4 | 8 | | AN ACT |
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5 | 9 | | relating to certain claims for benefits, compensation, or |
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6 | 10 | | assistance by certain public safety employees and survivors of |
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7 | 11 | | certain public safety employees. |
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8 | 12 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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9 | 13 | | SECTION 1. The heading to Subchapter B, Chapter 607, |
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10 | 14 | | Government Code, is amended to read as follows: |
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11 | 15 | | SUBCHAPTER B. DISEASES OR ILLNESSES SUFFERED BY DETENTION |
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17 | | - | (1) "Custodial officer" means a person who is employed |
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18 | | - | by the Board of Pardons and Paroles or the Texas Department of |
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19 | | - | Criminal Justice as a parole officer or caseworker or who is |
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20 | | - | employed by the correctional institutions division of the Texas |
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21 | | - | Department of Criminal Justice and certified by the department as |
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22 | | - | having a normal job assignment that requires frequent or infrequent |
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23 | | - | regularly planned contact with, and in close proximity to, inmates |
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24 | | - | or defendants of the correctional institutions division without the |
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25 | | - | protection of bars, doors, security screens, or similar devices and |
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26 | | - | includes assignments normally involving supervision or the |
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27 | | - | potential for supervision of inmates in inmate housing areas, |
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28 | | - | educational or recreational facilities, industrial shops, |
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29 | | - | kitchens, laundries, medical areas, agricultural shops or fields, |
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30 | | - | or in other areas on or away from property of the department. |
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| 21 | + | (1) "Corrections employee" means an employee of the |
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| 22 | + | Texas Department of Criminal Justice whose job duties require |
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| 23 | + | regular interaction with the public or an incarcerated population. |
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31 | 24 | | (1-a) "Detention officer" means an individual |
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32 | 25 | | employed by a state agency or political subdivision of the state to |
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33 | 26 | | ensure the safekeeping of prisoners and the security of a |
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34 | 27 | | municipal, county, or state penal institution in this state. |
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35 | 28 | | (1-b) "Disability" means partial or total disability. |
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36 | 29 | | SECTION 3. Sections 607.052(a), (b), (e), and (g), |
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37 | 30 | | Government Code, are amended to read as follows: |
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38 | 31 | | (a) Notwithstanding any other law, this subchapter applies |
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42 | | - | detention officer, custodial officer, firefighter, peace officer, |
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43 | | - | or emergency medical technician, received a physical examination |
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44 | | - | that failed to reveal evidence of the illness or disease for which |
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45 | | - | benefits or compensation are sought using a presumption established |
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46 | | - | by this subchapter; |
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| 35 | + | detention officer, corrections employee, firefighter, peace |
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| 36 | + | officer, or emergency medical technician, received a physical |
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| 37 | + | examination that failed to reveal evidence of the illness or |
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| 38 | + | disease for which benefits or compensation are sought using a |
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| 39 | + | presumption established by this subchapter; |
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54 | 47 | | (b) A presumption under this subchapter does not apply: |
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55 | 48 | | (1) to a determination of a survivor's eligibility for |
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56 | 49 | | benefits under Chapter 615; |
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57 | 50 | | (2) in a cause of action brought in a state or federal |
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58 | 51 | | court except for judicial review of a proceeding in which there has |
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59 | 52 | | been a grant or denial of employment-related benefits or |
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60 | 53 | | compensation; |
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61 | 54 | | (3) to a determination regarding benefits or |
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62 | 55 | | compensation under a life or disability insurance policy purchased |
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64 | 57 | | firefighter, peace officer, or emergency medical technician that |
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65 | 58 | | provides coverage in addition to any benefits or compensation |
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66 | 59 | | required by law; or |
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67 | 60 | | (4) if the disease or illness for which benefits or |
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68 | 61 | | compensation is sought is known to be caused by the use of tobacco |
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69 | 62 | | and: |
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70 | 63 | | (A) the firefighter, peace officer, or emergency |
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71 | 64 | | medical technician is or has been a user of tobacco; or |
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72 | 65 | | (B) the firefighter's, peace officer's, or |
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73 | 66 | | emergency medical technician's spouse has, during the marriage, |
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74 | 67 | | been a user of tobacco that is consumed through smoking. |
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84 | 77 | | medical technician who provides services as an employee of an |
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85 | 78 | | entity created by an interlocal agreement. |
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86 | 79 | | SECTION 4. Section 607.054, Government Code, is amended to |
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87 | 80 | | read as follows: |
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88 | 81 | | Sec. 607.054. TUBERCULOSIS OR OTHER RESPIRATORY ILLNESS. |
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89 | 82 | | (a) A firefighter, peace officer, or emergency medical technician |
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90 | 83 | | who suffers from tuberculosis, or any other disease or illness of |
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91 | 84 | | the lungs or respiratory tract that has a statistically positive |
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92 | 85 | | correlation with service as a firefighter, peace officer, or |
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93 | 86 | | emergency medical technician, that results in death or total or |
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94 | 87 | | partial disability is presumed to have contracted the disease or |
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95 | 88 | | illness during the course and scope of employment as a firefighter, |
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96 | 89 | | peace officer, or emergency medical technician. |
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97 | 90 | | (b) This section does not apply to a claim that a |
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98 | 91 | | firefighter, peace officer, or emergency medical technician |
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99 | 92 | | suffers from severe acute respiratory syndrome coronavirus 2 |
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100 | 93 | | (SARS-CoV-2) or coronavirus disease 2019 (COVID-19). |
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101 | 94 | | SECTION 5. Subchapter B, Chapter 607, Government Code, is |
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102 | 95 | | amended by adding Section 607.0545 to read as follows: |
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103 | 96 | | Sec. 607.0545. SEVERE ACUTE RESPIRATORY SYNDROME |
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104 | 97 | | CORONAVIRUS 2 (SARS-CoV-2) OR CORONAVIRUS DISEASE 2019 (COVID-19). |
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105 | | - | (a) A detention officer, custodial officer, firefighter, peace |
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106 | | - | officer, or emergency medical technician who suffers from severe |
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107 | | - | acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or |
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108 | | - | coronavirus disease 2019 (COVID-19) that results in death or total |
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109 | | - | or partial disability is presumed to have contracted the virus or |
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110 | | - | disease during the course and scope of employment as a detention |
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111 | | - | officer, custodial officer, firefighter, peace officer, or |
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112 | | - | emergency medical technician if the detention officer, custodial |
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113 | | - | officer, firefighter, peace officer, or emergency medical |
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114 | | - | technician: |
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| 98 | + | (a) A detention officer, corrections employee, firefighter, peace |
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| 99 | + | officer, or emergency medical technician who, based on a test |
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| 100 | + | approved by the United States Food and Drug Administration, suffers |
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| 101 | + | from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) |
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| 102 | + | or coronavirus disease 2019 (COVID-19) that results in death or |
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| 103 | + | total or partial disability is presumed to have contracted the |
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| 104 | + | virus or disease during the course and scope of employment as a |
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| 105 | + | detention officer, corrections employee, firefighter, peace |
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| 106 | + | officer, or emergency medical technician if the detention officer, |
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| 107 | + | corrections employee, firefighter, peace officer, or emergency |
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| 108 | + | medical technician: |
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124 | | - | (1) is employed as a detention officer, custodial |
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125 | | - | officer, firefighter, peace officer, or emergency medical |
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126 | | - | technician on a full-time basis; |
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127 | | - | (2) is diagnosed with severe acute respiratory |
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| 118 | + | (1) is employed as a detention officer, corrections |
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| 119 | + | employee, firefighter, peace officer, or emergency medical |
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| 120 | + | technician on a full-time basis; and |
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| 121 | + | (2) was last on duty not more than 14 days before the |
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| 122 | + | date the person tests positive for severe acute respiratory |
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129 | | - | (COVID-19): |
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130 | | - | (A) using a test authorized, approved, or |
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131 | | - | licensed by the United States Food and Drug Administration; or |
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132 | | - | (B) if the person is deceased: |
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133 | | - | (i) using a test described by Paragraph |
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134 | | - | (A); or |
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135 | | - | (ii) by another means, including by a |
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136 | | - | physician; and |
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137 | | - | (3) was last on duty: |
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138 | | - | (A) not more than 15 days before the date the |
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139 | | - | person is diagnosed with severe acute respiratory syndrome |
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140 | | - | coronavirus 2 (SARS-CoV-2) or coronavirus disease 2019 (COVID-19) |
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141 | | - | using a test described by Subdivision (2)(A); or |
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142 | | - | (B) if the person is deceased, not more than 15 |
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143 | | - | days before the date the person: |
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144 | | - | (i) was diagnosed with severe acute |
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145 | | - | respiratory syndrome coronavirus 2 (SARS-CoV-2) or coronavirus |
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146 | | - | disease 2019 (COVID-19) using a test described by Subdivision |
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147 | | - | (2)(A); |
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148 | | - | (ii) began to show symptoms of severe acute |
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149 | | - | respiratory syndrome coronavirus 2 (SARS-CoV-2) or coronavirus |
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150 | | - | disease 2019 (COVID-19) as determined by a licensed physician; |
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151 | | - | (iii) was hospitalized for symptoms related |
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152 | | - | to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or |
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153 | | - | coronavirus disease 2019 (COVID-19); or |
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154 | | - | (iv) died if severe acute respiratory |
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155 | | - | syndrome coronavirus 2 (SARS-CoV-2) or coronavirus disease 2019 |
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156 | | - | (COVID-19) was a contributing factor in the person's death. |
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| 124 | + | (COVID-19). |
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159 | 127 | | emergency medical technician to provide proof, without the use of |
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160 | 128 | | the presumption under this section, that an injury or illness |
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161 | 129 | | occurred during the course and scope of employment. |
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162 | 130 | | (d) Sections 409.009 and 409.0091, Labor Code, do not apply |
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163 | 131 | | to a claim for compensation determined to be compensable or |
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164 | 132 | | accepted by an insurance carrier as compensable using the |
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165 | 133 | | presumption under this section. Notwithstanding this subsection, |
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166 | 134 | | an injured employee may request reimbursement for health care paid |
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167 | 135 | | by the employee as provided by Section 409.0092, Labor Code. |
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174 | | - | officer's, custodial officer's, firefighter's, peace officer's, or |
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175 | | - | emergency medical technician's disability or death resulted from a |
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176 | | - | disease or illness contracted in the course and scope of employment |
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177 | | - | for purposes of benefits or compensation provided under another |
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178 | | - | employee benefit, law, or plan, including a pension plan. |
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| 141 | + | officer's, corrections employee's, firefighter's, peace officer's, |
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| 142 | + | or emergency medical technician's disability or death resulted from |
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| 143 | + | a disease or illness contracted in the course and scope of |
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| 144 | + | employment for purposes of benefits or compensation provided under |
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| 145 | + | another employee benefit, law, or plan, including a pension plan. |
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179 | 146 | | SECTION 7. Section 607.058, Government Code, is amended to |
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180 | 147 | | read as follows: |
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181 | 148 | | Sec. 607.058. PRESUMPTION REBUTTABLE. (a) A presumption |
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182 | 149 | | under Section 607.053, 607.054, 607.0545, 607.055, or 607.056 may |
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183 | 150 | | be rebutted through a showing by a preponderance of the evidence |
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184 | 151 | | that a risk factor, accident, hazard, or other cause not associated |
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187 | 154 | | technician was a substantial factor in bringing about the |
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188 | 155 | | individual's disease or illness, without which the disease or |
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189 | 156 | | illness would not have occurred. |
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190 | 157 | | (b) A rebuttal offered under this section must include a |
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191 | 158 | | statement by the person offering the rebuttal that describes, in |
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192 | 159 | | detail, the evidence that the person reviewed before making the |
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193 | 160 | | determination that a cause not associated with the individual's |
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195 | 162 | | peace officer, or emergency medical technician was a substantial |
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196 | 163 | | factor in bringing about the individual's disease or illness, |
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197 | 164 | | without which the disease or illness would not have occurred. |
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198 | 165 | | (c) In addressing an argument based on a rebuttal offered |
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199 | 166 | | under this section, an administrative law judge shall make findings |
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200 | 167 | | of fact and conclusions of law that consider whether a qualified |
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201 | 168 | | expert, relying on evidence-based medicine, stated the opinion |
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202 | 169 | | that, based on reasonable medical probability, an identified risk |
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203 | 170 | | factor, accident, hazard, or other cause not associated with the |
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205 | 172 | | firefighter, peace officer, or emergency medical technician was a |
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206 | 173 | | substantial factor in bringing about the individual's disease or |
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207 | 174 | | illness, without which the disease or illness would not have |
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208 | 175 | | occurred. |
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209 | 176 | | (d) A rebuttal offered under this section to a presumption |
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210 | 177 | | under Section 607.0545 may not be based solely on evidence relating |
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211 | 178 | | to the risk of exposure to severe acute respiratory syndrome |
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212 | 179 | | coronavirus 2 (SARS-CoV-2) or coronavirus disease 2019 (COVID-19) |
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215 | | - | resides. This subsection expires September 1, 2023. |
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| 182 | + | resides. |
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| 183 | + | (e) A rebuttal offered under this section to a presumption |
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| 184 | + | under Section 607.0545 may be based on evidence that a person with |
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| 185 | + | whom a detention officer, corrections employee, firefighter, peace |
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| 186 | + | officer, or emergency medical technician resides had a confirmed |
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| 187 | + | diagnosis of severe acute respiratory syndrome coronavirus 2 |
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| 188 | + | (SARS-CoV-2) or coronavirus disease 2019 (COVID-19). |
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219 | | - | CERTAIN INJURED EMPLOYEES. (a) An injured employee who is subject |
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220 | | - | to Section 607.0545, Government Code, and whose claim for benefits |
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221 | | - | is determined to be compensable by an insurance carrier or the |
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222 | | - | division, may request reimbursement for health care paid by the |
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223 | | - | employee, including copayments and partial payments, by submitting |
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224 | | - | to the carrier a legible written request and documentation showing |
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225 | | - | the amounts paid to the health care provider. |
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| 192 | + | CERTAIN INJURED EMPLOYEES. (a) An injured employee whose claim for |
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| 193 | + | compensation is determined to be accepted by an insurance carrier |
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| 194 | + | as compensable using the presumption under Section 607.0545, |
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| 195 | + | Government Code, may request reimbursement for health care paid by |
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| 196 | + | the employee, including copayments and partial payments, by |
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| 197 | + | submitting to the carrier a legible written request and |
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| 198 | + | documentation showing the amounts paid to the health care provider. |
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226 | 199 | | (b) Not later than the 45th day after the date an injured |
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227 | 200 | | employee submits a request for reimbursement for health care to an |
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228 | 201 | | insurance carrier under Subsection (a), the carrier shall provide |
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229 | 202 | | reimbursement or deny the request. |
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230 | 203 | | (c) If an insurance carrier denies an injured employee's |
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231 | 204 | | request for reimbursement for health care, the employee may seek |
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232 | 205 | | medical dispute resolution as provided by Chapter 413 and division |
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233 | 206 | | rules. Notwithstanding any other law, an employee's request for |
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234 | 207 | | medical dispute resolution is considered timely if the employee |
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235 | 208 | | submits the request not later than the 120th day after the date the |
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236 | 209 | | carrier denies the employee's request for reimbursement. |
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247 | 219 | | detention officer's, an emergency medical technician's, a |
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248 | 220 | | firefighter's, or a peace officer's disability or death for which a |
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249 | 221 | | presumption is claimed to be applicable under Subchapter B, Chapter |
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250 | 222 | | 607, Government Code, the notice must include a statement by the |
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251 | 223 | | carrier that: |
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252 | 224 | | (1) explains why the carrier determined a presumption |
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253 | 225 | | under that subchapter does not apply to the claim for compensation; |
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254 | 226 | | and |
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255 | 227 | | (2) describes the evidence that the carrier reviewed |
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256 | 228 | | in making the determination described by Subdivision (1). |
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257 | 229 | | SECTION 10. (a) The changes in law made by this Act apply to |
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258 | | - | a claim for benefits pending on or filed on or after the effective |
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259 | | - | date of this Act. A claim for benefits filed before that date is |
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260 | | - | covered by the law in effect on the date the claim was made, and that |
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261 | | - | law is continued in effect for that purpose. |
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262 | | - | (b) Notwithstanding any other law, a person subject to |
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263 | | - | Section 607.0545, Government Code, as added by this Act, who on or |
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264 | | - | after the date the governor declared a disaster under Chapter 418, |
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| 230 | + | a claim for benefits, compensation, or assistance pending on or |
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| 231 | + | filed on or after the effective date of this Act. A claim for |
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| 232 | + | benefits, compensation, or assistance filed before that date, other |
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| 233 | + | than a claim pending on that date, is covered by the law in effect on |
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| 234 | + | the date the claim was made, and that law is continued in effect for |
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| 235 | + | that purpose. |
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| 236 | + | (b) Notwithstanding any other law, a person who on or after |
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| 237 | + | the date the governor declared a disaster under Chapter 418, |
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268 | | - | for benefits related to SARS-CoV-2, coronavirus disease 2019 |
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269 | | - | (COVID-19), on or after the effective date of this Act, regardless |
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270 | | - | of whether that claim is otherwise considered untimely and the |
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271 | | - | changes in law made by this Act apply to that claim. A claim |
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272 | | - | authorized under this subsection must be filed not later than six |
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273 | | - | months after the effective date of this Act. |
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| 241 | + | for benefits, compensation, or assistance related to SARS-CoV-2, |
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| 242 | + | coronavirus disease 2019 (COVID-19), on or after the effective date |
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| 243 | + | of this Act, regardless of whether that claim is otherwise |
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| 244 | + | considered untimely and the changes in law made by this Act apply to |
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| 245 | + | that claim. A claim authorized under this subsection must be filed |
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| 246 | + | not later than six months after the effective date of this Act. |
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275 | | - | Section 409.003, 409.007, 410.169, or 410.205, Labor Code, a person |
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276 | | - | subject to Section 607.0545, Government Code, as added by this Act, |
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277 | | - | who on or after the date the governor declared a disaster under |
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278 | | - | Chapter 418, Government Code, relating to SARS-CoV-2, coronavirus |
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279 | | - | disease 2019 (COVID-19), but before the effective date of this Act, |
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280 | | - | filed a claim for benefits related to SARS-CoV-2, coronavirus |
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281 | | - | disease 2019 (COVID-19), and whose claim was subsequently denied |
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282 | | - | may, on or after the effective date of this Act, request in writing |
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283 | | - | that the insurance carrier reprocess the claim and the changes in |
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284 | | - | law made by this Act shall apply to that claim. A request to |
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285 | | - | reprocess a claim as authorized by this subsection shall be filed |
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286 | | - | not later than one year after the effective date of this Act. |
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| 248 | + | Section 409.003, 410.169, or 410.205, Labor Code, a person who on or |
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| 249 | + | after the date the governor declared a disaster under Chapter 418, |
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| 250 | + | Government Code, relating to SARS-CoV-2, coronavirus disease 2019 |
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| 251 | + | (COVID-19), but before the effective date of this Act, filed a claim |
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| 252 | + | for benefits, compensation, or assistance related to SARS-CoV-2, |
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| 253 | + | coronavirus disease 2019 (COVID-19), and whose claim was |
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| 254 | + | subsequently denied may, on or after the effective date of this Act, |
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| 255 | + | request in writing that the insurance carrier reprocess the claim |
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| 256 | + | and the changes in law made by this Act shall apply to that claim. A |
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| 257 | + | request to reprocess a claim as authorized by this subsection shall |
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| 258 | + | be filed not later than one year after the effective date of this |
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| 259 | + | Act. |
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287 | 260 | | (d) Not later than the 60th day after the date an insurance |
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288 | 261 | | carrier receives a written request to reprocess a claim under |
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289 | 262 | | Subsection (c) of this section, the insurance carrier shall |
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290 | 263 | | reprocess the claim and notify the person in writing whether the |
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291 | 264 | | carrier accepted or denied the claim. If the insurance carrier |
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292 | 265 | | denies the claim, the notice must include information on the |
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293 | 266 | | process for disputing the denial. The notice provided by the |
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294 | 267 | | insurance carrier must use the notice provisions prescribed by the |
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295 | 268 | | division of workers' compensation of the Texas Department of |
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296 | 269 | | Insurance under Subsection (e) of this section. |
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297 | 270 | | (e) As soon as practicable after the effective date of this |
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298 | 271 | | Act, the division of workers' compensation of the Texas Department |
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299 | 272 | | of Insurance shall prescribe notice provisions for an insurance |
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300 | 273 | | carrier to use when providing notice of the insurance carrier's |
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301 | 274 | | acceptance or denial of a person's claim. The notice provisions |
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302 | 275 | | must be clear and easily understandable. |
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303 | 276 | | SECTION 11. This Act takes effect immediately if it |
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304 | 277 | | receives a vote of two-thirds of all the members elected to each |
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305 | 278 | | house, as provided by Section 39, Article III, Texas Constitution. |
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306 | 279 | | If this Act does not receive the vote necessary for immediate |
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307 | 280 | | effect, this Act takes effect September 1, 2021. |
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308 | | - | ______________________________ ______________________________ |
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309 | | - | President of the Senate Speaker of the House |
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310 | | - | I hereby certify that S.B. No. 22 passed the Senate on |
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311 | | - | April 21, 2021, by the following vote: Yeas 31, Nays 0; |
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312 | | - | May 25, 2021, Senate refused to concur in House amendments and |
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313 | | - | requested appointment of Conference Committee; May 27, 2021, House |
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314 | | - | granted request of the Senate; May 30, 2021, Senate adopted |
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315 | | - | Conference Committee Report by the following vote: Yeas 31, |
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316 | | - | Nays 0. |
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317 | | - | ______________________________ |
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318 | | - | Secretary of the Senate |
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319 | | - | I hereby certify that S.B. No. 22 passed the House, with |
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320 | | - | amendments, on May 20, 2021, by the following vote: Yeas 139, |
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321 | | - | Nays 6, one present not voting; May 27, 2021, House granted request |
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322 | | - | of the Senate for appointment of Conference Committee; |
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323 | | - | May 30, 2021, House adopted Conference Committee Report by the |
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324 | | - | following vote: Yeas 139, Nays 3, two present not voting. |
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325 | | - | ______________________________ |
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326 | | - | Chief Clerk of the House |
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327 | | - | Approved: |
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328 | | - | ______________________________ |
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329 | | - | Date |
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330 | | - | ______________________________ |
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331 | | - | Governor |
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