An Act to Reduce Cost and Increase Access to Disease Prevention by
Maine Legislature, Session 132, LD 0093
Committee: Health and Human Services
Sponsors: ZAGER
Amends: 22 MRSA §1066, 22 MRSA §1963

Legislative Document
No. 93
H.P. 58
House of Representatives, January 8, 2025
An Act to Reduce Cost and Increase Access to Disease Prevention by 
Expanding the Universal Childhood Immunization Program to 
Include Adults
Submitted by the Department of Health and Human Services pursuant to Joint Rule 204.
Reference to the Committee on Health and Human Services suggested and ordered printed.
ROBERT B. HUNT
Clerk
Presented by Representative ZAGER of Portland.
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  22 MRSA §1066, as amended by PL 2017, c. 7, §1, is further amended by 
amending the section headnote to read:
§1066.  Universal Childhood Immunization Program
Sec. 2.  22 MRSA §1066, sub-§1, as enacted by PL 2009, c. 595, §2, is amended to 
read:
1.  Program established.  The Universal Childhood Immunization Program is 
established to provide all children from birth until 19 years of age individuals in the State 
with access to a uniform set of vaccines as determined and periodically updated by the 
Maine Vaccine Board.  The program is administered by the department for the purposes of 
expanding access to immunizations against all diseases as recommended by the federal 
Department of Health and Human Services, Centers for Disease Control and Prevention 
Advisory Committee on Immunization Practices, optimizing public and private resources 
and lowering the cost of providing immunizations to children individuals in the State.  The 
program is overseen by the Maine Vaccine Board.
Sec. 3.  22 MRSA §1066, sub-§2, ¶D, as enacted by PL 2009, c. 595, §2, is 
repealed.
Sec. 4.  22 MRSA §1066, sub-§2, ¶F, as enacted by PL 2009, c. 595, §2, is 
amended to read:
F.  "Fund" means the Childhood Immunization Fund established in subsection 7.
Sec. 5.  22 MRSA §1066, sub-§2, ¶G-1 is enacted to read:
G-1.  "Individual" means a person who resides in the State.
Sec. 6.  22 MRSA §1066, sub-§2, ¶I, as enacted by PL 2009, c. 595, §2, is amended 
to read:
I.  "Program" means the Universal Childhood Immunization Program established in 
subsection 1.
Sec. 7.  22 MRSA §1066, sub-§2, ¶M, as enacted by PL 2009, c. 595, §2, is 
amended to read:
M.  "Total costs of the fund" means the costs of vaccines provided under the program 
to children individuals projected to be covered by assessed entities during the 
succeeding program year and the annual operating expenses of the board, including 
costs the board may incur for staff, a service agent, legal representation, administrative 
support services and other expenses approved by the board.
Sec. 8.  22 MRSA §1066, sub-§5, as enacted by PL 2009, c. 595, §2, is amended to 
read:
5.  Assessments.  By January 1, 2011 and annually thereafter, the board shall determine 
an assessment for each assessed entity in accordance with this subsection. The board shall 
provide a mechanism to protect against duplicate counting of children individuals. The 
board may conduct an audit of the number of covered life months for children individuals 
as reported by an assessed entity. An assessment determination made pursuant to this 
subsection is an adjudicatory proceeding within the meaning of Title 5, chapter 375, 
subchapter 4.
A.  In determining the amount of the assessment, the board shall:
(1)  Determine the total costs of the fund for the succeeding program year;
(2)  Add a reserve of up to 10% of the total costs of the fund under subparagraph 
(1) for unanticipated costs associated with providing vaccines to children 
individuals covered by the assessed entity;
(3)  Subtract the amount of any unexpended assessments collected in the preceding 
year and any unexpended interest accrued to the fund during the preceding year; 
and
(4)  Calculate the assessment on a monthly basis per child individual to be paid by 
an assessed entity by dividing the amount determined in accordance with 
subparagraphs (1), (2) and (3) by the number of children individuals projected to 
be covered by the assessed entity during the succeeding program year divided by 
12.
B.  The board shall provide the assessed entity with notice of the assessment amount 
for the succeeding program year no later than January 1, 2011 and annually thereafter.
C.  Beginning July 1, 2011, the assessment must be paid on a quarterly basis as follows:
(1)  An assessed entity shall pay a quarterly assessment equal to the monthly 
assessment rate per child individual as described under paragraph A, subparagraph 
(4) multiplied by the number of child individual member months covered by the 
assessed entity in the preceding calendar quarter; and
(2)  The assessment must be paid within 45 days following the close of the calendar 
quarter.
D.  After the close of a program year, the board shall reconcile the total assessments 
paid by assessed entities, including interim assessments determined under paragraph 
E, with the actual costs of vaccines provided under the program to children individuals 
covered by assessed entities during that program year and the annual operating 
expenses of the program during that program year.  Any unexpended assessments must 
be used to reduce the assessment in the succeeding program year as required under 
paragraph A, subparagraph (3).
E.  The board may determine an interim assessment for new vaccines that the board 
has made available through the program pursuant to subsection 3, paragraph E.  The 
board shall calculate the interim assessment in accordance with paragraph A, and the 
interim assessment is payable the calendar quarter that begins no less than 30 days 
following the establishment of the federal contract price.  The board may not impose 
more than one interim assessment per year, except in the case of a public health 
emergency declared in accordance with state or federal law.
F.  If the combination of funding available from the United States Department of Health 
and Human Services, Centers for Disease Control and Prevention, Vaccines for 
Children Program and the immunization grant program under the federal Public Health 
Service Act, Section 1928 of the Social Security Act, 42 United States Code, Section 
1396s is insufficient to provide coverage for vaccines for the children who qualify for 
vaccines under the Vaccines for Children Program, money from the fund may not be 
used to cover the cost of vaccines for children who would otherwise be provided 
vaccines under the Vaccines for Children Program.
G.  If the assessments under this subsection are insufficient to cover the cost of vaccines 
to be provided to children individuals covered by assessed entities, the State is not 
required to cover the cost of vaccines for those children individuals.
Sec. 9.  22 MRSA §1066, sub-§7, as enacted by PL 2009, c. 595, §2, is amended to 
read:
7.  Fund.  The Childhood Immunization Fund is established for the sole purpose of 
funding the program, including any costs of vaccines provided under the program to 
children individuals and any costs the board may incur for staff, a service agent, 
administrative support services, legal representation and contracted services.  The fund is 
administered by the board or the service agent, which shall act as a fiduciary and manage 
and invest the fund in conformance with prudent investor standards and maintain complete 
records of all assets, investments, deposits, disbursements and other transactions of the 
fund. All money and securities in the fund must be held in trust by the Treasurer of State 
for the purpose of making payments under this section and are not money or property for 
the general use of the State.  The Treasurer of State is the custodian of the fund and may 
make disbursements only upon written direction from the board or the service agent. All 
assessments collected pursuant to this section, all interest on the balance in the fund and all 
income from any other source must be deposited into the fund.  The fund does not lapse.  
No portion of the fund may be used to subsidize other programs or budgets.
Sec. 10.  22 MRSA §1066, sub-§8, as enacted by PL 2009, c. 595, §2, is amended 
to read:
8.  Reporting.  By January 15th of each year, the board shall report to the joint standing 
committee of the Legislature having jurisdiction over health and human services matters 
regarding the operation of the program, the progress of the program in expanding access to 
immunizations for children individuals and the assets, investments and expenditures of the 
fund.
Sec. 11.  22 MRSA §1963, sub-§3, ¶I, as enacted by PL 2017, c. 312, Pt. A, §1, is 
amended to read:
I.  Support for activities of programs within the Maine Center for Disease Control and 
Prevention, including, but not limited to, the Universal Childhood Immunization 
Program under section 1066 and environmental health and tuberculosis programs;
SUMMARY
This bill amends the law governing the Universal Childhood Immunization Program 
to expand the program to provide immunizations to and cover the costs of recommended 
vaccines for adults in the State.