Committee hears sharp debate over bill to remove DHHS rulemaking power to add school vaccine mandates

Representative Jim Cofalt, the bill’s prime sponsor, told the committee HB 357 would remove the commissioner’s authority under RSA 141‑C:20‑a to add vaccines to the school and childcare immunization schedule by rule and instead require any new mandates to be enacted by the Legislature.

“Our belief is that when we mandate any kind of medical intervention, that is an extraordinarily serious matter,” Cofalt said. He said the change would make policymakers rather than agency rulemakers decide whether to expand mandated vaccines.

The Department of Health and Human Services urged the committee to reject the bill. Colleen Smith, bureau chief for the Bureau of Infectious Disease Control, and Dr. Benjamin Chan, the state epidemiologist, said the current rule‑making authority lets DHHS respond with deliberation, public input and speed when new evidence or an emerging threat requires action. Smith told the committee that administrative rules allow the department to specify vaccine dosing, ages and other operational details that do not fit well into statute.

"The department believes that the current statute provides a rigorous and conservative approach that prioritizes public input, protects parental choice, and carefully allows for expediency in times of an emergent threat," Smith said.

Medical societies and front‑line clinicians also opposed the bill. Dr. Christine Arseneau, a primary care pediatrician and vice president of the New Hampshire chapter of the American Academy of Pediatrics, said vaccine requirements protect vulnerable children who cannot be immunized and that outbreaks — notably recent measles clusters — can cause hospitalizations and, rarely, death. "Sometimes otherwise healthy kids do suffer severe consequences from these vaccine preventable illnesses," she said.

Nurses and public‑health advocates said mandates and the administrative rule process are tools to achieve high coverage that protects the population. Pam DiNapoli, a registered nurse and school nurse in Manchester, told the committee that schools use a simple standardized form and that the department’s rulemaking and school paperwork together help administrators manage student records and exclusion decisions during outbreaks.

Opponents included parent‑advocacy groups and some speakers who argued the change would restore democratic accountability and parental choice. Melissa Blasek, a volunteer advocacy director with a national group, said HB 357 is about “restoring accountability, transparency, and most importantly, putting power back into the hands of the people.” Several parents and health‑freedom advocates argued that DHHS already coordinates vaccination procurement and federal funding and therefore carries an institutional interest in maintaining mandates.

Committee members pressed sponsors and DHHS on trade‑offs between the speed of rulemaking and legislative deliberation. Representative Lamontagne asked how quickly the Legislature could respond in an outbreak; DHHS and supporters said there are emergency administrative processes and statutory tools (for example, exclusion authority) the commissioner could use while the Legislature convened. Smith noted that administrative rules typically include a public comment period and legal review and that the last time a childhood vaccine was added by rule in New Hampshire was varicella in February 2003.

No committee vote was taken. The public hearing closed after a full docket of witnesses for and against the bill.

Why it matters: HB 357 frames a larger question about the proper balance between technical public‑health decisionmaking and legislative accountability. The outcome will affect how quickly and through what process New Hampshire can add vaccines to school and childcare requirements and how details such as dosing and age are specified.