UPDATE: 5/25/2022 -SB 457 was signed by the governor on 5/24/2022 and will go into effect on 10/1/2022. The final version of the bill that was a substitute simply removes an expiration date requiring clinical medical assistants meet certain education requirements. SB 457 as introduced and passed by the Joint Committee on Public Health would have forced all adults into the CT Immunization Information System and expand the use and abuse of private information in the system. NVIC Advocacy was strongly opposed to this bill as introduced. After the bill was amended to require prior written consent, or make the system an "opt-in" system, the bill stalled and was ultimately amended again to remove the medical assistant education expiration date and the language that NVIC Advocacy was opposed to in the bill. The fiscal analysis of the bill after it was amended to require consent stated:
Currently, DPH has 15 federally funded staff members working on CIRTS. Federal funds cannot be utilized on an "opt-in" immunization information system. Thus, these 15 positions would have to be supported with a General Fund appropriation. The cost for these positions is estimated at over $500,000. Additionally, the current immunization information system cannot be reprogramed to operate an "op-in" system. It is estimated to cost over $2 million to switch to a new immunization registry and tracking system.
NVIC's position was neutral on the final passed bill.
UPDATE: 5/3/2022 - SB 457 was amended by the Senate and passed unanimously. The bill then passed the House as amended by the Senate 140-7-4 on the same day.
The amended version of the bill removes the date from the requirement for clinical medical assistants stating that they must have met certain educational requirements on or after 1/1/2023 in order to administer vaccines.
Link to bill analysis as amended: https://www.cga.ct.gov/2022/BA/PDF/2022SB-00457-R01-BA.PDF
UPDATE: 5/2/2022 - The most recent update for SB 457 was a fiscal analysis for amendment # 5489 - text - https://www.cga.ct.gov/2022/lcoamd/pdf/2022LCO05489-R00-AMD.pdf
According to the fiscal analysis of the amendment - https://www.cga.ct.gov/2022/fna/pdf/2022SB-00457-R00LCO05489-FNA.PDF :
Under the amendment, health care providers must obtain consent from a vaccine recipient, or the recipient's parent of guardian to enroll in the system. There will be significant costs for DPH to maintain an immunization registry and tracking system with "opt-in" enrollment. Currently, DPH has 15 federally funded staff members working on CIRTS. Federal funds cannot be utilized on an "opt-in" immunization information system. Thus, these 15 positions would have to be supported with a General Fund appropriation. The cost for these positions is estimated at over $500,000. Additionally, the current immunization information system cannot be reprogramed to operate an "op-in" system. It is estimated to cost over $2 million to switch to a new immunization registry and tracking system.
This should make it clear to the citizens of CT that while the CT immunization registry law was set up to allow parents to decline enrollment in the registry it is not an "opt-in" system and would not be an opt-in system for all the adults who would be put into this tracking system if SB 457 were to pass.
UPDATE: 4/5/2022 - SB 457 was reported favorably out of the Legislative Commissioner's Office as a substitute with a few minor changes that do not affect NVIC Advocacy's position on 4/5/2022. The bill is now on the calendar to be heard by the full Senate on 4/6/2022.
UPDATE: 3/23/2022 - SB 457 passed the Joint Committee on Public Health on 3/23/2022 by a vote of 22 yes and 9 no.
SB 457 was introduced on 3/16/2022 and is scheduled for a hearing in the Joint Committee on Public Health on 3/21/2022. This bill is sponsored by PH, the Public Health Committee. See additional information and history below the summary of what this bill does.
This bill does the following:
Changes current law to require all vaccines administered to all ages be put into the immunization information system. Current law, 19a-7h - Childhood Immunization Registry Regulations only applies to children who have not begun 1st grade.
Makes the immunization information system mandatory. Current law states the Commissioner of Public Health or his designee may, within the limitations of available resources, establish a childhood immunization registry.
Requires the commissioner, or the commissioner's designee, provide the director of health of any municipality or health district with sufficient information on the persons who live in such director's jurisdiction and who are listed on the immunization information system in order to address undervaccinated communities and improve health equity.
Allows the commissioner to use the information in the immunization information system for the purposes set forth in sections 19a-25 and 19a-215.
Allows the commissioner, or the commissioner's designee, to exchange immunization information system information with federal agencies providing health care services and other states' immunization information systems.
Exempts the uses described in Sections b through h of the bill from current law, 19a-25 on the confidentiality of records, removing what little protection there is currently in state law, allowing for the disclosure of personal information without authorization.
Gives rulemaking authority to the Commissioner of Public Health to regulate how the system is used and how a vaccine recipient or a parent may decline enrollment in the information system.
Requires the commissioner to adopt regulations to facilitate interoperability between the immunization information system and the State-wide Health Information Exchange.
Requires health care providers to provide a vaccine recipient or parent information regarding how such vaccine recipient or such child may decline enrollment in the immunization information system. However, there are no details in the bill on how this will be done and there is no penalty if the health care provider does not provide the information.
If passed, the law would go into effect on Oct. 1, 2022.
The Department of Health and the commissioner are not following the original intent of the law which was to allow parents to decline enrollment in the registry.
Here is some additional information and history on the registry/tracking system:
Current CT Law, Sec. 19a-7h(c), states in part- the commissioner shall adopt regulations to specify how parents or guardians may decline their child's enrollment in the registry. In other words, state law is supposed to give parents the option not to have their children put into the system at all. SB 457 as introduced, does not change this law.
However, the administrative rule adopted by the Department of Public Health states – parents shall receive a written informational statement from the department about the immunization registry at the time of birth or, for qualifying children who come to Connecticut after birth, at the time of their coming to the attention of the immunization registry. Such statement shall inform the parent or guardian that their child’s immunization information will be reported to and maintained by the immunization registry and that they may submit a written request to the immunization registry at any time requesting that their child’s immunization record no longer be maintained. Once the request is received, the immunization registry shall no longer update nor make available that child’s immunization record.
The current Connecticut Immunization Registry and Tracking System is called CRITS. However, the department is moving to a new Connecticut Immunization Information System, CT WiZ.
The CT WiZ web site states the system is an opt-out system and the notice that is supposed to be given to parents states- you can choose to exclude your shot formation from CT WiZ. This means, even if you were told you could “opt-out” your child from the system, their personally identifiable information is not removed.
The Connecticut electronic birth registry system has been used to populate the Connecticut Immunization Registry and Tracking System since 1999. See Sec. 19a-7h-2. Registration.
Once your child or your information is in the system, it can be used and disclosed without your knowledge or consent for multiple reasons, including, but not limited to, public health activities. This is because federal law, The Health Insurance Portability and Accountability Act of 1996 (HIPAA), allows it. See § 164.512 Uses and disclosures for which an authorization or opportunity to agree or object is not required. Keeping information “confidential” does not mean it is private. It means that it can be used for whatever the law allows.
The only way to protect privacy in an immunization information/tracking system is not to be put in one. The CT Legislature should require the department of health and the commissioner follow the law. No child or individual should be put into one of these systems without the parent’s or individual’s prior written consent.
https://www.cga.ct.gov/asp/cgabillstatus/cgabillstatus.asp?selBillType=Bill&which_year=2022&bill_num=SB457 - text, status and history for SB 457