S.B. No. 968
AN ACT
relating to public health disaster and public health emergency
preparedness and response; providing a civil penalty.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter B, Chapter 418, Government Code, is
amended by adding Section 418.0125 to read as follows:
Sec. 418.0125. LIMITATIONS ON MEDICAL PROCEDURES. (a) In
this section, "nonelective medical procedure" means a medical
procedure, including a surgery, a physical exam, a diagnostic test,
a screening, the performance of a laboratory test, and the
collection of a specimen to perform a laboratory test, that if not
performed within a reasonable time may, as determined in good faith
by a patient's physician, result in:
(1) the patient's loss of life; or
(2) a deterioration, complication, or progression of
the patient's current or potential medical condition or disorder,
including a physical condition or mental disorder.
(b) The Texas Medical Board during a declared state of
disaster may not issue an order or adopt a regulation that limits or
prohibits a nonelective medical procedure.
(c) The Texas Medical Board during a declared state of
disaster may issue an order or adopt a regulation imposing a
temporary limitation or prohibition on a medical procedure other
than a nonelective medical procedure only if the limitation or
prohibition is reasonably necessary to conserve resources for
nonelective medical procedures or resources needed for disaster
response. An order issued or regulation adopted under this
subsection may not continue for more than 15 days unless renewed by
the board.
(d) A person subject to an order issued or regulation
adopted under this section who in good faith acts or fails to act in
accordance with that order or regulation is not civilly or
criminally liable and is not subject to disciplinary action for
that act or failure to act.
(e) The immunity provided by Subsection (d) is in addition
to any other immunity or limitation of liability provided by law.
(f) Notwithstanding any other law, this section does not
create a civil, criminal, or administrative cause of action or
liability or create a standard of care, obligation, or duty that
provides the basis for a cause of action for an act or omission
under this section.
SECTION 2. Subchapter C, Chapter 418, Government Code, is
amended by adding Section 418.0435 to read as follows:
Sec. 418.0435. PERSONAL PROTECTIVE EQUIPMENT CONTRACTS.
(a) The division shall enter into a contract with a manufacturer or
wholesale distributor of personal protective equipment that
guarantees a set amount and stocked supply of the equipment for use
during a public health disaster declared under Section 81.0813,
Health and Safety Code.
(b) The division may purchase personal protective equipment
under a contract described by Subsection (a) only if the division
determines the state's supply of personal protective equipment will
be insufficient based on an evaluation of the personal protective
equipment:
(1) held in reserve in this state; and
(2) supplied by or expected to be supplied by the
federal government.
(c) The division shall pursue all available federal funding
to cover the costs of personal protective equipment purchased under
a contract described by Subsection (a).
(d) In entering into a contract under Subsection (a), the
division shall ensure that the manufacturer is located in the
United States to the extent practicable.
SECTION 3. Subchapter E, Chapter 418, Government Code, is
amended by adding Section 418.1085 to read as follows:
Sec. 418.1085. LIMITATIONS ON CONSTRUCTION AND RELATED
SERVICES. The presiding officer of the governing body of a
political subdivision may not issue an order during a declared
state of disaster or local disaster to address a pandemic disaster
that would limit or prohibit:
(1) housing and commercial construction activities,
including related activities involving the sale, transportation,
and installation of manufactured homes;
(2) the provision of governmental services for title
searches, notary services, and recording services in support of
mortgages and real estate services and transactions;
(3) residential and commercial real estate services,
including settlement services; or
(4) essential maintenance, manufacturing, design,
operation, inspection, security, and construction services for
essential products, services, and supply chain relief efforts.
SECTION 4. Subchapter H, Chapter 418, Government Code, is
amended by adding Section 418.1861 to read as follows:
Sec. 418.1861. DISEASE PREVENTION INFORMATION SYSTEM. (a)
The Department of State Health Services, using existing resources,
shall develop and implement a disease prevention information system
for dissemination of immunization information during a declared
state of disaster or local state of disaster.
(b) During a declared state of disaster or local state of
disaster, the Department of State Health Services shall ensure that
educational materials regarding immunizations are available to
local health authorities in this state for distribution to:
(1) public and private schools;
(2) child-care facilities as defined by Section
42.002, Human Resources Code;
(3) community centers offering youth services and
programs;
(4) community centers offering services and programs
to vulnerable populations, including communities of color,
low-income individuals, and elderly individuals;
(5) local health care providers; and
(6) veterans homes as defined by Section 164.002,
Natural Resources Code.
(c) The educational materials must include:
(1) the most recent immunization schedules by age as
recommended by the Centers for Disease Control and Prevention; and
(2) locations, if any, of local health care providers
that offer immunizations.
SECTION 5. Chapter 418, Government Code, is amended by
adding Subchapter J to read as follows:
SUBCHAPTER J. WELLNESS CHECKS FOR MEDICALLY FRAGILE INDIVIDUALS
DURING CERTAIN EMERGENCIES
Sec. 418.301. DEFINITIONS. In this subchapter:
(1) "Commission" means the Health and Human Services
Commission.
(2) "Department" means the Department of State Health
Services.
(3) "Emergency assistance registry" means the
registry maintained by the division that provides local emergency
planners and emergency responders with additional information on
the needs of certain individuals in their communities.
(4) "First responder" means any federal, state, or
local personnel who may respond to a disaster, including:
(A) public health and public safety personnel;
(B) commissioned law enforcement personnel;
(C) fire protection personnel, including
volunteer firefighters;
(D) emergency medical services personnel,
including hospital emergency facility staff;
(E) a member of the National Guard; or
(F) a member of the Texas State Guard.
(5) "Medically fragile individual" means any
individual who, during a time of disaster or emergency, would be
particularly vulnerable because of a medical condition, including
individuals:
(A) with Alzheimer's disease and other related
disorders;
(B) receiving dialysis services;
(C) who are diagnosed with a debilitating chronic
illness;
(D) who are dependent on oxygen treatment; and
(E) who have medical conditions that require
24-hour supervision from a skilled nurse.
Sec. 418.302. MEDICALLY FRAGILE INDIVIDUAL DESIGNATION.
The division shall develop a process for designating individuals
who are included in the emergency assistance registry as medically
fragile for the purposes of this chapter.
Sec. 418.303. EMERGENCY ASSISTANCE REGISTRY ACCESS. The
division shall authorize the following persons to access the
emergency assistance registry to assist medically fragile
individuals during an event described by Section 418.305:
(1) the commission;
(2) the department;
(3) first responders;
(4) local governments; and
(5) local health departments.
Sec. 418.304. REQUIRED WELLNESS CHECK. The division shall
collaborate with the persons authorized to access the emergency
assistance registry under Section 418.303 and with applicable
municipalities and counties to ensure that a wellness check is
conducted on each medically fragile individual listed in the
emergency assistance registry and located in an area that
experiences an event described by Section 418.305 to ensure the
individual has:
(1) continuity of care; and
(2) the ability to continue using electrically powered
medical equipment, if applicable.
Sec. 418.305. EVENTS REQUIRING WELLNESS CHECKS. (a) The
division, in collaboration with the commission and the department,
shall adopt rules regarding which events require a wellness check,
including:
(1) an extended power, water, or gas outage;
(2) a state of disaster declared under this chapter;
or
(3) any other event considered necessary by the
commission, the department, or the division.
(b) If more than one disaster is declared for the same
event, or the same event qualifies as an event requiring a wellness
check for multiple reasons under Subsection (a), only one wellness
check is required to be conducted under this subchapter.
Sec. 418.306. REQUIREMENTS FOR WELLNESS CHECK. (a) The
division, in collaboration with the commission and the department,
by rule shall develop minimum standards for conducting wellness
checks. Each county and municipality shall adopt procedures for
conducting wellness checks in compliance with the minimum
standards.
(b) A wellness check on a medically fragile individual under
this subchapter must:
(1) include:
(A) an automated telephone call and text to the
individual;
(B) a personalized telephone call to the
individual; and
(C) if the individual is unresponsive to a
telephone call under Paragraph (B), an in-person wellness check;
and
(2) be conducted in accordance with the minimum
standards prescribed by division rule and the procedures of the
applicable county or municipality.
(c) A wellness check must be conducted as soon as
practicable but not later than 24 hours after the event requiring a
wellness check occurs.
Sec. 418.307. RULES. The division, in collaboration with
the commission and the department, shall adopt rules to implement
this subchapter.
SECTION 6. The heading to Subtitle D, Title 2, Health and
Safety Code, is amended to read as follows:
SUBTITLE D. PREVENTION, CONTROL, AND REPORTS OF DISEASES; PUBLIC
HEALTH DISASTERS AND EMERGENCIES
SECTION 7. The heading to Chapter 81, Health and Safety
Code, is amended to read as follows:
CHAPTER 81. COMMUNICABLE DISEASES; PUBLIC HEALTH DISASTERS; PUBLIC
HEALTH EMERGENCIES
SECTION 8. Section 81.003, Health and Safety Code, is
amended by amending Subdivision (7) and adding Subdivision (7-a) to
read as follows:
(7) "Public health disaster" means:
(A) a declaration by the governor of a state of
disaster; and
(B) a determination by the commissioner that
there exists an immediate threat from a communicable disease,
health condition, or chemical, biological, radiological, or
electromagnetic exposure that:
(i) poses a high risk of death or serious
harm [long-term disability] to the public [a large number of
people]; and
(ii) creates a substantial risk of harmful
public exposure [because of the disease's high level of contagion
or the method by which the disease is transmitted].
(7-a) "Public health emergency" means a determination
by the commissioner, evidenced in an emergency order issued by the
commissioner, that there exists an immediate threat from a
communicable disease, health condition, or chemical, biological,
radiological, or electromagnetic exposure that:
(A) potentially poses a risk of death or severe
illness or harm to the public; and
(B) potentially creates a substantial risk of
harmful exposure to the public.
SECTION 9. The heading to Subchapter B, Chapter 81, Health
and Safety Code, is amended to read as follows:
SUBCHAPTER B. PREVENTION AND PREPAREDNESS
SECTION 10. Section 81.044, Health and Safety Code, is
amended by adding Subsection (b-1) to read as follows:
(b-1) In this subsection, "cycle threshold value" means for
a communicable disease test the number of thermal cycles required
for the fluorescent signal to exceed that of the background and
cross the threshold for a positive test. The executive
commissioner shall require the reports of polymerase chain reaction
tests from clinical or hospital laboratories to contain the cycle
threshold values and their reference ranges.
SECTION 11. Section 81.081, Health and Safety Code, is
amended to read as follows:
Sec. 81.081. DEPARTMENT'S DUTY. The department is the
preemptive authority for purposes of this chapter and shall
coordinate statewide or regional efforts to protect public health.
The department shall collaborate with local elected officials,
including county and municipal officials, [impose control
measures] to prevent the spread of disease and [in the exercise of
its power to] protect the public health.
SECTION 12. Subchapter E, Chapter 81, Health and Safety
Code, is amended by adding Sections 81.0813, 81.0814, and 81.0815
to read as follows:
Sec. 81.0813. AUTHORITY TO DECLARE PUBLIC HEALTH DISASTER
OR ORDER PUBLIC HEALTH EMERGENCY. (a) The commissioner may declare
a statewide or regional public health disaster or order a statewide
or regional public health emergency if the commissioner determines
an occurrence or threat to public health is imminent. The
commissioner may declare a public health disaster only if the
governor declares a state of disaster under Chapter 418, Government
Code, for the occurrence or threat.
(b) Except as provided by Subsection (c), a public health
disaster or public health emergency continues until the governor or
commissioner terminates the disaster or emergency on a finding
that:
(1) the threat or danger has passed; or
(2) the disaster or emergency has been managed to the
extent emergency conditions no longer exist.
(c) A public health disaster or public health emergency
expires on the 30th day after the date the disaster or emergency is
declared or ordered by the commissioner. A public health disaster
may only be renewed by the legislature or by the commissioner with
the approval of a designated legislative oversight board that has
been granted authority under a statute enacted by the legislature
to approve the renewal of a public health disaster declaration.
Each renewal period may not exceed 30 days.
(d) A declaration or order issued under this section must
include:
(1) a description of the nature of the disaster or
emergency;
(2) a designation of the area threatened by the
disaster or emergency;
(3) a description of the condition that created the
disaster or emergency; and
(4) if applicable:
(A) the reason for renewing the disaster or
emergency; or
(B) the reason for terminating the disaster or
emergency.
(e) A declaration or order issued under this section must be
disseminated promptly by means intended to bring its contents to
the public's attention. A statewide or regional declaration or
order shall be filed promptly with the office of the governor and
the secretary of state. A regional declaration or order shall be
filed with the county clerk or municipal secretary in each area to
which it applies, unless the circumstances attendant on the
disaster or emergency prevent or impede the filing.
Sec. 81.0814. CONSULTATION WITH TASK FORCE ON INFECTIOUS
DISEASE PREPAREDNESS AND RESPONSE. After declaring a public health
disaster or ordering a public health emergency, the commissioner
shall consult with the Task Force on Infectious Disease
Preparedness and Response, including any subcommittee the task
force forms to aid in the rapid assessment of response efforts.
Sec. 81.0815. FAILURE TO REPORT; CIVIL PENALTY. (a) A
health care facility that fails to submit a report required by the
department under a public health disaster is liable to this state
for a civil penalty of not more than $1,000 for each failure.
(b) The attorney general at the request of the department
may bring an action to collect a civil penalty imposed under this
section.
SECTION 13. Sections 161.00705(a) and (c), Health and
Safety Code, are amended to read as follows:
(a) The department shall maintain a registry of persons who
receive an immunization or[,] antiviral[, and other medication]
administered to prepare for a potential disaster, public health
disaster [emergency], terrorist attack, hostile military or
paramilitary action, or extraordinary law enforcement emergency or
in response to a declared disaster, public health disaster
[emergency], terrorist attack, hostile military or paramilitary
action, or extraordinary law enforcement emergency. A health care
provider who administers an immunization or[,] antiviral[, or other
medication] shall provide the data elements to the department. At
the request and with the authorization of the health care provider,
the data elements may be provided through a health information
exchange as defined by Section 182.151.
(c) The department shall track adverse reactions to an
immunization or[,] antiviral[, and other medication] administered
to prepare for a potential disaster, public health disaster
[emergency], terrorist attack, hostile military or paramilitary
action, or extraordinary law enforcement emergency or in response
to a declared disaster, public health disaster [emergency],
terrorist attack, hostile military or paramilitary action, or
extraordinary law enforcement emergency. A health care provider
who administers an immunization or[,] antiviral[, or other
medication] may provide data related to adverse reactions to the
department.
SECTION 14. Subchapter A, Chapter 161, Health and Safety
Code, is amended by adding Section 161.0085 to read as follows:
Sec. 161.0085. COVID-19 VACCINE PASSPORTS PROHIBITED. (a)
In this section, "COVID-19" means the 2019 novel coronavirus
disease.
(b) A governmental entity in this state may not issue a
vaccine passport, vaccine pass, or other standardized
documentation to certify an individual's COVID-19 vaccination
status to a third party for a purpose other than health care or
otherwise publish or share any individual's COVID-19 immunization
record or similar health information for a purpose other than
health care.
(c) A business in this state may not require a customer to
provide any documentation certifying the customer's COVID-19
vaccination or post-transmission recovery on entry to, to gain
access to, or to receive service from the business. A business that
fails to comply with this subsection is not eligible to receive a
grant or enter into a contract payable with state funds.
(d) Notwithstanding any other law, each appropriate state
agency shall ensure that businesses in this state comply with
Subsection (c) and may require compliance with that subsection as a
condition for a license, permit, or other state authorization
necessary for conducting business in this state.
(e) This section may not be construed to:
(1) restrict a business from implementing COVID-19
screening and infection control protocols in accordance with state
and federal law to protect public health; or
(2) interfere with an individual's right to access the
individual's personal health information under federal law.
SECTION 15. Subchapter C, Chapter 1001, Health and Safety
Code, is amended by adding Section 1001.0515 to read as follows:
Sec. 1001.0515. OFFICE OF CHIEF STATE EPIDEMIOLOGIST. (a)
The commissioner shall:
(1) establish an Office of Chief State Epidemiologist
within the department to provide expertise in public health
activities and policy in this state by:
(A) evaluating epidemiologic, medical, and
health care information; and
(B) identifying pertinent research and
evidence-based best practices; and
(2) appoint a physician licensed to practice medicine
in this state as the chief state epidemiologist to administer the
Office of Chief State Epidemiologist.
(b) The chief state epidemiologist must:
(1) be board certified in a medical specialty; and
(2) have significant experience in public health and
an advanced degree in public health, epidemiology, or a related
field.
(c) The chief state epidemiologist serves as:
(1) the department expert on epidemiological matters
and on communicable and noncommunicable diseases; and
(2) the department's senior science representative and
primary contact for the Centers for Disease Control and Prevention
and other federal agencies related to epidemiologic science and
disease surveillance.
(d) The chief state epidemiologist may provide professional
and scientific consultation regarding epidemiology and disease
control, harmful exposure, and injury prevention to state agencies,
health facilities, health service regions, local health
authorities, local health departments, and other entities.
(e) Notwithstanding any other law, the chief state
epidemiologist may access information from the department to
implement duties of the epidemiologist's office. Reports, records,
and information provided to the Office of Chief State
Epidemiologist that relate to an epidemiologic or toxicologic
investigation of human illness or conditions and of environmental
exposure that are harmful or believed to be harmful to the public
health are confidential and not subject to disclosure under Chapter
552, Government Code, and may not be released or made public on
subpoena or otherwise, except for statistical purposes if released
in a manner that prevents identification of any person.
SECTION 16. Section 1001.089(a)(2), Health and Safety Code,
is amended to read as follows:
(2) "Local public health entity" means a local health
authority, local health unit, local health department, or public
health district.
SECTION 17. Section 81.082(e), Health and Safety Code, is
repealed.
SECTION 18. (a) In this section, "council" means the
Preparedness Coordinating Council advisory committee established
by the Health and Human Services Commission under Section 1001.035,
Health and Safety Code, for the Department of State Health
Services.
(b) In coordination with the emergency management council
established by the governor under Section 418.013, Government Code,
the council shall conduct a study on this state's response to the
2019 novel coronavirus disease. The council shall examine the
roles of the Department of State Health Services, the Health and
Human Services Commission, and the Texas Division of Emergency
Management relating to public health disaster and emergency
planning and response efforts and determine the efficacy of the
state emergency operations plan in appropriately identifying
agency responsibilities. The council may collaborate with an
institution of higher education in this state to conduct the study.
(c) Not later than nine months after the date the declared
public health disaster related to the 2019 novel coronavirus
disease is terminated, or September 1, 2023, whichever is earlier,
the council shall prepare and submit a written report to the
governor, the lieutenant governor, the speaker of the house of
representatives, and the members of the legislature on the results
of the study conducted under Subsection (b) of this section. The
report must include recommendations for legislative improvements
for public health disaster and public health emergency response and
preparedness.
(d) This section expires September 1, 2023.
SECTION 19. Section 418.0125, Government Code, as added by
this Act, applies only to an order issued or regulation adopted on
or after the effective date of this Act.
SECTION 20. As soon as practicable, but not later than
August 31, 2022, the Department of State Health Services shall
implement the disease prevention information system as required by
Section 418.1861, Government Code, as added by this Act.
SECTION 21. As soon as practicable after the effective date
of this Act, the Texas Division of Emergency Management shall adopt
the rules necessary to implement Subchapter J, Chapter 418,
Government Code, as added by this Act.
SECTION 22. (a) The Department of State Health Services
and the Preparedness Coordinating Council advisory committee are
required to implement this Act only if the legislature appropriates
money specifically for that purpose. If the legislature does not
appropriate money specifically for that purpose, the department and
council may, but are not required to, implement this Act using other
appropriations available for that purpose.
(b) The Department of State Health Services shall use any
available federal money to implement 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, 2021.
______________________________ ______________________________
President of the Senate Speaker of the House
I hereby certify that S.B. No. 968 passed the Senate on
April 21, 2021, by the following vote: Yeas 31, Nays 0; and that
the Senate concurred in House amendments on May 30, 2021, by the
following vote: Yeas 28, Nays 3.
______________________________
Secretary of the Senate
I hereby certify that S.B. No. 968 passed the House, with
amendments, on May 26, 2021, by the following vote: Yeas 146,
Nays 2, one present not voting.
______________________________
Chief Clerk of the House
Approved:
______________________________
Date
______________________________
Governor