legislature's regulations review process, the bipartisan committee that is a public process. In addition, we have mandates, currently in statute, that are in nursing homes. Again, regulations are required for those mandates to go through. I'm sure the good representative and I will talk a little bit more about this. The bill in the nursing home section of the statute or of the bill talks about the fact that we are putting in statute that the commissioner shall add the respiratory virus, viral me/ak 41 vaccines, that has to go through the regulatory review process in the end. And we have allowed what we call policies and procedures to be put into place in the interim before the full regulatory review process would happen. We did put in language that there would have to be notice of intent, which means the commissioner would have to publicly file on the e-regulation system that those regulations were being changed, and then a public process would commence. So both of those mandated areas require a public review process. Through you.

Thank you. Madam Chair, to the proponent of the bill. She did state that the nursing home section and the school immunization section has to still go or is currently and will still go through the regulation review process. Is there any me/ak 42 section in the bill now that does not have to go through the regulation review process? Through you.

Thank you very much, Madam Speaker. I thank the good representative for the question. The places where we require vaccines are the congregate settings, schools, daycares, colleges, universities, and nursing homes. So in the bill, higher education, for example, we do require vaccinations for anyone who enters college, anyone who is living in a college dormitory setting. Those vaccines that are listed in statute. So we do not have a regulatory process for the higher education vaccines because we put them in statute. If we were to change those mandated vaccines for higher education, we would need to do so through the legislative process, which would me/ak 43 require us to do what we do here. Here are the bills and vote. Through you, Madam Speaker.

Thank you. And through you, Madam Speaker, I have a few questions to the proponent of the bill for legislative intent.

Thank you. And through you, the bill uses the phrase, quote standard of care, which has been in statute Section 19A-71 for many years. Does the phrase, quote, standard of care remain in 19A-7F in this bill?

Thank you very much, Madam Speaker. Madam Speaker, I want to make sure that I fully heard the good representative's question, as I was, admittedly, multitasking for just a moment. What I believe the good representative is asking is, does this language here in Section 1 of the bill in 19A-7F, is that the same as the other statutory reference? I don't remember what she shared in terms of the standard of care liability. And if I am hearing that question correctly, this language in the standard of care section, no. This is not the same language. The standard of care language elsewhere in statute will remain. Those requirements will remain. Those potential liabilities elsewhere will remain. That is not the case here in this section of the bill. Through you.

Thank you. And through you, Madam Speaker, again, for legislative intent, does the phrase standard of care in the bill intended to impact or apply to the similar term standard of care used in Section 52-184C of the general statutes?

Thank you very much, Madam Speaker. Simply no. Through you.

And thirdly, Madam Speaker, to clarify, the standard of care in Section 52-184C, which is specific to negligent actions me/ak 46 against healthcare providers, is not impacted in any way by HB 5044.

Thank you very much, Madam Speaker. And the good representative is correct. Through you.

Thank you, Madam Speaker. And now I'm back to my regular questions. Through you, in this section, Section 1, ACOG, the American College of Obstetrics and Gynecology is entirely new to this bill. Is that correct?

Thank you very much, Madam Speaker. Madam Speaker, yes. Through you.

And through you, Madam Speaker, ACOG's primary immunization guidance covers vaccine during pregnancy, like flu, COVID, RSV, and Tdap. Is that correct?

me/ak 48 Thank you very much, Madam Speaker. That is correct. As I mentioned in my opening remarks, this addition allows us to look more fully at the full spectrum of our primary immunization target groups, which are young people, where we have the American Academy of Pediatrics. People who are pregnant, that's ACOG. Again, forgive the alphabet soup, but the American College of Obstetrics and Gynecology and the American Academy of Family Physicians for our older population. Through you.

And through you, Madam Speaker, continuing with our alphabet soup, do we know what specific vaccines are being considered when we talk through ACOG guidance that are not already covered by either CDC, AAP, and AFP?

Thank you very much, Madam Speaker. I joked with my good co-chair, in the senate, who is a physician, that he would certainly be quicker on his feet when it comes to the specific recommended vaccinations. I don't have the specific list in front of me. I certainly can get that. Currently, as I mentioned before, the recommendations that all those alphabet soup groups, I'll call them, and the federal government, ACIP through the Center for Disease Control, there hasn't been any daylight between those in the past. Again, that's currently in flux. So, the obstetrics and gynecology, ACOG, I think I'll stick with alphabet soup for now. They also have had a long history and process for how they adopt their recommended schedule of vaccines, but I -- that's the long answer to I don't have the specific list and the discrepancies at this point. Through you.

Thank you for that answer. And through you, Madam Speaker, I want to understand the real world motivation for this bill. Is this bill truly designed to allow Connecticut to maintain or expand the vaccine requirements, because the federal government might be rolling some back?

Thank you, Madam Speaker. And I thank the good representative for the question. That is indeed the case. So, as we have discussed this bill in committee and in other places, we want to be able to maintain the ability for Connecticut residents to have the choice to receive accessible, affordable vaccines that they have been receiving. me/ak 51 So currently, as I mentioned previously, our purchasing authority, for example, for childhood vaccines, is tied to those CDC, ACIP recommendations. So what we want to do is to be sure that we, as a state, can still purchase the vaccines for children, that we can still recommend and offer, and have insurance coverage and pharmacists be able to give vaccines that may be different, as the good representative was referring. That may be different from what the ACIP recommends. And they may be, in fact, the same vaccines that have been recommended for years and decades, but differ now, potentially at the federal level. Through you.

Thank you, Madam Speaker. I know I've said this in a different way before, or maybe, actually, I said it. But is this bill a direct response to what the feds and RFK is doing to the CDC's schedule? me/ak 52

Thank you very much, Madam Speaker. And I suppose, yes, that some people have and would frame it that way. I think the important thing for me is that this bill is all of us in Connecticut saying, we want our residents to be able to get the vaccines that they need, that they want, and that they are able to afford and access. And yes, unfortunately, the changes at the federal level have necessitated parts of this. I have shared with many people I wish that we didn't have to do many parts of this bill. And in fact, it is my hope that we will return to having that very transparent, very rigorous, very public federal process that has been in place for decades, that we can, as all states, then rely on. But until that happens, we are trying to take the step here to assure continuity in our state through you, Madam Speaker.

Thank you. And Madam Speaker, we're going to move on to Section 2, the children's vaccine program. And through you, the bill allows DPH to purchase vaccines for the children's program through other means of procurement, other than the CDC, which they've normally done. Is that correct?

Thank you very much, Madam Speaker. Yes. The good representative is correct. It would allow us to have authority that we do not have to purchase any vaccines that might be outside of what that ACIP CDC recommendation is. Through you.

And through you, do we know what sources are being contemplated for purchase? Through you.

Thank you very much, Madam Speaker. Not specifically, the one example that was given was that Massachusetts is also doing the same. That we could actually combine forces with them as a state, of course, using our proper procurement and procedures. But that could be an available option to us. Again, I'm hoping that we don't have to use that option, that we will continue to have the ability to purchase through the CDC, but this would give us that option. Through you.

Through you, Madam Speaker, will the commissioner be able to use international companies for these vaccine purchases?

Thank you very much, Madam Speaker. And my understanding is as long as it follows the proper state procurement process, there would be the ability to do so. I don't know exactly how the procurement process works, but I'm going to imagine yes. But I would have to get back to the representative with a definitive answer on that. Through you.

me/ak 56 Thank you. And through you, Madam Speaker, what FDA oversight applies to vaccines purchased outside the CDC's established distribution network?

Thank you very much, Madam Speaker. Madam Speaker, we will continue to need to look at FDA-approved immunizations. I again go back to those groups who recommend schedules. And if history is an idea of where we are headed, that is exactly what they have done. Because we are wanting to make sure that these vaccines have been properly vetted, approved, and gone through a really rigorous process. So in addition to the FDA, we then have those groups as well. So, yes, we would still have that FDA involvement. Through you.

Thank you. And if Connecticut shifts, the children's vaccine procurement away from the CDC channels, as stated in this bill under Section 2, does that jeopardize Connecticut's eligibility for that Section 317 federal funds that currently support the existing program or help with the existing program?

Thank you very much, Madam Speaker. Madam Speaker, I don't believe so. But I will say that part of the issue that we have is that there is some uncertainty in terms of the interaction with the federal government. Through you.

And Madam Chair, the issue is cost equivalency determination. Is that made by the Department of Public Health commissioner unilaterally?

Thank you very much, Madam Speaker. I do not believe so. I believe that again has to go through the proper state procurement process. We've got administrative services, and that's my understanding. Through you.

me/ak 59 And through you, Madam Speaker, as far as that procurement process, if a cheaper vaccination price is available, we all know that cheaper isn't always sometimes better, who will make that determination? Through you.

Thank you very much, Madam Speaker. Madam Speaker, my understanding is that we are retaining choice within this. Again, I think this goes to that procurement process, which I arguably am going to need to learn more about the specifics of, perhaps even today. But again, to the good representative's point, it's not always about cheaper is better, but the language of the bill is very specific that if we are to engage in other purchasing agreements that we will need to provide the procurement conforms with practices designed to reduce costs and result in more efficient state procurement. Through you. me/ak 60

Thank you. And through you, Madam Speaker, if the Connecticut Department of Public Health standard removes a vaccine that the CDC still recommends, let's say it's HPV vaccines for adolescents, does the Connecticut vaccine program stop covering it?

Thank you very much, Madam Speaker, and I don't believe so. I can, again, confirm that for the majority of the conversation, we have been talking about vaccines that -- the difference would be that Connecticut standard is more likely to have more vaccines than what is currently being recommended at the federal level. And that's given the action that was taken federally to me/ak 61 subtract some of those recommendations. So I'd have to confirm. Through you.

Thank you, Madam Speaker. And I'm going to move on to Section 4, the nursing home section. And through you, there's a new Subsection B in this Section 4. It allows DPH to impose immunization requirements on nursing homes through an internal policy while the formal rule-making process, regulation process moves forward. How long could that interim policy remain in effect?

me/ak 62 Thank you very much, Madam Speaker. And Madam Speaker, the simple answer is there isn't a deadline for that, which we do do in some other bills. However, what we did do here is say that if that policy is put into effect by the Department of Public Health, then the notice has to be posted publicly on what's called our e-regulation system, a notice of intent to adopt regulations no later than 20 days. I'm looking at some of my colleagues who know a lot more about this process than I do, also serving on the regs review committee. What that does is it then requires that a process begins within 30 days. There's a public comment period, and the department does have discretion to hold that public comment period open. And I will say that in conversations with the department related to this particular bill, my understanding is that the intention is to move that forward in as quick a process as it can, though it's not specified in language. And I will say quick with quotations because there are a number of review steps that are required. So it will take a number of months before it would go through that full regulatory review process. Through you. me/ak 63

Thank you. And through you, Madam Speaker, in I think it's line 129ish, nursing home residents retain the right to refuse immunization still on their religious grounds under Section 3 of this section. Is that language still preserved in this bill?

Thank you very much, Madam Speaker. Through you, indeed. Nursing home residents retain both a medical and a religious exemption. Through you.

Thank you, Madam Speaker. And moving on to Section 5, the medical exemption certificate, sorry, section, in lines 152 and 153 in a form and matter prescribed by the commissioner. Is this new?

Thank you very much, Madam Speaker. Both the language in a form and manner prescribed by the commissioner and the addition of license as a descriptor of physician, physician assistant, or APRN, advanced practice registered nurse. Those are clarifying pieces to the legislation. What is happening currently in practice is that there is an online form that is used and must be used properly in order to obtain the religious exemption. So this really clarifies and underscores, no pun intended, that this is what is required. Through you. me/ak 65

And through you, Madam Speaker, previously, were they having issues with how this form was being filled out or prescribed, and the reason for adding this section, this part?

Thank you very much, Madam Speaker. Madam Speaker, we have heard some stories. We heard in testimony that there were some folks who had struggled with the form the department had shared, that they have provided some technical support. We know that whenever we move from paper forms also to online, that can be an issue. And the Department of Public Health does not make a determination. They do not approve or me/ak 66 deny the medical exemptions, but what they do is to ensure that the form is filled out properly. So we want to make sure that's clear in the statute. Through you, Madam Speaker.

Thank you. And Madam Speaker, to the good chair's last statement, who does approve the medical exemptions? Through you.

Thank you very much, Madam Speaker. Madam speaker, a medical exemption is granted by a provider that licensed physician, physician assistant, or APRN, and then submitted in the case of a school or nursing home to that body or that organization. me/ak 67 So the form, if it's properly filled out, is then taken to the school, often a school nurse, or to a nursing home, and the proper administrative official there. Through you.

Thank you. And through you, Madam Speaker, I just want to make this crystal clear. I go to my health care provider. They write me a medical exemption per the criteria from the Department of Public Health. If they check off all those proper boxes, then they're automatically granted the medical exemption. It doesn't go back to DPH for a blessing, so to speak.

me/ak 68 Thank you very much, Madam Speaker. Madam Speaker, and I appreciate the representative outlining that. If all the boxes are checked and done appropriately, and then it's given to the school, it's the school nurse who says, you've got this all filled out correctly. You're good. Come on in to school. Through you.

Thank you. And through you, is there anywhere in this bill? And if not, does this give the Department of Public Health commissioner the ability to change what the contraindications are for a medical exemption?

me/ak 69 Thank you very much, Madam Speaker. And I thank the good representative for that question. So contraindications is when medicine or a vaccine or something that might help most people is actually bad for some people and might hurt you. So there is a schedule for what's called contraindications that currently comes with that recommended schedule of vaccines that the ACIP and the CDC provides. In section one of the bill, when the commissioner sets that standard of care for the recommended vaccines to be given, the commissioner also will set that schedule or standard for those contraindications. Again, referencing those groups that we've been talking about, which I think I'll just call alphabet soup for now. And so, yes, the commissioner would do so, but the need will be to look at those groups. Those groups also have recommended contraindications. All that said, in our state, you can receive a medical exemption due to a contraindication, but you can also receive a medical exemption if your physician writes in other and shares that reason for you to receive that medical exemption. Through you, Madam Speaker. me/ak 70

Thank you for that explanation. And my last clarification on this, the DPH commissioner does not have the unilateral authority on her own to make those changes to the contraindications. Does she go to a group of other people, whether it's the alphabet soup group or the advisory group that she currently has access to? Through you.

Thank you very much, Madam Speaker. And the commissioner shall consider the schedules from the American Academy of Pediatrics, American Academy of Family Physicians, the ACIP, which is the CDC group, and the American College of Obstetrics and Gynecology. Those all shall be considered. Through you. me/ak 71

Thank you, Madam Speaker. And moving on to Section 7, the higher education immunization section. In Connecticut, if the standard changes from CDC to DPH, which it does in this bill, how will the out-of-state or international students and their medical providers know these changes have happened? Who will notify them?

Thank you very much, Madam Speaker, for that question. In this case, in the higher education section, we specify the mandated vaccines right here in statute, and they are listed, measles, rubella, mumps, and varicella, as set forth in that me/ak 72 schedule. So we have them in statute. So we would have to go through that process and make the change. Through you.

Thank you. And moving on to Section 8, the public health emergency. Does this bill state that a standing order under this new provision can be issued by the commissioner's designee, not the commissioner herself?

Thank you very much for that question. Yes. If the governor declares a public health emergency, the governor may allow the commissioner or the commissioner's designee to issue that me/ak 73 standing order. That commissioner or the designee will need to be a physician. So, in the event that we had a commissioner who was not a physician, which is not the case right now, but if we did, that commissioner would need to designate a physician to write that standing order. Through you.

And as far as that physician and qualifications, it can only be a physician that can't be an APRN or a PA through you.

me/ak 74 Thank you very much, Madam Speaker. And I would love to take this opportunity to just clarify. We are doing nothing to change what our APRNs and PAs are able to do within statute. What we are doing is to say for this one particular standing order, which I would describe as a prescription for the whole state, that we would then not, as individuals, in the case of a public health emergency, have to go into our own individual providers. We would be able to access that medication or that vaccine without that. So for that reason, that language is specific. Just for issuing the standing order is specific just to a physician. Through you.

Madam Chair, through you, Madam Speaker, through you, what triggers the end of a standing order? me/ak 75

Thank you very much, Madam Speaker. I believe that would be the end of the declared public health emergency. And it is possible, though I'm not certain, that the standing order could be time-limited, but again, the public health emergency is what allows for that. So at the end of a public health emergency, that authorization would no longer be possible. Through you.

Thank you. And I have another for legislative intent, and the good chair may have touched upon it already, but I need to do it anyway. In this Section 8, line 315, that relates to the public health emergency. The standing orders do not take away me/ak 76 from the APRN or PA's authority to disperse or administer prescriptions. Is that correct?

Thank you, Madam Speaker, and thank the good representative for the question. Indeed, that is correct. Through you.

And through you, Madam Speaker, in this new section with the public health emergency, how does it differ from the authority the governor has currently?

Thank you very much, Madam Speaker. Madam Speaker, what this does is explicitly allow for that, standing order. And the example that I've used is, for example, we had a terrible flu outbreak overnight, and we all needed to access Tamiflu. And we couldn't all get to our physician overnight. The commissioner or the physician designee would be able to write that prescription, and we could all run out and get it. Now there may not be enough supply of Tamiflu for us, if that were the case, but that's the purpose. Through you.

Thank you for that clarification. And in Sections 9 and 10, to confirm for the record, no adult is required to receive a vaccine under this program. me/ak 78

Thank you very much, Madam Speaker. Absolutely not. This is a purely voluntary program, and in fact, is actually limited to a few different groups, free clinics, municipal health authorities, districts, and is intended to provide support for our un and underinsured residents. It may also provide support to some municipalities, like my home municipality of Fairfield who offers a flu vaccine clinic each year, and those funds would have to be budgeted. Through you, Madam Speaker.

Thank you. And, again, does this bill expands the free vaccine program from children to adults? Through you. me/ak 79

Thank you very much, Madam Speaker. I will say yes and an answer to that question because the vaccine program for children offers a universal. This is not a universally available program. In fact, I think the current budget amount that came out of the appropriations committee and was offered by the governor is about $892,000. So that will not meet the demand for the flu vaccine that's out there. It will be more limited. So, yes, it does expand and create a program for adults, but it's definitely not the same as the Connecticut Children's Vaccine Program. Through you.

me/ak 80 Thank you. And through you, Madam Speaker, does the commissioner decide unilaterally which vaccines the state money can purchase, and which providers are eligible, with no public process, no comment period, and no regulatory period. Is that true? Through you.

Thank you very much, Madam Speaker. And Madam Speaker, yes, the Department of Public Health will make the determination about which vaccines would be purchased, likely based on need and most likely the flu vaccine, which is the primary vaccine that we've talked about as the goal and hope for this program. We've seen a decline in the uptake of the flu vaccine since the pandemic, and I think the hope is to help get it back out there and available for more people. Through you.

And through you, Madam Speaker, excuse me, to continue with our alphabet soup, can the good chair explain what the UAPA, the Uniform Administrative Procedure Act, does?

Fourth grade level.

Representative Klarides-Ditria.

Representative McCarthy Vahey.

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Representative McCarthy Vahey.

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me/ak 90 Representative McCarthy Vahey.

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me/ak 92 Representative McCarthy Vahey.

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Representative Klarides-Ditria.

Thank you very much, Representative. Representative Carpino of the 32nd district, which includes Cromwell, which is the home to many generations of Linehan's. You have the floor, madam.

Thank you very much.

Please proceed.

Yes. Please proceed.

Thank you very much, ma'am. Representative Reddington- Hughes of the 66th. For what reason do you rise?

Absolutely. Please proceed.

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Representative Reddington-Hughes.

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Representative Reddington-Hughes.

Thank you very much, Representative. Representative Dauphinais. Good afternoon, madam.

Please proceed.

Thank you very much, representative. Representative Zupkus of the 89th District, which includes the fabulous best little town of Cheshire. How are you today, madam?

Please proceed.

Representative McCarthy Vahey.

Representative Zupkus.

Representative McCarthy Vahey.

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Let's see. Representative Zupkus.

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me/ak 147 Representative McCarthy Vahey.

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Representative McCarthy Vahey.

Let's double-check. Representative Zupkus.

Thank you very much, Madam Speaker. Simply put, a child could not be vaccinated. A child may not be vaccinated without parental permission. So, for example, there is language in the statute about pharmacists being able to give vaccines to those who are 12 to 17 only. And in that case, they must have parental permission, a legal guardian, or a parent, or there has to an alternate be evidence that they are an emancipated minor. So those would be the only cases in which that would be able to happen, but there has to be consent, through you, Madam Speaker.

Thank you, Madam Speaker. So I'll use myself just as an example. If I choose not to give my child all of the vaccines me/ak 154 that are required, send them to school, what would happen, through you, Madam Speaker?

Thank you very much, Madam Speaker. Madam Speaker, at this point, the state of Connecticut requires that certain vaccinations according to a schedule be given in order for a student to enter school in a congregate setting. And why is that? It's because congregate settings are where we share lots of things, including our germs and viruses, and some diseases. And so that is the policy decision that has been made by the state. So if those vaccination schedule requirements, the school vaccination schedule, that mandated schedule, if that was not met, a student would be unable to enroll in school or to go to college, as well, without those vaccinations, through you, Madam Speaker.

Thank you, Madam Speaker. And that would be college in Connecticut, through you, Madam Speaker.

Thank you very much. I thank the good representative for the clarification. That's absolutely correct. To colleges and universities here in the state of Connecticut, that is our state law, through you, Madam Speaker.

me/ak 156 Thank you. And for kids who come to UConn, we have kids from everywhere. So, do those have to -- do those students have to abide by the vaccine policy, through you, Madam Speaker?

Thank you very much, Madam Speaker. Whether UConn, Fairfield U, Sacred Heart, Western, I'm just giving a shout out to some of our great universities. Yes. That's correct. Through you, Madam Speaker.

Thank you. I just used them as an example, but Fairfield, I get thank you. And so if I choose not to give my child all of me/ak 157 the vaccines, they're not allowed in school, how will these schools educate my child, through you, Madam Speaker?

Thank you very much, Madam Speaker. Madam Speaker, that is a parental choice. A parent has the choice then to homeschool. At this point, the courts have ruled about the constitutionality on all counts of our religious exemption, the removal of the religious exemption, and the law has been found constitutional, through you, Madam Speaker.

me/ak 158 Thank you, Madam Speaker, for that. Am I to understand that there will be, could be, vaccinations given to children or adults that are not approved by the feds, through you?

Thank you very much, Madam Speaker. No. The vaccines would still need to go through that FDA approval, through you, and that's not Madam Speaker -- Mr. Speaker, nice to see you up there.

Thank you. And thank the good chair for the answers. And I'll just end with my good colleague from the 32nd district really spoke very well about, first of all, the public hearing. me/ak 159 We hold public hearings to hear from the public. And it was very sad, disappointing, discouraging that the Chairs chose to only hold the public hearing for a little while, where many, many, many, many voices could not be heard. And that to me, that is just really disrespectful to the residents of our state that had something to say about it, especially when you have bills this large that affect this many people. Every voice should be heard. I understand written testimony. I can tell you and almost guarantee you the thousands of pieces that were submitted, they are not all read. Very, if they are, it's a page scanned through. And so people's voices really were not able to be heard and not even with the Commissioner being there at this bill that gives her at the right now of a -- a woman gives her all of this power is really disheartening. This piece of legislation affects every citizen in this state. And for us, proponents to continue down a path that the majority of the people do not want is, I would say, disheartening. And so there have been comments made about, no kings and people that protest no kings. We don't want kings, and we don't want queens. And so I would encourage everybody me/ak 160 that has ever attended one of those no kings rally to really look at what's going on here. So I will not be supporting this bill. I think there are many, many unintended consequences that are going to be coming down the road. And as I've seen since I've been in this building, it's a step open to a door that just continues to grow and grow. So thank you, Mr. Speaker, and I would encourage everyone not to support this bill. Thank you.

Thank you so much, Mr. Speaker. I have been sitting and listening to the debate on this bill, and I sat and listened to many, many hours of testimony and would have listened to many more hours of testimony had it been allowed. I guess I'd like to start with why we are in this situation right now. I am a firm me/ak 161 believer in health care, I'm a firm believer in vaccinations, I'm a firm believer in studying vaccines. I'm a believer in giving people information and education on vaccines, the risks, the benefits. And it is my belief that we are here in this situation right now because we skipped that process, giving the community the education on the risks and benefits. I know anybody that watches TV right now, sitting watching the Super Bowl or sitting watching evening news, we all get bombarded with commercials that talk about whatever itchy medicine might be out there. Right? And when I was in pharmacy school, this is kind of when we all of a sudden went direct to customer advertising and there were rules around it. And the biggest rule was that you had to give the side effects and the risks when you had these advertisements and these commercials. And we all you know it gets annoying at the end that you said, hear them say, this may cause headache, diarrhea, vomiting, and everything else that you don't want to have. But it's very important for people to understand when they're taking a new drug, when they're taking a vaccine to understand that there are risks and there are benefits. me/ak 162 One of the reasons why we are here and we have to contemplate this bill right now is because we decided educating the public is not needed anymore. We decided that it is okay to tell the public they have to do something. Before we had mandates on vaccines in the state, we had an amazingly high rate of vaccines across the state because we, as a state, did a very good job of educating the public, making sure the public understood what the risks and benefits are for vaccines. That's why if you ask people in this room, anyone that has kids, you will hear that most of the people in this room have vaccinated their kids. Because we went through those series where we talked to our doctor and we had those conversations back and forth of what we should do and what we shouldn't do. But sometime during COVID, all of a sudden, that went out the window, and people were told, oh, not anymore. You actually have to have it, and it's just good for you. It's just good for you, and that's really all you need to know. And then we saw commercials and advertisements saying, get your vaccine. It's good for you. And you heard nothing about what the risks are. And you know what? People are not stupid. And when you treat them like they're stupid, when you tell them that there's no me/ak 163 risk for something, you lose them. You lose their trust. We have to be able to trust in the public, and we have to be able to have that trust from our health care provider, or they lose it. And that is what concerns me about what we are doing in this state is we are losing the trust of the residents. And why do I know that? Because I saw the thousands of people that signed up for the public hearing when we brought this bill forward. Those people don't trust the government, and now they don't trust their health care provider. So now we've had to move to the never mind. We don't even care if you trust us. You just actually have to do this. And so then along comes a federal government that understands this, that understands that people don't necessarily trust the government, and they don't trust their health care provider. So let's give them a little bit more. Let's let them now have access to their health care provider to say, well, there are these vaccines that maybe you should talk to your health care provider, and maybe you should understand if it is right for you. I love my doctor. I love my pediatrician. I talk to them regularly. I go for my checkups. When I have issues, when I have medication that I think I need, I sit and I talk with my doctor. me/ak 164 I talk with my pharmacist. I talk with my health care providers. I do my research. I ask questions. I have that rapport with them, and I think everyone should. One of the other things that has happened with the federal government is that they said, with vaccines, we need to have a more rigorous understanding of the side effects. And that really should have been happening all along when drugs come out into the market, they're not just out into the market and free for all. The research continues afterwards. And one of the things that is supposed to happen is that side effects of the medication need to be reported. Side effects of the vaccines need to be reported so that people understand what happens when you -- because it's a very different thing. When you have a drug or a vaccine come out in a group of, like, 10 people, 20 people, 100 people, 200 people, and then you have all that come out nationwide, all of a sudden, we're not alike. We have different genetic makeup, and something that may not be prevalent in my body and how I react to medications may be very different from a thousand other people. So seeing how these spread throughout the community is really important, and then you see the trends. So that was one of the things that we saw at the federal government. And, I fail to me/ak 165 understand why we've jumped to conclusions here. So, through you, Mr. Speaker, I do have some questions for the proponent of the bill.

Thank you. Right now, what does the Commissioner do with figuring out vaccine combinations? Where do we get that information with the vaccine combinations and the dosage forms? Are we getting that currently from the federal government, or does the Commissioner already do this? Through you?

Thank you very much, Mr. Speaker. And, Mr. Speaker, if I may, just to clarify so that I can properly answer the good me/ak 166 representative's question, is the good representative referring to what that standard of care and those recommended schedules are, through you?

Currently. Yes.

Thank you very much. Currently, our Commissioner is tied to the CDC's ACIP, the Advisory Committee for Immunization Practices and the American Academy of Pediatrics, and the family physicians. So those are the groups who are currently providing that. And, essentially, as the good ranking member and I discussed earlier, there's a strong tie there. This has been me/ak 167 really important because the ACIP has what's called a grade process. I hope no one asked me to spell out what those alphabet soup letters are for. But essentially, it's a recommendation to implementation process. It goes through a rigorous vetting by the appointed members of ACIP. So those that's an appointed body, also, not an elected body. But that group goes through a public process, and currently, the Commissioner basically uses those recommendations that have come through that, through you, Mr. Speaker.

Okay. So currently, the Commissioner uses those recommendations and doesn't form kind of commission upon herself. So moving forward, I guess, I'm trying to understand really how much time the Commissioner is going to need to spend on this, through you. me/ak 168

Thank you very much, Madam Speaker. I would make a guess that it's not going to be very different than what it is now because current statute already has the American Academy of Pediatrics within that language. Connecticut and there are, I believe, 28 other states, as of March, according to the Kaiser Family Foundation, that were using that American Academy of Pediatric recommendation, that recommended schedule, including blue states and red states, some red states, not as many. But that is what we tried to do here in this language, so that it would limit the Commissioner's consideration to those bodies that are already doing that work. In other words, I know the good representative has said we don't want to recreate some of the things that happened at the federal level. And I think that's important here because there's already a process that is in place. That's one of the reasons why we're going to those bodies, through you, Mr. Speaker. me/ak 169

Okay. It's good to know that it doesn't seem to be like it's going to be as much time. Exactly who will the Commissioner be consulting when she goes through these different recommendations from these different bodies, if there's discrepancies, who exactly will she be consulting? What will be her committee to discuss this, through you?

Thank you very much, Mr. Speaker. Mr. Speaker, the current statute actually doesn't contemplate that itself. So in the current statute, if there was a discrepancy between these bodies, there isn't really contemplation for that. Likewise, what we are changing here is not saying, well, if we have a me/ak 170 discrepancy between these bodies, the Commissioner then has to take x, y, and z steps. However, later on in the language of the bill and from a previous bill that we had passed, I believe it was Senate Bill 7 last year, the Commissioner does have an Advisory Committee that she has been able to establish. I am aware of at least two meetings of that Advisory Committee that has occurred. Both of those meetings have been discussions with members related to -- well, have included discussions related to the vaccine. One of the members of that Advisory Committee happens to have previously served on the ACIP. So there is a group that she has access to to be able to consult. It's my sincere hope, my very sincere hope that we will not see discrepancy between and among those bodies. And I will note that there are 12 -- last I checked, there were at least 12 different professional organizations, national organizations that had endorsed the American Academy of Pediatrics schedule for children. Through you, Mr. Speaker.

Okay. So my understanding is that the Commissioner is going to look at these different groups, and then she's going to meet with herself. And if there's discrepancies, will decide amongst the meeting of herself and come up with some sort of schedule. And so the ACIP actually meets three times a year to discuss any vaccine differences. How often will the Commissioner be meeting with herself to come up with vaccine issues or changes? Through you, Mr. Speaker.

Thank you very much, Mr. Speaker. Again, I will add that the current statute does not have the Commissioner consulting with the body at this point. And I will again add that I regret that we even have to contemplate these changes. I would like to see us be able to rely on the ACIP the way that we have because that has been the public, transparent process, again, by me/ak 172 appointed members, that we have relied on for decades in this country. So, it's not a perfect system, what we're looking at. But we, as a legislature, if we find that this is not working for us, we can change it. We did, even from the committee process to now, try to narrow that so that we could at least have parameters. There's nothing in the statute that requires the Commissioner to meet regularly with that Advisory Committee. I've happened to be present for one of those meetings. We were very fortunate to have, as I said, some pretty some national experts who are advising. They allowed public comment at that advisory meeting. I commented and had input for that. So, again, it's not in statute, but it's my expectation based on the fact that there have already been two meetings of that Advisory Committee that if we were to face some kind of discrepancy, and again, I hope that will not occur, that there would at least be somebody that is, something she would rely on based on that past practice, through you, Mr. Speaker.

Okay. Thank you. And let's say there's a new vaccine that comes out that isn't necessarily recommended by one of these groups. Can the Commissioner? I'm not saying will the Commissioner, but I'm saying can the Commissioner add that to a schedule of vaccines, through you, Mr. Speaker?

Thank you very much, Mr. Speaker. The standard of care shall be based on a consideration of those groups. That shall language does help me, have confidence that that's where the limitation is. I understand that word consideration is part of that expansion. Again, that's kind of at the heart of this conversation. We are uncoupling, and I really -- I wish that I was coming up with a better word than our Commissioner is not rubber-stamping, but then a clear line of approval from ACIP to us. And we're uncoupling not because we want to do anything me/ak 174 different, but because something different is being done at the federal level, through you, Mr. Speaker.

Okay. Well, I appreciate that that is the intent that what we're expecting to happen. I don't see this as preventing it. And that to me is, is a concern. It's one thing to use something as the basis, but to have that allowance for a Commissioner to add something to the schedule that hasn't been recommended by our federal government, that hasn't been recommended by the Academy of Pediatrics, is a concern. Are there currently any discrepancies between ASAP guidelines and what we're doing here in the state of Connecticut? Through you.

Thank you very much, Mr. Speaker. I am not an expert on that whole formal ACIP process, but my understanding is that at some point, the secretary made recommendations, though they were not formally adopted by the ACIP. And in addition, there is now a court case, which Connecticut and many states are part of, which has basically put a halt on those changes. So, in this moment in time today, as we stand here, we have the ACIP recommendations available to us, and we're good in terms of our insurance coverage and in terms of our pharmacists and all of that. The issue is that it's all up in the air at this point. And as that court case proceeds, we don't know what may or may not happen. And this statute will allow us some continuity and predictability. Through you, Mr. Speaker.

me/ak 176 Thank you. And I agree. We are in compliance with ACIP right now, and we are in agreement with ACIP right now. And while government can be messy sometimes, to me, it seems like our federal government is working. We are going through the process. There is a process in place. So what could happen if -- the concern is that there's going to be a change at the federal government, and maybe we might not like it here. Is there a reason why we didn't just say if all of a sudden vaccines are taken away, that we have had in place for x amount of years, or we have had x amount of -- have had in the state of Connecticut? Is there anything that we have thought about if that happens, through you?

Thank you, Mr. Speaker. And forgive me. I lost the train from the beginning. Not on the good representative. That's on me. So if she could just repeat the beginning of her question so that I can properly answer through you. me/ak 177

Thank you. Sorry. I think that was a bit of a wonky question. So I think that was on me. I don't think I'll ask it as a question. I'll just really make a statement that, in my opinion, it seems like the better route. Instead of all of a sudden making a brand new system, making a brand new person to come up with all the new schedules of children and adults, and nursing homes, and look at this recommendation, that recommendations, all the recommendations that are out there, and create all this extra work here in the state of Connecticut. Maybe we could have just said, instead, hey. If something looks like it's going to change, and we disagree with it, maybe we can come in at that point. But not try to preemptively try to figure this out in such a -- and I'll use the word wonky again, wonky way. And recreating the wheel as I know the good chair has heard me talk about us doing that in the state of Connecticut over and over and over again. So, I guess I wouldn't mind moving on to the medical exemptions portion. Does this do anything with a me/ak 178 medical contraindication certificate? Does this do anything to expedite, clarify, make the process easier for folks looking for medical exemptions for vaccines? Through you.

Thank you very much, Mr. Speaker. I don't think it does much to change the process as it is today. It simply clarifies in statutory language. The current process, and we did hear a bit about this -- quite a bit about this during the testimony. It is required to be -- the medical exemption is required to be granted by a licensed physician, PA, or APRN. There I go with alphabet soup again. And also to be done, as the language says, in a form and manner, prescribed by the Commissioner, which is an online form. It a form that does have check boxes, but also has a place to put other. So our medical exemption statute provides a really some broad opportunity. me/ak 179 Some of the issues that we've heard are the administrative aspects of it. We also heard from folks related to the difficulty in getting that religious exemption. And I'll again take this opportunity to say, it's not the Department of Public Health that grants or denies that exemption. That exemption has to come from a provider. And we are seeing that, for example, with our pediatricians, there are not a large number of pediatricians who are eager to provide medical exemptions. And so it can be difficult for those who are seeking a medical exemption to find a provider who is able to do so. But that's a different issue connected, but a different issue to the actual form and the process through the Department of Public Health. Through you, Mr. Speaker.

Thank you so much. I agree. We heard a lot of people come forward in our many hours of testimony. And one of the discussions was about medical exemptions, which I don't think we me/ak 180 went far enough in this bill to contemplate all the issues surrounding medical exemptions. And that's really unfortunate, because we know that well, I know, and I guess I will let people around here know that there's more reasons that you may want to get an exemption from a medication, from a vaccine, besides anaphylaxis. Anaphylaxis seems to be the thing that you can get an exemption for, but just short of almost dying, it's hard to get that. And, we had, I will say, at 1 AM, which was past our public hearing, but in our extra room where we heard the rest of the folks that were in person, I will say one of the most profound testimonies I heard was from someone who held up a picture of her child who had hives all over him and looked deathly ill in the picture. Obviously, I didn't get to see this child in person. But it took her years to get a medical exemption for her child. She may not have been there that evening talking about this bill if we had actually fixed the system and acknowledged that someone that has a reaction to a medication that severe, maybe shouldn't get the vaccination, maybe should get a different type of vaccination. Maybe should get a different schedule of vaccinations, maybe should divide up the vaccines. But we really me/ak 181 don't contemplate that in here. We don't contemplate that in our statute. And in fact, I just don't think there's been enough done by DPH to look at that. I think if that were in here today, that would make this a lot more palatable. We have a lot of people that that may have issues with vaccines that are are frustrated with us making them do vaccines and making them get more vaccines. And now they don't have control over what people are saying simply because they may have a reaction or they may have a concern. I might come back to that in a second, but I really want to move on to the pharmacist section. And this acknowledges that pharmacists give vaccines. Through you, Mr. Speaker, is there anything in this bill that allots for pharmacists to get compensated for giving vaccines?

me/ak 182 Thank you very much, Mr. Speaker. And Mr. Speaker, this bill does not do anything to change the compensation structure that currently exists for pharmacists through you.

Thank you so much, Mr. Speaker. The title of this bill is Establishing Connecticut Vaccine Standards. And I will tell you one of the biggest providers for vaccines across the state of Connecticut is our pharmacists. Apparently, they do this out of the goodness of their heart because they don't get compensated. And -- I mean, I stand up here all the time, and I like to brag about Connecticut being forward thinking on health care, but this is yet another way that we're not forward thinking on health care. We need to be compensating people that are doing the good work that we need to have done in the state of Connecticut. I go back to what I said before, and the reason why we're here to begin with is because we've stopped educating the public. me/ak 183 We've stopped being honest with them about the risks and the benefits of medications of vaccines, and pharmacists are ones that can do that. You want higher vaccine rates? How about we educate people instead of actually just making them do it? I know it's a little bit quicker and a little bit easier just to say you have to. I mean, I got to say, growing up, when I used to ask my mom if I could do something, or if I couldn't do something or ask her about something, sometimes she would just say, because I said so. And I swore to myself that I would never say that to my kids. I would always give them a reason. I would always let them understand. I would always educate them on the reasons that they should be doing something or they shouldn't be doing something. But that's what we're doing in the state of Connecticut, and that's what we continue to support in all these proposals, because I said so. I want to go back a little bit to it was the Advisory Committee. And I know you did, you said that this Advisory Committee isn't necessarily in here, but you mentioned that this is happening. So, through you, Mr. Speaker, can you please explain a little bit more about this Advisory Committee and where that falls in this process? Thank you. me/ak 184

Thank you very much, Mr. Speaker. Mr. Speaker, when the good representative and I were speaking earlier, we were talking mostly about Section 1 of the bill, which was the creation of that standard of care. And I was making reference to that Advisory Committee that we passed previously in legislation. I don't remember the public act number, but it was Senate Bill 7 last year, allowing the Commissioner to establish this Advisory Committee. That committee is referenced here within the bill, but it's referenced within, I believe, it is the adult vaccine program section of the bill. It's referenced in a line 340 and line 341. So that when the Commissioner is creating that new adult vaccine program, the Commissioner may consult with that Advisory Committee. And that is -- the plan is who she or they whoever that Commissioner would be, in order to have someone to consult related to the determination of which vaccines to purchase, that Advisory Committee would be available to the me/ak 185 Commissioner. And it's, again, referenced here in that part of the statute, through you, Mr. Speaker.

Thank you. Is this Advisory Committee -- is this in the state of Connecticut, through you?

Through you, Mr. Speaker, yes. This is an Advisory Committee that was established after the Public Health Committee and the general assembly passed the bill. It's a group that I believe the membership is even online. I may -- I will clarify that and confirm that. Again, there have been at least two meetings, to my knowledge, of this group. One of which was here me/ak 186 at the Legislative Office Building that I attended. Again, I mentioned that there was some public comment, but that is a group that was created and allowed for via statute. I will say that when we debated that advice -- creating that Advisory Committee in public health, there were some of us, and at times I will confess, myself included, that said, do we need to create an Advisory Committee? Because the Commissioner has the ability to reach out to many. And in fact, here in Connecticut, we have some of the nation's leading experts on vaccines who are serving. I met with some of them, who are teaching and serving at Yale, for example, and other institutions. So the Commissioner would have access to some of those conversations. But now we know that there is something a little bit more formal that can be utilized and also allows for the possibility of public engagement, through you, Mr. Speaker.

me/ak 187 Thank you so much. So am I to be clear that when the Commissioner is making decisions on any of the vaccines, then the Commissioner is not discussing with any of the other states, through you.

Thank you very much, Mr. Speaker. Mr. Speaker, no. I wouldn't make that representation here myself. The statute creates some boundaries for us. But as would be the case with us as legislators or any professional an attorney, an accountant, you may have conversations with your peers, with others who may offer input to you as you make a decision that then, in the case of the Commissioner, and this process will have to be made within the bounds of statute. But I would hope that our Commissioner would avail herself of some of the amazing resources that are available here in Connecticut with the kind of expertise and experience. me/ak 188 For example, when we had -- in the fall, the Public Health Committee had a forum to talk about vaccinations. We had people from Hartford Healthcare. We had people from the American Academy of Pediatrics. We had professors from Yale. We had a representative from the Fairfield County Medical Association. And we talked with one another and heard from each other. So I do -- It's my hope that indeed the Commissioner will continue to engage in relationships and reach out to stakeholders. Also, in particular, to providers who are meeting with patients and can hear that patient experience, through you, Mr. Speaker.

Thank you so much. At one point, we heard that there was going to be a group of states that were going to come together to kind of form their own guidelines. Is that at all contemplated in here? Is that something that is happening, through you, Mr. Speaker? me/ak 189

Thank you very much. I thank the good representative for giving me the opportunity to answer the first question that she asked about other states. And there has been -- there have been conversations with a number of other states. I believe I don't know if the proper nomenclature is the New England Health Collaborative, but there are some other organizations and conversations across states. There is no plan for us as a state to be deferring to guidelines set forth by that group. However, just as I was talking about stakeholders who are here in the state, the Commissioner and all of our leaders, whether it's our Secretary of State, et cetera, are working with and meeting with those national organizations. But, no. To be very clear, there is not a plan for a regional group to provide those recommendations and for us to adopt them here in Connecticut, through you.

Thank you. I really appreciate hearing that. I think that's really important because clearly, we already have a collaborative of states, and it's called The United States. And I think that that's something that we need to make sure that we hold strong. I realize that things aren't more -- aren't perfect right now at the federal level, but the United States of America was never meant to be perfect. It was always to be made more perfect. So I hope that we don't just turn against the FDA, the CDC, all because we think -- maybe they're not doing things perfectly right now, and that we continue to work with our federal government. And then just in closing, I have appreciated our discussion. This is obviously not going to be a bill that I'm going to support because I believe it does move away from our federal government. And it takes on responsibility within the state that I don't think is the role of the state government, and I don't think should be done by the state government. But there's more here that has been frustrating to me than just this bill, and me/ak 191 it's been the process of this bill. When we brought this bill out, instead of welcoming the public into the people's house, we put restrictions on them. It was a chaos of a day that we had when we had a public hearing on these vaccines. And I was really disappointed with the greeting that they got. We had families that came in. They were there for homeschool. They were there for a guns public hearing. They were there for the vaccine public hearing. And we did not welcome them into the house like we should have. Matter of fact, we did make them feel dirty. We had people wearing masks, whatever the intent of those masks were, which I will not contemplate, it was taken as such to mean that everyone that's coming in here, you're probably not vaccinated. You're probably young kids. You're probably dirty. This is gross. I can't believe you're here. And I don't want to hear you that long, so we're just going to stop the hearing early so you can go home, and we can go home. This was really disappointing, this whole process. And I believe this bill is disappointing. I believe that this is not the route we should be going. It does not put trust into our public. It does not have faith that the me/ak 192 residents of the state of Connecticut can make health care decisions on their own. And all of a sudden, says that a Commissioner has more information and more knowledge and more ability to make knowledge over your health care decisions than your doctor with you, which is not the message we should be giving the people of Connecticut. It's not the message we should be giving the physicians, and I'm not going to be supporting this bill. Thank you.

Thank you, Mr. Speaker. Good afternoon to you. Mr. Speaker, when we -- I recall about five years ago in 2021, when we were debating the removal of the religious exemption for childhood to me/ak 193 require childhood vaccines, where the religious exemption would no longer be allowed to our parents and children to attend school. That was -- the religious exemption was removed. I recall at the time having Q&A and dialogue on this very floor with the Public Health Committee chair at that time. And we went through and talked about what was the requirements to have a vaccine or a potential vaccine on our schedule. And at that time, he had explained that we're going to go through the CDC. That the CDC is the gold standard. They come out with recommendations. From those recommendations, DPH puts those on a list that then comes to the regs review committee to approve. And again, it was highlighted and emphasized that the CDC was the gold standard. And it was exponentially important that we follow the CDC guidelines and their recommendations. So, Mr. Speaker, through you, a question to the current good chair of the Public Health Committee. I'm curious, why are we no longer just following the rule, the guidelines, and the recommendations from the CDC? Why are we changing course on this, through you, Mr. Speaker? me/ak 194

Thank you, Mr. Speaker. And I thank the good representative for the question. I'm sad that we're not able to continue to rely on the ACIP recommendations. The current secretary made a decision to fire the members and to unappoint, to remove the members of that committee, and replace them with a number of members. The current secretary has made a decision not to follow the decades-long process to go from evidence to adoption. A public process, a rigorous process, an evidence-based process. It is my sincere hope that our CDC, and perhaps under a new director that is being vetted now, would move back into that process. But because that process remains in doubt and because our secretary has recommended a schedule of vaccines that differs from all of those other medical leadership societies that we've been talking about, Connecticut has said, We would like to keep that standard that's been in place for so long. me/ak 195 And, in fact, as I have mentioned, 28 other states are looking at using the American Academy of Pediatrics recommendations when it comes to children because the changes were recommended by the secretary. There is not agreement at this point in terms of the political process or I guess I should say, the approval process. So what we would like to do is in Connecticut to continue to be able to rely on that kind of rigorous, evidence-based, and time-tested process for approvals of schedules. I mentioned before the American Academy of Pediatrics their recommended schedule, the process for approving that has been in place for about 100 years. It's evolved over time. There's a special or specific committee, I've been told it's called the Red Book Committee, and they go through that process. So we're doing what I would call the best we can in the face of those changes. As the previous representative discussed, I very much wish that we could continue to rely on those federal standards. But at this point, we are going to make sure that here in Connecticut, we are continuing to go with those tried and true, safe, effective, and evidence-based rigorously studied, and the things that have me/ak 196 gone through that public process previously by the ACIP, through you, Mr. Speaker.

Well, thank you, thank you, Mr. Speaker. Thank you for that very long answer. Now, at the beginning of that answer, which I think is key, the good chair mentioned that the secretary of HHS put some new people on these boards or committees, within CDC, that recommended all these changes. This ain't nothing -- this ain't a new or novel concept. Before this administration, before Secretary Kennedy, before the current administration in Washington, that was still the process. Any HHS secretary prior had the ability to put different people on these same boards. Isn't that correct, Mr. Speaker, through you?

Thank you very much, Mr. Speaker. And I want to make sure that I heard the good representative's question properly. Is the good representative asking, has the process changed in terms of how people are placed on the ACIP or removed from it? Is that the question, through you?

Thank you, Mr. Speaker. If I heard the good chair's response correctly, she said that the Secretary of HHS replaced a lot of the people on these boards. Isn't that the right of the HHS secretary? And isn't that -- wasn't that the right of HHS secretaries previously and prior years and decades before the current HHS secretary, through you, Mr. Speaker?

Thank you very much, Mr. Speaker. Indeed, the executive branch has the ability to appoint people. Much like here in our state, the governor has the ability to appoint the Commissioner. And that appointed body at the federal level, just like our appointed Commissioner here, that appointed body is the one who makes the decisions. So certainly, it is within the secretary's right within process. And that's I don't know all the ins and outs of the lawsuit that has been brought against the secretary related to this. But part of it is, we have regulations. We have processes and procedures that must be followed. And in this case, I don't know the status of that, and if those proper procedures were followed, I don't have that answer. What I do know is that the approval process for that vaccination, so the secretary actually recommended changes. But that approval process that the ACIP has always used, which again is a public process, is not being honored and happening in the same way. So that is a very significant concern for us and for public health in Connecticut, through you, Mr. Speaker.

Thank you, Mr. Speaker. Thank you to the good chair. I guess my other question on related to this is she mentioned that there is decades of evidence, decades of research that was done in the other direction. How do we know, how are we confident standing here today that those decades prior was the right track we were on and they weren't going too far in the other direction. And this is a course correction that the president's CDC and the administration has taken, through you, Mr. Speaker.

Thank you so much, Mr. Speaker. And I thank the good representative for that question truly and sincerely because you're really getting to the heart of the issue. Because one man or one woman should not have the ability to just unilaterally, me/ak 200 based on their own personal decisions, make a decision about what our vaccines should be for the country. Similarly, and I know that the argument's being made that, Oh, well, our Commissioner is the one person who's going to make that recommendation. We are tying that to bodies who have a process. In the federal government, that Commissioner -- or that secretary, excuse me, has been tied to the ACIP, which is a multi-member committee who are vetted, who bring different perspectives and experiences. There are patients. There are experts. There are providers. That's been the history of the folks who have come. There is an opportunity for the public to weigh in, for voices to share the research. And you know what? The good representative who said earlier, the science is settled. Science is always evolving. I could not agree with that statement more. And that's why it's so important to have a committee and a group who brings those various perspectives, who publicly vets that process, who actually allows us to address the kinds of concerns that the good representative had referenced earlier, and to go through a process. And not that it's one person. Again, here in Connecticut, we are asking our Commissioner to tie those decisions to bodies. me/ak 201 To bodies of people who are also trained in evidentiary practices, in research, in how we all can read research, but we're not all as astute a at that as those who have been trained. So it's that the multiple perspectives that we really need and value and have counted on here in this country, for so long. Through you, Mr. Speaker.

Thank you kindly, Mr. Speaker. I appreciate that answer. I'm going to just move briefly over to the adult schedule. If the good chair would just be kind enough, the adult schedule that the Commissioner of DPH has to put in place, for legislative intent, that is not a mandate. That is going to be an elective adult schedule. Is that correct for you, Mr. Speaker?

Thank you very much, Mr. Speaker, and I appreciate that question. No. There is no mandate, and I have used and I will continue to use, the shingles vaccine as an example, as one that, would be recommended, but people would have the choice as to whether or not they would avail themselves of it, which is the same is true for flu or any of the other vaccines that might be recommended for adults, particularly for older adults, through you, Mr. Speaker.

Thank you, Mr. Speaker. Is there any contemplation? Was there any testimony during the public hearing? Roughly how many vaccines or dosages would be recommended on the schedule, through you, Mr. Speaker? me/ak 203

Thank you very much, Mr. Speaker. The bill doesn't specifically talk about the specifics of the number of vaccines recommended. We did hear testimony as we heard discussion earlier here in the chamber about the changes in the number of vaccines that are part of the schedule, different from when I and some others, who are my peers in this chamber age-wise, were vaccinated as children. And now, because of advances and because of an approval process, FDA approval, and approval through the ACIP, the decisions have been made to add those vaccines in order to be able to address and prevent. Childhood vaccines can prevent disease. Unlike some of our adult vaccines, for example, flu or COVID, which can mitigate the effects of disease, which can decrease serious complications or hospitalizations, sometimes help you to avoid death. But those childhood vaccines can prevent disease, through you, Mr. Speaker.

Thank you, Mr. Speaker. So if I understand the good chair correctly, some of the -- a lot of the vaccines that could be recommended on the adult schedule could be an additional dosage or so from the childhood vaccine schedule. Is that correct, Mr. Speaker, through you?

With my sincere apologies to the good representative, if he wouldn't mind repeating his question through you.

me/ak 205 No apologies are necessary. Mr. Speaker, if I understood the good chair correctly, some of the recommendations that could appear on the adult schedule could be recommendations of additional dosages that were from the childhood vaccine schedule. Is that correct, through you, Mr. Speaker?

Thank you very much, Mr. Speaker. I will take a stab and see if I am answering your question or understand your question properly. The childhood vaccine schedule, which is separate, there are two things. There's the recommended standard of care, which would be the full list of here are all the vaccines that the ACIP and the American Academy of Pediatrics say are the vaccines that we recommend your child to receive. Then we have a smaller subset of that, which is the mandated school vaccine schedule. And the school vaccine schedule and that recommended standard of care for children has changed over time, and we have me/ak 206 added recommendations and changed some of those vaccines over time. In terms of adults, similarly, there have been changes to recommendations, and I would use the RSV vaccine as a more recent example. I'm not an expert in the history of vaccines, but we know now that that RSV vaccine can do a lot to help our elderly, also our youngest, but our elderly family members and friends stay safe and healthy. So these are the kinds of things that would be added, through you, Mr. Speaker.

Okay. I think, thank you, Mr. Speaker. I think she touched on what I'm asking, but just for the immediate question, I want to step away from mandate versus non-mandate. My question is regarding the schedule. So, for the adult vaccine schedule that this legislation speaks to, based on the testimony the committee heard, maybe what's being contemplated. Some of the vaccines me/ak 207 that could be recommended on the adult schedule could be additional dosages that you got when you were a child. Is that correct, through you, Mr. Speaker?

Thank you, Mr. Speaker, and thank you to the good representative for clarifying. I'm not sure the answer that I have to that. I'll use this as an example. Some of us who were vaccinated, and I believe it was between 1965 -- and the I'm talking about the measles vaccine and people's immunity to measles. So, you know what? I'm not going to say specifics here because I don't have it. But essentially, there are some adults who had a different kind of measles vaccine when they were younger. So they may not currently retain immunity in the same way today as those who were vaccinated at a time if you were born after -- I'll say 1975 because I know that for sure. So, is something that is being added or recommended as an addition? I don't know, and I don't believe so. But those are the kinds of me/ak 208 things that we think about when we think about what we want our Commissioner to be able to help us understand as shifts happen in our understanding of public health and what the needs are based on the threats out there, through you, Mr. Speaker.

Thank you, Mr. Speaker. We're talking about also the childhood vaccines. And we removed the religious exemption for children to go to school that they could no longer take the religious exemption to be in enrolled in school in the state of Connecticut. We passed that in 2021. And maybe in just a few words, what was the main reason? What was the main idea why we removed the religious exemption for kids to go to school? Why was that so crucial, through you, Mr. Speaker?

Thank you very much, Mr. Speaker. And, I won't speak for the speaker who was a real champion of that when we started that conversation. But essentially, we want to, here in Connecticut, make sure that in our congregate settings, schools, daycares, colleges, nursing homes, that we are retaining and maintaining a high vaccination rate. In our schools, in many places in the country, and in places in Connecticut, we were seeing vaccination rates that were taking us below herd immunity and putting kids at risk. I know that was part of, and probably the biggest impetus for looking at removing that religious exemption, because we were not alone in Connecticut with that change, and the increase in the number of people who were availing themselves of the religious exemption. And the concern was for the population health at the time, through you, Mr. Speaker.

me/ak 210 Thank you, Mr. Speaker. So again, I'm understanding this, I don't want to put words in the good chair's mouth, but if she just want -- I'm going to kind of paraphrase, make sure I'm understanding it. So in a congregate setting, where so school would be a congregate setting. So where there's a lot of kids, it's sort of in a confined area. Because they're in a confined area, smaller spaces, that's why it was so urgent and necessary that they're fully vaccinated and have all the vaccines on the schedule. Is that correct for you, Mr. Speaker?

Thank you very much, Mr. Speaker. I think the good representative did a great job summarizing what I was saying. When we think about the spread of disease, we think about the ways that we can mitigate that. And unfortunately, we all learned and experienced this during COVID. We have vaccinations as one really important tool. Masking is another important tool for certain diseases in terms of people being in closed spaces, me/ak 211 like committee hearing rooms, and air chamber here. Although we have a lot of nice open air here. But, yes, you summarize that very well, through you, Mr. Speaker.

Thank you, Mr. Speaker. Okay. So we have teachers and staff, principals adults that are also in the school with the children. Correct, Mr. Speaker?

Thank you, Mr. Speaker. This was waiting for my microphone. I had turned it off for a second. me/ak 212

Mr. Speaker, thank you. Yes. Indeed, we have adults who are in school settings. Absolutely. And adults' immune systems are a little bit different. As I talked about before, our primary populations for focus of vaccination tend to be those who are our children. Their immune systems are still learning, so that's part of what the vaccinations do, is actually allow their immune systems to learn. That's also what the colds they get in daycare and at school, that does that too. Our people who are pregnant, moms who are having babies, and our older population. So those of us who are not immunocompromised in particular, who are adults at school, with children, perhaps could be someone who's older, who's more at risk. But it's those kiddos who, I would, by the way, never call, whether vaccinated or unvaccinated, any child or person dirty. They are children. Those children who are in school, they are more at risk and more susceptible than most of the adults who are there in school with them, through you. me/ak 213

Thank you, Mr. Speaker. And I thank the good chair lady for her answers. I do not have any more questions. So if you would like to relax for a few minutes, I do have a few comments. Mr. Speaker, I'm concerned with what we're doing here. First of all, I have a lot of consumers that we're in 2021, it was emphasized that we need to follow CDC guidelines, that's the gold standard. Science is always evolving. Science is changing. Our CDC gets the big picture, is seeing -- get all the real-time updates. And what their recommendations are, that's what we need to use for the schedule. At the time, we had -- perhaps an administration, we had a lot a few administrations that were, maybe promoting a certain agenda, trying to push things in a certain way. Now that we got a CDC that's taking a second look at a lot of this stuff, all of a sudden, we need to change course. CDC ain't the gold standard no more. We need to give more power to one person with all due me/ak 214 respect to the DPH Commissioner. We need to maybe play this a little more fast and loose in some way. That concerns me. It almost seems like when the CDC is suiting our needs and is aligning with our political agenda and what we're trying to do as a state, all is fine and dandy. But when it's changing and there are some new people in there that say, let's take a second look at some of this, now we need to rush and we're going to push the CDC aside, and we're going to let the DPH Commissioner decide what we want to put on a non-mandatory adult schedule, for example. My concern, Mr. Speaker, as I have -- I've been here now for a few years, and I noticed when we like to take things on blocks. We like to get the camel's nose under the tent. And when we do that, once it's under the tent, we like to go for more and more and more. We keep coming back and we keep taking more. So I'm looking at what's before us on the adult schedule. So this is going to enable the DPH Commissioner essentially to unilaterally put a non-mandatory schedule of adult vaccine recommendations on that schedule. And once that's placed on that schedule, it don't need to come here. It don't need to come before the legislative branch of government. Whatever the me/ak 215 Commissioner sees fit on that schedule, that suffices. And that's what we're voting on here. My concern is, what are we going to be voting on tomorrow? Once this train leaves the station, what's the next stop? My concern, and I heard this from a lot of teachers in my district and different people that work in the school systems, is what's to prevent us from tomorrow, making that non-mandatory adult schedule mandatory. And once that happens, there's no regs review process. They don't have to come before the regs review committee, because we already passed today that for an adult schedule, there's no need for the regs review process here in the legislature. That's a concern. What also bothers me immensely is we have a federal lawsuit in court from people who are using their constitutional rights to challenge the removal of the religious exemption under federal, that's a pending federal case. And if we pass this legislation today, what we're essentially doing as a legislature is flexing our muscles and trying to prevent these people from having their day in court and to be able to litigate. It's like we're carving out, we're picking and choosing, and we're not allowing these residents of Connecticut to be able me/ak 216 to express themselves in federal court. It's going to make the matter moot, and it's going to diminish their lawsuit. That is wholly and completely unfair. It's irresponsible, and it's wrong. And most importantly, Mr. Speaker, what we're doing under this legislation is empowering one person. The Commissioner of DPH can put on the schedule whatever they see fit. With all due respect to the current Commissioner, and I'm not referring to the current Commissioner, but as you know all too well. If we pass 5044 today, that law is going to be here after most of us, after this Commissioner, the next Commissioner, and probably 10 more Commissioners after that. So, as Lord Acton, a member of the British parliament, so eloquently said in the 19th century, absolute power corrupts absolutely. And think about what we're doing. We're taking one person, the Commissioner of DPH, and they're going to be allowed to put on the schedule whatever vaccine they see fit. They can put that. They can add that. And as I heard with the prior Q&A with the representative from the 141st and the chair, literally, it could be one person that can make that decision by themselves. That is not what our founding fathers envisioned with checks and balances. me/ak 217 The speaker of the House has a lot of power in this chamber to be able to put certain pieces of legislation on the board, what the agenda is going to look like. But at the end of the day, there's still 151 of us, and he's only one of 151 that has a vote on what we vote on. But, yet, we're going to empower one person to decide what's a good vaccine, what's a bad vaccine, what's the criteria they're going to use, what's the criteria that the DPH Commissioners of tomorrow and next week and next decade are going to use to make that determination? This is a slippery slope. I don't like where the train is going on this. It's wrong to evolve ourselves and try to handicap a pending federal lawsuit. That's not what we should be doing as a legislature. For all those reasons, Mr. Speaker, I'm going to oppose this legislation. I encourage all college to follow suit. Thank you very much.

Thank you, Mr. Speaker. I appreciate that. First, quick question to the proponent of the bill.

Thank you, Mr. Speaker. And right now, are there job classifications currently that essentially require individuals to get vaccinations, through you, Mr. Speaker?

Thank you, Mr. Speaker. Thank you to the good representative for asking this question, because I actually asked OLR specifically about our Corrections Department for the me/ak 219 state, our state employees at corrections, or at our hospitals, if there was any kind of vaccine mandate for them. Because many of our health care institutions do require vaccinations for health care providers who are working within their settings. We do not have such requirements. They are recommendations that are made, but there are not any requirements to my knowledge based on what I heard back from OLR. Employers, certainly, private employers have the ability to make those requirements, but not here in the state, through you, Mr. Speaker.

Thank you, Mr. Speaker. And I thought that would be the answer, having a sister who's a nurse. I know what she does. Jumping to Section 11, 12 that was brought up that you spoke of very eloquently earlier, that is deals with the requirement for health insurances policies to cover the cost of vaccines for their employees. If I reading that correct that, starting January 2027, because, yeah, we all know that policies, and I me/ak 220 don't think vaccinations are quite expensive anyways. But, through you, is that what we're doing? We're letting these health insurance plans require them to cover vaccines, through you, Mr. Speaker.

Thank you very much, Mr. Speaker. And, yes, we are continuing Connecticut practice and what's already in law related to the requirement, what we're doing is adjusting. Because of that ACIP change in the standard of care, we're making sure that if there's a vaccine that is in the Connecticut standard of care that is, for some reason, no longer in the ACIP recommended list, that we will have coverage for our residents here in Connecticut, through you.

And thank you for that answer. No. That kind of brings me to a comment that was you prefaced earlier by a speaker is that we're in a way, I'm concerned that this is just a camel's nose under the tent, that we're kind of going into a pattern where we're already requiring them in certain areas already. Obviously, senior housing and mandating in our schools. But in a way, where is this going down the road? Essentially, if we're going to make an adult vaccine list, we're going to require insurance companies to pay for those vaccines. The employer and employees are brunt in the cost of those. So, in a way, does an employer -- Other employers now are saying, "Hey, for the good of my company, for the what we call the health of it that we require as a point of employment that you follow this vaccine probe, the vaccine list." We kind of do that now in our own, our state health plan, not mandate, but continuum of care. If we look at if we don't meet the yearly requirements of our health plans, if you're on the state health plans, it costs you a little bit more. The idea is to be essentially healthier. That's the goal of it. I've had two operations lately. They don't think it had anything to do me/ak 222 with my diet or anything, but I'm not sure if that plan's working out that well for me right now. So, that's an area that I'm a little bit concerned about. The other area I am concerned about is I've been here 16 years, and I get a constituent that calls me on an issue. And we start to dive into that issue. And all of a sudden, I find out that that person's already got an attorney. At that point, we back away. We say, "Okay. This is already in a judicial branch. We're not going to get the second legislative branch involved in this at this point. We need you to resolve it on that end before I can step in." That's kind of been the protocol that I've had here. But as I read what we're doing in Section 14 on line 436, we are getting involved with the judicial branch. Effective from passage and applicable to any civil action pending on or filed after said date. This legislation is really about. Coming up with ideas of what may be good policies health wise for vaccines, not a bad idea. Maybe including them in insurance. I always hate insurance mandates or someone that pays them, but sometimes if it's a low cost and maybe it's going to help that person on insurance, you know, maybe not a bad idea. But me/ak 223 when we step in and say, "Hey, this current action taking place in a judicial branch. Nope. Nope. We're not going to allow you to do that. We are stepping in." And so, this is where I really have pause with this. Not the idea that it's going to make us potentially healthier. I did vote against the removal of the religious exemption in the past. I didn't want people to have their own ability to choose for themselves and their family how to have their health care, but also still allow them to have public education. So, so much has already been said and covered by people that are more involved with the health care, the good ranking member. And we have a pharmacist here and nurses that have spoke on this. But this is really where I pause as to what we're doing is primarily Section 14 where we say you cannot use Section 52-571b action or defense authorized when state or political subdivision burdens a person's exercise of religion. That's where I draw the line on this legislation. We are imposing our will on somebody's freedom to take action against the state. Please, please, let that process go through. See where that suit ends up. Vote no on this piece of legislation. Thank you, Mr. Speaker. me/ak 224

Thank you, Mr. Speaker. I just have some comments. No questions.

I have a godson in his 30s who's married with two young sons. In December 2022, he got a COVID booster shot. A couple days later, he came in from the cold after walking his dog and had sudden onset of very strange symptoms. He lost the feeling in his left arm and his legs. Scary as you might imagine. His diagnosis was transverse myelitis. This me/ak 225 was already a known side effect of the COVID vaccine with 600 cases at the time of the onset of his paralysis. As you can imagine, this had a devastating impact on his psyche, on his family. Now after a couple relapses, I'm glad to say he's largely recovered, but he has significant chronic leg pain three and a half years later. My point of bringing this up is vaccine risk is not just stats. It's about what happens to our family and to our friends. Vaccines do save lives. I'm fully vaccinated with a few extras from serving in the military. But vaccines do have risks, sometimes severe like I relayed on my godson and like my colleague from the 44th so strongly iterated. And the last speaker spoke about Section 14. This doubles down and reinforces the loss of religious exemptions for students. Vaccines should be based on informed choice, not state mandates. The state should recognize that parents have authority over the health care of their children and college students who virtually all are adults should have the authority over what vaccines they take. me/ak 226 I would like to propose a new exemption that goes beyond the religious. It's even available to atheists, who owns your body? Is it you or the government? I say you do. Bodily sovereignty does not depend on religion. There's a well-known phrase. In the case of vaccines, I think it fully applies. That phrase is my body, my choice. I urge my colleagues to vote no on HB 5044. Thank you, Mr. Speaker.

Thank you, Mr. Speaker. Good afternoon. It's been a long day, and thank you to the good Chair of the Public Health Department for your endurance this morning into afternoon. I have one question followed by a few comments if I can, Mr. Speaker. me/ak 227

Thank you. I just want to be clear. Does this bill, HB 5044, set the stage for a mandatory schedule of vaccinations for adults through you, Mr. Speaker?

Thank you very much, Mr. Speaker. Mr. Speaker, no. There is no mandated vaccine for adults. This is a recommended schedule. I can't make any promises for what any future legislature might do, but as we have experienced here in our state, it's public health emergencies where we get into those really difficult conversations. me/ak 228 But in terms of what we're trying to do here today, this is about being clear about recommendations and a standard of care. This is about a change in the nursing home mandate, which would allow for that respiratory virus. But otherwise, no. Through you, Mr. Speaker.

Thank you, Mr. Speaker. And I appreciate that for the senior homes. I think by the time we get there, I might be in one of those homes. But thank you. And just as you said that, this bill does not set that, but future legislatures could. And I think that, unfortunately, sends fear to our residents of the state of Connecticut. But I thank the good Chairwoman, the Proponent of the bill. And just a couple of comments, Mr. Speaker, if I may.

So, as we all know, and I don't know if we heard it before, the Public Health Committee held a public hearing back on March 11th. That committee was called to order at 10:30AM, and we concluded our business at 12:15AM. There were 555 people scheduled to testify that day. Unfortunately, we only heard of about 148 speakers that day. So, essentially, we only heard, what, 20% of the people that wanted to speak on this bill. In addition, over 3,000 pieces of written testimony were submitted. I would say that I think everyone in this room or let me rephrase that. Every member of the Public Health Committee received correspondence on a regular basis upwards of 15 to 25 emails a day from, I think, just about a resident of every single one of the 169 municipalities in this wonderful state of Connecticut. Did we have the opportunity to really listen to all of those people? It's my humble opinion that we did not. And that we didn't go through -- We stripped our residents of the me/ak 230 fundamental protections in the processes. This bill is about more than vaccinations. I think we've pretty much determined that today. It's about what might be going on up at the federal level. It might be what could happen, what may not happen. I have heard from, as I said, not residents just from the two towns that I represent, but every resident in all of our towns throughout the state. That says something about what we're putting through, what we're trying to legislate today. I ask, are you listening? Are we listening? Have we done our due diligence today? I cannot support this legislation today, and I encourage each of the legislators today, everyone in this room, to please vote no today on this piece of legislation. Thank you, Mr. Speaker.

Thank you, Mr. Speaker. I appreciate that. A few questions for the Proponent, if I may.

Thank you. And through you, Mr. Speaker, is it true that every child in this state has a constitutional right to a free public education through you?

Thank you very much, Mr. Speaker. And Mr. Speaker, before I answer the good Representative's questions, I just want to say I'm having flashbacks to my days as P&D Chair, and it's nice to me/ak 232 see you over there, Representative. And yes. Hello. And through you, Mr. Speaker, the answer to the good Representative's question is yes.

Thank you, Mr. Speaker. And I thank the good Proponent for her response. And is it also true that the state of Connecticut has a constitutional obligation to provide a free public education to every child in the state. Through you.

Thank you very much, Mr. Speaker. And through you, that's correct. And if I may anticipate the good Representative's line of reasoning, the religious exemption statute that we passed in me/ak 233 2021, our courts have ruled that we passed those constitutional tests by allowing that religious exemption. But I look forward to continuing conversation through you, Mr. Speaker.

Thank you, Mr. Speaker. And is it also true that a child still has a right to a public education if her parents abuse or neglect her through you?

Thank you very much, Mr. Speaker. Through you, yes.

Thank you, Mr. Speaker. And in such an instance, does the state still have a constitutional duty to provide a free public education to a child whose parents abuse her. Through you.

Thank you very much, Mr. Speaker. Though I do not pretend to be a constitutional scholar, I will say yes through you.

me/ak 235 Thank you, Mr. Speaker. And do violent and disruptive children who disrupt the classroom still have a constitutional right to a free public education, through you?

Thank you very much, Mr. Speaker. Yes. But I will also say that there are constitutional rights, and then there are also statutory and regulatory and other practices that will impact what happens. For example, if a child who is disruptive or violent to the extent that charges would be made against them, there would be consequences through the courts, through you, Mr. Speaker.

me/ak 236 Thank you, Mr. Speaker. So, in such an instance, there would be alternative arrangements made for the education of that child. Is that right, through you?

Thank you very much, Mr. Speaker. I also not being the Chair of education or in that. But, yes, we have lots of protections for our children through you, Mr. Speaker.

Thank you, Mr. Speaker. Because in such an instance where there is a disruptive child, the state still has a constitutional obligation to educate that child. Correct, through you? me/ak 237

Thank you very much, Mr. Speaker. It's my understanding. Yes.

Thank you, Mr. Speaker. Do sick children have a constitutional right to a public education, through you?

Through you, Mr. Speaker. Yes. me/ak 238

Thank you, Mr. Speaker. So, the state still has a constitutional obligation to provide a free public education to a child who is sick, through you.

Thank you, Mr. Speaker. Through you, yes. Through you, Mr. Speaker.

me/ak 239 Thank you, Mr. Speaker. And if that child is sick with measles, does that child still have a constitutional right to a public education, through you?

Thank you, Mr. Speaker. Mr. Speaker, yes.

Thank you, Mr. Speaker. Because the state still has a constitutional obligation to provide a free public education to a child who is sick with measles. Is that true? Through you.

Thank you very much, Mr. Speaker. Well, I'm going to give a lawyerly answer and say it depends. It depends. Because if that child had not been vaccinated and under our law that has been ruled on by our courts has measles, then in that case, the answer would be no. But if that child was vaccinated or had been grandfathered, was unvaccinated and had been grandfathered, then it's my understanding the answer would be yes, through you, Mr. Speaker.

I see. So, the constitutional obligation to educate a sick child that is sick with measles depends on whether or not that child was vaccinated for measles. Is that right, through you? me/ak 241

Thank you, Mr. Speaker. Mr. Speaker, I believe the good Representative is trying to demonstrate that our children have many constitutional rights and protections when it comes to education. And when a parent has made a choice or decision to not vaccinate a child, because of the laws that we passed, yes, that constitutional right has been forfeited as a result of that. Now, again, I am not an attorney, so I may not be expressing this in the proper legal language. But we as a state have made the decision to remove that religious exemption, which means that the children who are not vaccinated, those who are grandfathered are able to continue to attend. The children who are not vaccinated going forward are not able to attend public school. Again, that congregate setting because that child with measles, I'll use the unvaccinated example since I'm talking me/ak 242 about the religious exemption, there could be the opportunity for them to spread that in that congregate setting. And so, I understand the point that the Representative is making, or I think I do. I know that you're not done making your points, and I'm happy to listen. But there is a difference now that we have passed that religious exemption statute, through you, Mr. Speaker.

Thank you, Mr. Speaker. Would the good Proponent agree with me that a child who has already had measles is not at risk of getting it a second time, through you?

me/ak 243 Thank you very much, Mr. Speaker. Besides not being a lawyer, I'm also not a medical provider. And I am not 100% sure of the answer to that. I believe that's the case, but I don't know for sure whether that is the case. So, I'm sorry that I can't provide a better answer to the good Representative, through you, Mr. Speaker.

Thank you, Mr. Speaker. Well, assuming for a moment that a person only gets measles once and that they are not at risk for getting it a second time, a child who has already had measles and recovered from it, would not be a reasonable candidate for a measles vaccine. Would the good Proponent agree with me on that?

Thank you very much, Mr. Speaker. I am not comfortable speculating and giving what I would consider to be a medical opinion that I am not qualified to provide. The good Representative may be right, but I don't know, through you, Mr. Speaker.

Thank you, Mr. Speaker. So, our little colloquy came up with the answers that a child has a constitutional right to a free public education, even if the parents abuse or neglect her, even if she is sick. However, if she has measles, it depends on whether or not she was vaccinated. So, does a child forfeit her constitutional rights to a public education under our state constitution based on what her parents decide to do? Whether her parents decide to get her me/ak 245 vaccinated even if she doesn't need that vaccination, through you?

Thank you very much, Mr. Speaker. Mr. Speaker, I would answer by saying that children and their religious exemption status is something that is done with their parents' consent or not consent. So, it's a parent who makes the decision. As we talked about earlier in this Chamber, no child may be vaccinated without parental consent, period. Through you.

Thank you, Mr. Speaker. And no slight to the good Proponent, but the answers I'm getting are the answers that I me/ak 246 expected to get, which are, I'm sorry to say this, a bit mushy because this concept is a bit mushy under the law. Stripping people of their constitutional rights for refusing to be medicated with a medication they don't need doesn't make any sense. So, I didn't figure I would get concise answers. And it's no slight to the Proponent because it's based on what's in the bill. So, a child who's recovered from measles with no risk of getting measles again, apparently has no right to a public education if they don't get a vaccine they don't need. Where is the sense in that? All right. I want to talk for a moment about adults. I watched the press conference with great interest this morning prior to session, and the good Proponent of the bill and the Speaker and the majority leader all talk about this coming bill. And we were all assured that there are no mandates for adults. I'd like to explore that just a little bit. Through you, Mr. Speaker, is the state of Connecticut going to require state employees get all the vaccinations on the recommended list, through you? me/ak 247

Thank you, Mr. Speaker. Mr. Speaker, through you, there is nothing in this bill that is requiring any state employee to receive a mandated vaccine, through you, Mr. Speaker.

Thank you, Mr. Speaker. I understand there's nothing in the bill, but that was not my question. My question was, will the state of Connecticut require that all state employees get all the vaccinations on the list, through you?

Thank you, Mr. Speaker. Mr. Speaker, I can't answer what the state may do in the future. I can only say what this bill is doing today. And if I understand, and I would like to be able to answer the good Representative's question fully, is is there anything in this bill that is requiring state employees to receive vaccinations based on any schedule that would be contemplated in this bill? Is that what the good Representative is referring to through you, Mr. Speaker?

No. My question is not about whether this bill says it. I know the bill doesn't say it, but that doesn't answer the question. The question is once this bill is in place, we now have a structure. We now have a list of best practices. We now have a list of recommended vaccinations. me/ak 249 And my question is, once we have that in place, will the state of Connecticut use that and tell all state employees, including the people in this Chamber, that they must get every one of these vaccinations? That's my question, through you.

Thank you very much, Mr. Speaker. And Mr. Speaker, I think the good Representative knows that I cannot answer that affirmatively or in the negative. That I can't predict what may happen in the future. But what I can say is those recommended schedules for adults, they exist in other places already. And we, in changing that standard of care to include not just children and adults, are simply making sure that the residents of our state are aware and know that these are the recommended vaccines. We're also making sure that if those residents choose to get those vaccines, they can have them covered by insurance. me/ak 250 Those insurances that we regulate, and that they can continue to go to their pharmacy. For example, if I want to go get a flu shot and it's no longer recommended by ACIP, but it's on now our recommended schedule, I can still be sure that I can go to my pharmacy, that the pharmacist is allowed to give me that. Flu shot may be a bad example, but -- And it's also going to be covered through my insurance through you, Mr. Speaker.

Thank you, Mr. Speaker. Well, perhaps I have greater predictive powers, but I do predict it. I predict that if this bill goes through, the state of Connecticut is going to come down like a nine pound hammer on state employees and force every single one of them to get every vaccine on this list, including every single person in this Chamber. me/ak 251 And I think that's a big problem. Through you. Mr Speaker, have the collective bargaining units been consulted about whether or not they are going to be forced to adhere to the vaccination list that is going to be promulgated under this bill, through you?

Thank you very much, Mr. Speaker. And Mr. Speaker, I have predictive ability as well and I have a different prediction. I think that it is highly unlikely. I'm offering an opinion at this point, which I think is not, you know, necessarily the best thing to be doing in this Chamber. But no. No collective bargaining units have been consulted because there is no mandate in this bill. And there is no attempt or effort to have employees be mandated to take a vaccine. And in fact, earlier in conversation with the good Representative, I spoke about the fact that I did specifically me/ak 252 ask our Office of Legislative Research if there are currently state employees who work in healthcare settings or in our corrections who are required to take vaccines that we already know are recommended. And the answer to that was no. So, I do not anticipate that we will be forcing our state employees to adult state employees to take vaccines. But to answer the good Representative's question, no. No collective bargaining unit has been consulted about something that may or may not occur that we have different opinions about, through you, Mr. Speaker.

Thank you, Mr. Speaker. Did any of those collective bargaining units submit any testimony on this issue, through you?

Thank you, Mr. Speaker. I cannot remember because as the good Representative who sits right in front of you said earlier, there were thousands of pieces of testimony. I did read the majority of them. I do not recall specifically if there was testimony from someone who was a member of those collective bargaining units. I can say that we did not have direct conversation with folks on a stakeholder basis as a committee, through you.

Thank you, Mr. Speaker. So, in the event that the state employees were compelled to get the vaccination on this list, who would make those decisions, through you? me/ak 254

Thank you, Mr. Speaker. Mr. Speaker, I think this is just there's -- I can't answer the question. I'm not able to answer the question. Because as the good Representative mentioned, there are collective bargaining agreements, and there are different things that are put in place related to insurance plans. I see, I recognize the comptroller is here today, actually, just for a visit. So, I don't think I can provide a helpful answer into something that I again, my own opinion, I don't believe would happen, but I also don't have an answer to that question for the good Representative, through you.

me/ak 255 Thank you, Mr. Speaker. So, for the state employees that are in this chamber and in this state, is there any way that we can get some assurance that they will not be compelled to take these vaccines upon threat of losing their jobs, through you?

Thank you, Mr. Speaker. I will. Because I think they should take assurance in the fact that in health care settings throughout our nation and here in our state, private providers require many health care providers to be vaccinated, for example, for the flu. We at UConn Health, we don't require that to occur. Even though that is a standard that is happening in many places, that is not a requirement. Currently, it is a recommendation. So, I do think that our state employees and those in this Chamber should know that that is the practice currently with respect to those particular groups who are working in health me/ak 256 care settings. I think that should help, through you, Mr. Speaker.

Thank you, Mr. Speaker. So, just for the record, my interpretation of the good Proponent's response is that there will be no compulsion for any state employee to take any of the vaccines on this list under threat of losing their job. Is that correct? Through you.

Through you, Mr. Speaker, that is not correct. Because I refuse to make a commitment for a future legislature. I cannot make that commitment standing here. What I can say is my own me/ak 257 personal belief and opinion. What I can say is what I see has been occurring so far, but I cannot stand here today and make a promise or a firm attestation that no future legislature -- My mother taught me to never say never. What I can say is that what we are doing now as a state in no way is requiring that. I can also say that we live through a public health emergency. And the regular day-to-day course of life versus an emergency, those are also different circumstances. So, no. I do not agree with the good Representative's characterization of my remarks, through you.

Okay, Mr. Speaker. Then I believe that the state employees in this state should be very concerned about the passage of this bill. If we can't get a guarantee that they will not be forced under threat of losing their employment to take the vaccines that a single person is going to decide on. me/ak 258 But moving on, we have as a benefit of state employment, many state employees get health insurance. There's been some discussion about health insurance with the previous Representatives. Through you, Mr. Speaker, have the insurance companies been consulted on the enactment and implementation of this bill, through you?

Thank you, Mr. Speaker. Mr. Speaker, I cannot say that I personally have had individual conversations with folks from the insurance company. I don't know if our Department of Public Health folks had any conversations with our insurance companies during the time that they were working on the language of the bill. I just got a thumbs up from our legislative liaison that the department did have conversations about that. What I will also say in terms of the coverage is that we are currently me/ak 259 covering the vaccines that come through those ACIP recommendations through you, Mr. Speaker.

Thank you, Mr. Speaker. I would ask the good Proponent if there's somebody else in the room that would be better suited to answer that question, through you.

Thank you very much, Mr. Speaker. Mr. Speaker, I think I did answer the question that I did not have. Excuse me. The good Representative asked if conversations had been held with the insurance folks. me/ak 260 And I was not certain when I first answered if the Department of Public Health had had those conversations. I personally did not have those conversations, but I have been informed that the Department of Public Health did have those conversations through you, Mr. Speaker.

Thank you, Mr. Speaker. If the Proponent did not personally have those conversations, then I would ask who did, if anyone, through you.

Thank you very much, Mr. Speaker. Mr. Speaker, as Chairs when we work on these bills, we talk to dozens and hundreds of me/ak 261 people, which was the case with this bill. In this case, I and the good co-chair and the members of the committee have talked with many different stakeholders. We've been working closely with the Department of Public Health and the Office of Policy and Management. And it's my understanding that folks from the Office of Policy and Management had direct conversations with those who represent the insurance carriers, through you, Mr. Speaker.

Okay. Thank you, Mr. Speaker. Well, I'll stick to close to home. Through the General Assembly, we have insurance through Anthem. Has Anthem been consulted? And if so, who spoke to them? Through you.

Thank you, Mr. Speaker. I do not know. Through you.

Thank you, Mr. Speaker. So, we don't know what the -- I'm sorry. So, did Anthem or any of the other insurance companies submit any testimony with regard to this bill, through you?

Thank you, Mr. Speaker. Not that I remember or I'm aware of, through you, Mr. Speaker.

Thank you, Mr. Speaker. Does the good Proponent or anybody else in her circle have any idea how the insurance companies are going to react or amend any of the requirements for insurance based on this bill, through you?

I do. Thank you, Mr. Speaker. I would like to reassure the Chamber that the members of the insurance community, many of those who represent them, have my cell phone. And what happens in public health is we hear very clearly from them when they are concerned or have an objection to legislation that we are passing. And what I can share is that I did not hear any kind of objections coming directly to the chairs or through the committee related to what we are doing in the bill. me/ak 264 I think the good Representative's question is something slightly different, which is with respect to did insurance committees talk about any extra requirements or mandates that might be added? And the answer is no, because this bill is not seeking to add a mandate for an adult. It's not an adult vaccine mandate, through you, Mr. Speaker.

Thank you, Mr. Speaker. As many of us know, state employees, not just legislators, but many state employees get a benefit, a reduction in their health insurance premiums if they satisfy certain yearly requirements, and they get a significant penalty and they have to pay more for insurance if they fail to satisfy those requirements. Things like getting a yearly physical, getting their teeth cleaned, getting a colonoscopy every 10 years for men. I have no idea what it is for women. Sorry. So, my question is, will the me/ak 265 state health insurance providers charge state employees a penalty for not getting all of the vaccinations that are on the new list, through you?

Thank you, Mr. Speaker. Mr. Speaker, I'm happy for the opportunity for the question and to answer this question because the good Representative is referring to the Health Enhancement Program, which is a program that our state insurance uses to, as the good Representative said, encourages us and incentivizes us financially because many of us are understandably motivated from a financial standpoint to do preventive screenings in order to remain healthier. And at this point in time, we already have a standard of care in the state that comes from the ACIP. And because we've even given some of the changes, we are still within those ACIP me/ak 266 recommendations. So, there are recommendations that exist, for example, for the flu vaccine. I'll continue to use the flu vaccine as an example. Currently, the state is not requiring us to get the flu vaccine in order to be able to receive that financial benefit and having gone through those preventive screenings. Again, I will not try to predict what someone else who I have no say in what they choose to do will do. But I will say, and again, another public service announcement from your Public Health Co-Chair that the flu vaccine helps to prevent disease. It helps to, if not, do that, reduce seriousness of illness, reduce hospitalization, and prevent death. Through you, Mr. Speaker.

me/ak 267 Thank you, Mr. Speaker. And if there were to be any changes to that program, would they need to be negotiated as part of the collective bargaining agreement, through you?

Thank you very much, Mr. Speaker. Again, I would say it depends. There are certain state employees, for example, all of us in this Chamber, who are not part of a collective bargaining agreement. So, that would probably not apply universally, through you.

Thank you, Mr. Speaker. Now the vaccinations that will be on the list, from the discussion with my colleagues, I me/ak 268 understood that only vaccines that had been approved by the Food and Drug Administration could be added to that list. Is that correct, through you?

Thank you very much, Mr. Speaker. And I thank the good Representative for the question. Vaccines can't go to market and be sold without that FDA approval, so we would not be able to add them to that schedule without such approval, through you.

Thank you, Mr. Speaker. So, the COVID vaccine, for example, was initially approved under an emergency certification, which me/ak 269 has now been revoked. So, is it possible for the COVID vaccine to be added to the list under this bill, through you?

Thank you very much, Mr. Speaker. I will answer the question with the answer specific to sections of the bill. So, when the good Representative refers to list in Section 1 of the bill that is the standard of care, that is a recommended list. And depending on what those bodies, the ACIP, what I was formally referring to as alphabet soup, AAP, ACOG, AAFP, depending on what those recommendations would have, it could. Specifically, to the nursing home section of the statute. That section of the bill allows the commissioner, actually requires the commissioner to add the respiratory viral vaccines or the ability to add a respiratory viral vaccine to those required vaccines for nursing homes, just for nursing homes. me/ak 270 Now RSV and COVID are two respiratory viral vaccines. So, there is a possibility that the COVID vaccine could be added to the nursing home mandate. I will add what I shared earlier, I think in another setting, which is that generally speaking, with the mandated schedules for school and nursing home, a vaccine is not added there until there's been about an 80% uptake of that vaccine, and COVID is nowhere near that. That mandate would be required to go through the regulatory process, the Regs Review Committee. Through you, Mr. Speaker.

Thank you, Mr. Speaker. I'm worried that I just heard that if these organizations recommend a vaccine that has not been approved by the FDA that it could still be on one of the several lists from this bill. Did I misunderstand that, through you?

Thank you very much, Mr. Speaker. Mr. Speaker, the standard of care that is to be set by the commissioner will consider the recommended schedules from the ACIP, the American College of Obstetrics and Gynecology, the American Academy of Family Physicians, and who am I forgetting? I'm forgetting one. But those are schedules that would be adopted through, again, a rigorous process. And I can find out for the good Representative what the current ACIP recommendations are and get back to you on that, through you, Mr. Speaker.

Okay. So, we've got three organizations there. Let's say two of them say they want the COVID vaccine on as part of standard of care and the COVID vaccine has no FDA approval. Do me/ak 272 we suddenly get that in Connecticut as part of our standard of care even though it has no FDA approval and one of the three organizations said, "No. We don't think it's right," through you?

Thank you, Mr. Speaker. Mr. Speaker, would the good Representative be willing to repeat his question, through you?

Sure. The question is, do I understand it correctly that if two of the three organizations or even three of the three organizations recommend the covid vaccine, and the covid vaccine me/ak 273 has no current FDA approval. We would adopt that as part of our standard of care even though it is not approved by the FDA, through you?

Thank you very much, Mr. Speaker. If I may answer the question as to what the current ACIP recommendations are coming from the federal government, which is what our current statute requires. And those current recommendations do include COVID for certain populations, through you.

Okay. If there's a vaccine on the Standard of Care list and the state or a private employer mandates that an employee take me/ak 274 all the vaccines on the Standard of Care list under threat of losing his job. And he gets these vaccines, and he gets sick or dies, does he have a claim against the state, against his employer, through you?

Thank you, Mr. Speaker. I've already answered and discussed the issues around the state and whether or not I can make predictions around that. A private company has a choice. They have their own choices about what they will require for vaccinations, and I can't say what exactly private right of action or cause for action. I'm not an attorney as I've said, but also, I don't know what the current status of that is for the employers who already do require vaccines. And to my knowledge, they do not have liability, but again, I cannot answer that definitively, through you, Mr. Speaker. me/ak 275

Thank you, Mr. Speaker. I actually was hoping for responses that would give me a little more comfort with this bill. And unfortunately, instead, the responses from the good Proponent have made me all the more anxious about this bill and about how it's going to affect the people of this state and the people in my district. Specifically, I'm concerned about how it's going to affect state employees, and I'm concerned that both state employers, state departments and the private sector and especially the insurance sector is going to view this new Standard of Care as a mandate. Even if the bill swears up and down, it's not one. And the old saying is perception is reality. And when everybody thinks this is a mandate, it is a mandate. And I'm concerned about the unintended consequences of this bill, and certainly could not support it. Thank you, Mr. Speaker. Thank you. Thank you to the good Proponent. me/ak 276

Thank you, Mr. Speaker. Mr. Speaker, I have a few comments. No questions for the Proponent. Just some comments.

Mr. Speaker, we're here today to talk about 5044 vaccines. Today, I want to talk about the state of Connecticut, the freedoms, the constitution state. Mr. Speaker, serving on Human Services, we have a lot of issues in this state. Our schools are struggling. We can't fund them. Our nonprofits are struggling. me/ak 277 We're known for the longest wait list for people to get services in the IDD community, the autism community. We need to be here today to fix our state, not for more mandates. Today, we're here to undercut the people for their religious beliefs, their culture. It's about control. We are the constitution state. We're here today to talk about one bill all day long that we cut the public's right off to speak over in committee and we're taking a day to have one vote. To act like a king, to take control. The rights of our people to decide what they want to do is being stripped today with this policy. Mr. Speaker, I'll end with this. My body, my choice, no kings. Thank you.

me/ak 278 Thank you very much, Mr. Speaker. Mr. Speaker, I rise. I do have some questions to the Proponent of the bill, if I may.

Thank you. I just want to first start off by saying that, you know, it's really interesting in this legislature. It's a short session, and many of the bills that we do are supposed to deal with revenue and budgetary items, and yet I would say 90% of the bills or 95% of the bills that come before us have nothing to do with that at all, including this particular one. Through you, Mr. Speaker, the first question I have is actually on line 10 of the bill, it actually adds the word adults to the recommended schedule. And the good chairman of this committee could have answered that question before, and I didn't hear it. I'm just saying curious, Mr. Speaker, as to why we are including adults. I know it's always been for children and for schools, but now we are including adults, through you. me/ak 279

Thank you very much, Mr. Speaker. And I thank the good Representative for the question. Our primary populations for immunization are young people, so children is who we all think of first. But the other primary groups for immunization are people who are pregnant, moms who are having babies, people who are having babies, and then our older population. So, we've talked about nursing homes and the requirements in nursing homes. But because those are three groups that are, I'll say more at risk, though they're not all necessarily at risk, but they're in positions where immunization is a more pressing conversation, we wanted to be sure that we were providing those recommendations guidance and then that tie into the insurance coverage and the pharmacies. And together with that adult language, we also added the American College of Obstetrics and Gynecology to the list of the me/ak 280 groups because they particularly are focused on people who are pregnant. Through you, Mr. Speaker.

Thank you, Mr. Speaker. Thank you for that answer. And I would respond by saying, there's nothing in here that specifically limits it to just nursing homes, maybe people that are pregnant. But that's not even the issue. The issue is as if for decades and decades, adults made their own decisions about vaccinations. They had those decisions, made those decisions with their physicians. And now the state is taking control over that. Now they are adding that to their requirements or to their recommendations. We keep hearing this word today, recommendations. I personally think by the end of the day when you read this, it's going to be requirements. me/ak 281 Because anything in this bill that has not stated that it's only a recommendation and they cannot mandate it, it's a mandate. So, by adding adults to this schedule, to this list, to me, is very, very concerning. Through you, Mr. Speaker, it gives the Department of Public Health broad authority to make recommendations. We keep hearing that word, recommendations, on certain vaccines that an adult should take as a recommendation. But based on the way I'm reading this, can the Commissioner of the Department of Public Health, based on the way this bill is written today, mandate that an adult take a certain vaccine? I know the bill doesn't address it. It doesn't say we've heard it. I've heard you say it many times that this bill does not mandate vaccines. And it doesn't say that it mandates vaccines. But what it doesn't say that it cannot mandate an adult vaccine. So, I'm wondering, based on the language the bill is written today, does the Department of Public Health Commissioner have the authority to mandate a vaccine, through you, Mr. Speaker?

Thank you, Mr. Speaker. Absent a public health emergency, no. Absolutely not. The recommendations are not a mandate. I understand that there are many people in this Chamber and beyond who have that concern, but that does not mean that that's what this bill does. And absent saying it doesn't make it a mandate. In fact, what makes it a mandate is a regulatory process or a statutory process. Those are the only ways that we can create mandates. Either through statute or regulation. Here in this bill, through statute, our higher ed attendees, those who matriculate, they are mandated based on what it says in statute. That is our decision as a legislature. In our schools and in our nursing homes, those mandates happen with the authority we give to allow regulations to occur, which is a process initiated by the executive branch. But then in Connecticut, we were one of the few states that has a legislative check on that. That is the only way that the me/ak 283 mandates can occur. It must be an affirmative process. So, there is not the ability to have a default mandate here in this bill, through you, Mr. Speaker.

Thank you, Mr. Speaker. Mr. Speaker, can --- Through you, thank you for that answer. I understand what you're saying is that only through a public health emergency, the Commissioner of Public Health would have the authority based on the language written here that she would be able to do that, if I'm understanding that correctly, if the Governor issued a public health emergency, through you.

me/ak 284 Thank you very much, Mr. Speaker. I thank the good Representative for the question and the chance to clarify that. My answer was in regular I don't like to use the word normal because what's normal? Life is kind of crazy. But in everyday times, that was what my previous answer was. This bill does not actually talk about the powers of a public health emergency specifically except for that the one thing we change is the ability for the Governor to say to the commissioner, or the commissioner to designate someone if the Governor says that that commissioner can then write a standing order. But that standing order is a prescription for the state basically. It is not a mandate for someone to take a vaccine. So, the conditions of I'm not as conversant today on all of the statutes around public health emergencies, but what I can say is what this bill contemplates is making sure that if we do have a public health emergency, we have that prescription for the state, the standing order, and that people have the choice. And there is actually, if the good Representative is willing to just give me a moment, I would love to just reference the section of the statute that the language within that me/ak 285 specifically notes that even within that public health emergency and within the standing order, the no resident is required to utilize such a medical intervention, and that could include a vaccination as part of that standing order. And forgive me. I'm having a little bit of trouble.

Thank you very much, Mr. Speaker. Okay. Where are we? Public health emergency. Okay. Purchasing, insurance, nursing homes. Which section? Will you help me? As you can see, medical attention. I don't like standing at ease. Okay.

me/ak 286 Thank you very much for the pause, Mr. Speaker, and everyone. So, this is in Section 8 of the bill. And in Section 8 of the bill in line 321 to 322. And again, this is about that standing order. This does not require any individual to receive or utilize any such medical intervention, through you, Mr. Speaker.

Thank you, Mr. Speaker. Thank you for that clarification. You mentioned that the Commissioner of Public Health can issue a standing order. Could you explain to me what a standing order is, through you?

me/ak 287 Thank you very much, Mr. Speaker. Mr. Speaker, the way I describe it and what I always say the fourth grade level for myself is a prescription for all of us. So, for example, I use the example if a terrible flu outbreak occurred tonight, and we all wanted to get Tamiflu to be able to deal with our flu symptoms, we would have to go visit a provider, get a prescription, and go through that process. In the events of such emergency, the Commissioner, if the Governor designated the Commissioner, and as long as the Commissioner was a physician, if not, the Commissioner would have to designate a physician to write a script for all of us. Then tonight, at the end of the night, we could just go get the Tamiflu without having to go to our own individual provider. And that could be for, you know, a medication or a vaccine, through you, Mr. Speaker.

me/ak 288 Thank you, Mr. Speaker. So, I understand what you're saying when it comes to a standing order. I mean, when I read this bill, to me, it gives the department of the Commissioner of Public Health, who I believe I'm not sure that is a physician itself or any Department of Public Health Commissioner is actually a doctor, gives them broad authority, in my opinion, based on the language of this bill to have requirements for adults for vaccines. I find that part extremely disturbing. Very, very concerning. Also, in here, I'm looking at you talk a little bit about nursing homes that the commissioner can require patients going into a nursing home to be vaccinated, whether it be for a flu shot or some other sickness out there. Can you confirm that is correct, through you?

me/ak 289 Thank you very much, Mr. Speaker. With apologies to the good Representative, if she wouldn't mind repeating her question, through you.

Sure. Thank you, Mr. Speaker. I just wanted confirmation. I believe I heard you say, even in the previous debate, that the Department of Public Health Commissioner can require or mandate that a senior or person going into a nursing home has certain vaccinations. And I wanted confirmation if that's correct, through you.

me/ak 290 Thank you. And I thank the good Representative for repeating her question. Yes. Currently, in law, those who are going to nursing homes are required to receive the pneumococcal and the flu vaccine. What we did in the language here is to add respiratory virus vaccinations, and those could be added by the Commissioner through policies and procedures, which then will have to go through the regulatory process. Through you, Mr. Speaker.

Thank you for that answer. Thank you, Mr. Speaker. So, if there is a senior or anybody, not necessarily a senior citizen in a hospital that's being released and admitted to a nursing home because they needed to go for extended care, and they were not vaccinated, are you saying they would not be accepted into the nursing home because of that, through you? me/ak 291

Thank you very much, Mr. Speaker. And the good Representative raises a good question because as we know, sometimes people are making a quick exit from the hospital and having to go. So, those are the requirements. I don't know what kind of transitional period there is. In other words, I'm being very granular just thinking about that day as they were headed to the nursing home. Would they need to get a vaccine before they could actually go? I don't know. But what I do know is that that is the statutory requirement. I'd have to check into how that actually has impact in practice in a situation such as what the good Representative is describing, through you, Mr. Speaker.

Thank you for that answer. I think it's important. I mean, these are really important questions, and I think they should have been answered prior to this bill moving forward. And I've seen that there was many discussions during the public hearing testimony, but maybe had we listened to everybody's testimony. Had the opportunity, maybe we would have found out those answers, and possibly you could have included it in here. But unfortunately, they chose not to go that route. So, here we are with a question putting seniors at risk, possibly that they cannot go into a nursing home because they don't have a vaccination. This bill gives the Department of Public Health Commissioner broad powers. And I have to wonder, I want you to think about this for a moment. The law always is bad enough that it allowed mandated vaccines for children. That's the current law. It's bad as it is. Now we're adding adults. So, what does that mean? If an adult was not going to be required to get a vaccine down the road, they wouldn't have added it. In my opinion, me/ak 293 adults are being added in here because there will be down the road, and I can guarantee you as I say this today, a requirement that an adult gets a vaccine, whether it's for working, as our Representative talked about here, for state workers, is we are heading down the wrong path. Maybe you'll need a vaccine to even go into the grocery store. Now that may seem extreme today, but look what's happening today. 10 years ago, you would never think of the stuff that we're talking about today would even come true. You wouldn't even think about it. They know that can't possibly happen. And it's happening. Because this is the door that you open when you give broad authority to one person, and it's not going through the legislature. It's happening because there's no way they would have added adults. There's always a mission. There's always an intention, and that intention is control. You know, it's amazing in this building that we often pass policy because something could have happened to someone. Maybe they were injured. We've heard a lot of discussion about vaccine injuries. And I'll just use Red Bull, for example, or sugary drinks. Maybe people think they're not healthy for you. So, we me/ak 294 try to pass laws limiting that because the people in this room feel that it's not healthy for you. Or maybe there could be some kind of a reaction to it. Not only Red Bull or sugary drinks, but many other things. So, we pass laws to prevent that. But yet, when it comes to vaccines, we don't. Because there are cases of vaccine injury. Some people respond to vaccines different than others. But yet, we are not putting any laws on the books preventing injuries from vaccines, but yet we put laws on the books to prevent injuries for everything else. If anything, we're promoting it, which in my mind is wrong. The problem here, Mr. Speaker and I won't go on because I know other people have many things to say. And trust me, if I had, I could sit here and talk about this bill for six hours, but I won't. I will save everybody today. But this bill, listen, I am a pro freedom person. I believe that people should be able to have the ability to make their own choices, and the people in this room have no business whatsoever demanding or mandating that someone take any type of a vaccine or anything else. me/ak 295 Think of it this way. What if the state of Connecticut or the government told you, everybody here in this room today, that you were not allowed to wear a mask, or you were not allowed to get a vaccine if you wanted it? How would you feel? So, I put that question to you so you can see how people feel on the other side about mandating it. My personal feeling is that people should make their own decisions when it comes to medical choices. Whether they get a vaccine or not is certainly none of my business. But where I am, Mr. Speaker, is pro freedom. And I think people should absolutely make those decisions themselves. And I am against discrimination because that's what this bill does. I do have one other question that actually just came to my mind on this when we talk about vaccines. And I'll ask it really quickly. It's about medical exemptions for vaccines. If I was to travel to another state and get a medical exemption for a vaccine, and then I came back here, is that exemption good in the state of Connecticut, through you, Mr. Speaker?

Thank you very much, Mr. Speaker. Through you, Mr. Speaker, no. Someone would need residency. The good Representative used the word travel. So, if you are a resident of the state of Connecticut and you are wanting to go to school, I'll use school as the example without vaccination and nursing home retains the religious exemption. So, the same thing for a medical exemption for a nursing home. You would need to adhere to the Connecticut medical exemption process and form in order to be able to be granted that medical exemption here through you, Mr. Speaker.

me/ak 297 Thank you, Mr. Speaker. So, that medical exemption has to come from a physician from the state of Connecticut. Am I understanding that correctly, through you?

Thank you, Mr. Speaker. And, again, if I may ask the good Representative to repeat her question so that I can answer properly.

Sure. So, let me just give a scenario. You go on vacation, you travel to another state, you take a vaccine in another state, and you get a really bad reaction to it. Maybe it was the me/ak 298 flu or for whatever vaccine it was, and you had a really bad reaction to it. And the doctor going forward in that state when you're traveling because maybe you're there for four months out of the year and you're in Connecticut for the remaining months. And the doctors there gave you a medical exemption for the vaccine. Now you come back to Connecticut. You're still a resident of Connecticut. You still pay taxes here because you're maybe we'll call those snowbirds, I guess. Is that medical exemption still good in the state of Connecticut, through you?

Thank you very much, Mr. Speaker. And I thank the good Representative for the clarifying of her question. And the medical exemption needs to be provided in the form and manner prescribed by the Commissioner, which is an online form currently, and by a licensed physician, PA, or APRN. me/ak 299 So, that can be someone who is that provider can be in another state as long as now we get into telehealth and location of the patient and other bills that we have talked about here previously. But if that provider, for example, is licensed here in Connecticut and is out of state, as long as they are properly licensed for the location of care of the patient, then that would be an appropriate and applicable medical exemption. Again, assuming that they were to complete the forms properly through you, Mr. Speaker.

Thank you. And, actually, by that answer, it kind of brings up another point, is that the inequity here. Right? What we're basically doing is you're really discriminating against someone who maybe can't afford to travel to another state. And maybe me/ak 300 somebody, a doctor in another state, would give you a medical exemption for it. I'm just curious how realistically they can actually afford that. Somebody can't afford to go to another state. Maybe for whatever reason, maybe they're visiting. Maybe they're there for three or four months out of the year. But the people that don't afford, cannot afford, and don't have the ability to do that, Mr. Speaker, is being discriminated against by this bill. You know, wealthy families can navigate. They can certainly figure a way around it. And, you know, this body spends a lot of time protecting people that cannot afford it. And this bill is actually doing the complete opposite of it. Through you, Mr. Speaker, just to clarify, if I am -- How about somebody coming from another state? If they were living in Florida and they came here to Connecticut, I'm just using Florida for example, can a doctor give that person a medical exemption? Because based on the way I'm reading this bill, it's very hard to give a medical exemption. It's almost intimidating physicians to not give a medical exemption, and sometimes they're necessary. me/ak 301 If I'm not mistaken that there's a form that I believe that they have to check off, and there has to be certain reasons why a medical exemption existed, through you, Mr. Speaker, if you can clarify if I'm understanding that correctly. And then sometimes there's other reasons that are not on that form that a doctor may want to give a medical exemption form. Does that other reason still exist with this language in here, through you?

Thank you very much, Mr. Speaker. You would think by now that I had all the sections of the bill memorized, but I don't. So, just give me a second.

Thank you very much, Mr. Speaker, and thank you for your indulgence. Section 5 is the section that addresses medical exemptions. And I would point to line No. 171, which is unchanged language. The words are his or her discretion. And this is important because when we talked earlier in the day about contraindications, which are those things that could be good for most of us. Medical interventions, good for most of us, but maybe hurt others. There is a list of those. However, you are not required to have a contraindication in order to receive a medical exemption here in the state of Connecticut. Your provider has the ability to use, as I referenced, his or her discretion, as it says in line 171. That continues. So, the provider's discretion is still there. What the good Representative is referring to is, you know, what we've heard from people that it's harder to get a medical exemption and some people attribute that to the fact that they think that the statute has changed. It has not, and it is not in this case here and in this bill. But in addition to the fact that there are providers not - me/ak 303 - I don't like to attribute intent. I will share what I have heard from providers. Providers who are wanting to adhere to the recommended American Academy of Pediatrics schedule, for example, and may or may not have the comfort level of giving that exemption. I do also just want to address the earlier question, the good question the Representative had in terms of that in state, out of state. And a person can receive a medical exemption from a provider who is out of state via telehealth if that provider is properly licensed here in the state of Connecticut, through you, Mr. Speaker.

Thank you, Mr. Speaker. Thank you for that clarification. Can you point out in this bill where it says that or in statute where it says that a medical exemption, they can get from somebody from out of state as long as they are also licensed me/ak 304 with the state of Connecticut to practice medicine here, through you?

Thank you very much, Mr. Speaker. Mr. Speaker, I will just point out in line 153 and 154 that the licensed physician, licensed physician assistant, or licensed APRN, those are the folks who are able to provide that medical exemption, and they must be licensed here in Connecticut. So, through you, Mr. Speaker, hopefully, that will answer the question.

Thank you. Through you, Mr. Speaker, can you explain that to me again? I am referring to lines 153 as you mentioned. It me/ak 305 just says in a form and manner prescribed by the Commissioner by a licensed physician that's not a licensed advanced practice registered nurse. They could be licensed, but doesn't necessarily mean they're licensed in Connecticut. It doesn't say Connecticut only here. You're licensed. You can have a license anywhere, through you.

Representative McCarthy Vahey.

Representative Mastrofrancesco.

Representative McCarthy Vahey.

Representative Mastrofrancesco.

Representative McCarthy Vahey.

me/ak 311 Representative Mastrofrancesco.

Representative McCarthy Vahey.

Representative Mastrofrancesco.

Thank you, Representative. Will you remark further on the bill as amended? Representative Johnson of the 49th District, you have the floor, ma'am.

Thank you, Representative. Will you remark further on the bill as amended? Will you remark further on the bill as amended? Representative Haines of the 34th, you have the floor, ma'am.

Thank you, Representative. Will you remark further on the bill as amended? Representative Weir of the 55th, you have the floor, sir.

Please proceed.

Representative McCarthy Vahey.

Representative Weir. me/ak 327

Representative McCarthy Vahey.

Representative Weir.

: me/ak 334 Thank you, Representative. Will your remark further on the bill as amended? Representative O'Dea of the 125th, you have the floor, sir.

Representative McCarthy Vahey.

Representative O'Dea.

Representative McCarthy Vahey.

Representative O'Dea.

Representative McCarthy Vahey. me/ak 337

Representative O'Dea.

Representative McCarthy Vahey.

Representative O'Dea.

me/ak 340 Representative McCarthy Vahey.

Representative O'Dea.

Representative McCarthy Vahey. me/ak 341

Representative O'Dea.

Representative McCarthy Vahey.

Well, what I'll do is this. I will give up the microphone, give up the floor. I'll come back for a second time if need be. I will just summarize by saying this legislation, I think, is an overreach. We are addressing a litigation that's going on where the state Supreme Court has stated that this should go back to the trial court to allow the case to proceed because of this overreach and what happened to a number of parents. And the sole -- well, I shouldn't say that. One of the main purposes of this bill and this legislation is to circumvent parental rights, and then litigation, and the rights of our residents. And they're trying to make it easier for the state to win in that case. And I won't get into the legal arguments with the good Chair, but this is an attack by the state on our residents and their rights, and we're trampling all over them. And it's upsetting to see. And I truly love this place, but every time I see the board, all green on one side, all red on the other, it hurts me. It pains me because that means you didn't listen. 80% me/ak 345 of the time you do, but that 20% of the time, it's painful over here. And we can do better. We should do better. And just because you have absolute power doesn't mean you should use it. So, please no more all green and all red on one side. Let's try and get all green together, or at least some bipartisanship. Thank you very much, Mr. Speaker.

Thank you very much. Mr. Speaker, the clerk is in possession of an amendment, LCO number 4424. I ask that the amendment be called and I be granted leave of the chamber to summarize.

House Amendment Schedule B LCO number 4424 offered by Representative McCarthy Vahey, Senator Anwar.

Thank you very much, Mr. Speaker. Mr. Speaker, this amendment is with respect to Section 14 of the bill. It will strike Subsection F of the section and insert the new language. These references are references to the part of the Religious Freedom Restoration Act that we are specifically removing with respect to vaccines. The language in the first amendment and the bill that we've been debating is a bit broader. So what this language does is make sure that the references are as narrow as possible so that we are clear that what we are doing is just me/ak 347 with respect to vaccines. And I will again share, I think I've shared earlier today, but just in case, I will share for everyone what those references mean. In 10-204a, these are the school vaccinations for K-12. In 10a-155, these are college. 10a-155(b), the on-campus housing. Subdivision one of subsection A and subsections B and C of Section 19a-79, that is child care centers. And then the final language within the amendment, the subdivision two of Subsection F and Subsections G and H of Section 19a-87b, those are family child care homes. Mr. Speaker, I move adoption.

Mr. Speaker, I would just simply say that I think this actually is a great amendment that I hope will have bipartisan me/ak 348 approval and would love if we could adopt it in a voice vote if possible.

Here we go again. You guys have it. The amendment is adopted. Will you mark further on the bill as amended? Will you remark further on the bill as amended? Representative Veach.

Will you remark further on the amendment? Will you remark further on the amendment? Representative Courpas.

Madam Chair?

Thank you, Madam. Representative Courpas?

Thank you, Madam. Representative Candelora, the floor, sir.

Thank you, Mr. Minority Leader. Representative Rojas, you have the floor, sir.

Thank you, Mr. Majority Leader. Staff and guests come to the well of the House. Members, take your seats. The machine will be open.

Have all the members voted? Have all the members voted? If all the members have voted, the machine will be locked. And will the Clerk please take and announce the tally? me/ak 359

The bill passes as amended. Calendar 259, please. No clapping. We do not clap in this chamber. Calendar 259, please.

Mr. Majority Leader.

Motions to refer to Appropriation. Seeing no objections, so ordered. Care to remark further? Representative Yaccarino.

Thank you, sir. Representative McGee? No? Maybe Representative Demicco can do it for her, or Representative Johnson, or somebody? A capable team over there. Able to pinch me/ak 361 it. No problem. We'll take anybody at this point. Yep. Representative Johnson.

Thank you, Madam.

me/ak 362 Thank you, Mr. Speaker. Before I move to adjourn for the day, I would like to know that House Democrats will be caucusing following our adjournment in Room 207A.

11:00 o'clock tomorrow.

Sounds good. me/ak 363

See you everybody at 11:00 o'clock tomorrow. We're going to adjourn, subject to the call of Chair without objection. Thank you. Drive safe. (On motion of Representative Rojas of the 9th District, the House adjourned at 5:36 o’clock p.m., to meet again at the Call of the Chair.) me/ak 364 CERTIFICATE I hereby certify that the preceding 363 pages is a complete and accurate transcription of a digital sound recording of the House Proceedings on Tuesday, April 21, 2026. I further certify that this digital sound recording was transcribed by the word processing department employees of Datagain, under my direction. Kanchan Mutreja Datagain 1 Creekside Court Secaucus, NJ 07094