85R2853 DMS-D
By: Howard H.B. No. 241
A BILL TO BE ENTITLED
AN ACT
relating to a health care practitioner counseling requirement for
persons claiming an immunization exemption on the basis of
conscience, including a religious belief.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 38.001(c), Education Code, is amended to
read as follows:
(c) Immunization is not required for a person's admission to
any elementary or secondary school if the person applying for
admission:
(1) submits to the admitting official:
(A) an affidavit or a certificate signed by a
physician who is duly registered and licensed to practice medicine
in the United States, in which it is stated that, in the physician's
opinion, the immunization required poses a significant risk to the
health and well-being of the applicant or any member of the
applicant's family or household; or
(B) an affidavit signed by the applicant or, if a
minor, by the applicant's parent or guardian stating that the
applicant declines immunization for reasons of conscience,
including a religious belief, and a completed health care
practitioner counseling certification stating that the
practitioner has provided information on the risks and benefits of
immunization; or
(2) is a member of the armed forces of the United
States and is on active duty.
SECTION 2. Sections 51.9192(d) and (d-3), Education Code,
are amended to read as follows:
(d) A student to whom this section applies or a parent or
guardian of the student is not required to comply with Subsection
(c) if the student or a parent or guardian of the student submits to
the institution:
(1) an affidavit or a certificate signed by a
physician who is duly registered and licensed to practice medicine
in the United States in which it is stated that, in the physician's
opinion, the vaccination required would be injurious to the health
and well-being of the student; or
(2) an affidavit signed by the student stating that
the student declines the vaccination for bacterial meningitis for
reasons of conscience, including a religious belief, or
confirmation that the student has completed the Internet-based
process described by Subsection (d-3) for declining the vaccination
on that basis, if applicable to the student, and a completed health
care practitioner counseling certification stating that the
practitioner has provided information on the risks and benefits of
immunization.
(d-3) The Department of State Health Services shall develop
and implement a secure, Internet-based process to be used
exclusively at those public junior colleges that elect to use the
process to allow an entering student to apply online for an
exemption from the vaccination requirement under this section for
reasons of conscience. The online process portal must be designed
to ensure that duplicate exemption requests are avoided to the
greatest extent possible. The exemption form used by a student to
claim an exemption under the process must contain a statement
indicating that the student understands the benefits and risks of
the immunization and the benefits and risks of not receiving the
immunization. A student who uses the Internet-based process under
this section is required to submit, in the manner prescribed by the
college, a completed health care practitioner counseling
certification stating that the practitioner has provided
information on the risks and benefits of immunization.
SECTION 3. Section 51.933(d), Education Code, is amended to
read as follows:
(d) No form of immunization is required for a person's
admission to an institution of higher education if the person
applying for admission:
(1) submits to the admitting official:
(A) an affidavit or a certificate signed by a
physician who is duly registered and licensed to practice medicine
within the United States in which it is stated that, in the
physician's opinion, the immunization required poses a significant
risk to the health and well-being of the applicant or any member of
the applicant's family or household; or
(B) an affidavit signed by the applicant or, if a
minor, by the applicant's parent or guardian stating that the
applicant declines immunization for reasons of conscience,
including a religious belief, and a completed health care
practitioner counseling certification stating that the
practitioner has provided information on the risks and benefits of
immunization; or
(2) is a member of the armed forces of the United
States and is on active duty.
SECTION 4. Section 161.004(d), Health and Safety Code, is
amended to read as follows:
(d) A child is exempt from an immunization required by this
section if:
(1) a parent, managing conservator, or guardian states
that:
(A) the immunization is being declined for
reasons of conscience, including a religious belief; and
(B) the parent, managing conservator, or
guardian has been counseled by a physician, advanced practice
registered nurse, or physician assistant on the risks and benefits
of immunization; or
(2) the immunization is medically contraindicated
based on the opinion of a physician licensed by any state in the
United States who has examined the child.
SECTION 5. The heading to Section 161.0041, Health and
Safety Code, is amended to read as follows:
Sec. 161.0041. IMMUNIZATION EXEMPTION AFFIDAVIT FORM AND
HEALTH CARE PRACTITIONER COUNSELING CERTIFICATION FORM.
SECTION 6. Section 161.0041, Health and Safety Code, is
amended by amending Subsections (a) and (c) and adding Subsections
(a-1), (d-1), and (d-2) to read as follows:
(a) A person claiming an exemption from a required
immunization based on reasons of conscience, including a religious
belief, under Section 161.004 of this code, Section 38.001,
51.9192, or 51.933, Education Code, or Section 42.043, Human
Resources Code, must:
(1) complete an affidavit on a form provided by the
department stating the reason for the exemption; and
(2) submit a completed health care practitioner
counseling certification.
(a-1) Subsection (a)(1) [This subsection] does not apply to
a person claiming the exemption using the Internet-based process
under Section 51.9192(d-3), Education Code.
(c) A person claiming an exemption from a required
immunization under this section may only obtain the affidavit form
by submitting a written request for the affidavit form to the
department. The department shall include a blank copy of the health
care practitioner counseling certification form described by
Subsection (d-1) with each affidavit form sent to a person.
(d-1) The department shall develop a blank health care
practitioner counseling certification form to be completed by a
physician, advanced practice registered nurse, or physician
assistant who has counseled a person and, if the person is a minor,
the person's parent, managing conservator, or guardian, about the
risks and benefits of immunization. The form must contain:
(1) spaces for:
(A) the name, signature, and license number of
the health care practitioner providing counsel;
(B) the name of the person claiming the
exemption, the name of the person's parent, managing conservator,
or guardian, as applicable, and the signature of the person or the
person's parent, managing conservator, or guardian, as applicable;
and
(C) the date; and
(2) the following statement or substantially similar
language:
"I certify that I have provided medically accurate
information on the risks and benefits of immunization."
(d-2) The department shall make the printable health care
practitioner counseling certification form available on the
department's Internet website.
SECTION 7. Section 224.002(c), Health and Safety Code, is
amended to read as follows:
(c) The policy may include procedures for a covered
individual to be exempt from the required vaccines based on reasons
of conscience, including a religious belief, provided that the
policy requires an individual claiming an exemption based on
reasons of conscience to certify that the individual has received
counseling from a physician, advanced practice registered nurse, or
physician assistant on the risks and benefits of vaccines.
SECTION 8. Section 42.043(d), Human Resources Code, is
amended to read as follows:
(d) No immunization may be required for admission to a
facility regulated under this chapter if a person applying for a
child's admission submits [one of the following affidavits]:
(1) an affidavit signed by a licensed physician
stating that the immunization poses a significant risk to the
health and well-being of the child or a member of the child's family
or household; or
(2) an affidavit signed by the child's parent or
guardian stating that the applicant declines immunization for
reasons of conscience, including a religious belief, and a
completed health care practitioner counseling certification
stating that the practitioner has provided information on the risks
and benefits of immunization.
SECTION 9. Section 42.04305(d), Human Resources Code, is
amended to read as follows:
(d) The policy shall include procedures for a facility
employee to be exempt from the required vaccines based on reasons of
conscience, including a religious belief, and those procedures must
include the requirement that the employee claiming the exemption
certify that the employee has received counseling from a physician,
advanced practice registered nurse, or physician assistant on the
risks and benefits of vaccines.
SECTION 10. (a) Not later than December 1, 2017, the
Department of State Health Services shall make the health care
practitioner counseling certification form required by Section
161.0041, Health and Safety Code, as amended by this Act, available
on the department's Internet website.
(b) A person claiming an immunization exemption on the basis
of conscience, including a religious belief, on or after January 1,
2018, is required to submit a completed health care practitioner
counseling certification or otherwise affirm that the person has
received counseling from a health care practitioner, as applicable.
(c) A person claiming an immunization exemption on the basis
of conscience, including a religious belief, before January 1,
2018, is required to submit a completed health care practitioner
counseling certification or otherwise affirm that the person has
received counseling from a health care practitioner, as applicable,
before September 1, 2018, to continue to be eligible for the
exemption.
SECTION 11. 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, 2017.