84R7676 JSC-D By: Schwertner, et al. S.B. No. 538 A BILL TO BE ENTITLED AN ACT relating to the control of infectious diseases. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: SECTION 1. Chapter 418, Government Code, is amended by adding Subchapter B-1 to read as follows: SUBCHAPTER B-1. STATE OF INFECTIOUS DISEASE EMERGENCY Sec. 418.031. DECLARATION OF STATE OF INFECTIOUS DISEASE EMERGENCY. (a) The governor by executive order or proclamation may declare a state of infectious disease emergency if the governor, in consultation with the commissioner of state health services and the division, finds that an infectious disease poses an imminent risk to the health and safety of the citizens of this state. (b) The state of infectious disease emergency continues until the governor: (1) finds that there is no longer an imminent risk to the health and safety of the citizens of this state; and (2) terminates the state of emergency by executive order. (c) An executive order or proclamation issued under this section must include the name of the communicable disease and a description of the threat to public health and safety. (d) An executive order or proclamation shall be disseminated promptly by means intended to bring its contents to the attention of the general public. An order or proclamation shall be filed promptly with the division and the secretary of state. Sec. 418.032. EFFECT OF DECLARATION. (a) An executive order or proclamation declaring a state of infectious disease emergency gives the commissioner of state health services authority for all state and local public health policy decisions, procedures, and disease control measures necessary to contain the infectious disease emergency. (b) The Department of State Health Services shall issue specific statewide preparedness guidelines and procedures for local health and emergency management authorities in the case of a state of infectious disease emergency. Sec. 418.033. RULES. The executive commissioner of the Health and Human Services Commission may adopt rules necessary for carrying out the purposes of this subchapter. SECTION 2. Section 81.008, Health and Safety Code, is amended to read as follows: Sec. 81.008. COMMUNICABLE DISEASE IN ANIMALS; EXCHANGE OF INFORMATION. (a) If the department or a local health authority has reasonable cause to believe that an animal has been infected with, has been exposed to, or is the carrier of a communicable disease, the department or local health authority may obtain a sample of the animal's blood or other bodily fluid to perform a test for an infectious disease without: (1) the permission of the animal's owner; or (2) a control order under Section 81.084. (b) The Texas Animal Health Commission and the Texas A&M University Veterinary Diagnostic Laboratory shall each adopt by rule a memorandum of understanding with the department to exchange information on communicable diseases in animals. SECTION 3. Section 81.046, Health and Safety Code, is amended by amending Subsection (b) and adding Subsection (f-1) to read as follows: (b) Reports, records, and information relating to cases or suspected cases of diseases or health conditions are not public information under Chapter 552, Government Code, and may not be released or made public on subpoena or otherwise except as provided by Subsections (c), (d), [and] (f), and (f-1). (f-1) The department may release to first responders the name and basic contact information of a person if: (1) the department reasonably believes that the person is infected with, has been exposed to, or is the carrier of a communicable disease; and (2) the communicable disease poses a serious health risk to first responders that do not wear the appropriate personal protective equipment. SECTION 4. Section 81.083, Health and Safety Code, is amended by amending Subsections (a), (b), and (e) and adding Subsection (d-1) to read as follows: (a) Any person, including a physician, who examines or treats an individual who has a communicable disease, or, the department or a local health authority, shall instruct the individual about: (1) measures for preventing reinfection and spread of the disease; and (2) the necessity for treatment until the individual is cured or free from the infection. (b) If the department or a health authority has reasonable cause to believe that an individual is infected [ill] with, has been exposed to, or is the carrier of a communicable disease, the department or health authority may order the individual, or the individual's parent, legal guardian, or managing conservator if the individual is a minor, to implement control measures that are reasonable and necessary to prevent the introduction, transmission, and spread of the disease in this state. The order may require the individual to remain in a health care facility or other location, including the individual's home. (d-1) A peace officer, including a sheriff or constable, may use reasonable force to: (1) secure an individual subject to an order issued under Subsection (b); and (2) except as directed by the department or the health authority, prevent the individual from leaving the facility or other location designated in the order. (e) An individual may be subject to emergency detention under Section 81.0891 or court orders under Subchapter G if the individual is infected with, has been exposed to, or is the carrier of or is reasonably suspected of being infected with, having been exposed to, or being the carrier of a communicable disease that presents an immediate threat to the public health and: (1) the individual, or the individual's parent, legal guardian, or managing conservator if the individual is a minor, does not comply with the written orders of the department or a health authority under this section; or (2) a public health disaster exists, regardless of whether the department or health authority has issued a written order and the individual has indicated that the individual will not voluntarily comply with control measures. SECTION 5. Sections 81.086(b), (c), and (i), Health and Safety Code, are amended to read as follows: (b) If the department or health authority has reasonable cause to believe that a carrier or conveyance has departed from or traveled through an area infected or contaminated with a communicable disease or that an individual transported by the carrier or conveyance is infected with, has been exposed to, or is the carrier of a communicable disease, the department or health authority may order the owner, operator, or authorized agent in control of the carrier or conveyance to: (1) stop the carrier or conveyance at a port of entry or place of first landing or first arrival in this state; and (2) provide information on passengers and cargo manifests that includes the details of: (A) any illness suspected of being communicable that occurred during the journey; (B) any condition on board the carrier or conveyance during the journey that may lead to the spread of disease; and (C) any control measures imposed on the carrier or conveyance, its passengers or crew, or its cargo or any other object on board during the journey. (c) The department or health authority may impose necessary technically feasible control measures under Section 81.083 or 81.084 to prevent the introduction and spread of communicable disease in this state if the department or health authority, after inspection, has reasonable cause to believe that a carrier or conveyance: (1) [that] has departed from or traveled through an infected or contaminated area and: (A) [(1)] is or may be infected or contaminated with a communicable disease; or (B) [(2)] has cargo or an object on board that is or may be infected or contaminated with a communicable disease; or (2) [(3)] has an individual on board who is infected with, has been exposed to, or is the carrier of[,] a communicable disease. (i) The department or health authority may require an individual transported by carrier or conveyance who the department or health authority has reasonable cause to believe is infected with, has been exposed to, or is the carrier of a communicable disease to be isolated from other travelers and to disembark with the individual's personal effects and baggage at the first location equipped with adequate investigative and disease control facilities, whether the person is in transit through this state or to an intermediate or ultimate destination in this state. The department or health authority may investigate and, if necessary, isolate or involuntarily hospitalize the individual until the department or health authority approves the discharge as authorized by Section 81.083. SECTION 6. Subchapter E, Chapter 81, Health and Safety Code, is amended by adding Sections 81.0891, 81.0892, 81.0893, 81.0894, and 81.0895 to read as follows: Sec. 81.0891. EMERGENCY DETENTION OF INDIVIDUAL SUBJECT TO CONTROL ORDER. (a) A peace officer, without a warrant, may take an individual into custody if the officer has reason to believe and does believe that: (1) the individual is subject to a written control order under Section 81.083; (2) the individual, or the individual's parent, legal guardian, or managing conservator if the individual is a minor, is not complying with or does not intend to comply with the control order; and (3) there is a substantial risk of serious harm to others unless the individual is immediately detained. (b) A substantial risk of serious harm to others under Subsection (a)(3) may be demonstrated by: (1) a previous violation of a control order by the individual or, if the individual is a minor, the individual's parent, legal guardian, or managing conservator; (2) evidence of illness and deterioration of the person's physical condition to the extent that the person cannot remain at liberty; or (3) information provided to the peace officer by the local health authority or the department. (c) The peace officer may form the belief that the individual may be subject to emergency detention under this section: (1) on information and belief from a credible person, including a local health authority or the department; or (2) on the basis of the conduct of the individual or the circumstances under which the individual is found. (d) A peace officer who takes an individual into custody under Subsection (a) shall immediately transport the individual to: (1) the nearest appropriate health facility; or (2) a location considered suitable by the department or local health authority, including the individual's home. (e) A peace officer who takes an individual into custody under Subsection (a) shall immediately inform the individual orally in simple, nontechnical terms: (1) of the reason for the detention; and (2) that a staff member of the facility, or the department or local health authority if the individual is detained at a location under Subsection (d)(2), will inform the individual of the individual's rights under Section 81.0895 not later than 24 hours after the time the individual is taken into custody under this section. Sec. 81.0892. PEACE OFFICER'S NOTIFICATION OF DETENTION. (a) A peace officer shall immediately file with a facility, or the local health authority or the department if the individual is detained at a location under Section 81.0891(d)(2), a notification of detention after transporting an individual to that facility or location under Section 81.0891. (b) The notification of detention must contain: (1) a statement that the officer has reason to believe and does believe that: (A) the individual is the subject of a communicable disease control order under Section 81.083; (B) the individual, or the individual's parent, legal guardian, or managing conservator if the individual is a minor, is not complying with or does not intend to comply with the control order; (C) the individual evidences a substantial risk of serious harm to others; and (D) the risk of harm is imminent unless the person is immediately detained; (2) a statement that the officer's beliefs are based on specific recent behavior, overt acts, attempts, statements, or threats that were observed by or reliably reported to the officer; and (3) a detailed description of the specific behavior, overt acts, attempts, statements, or threats and, if applicable, the name of the person who reported or observed the behavior, acts, attempts, statements, or threats. (c) If the individual is detained at a facility under Section 81.0891(d)(1), the facility in which the individual is detained shall include in the detained individual's file the notification of detention described by this section. (d) The peace officer shall give the notification of detention on the following form: Notification--Communicable Disease Emergency Detention NO. ____________________ DATE:_______________TIME:_______________ THE STATE OF TEXAS FOR THE BEST INTEREST AND PROTECTION OF: ______________________________________ NOTIFICATION OF COMMUNICABLE DISEASE EMERGENCY DETENTION Now comes _____________________________, a peace officer with (name of agency) _____________________________, of the State of Texas, and states as follows: 1. I have reason to believe and do believe that (name of individual to be detained) __________________________ is the subject of a control order issued under Section 81.083, Health and Safety Code. 2. I have reason to believe and do believe that the above-named individual (or, if applicable, the minor individual's parent, legal guardian, or managing conservator) is not complying with or does not intend to comply with the control order based on the following: ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ 3. I have reason to believe and do believe that the above-named individual evidences a substantial risk of serious harm to others based on the following: ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ 4. I have reason to believe and do believe that the risk of harm is imminent unless the above-named individual is immediately detained. 5. My beliefs are based on the following recent behavior, overt acts, attempts, statements, or threats observed by me or reliably reported to me: ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ 6. The names and addresses of those persons who reported or observed recent behavior, overt acts, attempts, statements, or threats of the above-named person are (if applicable): ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ For the above reasons, I present this notification to (name of facility or local health authority or department) _________________________ for the detention of (name of individual to be detained) __________________________. 7. Was the individual restrained in any way? Yes □ No □ _________________________BADGE NO. _____________________ PEACE OFFICER'S SIGNATURE Address: _________________________ Zip Code: ____________________ Telephone: ______________________ (e) A health facility, local health authority, or the department may not require a peace officer to execute any form other than the form provided by Subsection (d) as a condition of accepting for temporary admission an individual detained under Section 81.0891. Sec. 81.0893. ACCEPTANCE OF PERSON. A facility shall temporarily accept an individual for whom a peace officer files a notification of detention under Section 81.0892(a). Sec. 81.0894. RELEASE FROM DETENTION. (a) An individual detained under Section 81.0891 may be detained in custody for not longer than 48 hours after the time the individual is presented to the facility or location unless a written order for further custody or detention is obtained under Subchapter G. (b) If the 48-hour period ends on a Saturday, Sunday, legal holiday, or before 4 p.m. on the first succeeding business day, the individual may be detained until 4 p.m. on the first succeeding business day. If the 48-hour period ends at a different time, the individual may be detained only until 4 p.m. on the day the 48-hour period ends. (c) If extremely hazardous weather conditions exist or a disaster occurs, the presiding judge or magistrate may, by written order made each day, extend by an additional 24 hours the period during which the individual may be detained. The written order must declare that an emergency exists because of the weather or the occurrence of a disaster. Sec. 81.0895. RIGHTS OF INDIVIDUALS DETAINED. (a) An individual subject to emergency detention under Section 81.0891 has the right: (1) to be advised of the location of detention, the reasons for the detention, and the fact that the detention could result in a longer period of court-ordered management; (2) to a reasonable opportunity to communicate with and retain an attorney; (3) to be released from a facility as provided by Section 81.0894; (4) to be advised that communications with a health professional, local health authority, or the department may be used in proceedings for further detention; and (5) to a reasonable opportunity to communicate with a relative or other responsible person who has a proper interest in the individual's welfare. (b) An individual detained under Section 81.0891 must, not later than 24 hours after the time the individual is admitted to a facility or detained in another location, be informed of the rights provided by this section and this subchapter: (1) orally in simple, nontechnical terms and in writing in the person's primary language, if possible; or (2) through the use of a means reasonably calculated to communicate with a hearing or visually impaired individual, if applicable. (c) The executive commissioner of the Health and Human Services Commission by rule shall prescribe the manner in which the individual is informed of the individual's rights under this subchapter. SECTION 7. Section 81.152(c), Health and Safety Code, is amended to read as follows: (c) Any application must contain the following information according to the applicant's information and belief: (1) the person's name and address; (2) the person's county of residence in this state; (3) a statement that the person is infected with, has been exposed to, or is the carrier of or is reasonably suspected of being infected with, having been exposed to, or being the carrier of a communicable disease that presents a threat to public health and that the person meets the criteria of this chapter for court orders for the management of a person with a communicable disease; and (4) a statement, to be included only in an application for inpatient treatment, that the person fails or refuses to comply with written orders of the department or health authority under Section 81.083, if applicable. SECTION 8. Section 81.158(a), Health and Safety Code, is amended to read as follows: (a) An affidavit of medical evaluation must be dated and signed by the commissioner or the commissioner's designee, or by a health authority with the concurrence of the commissioner or the commissioner's designee. The certificate must include: (1) the name and address of the examining physician, if applicable; (2) the name and address of the person examined or to be examined; (3) the date and place of the examination, if applicable; (4) a brief diagnosis of the examined person's physical and mental condition, if applicable; (5) the period, if any, during which the examined person has been under the care of the examining physician; (6) an accurate description of the health treatment, if any, given by or administered under the direction of the examining physician; and (7) the opinion of the health authority or department and the reason for that opinion, including laboratory reports, that: (A) the examined person is infected with, has been exposed to, or is the carrier of or is reasonably suspected of being infected with, having been exposed to, or being the carrier of a communicable disease that presents a threat to public health; and (B) as a result of that communicable disease the examined person: (i) is likely to cause serious harm to himself; or (ii) will, if not examined, observed, or treated, continue to endanger public health. SECTION 9. Section 81.162(a), Health and Safety Code, is amended to read as follows: (a) The judge or designated magistrate may issue a protective custody order if the judge or magistrate determines: (1) that the health authority or department has stated its opinion and the detailed basis for its opinion that the person is infected with, has been exposed to, or is the carrier of or is reasonably suspected of being infected with, having been exposed to, or being the carrier of a communicable disease that presents an immediate threat to the public health; and (2) that the person fails or refuses to comply with the written orders of the health authority or the department under Section 81.083, if applicable. SECTION 10. Section 81.165(a), Health and Safety Code, is amended to read as follows: (a) A hearing must be held to determine if: (1) there is probable cause to believe that a person under a protective custody order presents a substantial risk of serious harm to the person [himself] or others to the extent that the person cannot be at liberty pending the hearing on a court order for the management of a person with a communicable disease; and (2) the health authority or department has stated its opinion and the detailed basis for its opinion that the person is infected with, has been exposed to, or is the carrier of or is reasonably suspected of being infected with, having been exposed to, or being the carrier of a communicable disease that presents an immediate threat to public health. SECTION 11. Section 81.166(d), Health and Safety Code, is amended to read as follows: (d) The notification of probable cause hearing shall read as follows: (Style of Case) NOTIFICATION OF PROBABLE CAUSE HEARING On this the _____ day of _________________, 20__ [19__], the undersigned hearing officer heard evidence concerning the need for protective custody of ___________ (hereinafter referred to as proposed patient). The proposed patient was given the opportunity to challenge the allegations that (s)he presents a substantial risk of serious harm to self or others. The proposed patient and his or her attorney _________________________ have been given written notice that the proposed patient was placed under an order of protective custody and the reasons for such order on ___________ (date of notice). I have examined the affidavit of medical evaluation and ________________ (other evidence considered). Based on this evidence, I find that there is probable cause to believe that the proposed patient presents a substantial risk of serious harm to himself or herself (yes ____ or no ____) or others (yes ____ or no ____) such that (s)he cannot be at liberty pending final hearing because (s)he is infected with, has been exposed to, or is the carrier of or is reasonably suspected of being infected with, having been exposed to, or being the carrier of a communicable disease that presents an immediate threat to the public health and (s)he has failed or refused to comply with the orders of the health authority or the Texas Department of Health delivered on __________ (date of service) ____________. SECTION 12. Section 81.170(f), Health and Safety Code, is amended to read as follows: (f) The jury shall determine if the person is infected with, has been exposed to, or is the carrier of or is reasonably suspected of being infected with, having been exposed to, or being the carrier of a communicable disease that presents a threat to the public health and, if the application is for inpatient treatment, has refused or failed to follow the orders of the health authority. The jury may not make a finding about the type of services to be provided to the person. SECTION 13. Section 81.171(a), Health and Safety Code, is amended to read as follows: (a) The court shall enter an order denying an application for a court order for temporary or extended management if after a hearing the judge or jury fails to find, from clear and convincing evidence, that the person: (1) is infected with, has been exposed to, or is the carrier of or is reasonably suspected of being infected with, having been exposed to, or being the carrier of a communicable disease that presents a threat to the public health; (2) has refused or failed to follow the orders of the health authority if the application is for inpatient treatment; and (3) meets the applicable criteria for orders for the management of a person with a communicable disease. SECTION 14. Section 81.172(a), Health and Safety Code, is amended to read as follows: (a) The judge or jury may determine that a person requires court-ordered examination, observation, isolation, or treatment only if the judge or jury finds, from clear and convincing evidence, that: (1) the person is infected with, has been exposed to, or is the carrier of or is reasonably suspected of being infected with, having been exposed to, or being the carrier of a communicable disease that presents a threat to the public health and, if the application is for inpatient treatment, has failed or refused to follow the orders of the health authority or department; and (2) as a result of the communicable disease the person: (A) is likely to cause serious harm to himself; or (B) will, if not examined, observed, isolated, or treated, continue to endanger public health. SECTION 15. Section 81.174(a), Health and Safety Code, is amended to read as follows: (a) The judge shall dismiss the jury, if any, after a hearing in which a person is found: (1) to be infected with, to have been exposed to, or to be the carrier of or to be reasonably suspected of being infected with, having been exposed to, or being a carrier of a communicable disease; (2) to have failed or refused to follow the orders of a health authority or the department if the application is for inpatient treatment; and (3) to meet the criteria for orders for the management of a patient with a communicable disease. SECTION 16. Chapter 81, Health and Safety Code, is amended by adding Subchapters J and K to read as follows: SUBCHAPTER J. TASK FORCE ON INFECTIOUS DISEASE PREPAREDNESS AND RESPONSE Sec. 81.401. DEFINITION. In this subchapter, "task force" means the Task Force on Infectious Disease Preparedness and Response. Sec. 81.402. PURPOSE AND FINDINGS. The legislature finds that: (1) infectious diseases are responsible for more deaths worldwide than any other single cause; (2) the State of Texas has a responsibility to safeguard and protect the health and well-being of its citizens from the spread of infectious diseases; (3) on September 30, 2014, the first case of Ebola diagnosed in the United States occurred in Dallas, Texas; (4) addressing infectious diseases requires the coordination and cooperation of multiple governmental entities at the local, state, and federal levels; (5) public health and medical preparedness and response guidelines are crucial to protect the safety and welfare of our citizens; and (6) Texas has nationally recognized infectious disease experts and other highly trained professionals across the state with the experience needed to minimize any potential risk to the people of Texas. Sec. 81.403. TASK FORCE; DUTIES. (a) The Task Force on Infectious Disease Preparedness and Response is created as an advisory panel to the governor. (b) The task force shall: (1) provide expert, evidence-based assessments, protocols, and recommendations related to state responses to infectious diseases, including Ebola; and (2) serve as a reliable and transparent source of information and education for Texas leadership and citizens. Sec. 81.404. APPOINTMENT OF MEMBERS; TERMS. (a) The governor may appoint members of the task force as necessary, including members from relevant state agencies, members with expertise in infectious diseases and other issues involved in the prevention of the spread of infectious diseases, and members from institutions of higher education in this state. (b) The governor shall appoint a director of the task force from among the members of the task force. (c) The governor may fill any vacancy that occurs on the task force and may appoint additional members as needed. (d) Members of the task force serve at the pleasure of the governor. (e) A state or local employee appointed to the task force shall perform any duties required by the task force in addition to the regular duties of the employee. Sec. 81.405. REPORTS. The task force may make written reports on its findings and recommendations, including legislative recommendations, to the governor and legislature. Sec. 81.406. MEETINGS. (a) The task force shall meet at times and locations as determined by the director of the task force. (b) The task force may meet telephonically. (c) The task force may hold public hearings to gather information. The task force shall endeavor to meet in various parts of the state to encourage local input. (d) The task force may meet in executive session to discuss matters that are confidential by state or federal law or to ensure public security or law enforcement needs. Sec. 81.407. ADMINISTRATIVE SUPPORT. State agencies with members on the task force shall provide administrative support for the task force. Sec. 81.408. REIMBURSEMENT. Task force members serve without compensation and are not entitled to reimbursement for travel expenses. SUBCHAPTER K. STATEWIDE INFECTIOUS DISEASE CONTROL MEASURES; PREPARATION Sec. 81.451. PERSONAL PROTECTIVE EQUIPMENT. (a) In this section, "personal protective equipment" means specialized clothing or equipment worn for protection against infectious materials. (b) The department shall establish a stockpile, or regional stockpiles, of personal protective equipment to support responses to infectious disease emergencies in the state, if funds are appropriated for the purposes of this section. Sec. 81.452. MOBILE APPLICATION. The department may contract to establish a mobile application for wireless communications devices that might be used by health officials and health care providers to monitor the spread of an infectious disease in real time. Sec. 81.453. PORTABLE MEDICAL WASTE TREATMENT. The department, the Texas Department of Transportation, and the Texas Commission on Environmental Quality shall: (1) evaluate portable treatment options for medical waste to render pathogens in that waste noninfectious; and (2) develop procedures to rapidly deploy the portable treatment options through vendor contracts or state purchase. SECTION 17. Subchapter B, Chapter 716, Health and Safety Code, is amended by adding Section 716.055 to read as follows: Sec. 716.055. EXCEPTION: DEPARTMENT OF STATE HEALTH SERVICES AUTHORIZATION. (a) A crematory establishment may cremate the deceased person's human remains without receipt of a cremation authorization form signed by the authorizing agent if the Department of State Health Services certifies that: (1) the deceased person was infected with, was exposed to, or was a carrier of a communicable disease that presents a threat to public health; and (2) burial of the body would pose a public health risk. (b) The executive commissioner of the Health and Human Services Commission may adopt rules necessary to implement this section. SECTION 18. The heading to Section 716.204, Health and Safety Code, is amended to read as follows: Sec. 716.204. IMMUNITY FROM CRIMINAL AND CIVIL LIABILITY[; WRITTEN DIRECTIONS]. SECTION 19. Section 716.204, Health and Safety Code, is amended by adding Subsection (c) to read as follows: (c) If Section 716.055(a) applies, a cemetery organization, a business operating a crematory or columbarium, a funeral director, an embalmer, or a funeral establishment is not criminally liable or liable in a civil action for cremating the human remains of a deceased person. SECTION 20. The Department of State Health Services, the Texas Animal Health Commission, the Texas A&M Veterinary Diagnostic Laboratory, and the Texas A&M College of Veterinary Medicine and Biomedical Sciences shall: (1) review documents published or updated by the federal Centers for Disease Control and Prevention providing guidance on infection control measures, including quarantine, for pets and livestock animals exposed to infectious diseases; (2) incorporate the recommendations of the federal Centers for Disease Control and Prevention in developing and revising guidelines for this state to use in preventing the spread of infectious disease through pets and livestock; (3) evaluate the current facilities and capabilities of this state to implement the guidelines adopted under Subdivision (2) of this section, including an evaluation of the sufficiency and capacity of available quarantine facilities; (4) solicit public feedback in developing any recommendations for legislative, administrative, or executive action to address perceived problems; and (5) submit a report on any findings, evaluations, and recommendations to the governor and the legislature not later than December 1, 2016. SECTION 21. (a) Not later than December 1, 2015, the Department of State Health Services shall submit a report to the legislature regarding the preparedness of this state for containing an infectious disease outbreak. (b) The report under this section must include: (1) any progress that the department has made on implementing recommendations of the Task Force on Infectious Disease Preparedness and Response; (2) recommendations for statutory changes that are necessary to enable the department to implement the recommendations of the Task Force on Infectious Disease Preparedness and Response; (3) a cost analysis for the implementation of any recommendations of the Task Force on Infectious Disease Preparedness and Response that the department determines are not possible to implement using existing resources; (4) an evaluation of portable medical waste treatment options under Section 81.453, Health and Safety Code, as added by this Act, proposed procedures for deploying the portable treatment options, any projected costs for those treatments, and any legislative recommendations necessary to implement any proposed portable medical waste treatment solutions; and (5) any recommendations for legislation or other measures that would assist the department in preparing for an infectious disease outbreak. (c) The Department of State Health Services shall coordinate with other state agencies as necessary to complete the report under this section. The report must specify if the department determines that a recommendation be implemented by another state agency. SECTION 22. On the effective date of this Act, a member serving on the Task Force on Infectious Disease Preparedness and Response created by executive order of the governor continues to serve on the Task Force on Infectious Disease Preparedness and Response under Subchapter J, Chapter 81, Health and Safety Code, as added by this Act. SECTION 23. This Act takes effect immediately if it receives a vote of two-thirds of all the members elected to each house, as provided by Section 39, Article III, Texas Constitution. If this Act does not receive the vote necessary for immediate effect, this Act takes effect September 1, 2015.