Texas 2023 - 88th Regular

Texas Senate Bill SB304 Compare Versions

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1	1	88R1036 MCF-F
2	2	By: Hall S.B. No. 304
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to prohibited immunization status discrimination and
8	8	vaccine mandates; authorizing administrative penalties.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	ARTICLE 1. PROHIBITED IMMUNIZATION STATUS DISCRIMINATION
11	11	SECTION 1.01. Subtitle C, Title 5, Business & Commerce
12	12	Code, is amended by adding Chapter 122 to read as follows:
13	13	CHAPTER 122. PROHIBITED IMMUNIZATION STATUS DISCRIMINATION
14	14	Sec. 122.001. DEFINITION. In this chapter, "public
15	15	accommodation" means a disposition, service, financial aid, or
16	16	benefit provided to members of the public.
17	17	Sec. 122.002. DISCRIMINATION PROHIBITED. A person may not
18	18	discriminate against or refuse to provide a public accommodation to
19	19	an individual based on the individual's vaccination history or
20	20	immunity status for a communicable disease by:
21	21	(1) providing to the individual a public accommodation
22	22	that is different or provided in a different manner than the
23	23	accommodation provided or manner of providing the accommodation to
24	24	other members of the public;
25	25	(2) subjecting the individual to segregation or
26	26	separate treatment in any matter related to providing the public
27	27	accommodation to the individual;
28	28	(3) restricting in any way the individual's enjoyment
29	29	of a public accommodation in a manner that distinguishes the
30	30	individual's enjoyment from the enjoyment of other members of the
31	31	public;
32	32	(4) treating the individual differently from other
33	33	members of the public in determining whether the individual
34	34	satisfies any admission, enrollment, quota, eligibility,
35	35	membership, or other requirement or condition that individuals must
36	36	satisfy before a public accommodation is provided; or
37	37	(5) denying the individual an opportunity to
38	38	participate in a program in a manner that differs from the manner
39	39	the opportunity is provided to other members of the public.
40	40	Sec. 122.003. COMPLAINT; EQUITABLE RELIEF. (a) A person may
41	41	file a complaint with the attorney general if the person asserts
42	42	facts supporting an allegation that another person has violated
43	43	Section 122.002. The person filing the complaint must include a
44	44	sworn affidavit stating that to the person's knowledge, all of the
45	45	facts asserted in the complaint are true and correct.
46	46	(b) If the attorney general determines a complaint filed
47	47	under Subsection (a) is valid, the attorney general may file a
48	48	petition for a writ of mandamus or apply for other appropriate
49	49	equitable relief in a district court in Travis County or in a county
50	50	in which the person against whom relief is sought resides to compel
51	51	the person to comply with Section 122.002.
52	52	Sec. 122.004. EFFECT ON OTHER LAW. This chapter prevails to
53	53	the extent of a conflict between this chapter and any other law.
54	54	SECTION 1.02. Subchapter A, Chapter 161, Health and Safety
55	55	Code, is amended by adding Sections 161.0057 and 161.0086 to read as
56	56	follows:
57	57	Sec. 161.0057. PROHIBITED IMMUNIZATION DISCRIMINATION BY
58	58	LONG-TERM CARE FACILITIES. (a) In this section, "long-term care
59	59	facility" means a facility licensed or regulated under Chapter 242,
60	60	247, or 252.
61	61	(b) A long-term care facility may not refuse to provide
62	62	services to a resident based on the resident's vaccination history
63	63	or immunity status for a communicable disease.
64	64	(c) A long-term care facility that violates this section is
65	65	ineligible to receive state money for services provided to
66	66	residents.
67	67	(d) A violation of this section is a violation of the
68	68	long-term care facility's applicable licensing law and subjects the
69	69	facility to disciplinary action and the imposition of
70	70	administrative penalties under that law.
71	71	(e) This section prevails to the extent of a conflict
72	72	between this section and any other law.
73	73	Sec. 161.0086. PROHIBITED IMMUNIZATION DISCRIMINATION.
74	74	(a) A health care provider or health care facility may not refuse to
75	75	provide a health care service to a patient based on a patient's
76	76	vaccination history or immunity status for a communicable disease.
77	77	(b) A health care facility providing clinical experience to
78	78	satisfy a student's degree requirements may not discriminate
79	79	against a student or prohibit admission, enrollment, or employment
80	80	as a student, intern, or resident based on the student's
81	81	vaccination history or immunity status for a communicable disease.
82	82	(c) Notwithstanding any other law, a health care provider or
83	83	health care facility that violates this section is ineligible to
84	84	receive state money for health care services provided to patients.
85	85	(d) A violation of this section is a violation of the health
86	86	care provider's or health care facility's applicable licensing law
87	87	and subjects the provider or facility to disciplinary action and
88	88	the imposition of administrative penalties under that law.
89	89	(e) This section prevails to the extent of a conflict
90	90	between this section and any other law.
91	91	SECTION 1.03. Chapter 544, Insurance Code, is amended by
92	92	adding Subchapter O to read as follows:
93	93	SUBCHAPTER O. IMMUNIZATION STATUS
94	94	Sec. 544.701. DEFINITIONS. In this subchapter:
95	95	(1) "Health benefit plan issuer" means an issuer,
96	96	administrator, or sponsor of a health benefit plan described by
97	97	Section 544.702.
98	98	(2) "Participating provider" means a health care
99	99	provider who has contracted with a health benefit plan issuer to
100	100	provide services to enrollees.
101	101	Sec. 544.702. APPLICABILITY OF SUBCHAPTER. (a) This
102	102	subchapter applies only to a health benefit plan that provides
103	103	benefits for medical or surgical expenses incurred as a result of a
104	104	health condition, accident, or sickness, including a group,
105	105	blanket, or franchise insurance policy or insurance agreement, a
106	106	group hospital service contract, or a group evidence of coverage or
107	107	similar coverage document that is offered by:
108	108	(1) an insurance company;
109	109	(2) a group hospital service corporation operating
110	110	under Chapter 842;
111	111	(3) a health maintenance organization operating under
112	112	Chapter 843;
113	113	(4) an approved nonprofit health corporation that
114	114	holds a certificate of authority under Chapter 844;
115	115	(5) a multiple employer welfare arrangement that holds
116	116	a certificate of authority under Chapter 846;
117	117	(6) a stipulated premium company operating under
118	118	Chapter 884;
119	119	(7) a fraternal benefit society operating under
120	120	Chapter 885;
121	121	(8) a Lloyd's plan operating under Chapter 941; or
122	122	(9) an exchange operating under Chapter 942.
123	123	(b) Notwithstanding any other law, this subchapter applies
124	124	to:
125	125	(1) a small employer health benefit plan subject to
126	126	Chapter 1501, including coverage provided through a health group
127	127	cooperative under Subchapter B of that chapter;
128	128	(2) a standard health benefit plan issued under
129	129	Chapter 1507;
130	130	(3) a basic coverage plan under Chapter 1551;
131	131	(4) a basic plan under Chapter 1575;
132	132	(5) a primary care coverage plan under Chapter 1579;
133	133	(6) a plan providing basic coverage under Chapter
134	134	1601;
135	135	(7) health benefits provided by or through a church
136	136	benefits board under Subchapter I, Chapter 22, Business
137	137	Organizations Code;
138	138	(8) the state Medicaid program, including the Medicaid
139	139	managed care program operated under Chapter 533, Government Code;
140	140	(9) the child health plan program under Chapter 62,
141	141	Health and Safety Code;
142	142	(10) a regional or local health care program operated
143	143	under Section 75.104, Health and Safety Code;
144	144	(11) a self-funded health benefit plan sponsored by a
145	145	professional employer organization under Chapter 91, Labor Code;
146	146	(12) county employee group health benefits provided
147	147	under Chapter 157, Local Government Code; and
148	148	(13) health and accident coverage provided by a risk
149	149	pool created under Chapter 172, Local Government Code.
150	150	(c) This subchapter applies to a life insurance company
151	151	that:
152	152	(1) issues or delivers a life insurance policy in this
153	153	state; or
154	154	(2) is organized under the laws of this state.
155	155	Sec. 544.703. PROHIBITED DISCRIMINATION AGAINST
156	156	INDIVIDUAL. A group health benefit plan issuer or a life insurance
157	157	company may not use an individual's vaccination history or immunity
158	158	status for a communicable disease to:
159	159	(1) reject, deny, limit, cancel, refuse to renew, or
160	160	increase the premiums for coverage of the individual under a plan
161	161	offered by the issuer or company;
162	162	(2) limit the amount, extent, or kind of coverage
163	163	available to the individual; or
164	164	(3) otherwise adversely affect the individual's
165	165	eligibility for coverage.
166	166	Sec. 544.704. PROHIBITED DISCRIMINATION IN GROUP PLAN
167	167	RATING. The vaccination history or immunity status for a
168	168	communicable disease of individuals covered under a group health
169	169	benefit plan that provides coverage in this state may not be used as
170	170	a factor in the rating of the plan.
171	171	Sec. 544.705. PROHIBITED DISCRIMINATION AGAINST
172	172	PARTICIPATING PROVIDER. (a) A health benefit plan issuer may not
173	173	use the vaccination history or immunity status for a communicable
174	174	disease of a health care provider's patients as a qualification or
175	175	requirement for contracting with the provider or as a basis for
176	176	terminating a contract with the provider.
177	177	(b) A health benefit plan issuer may not use the vaccination
178	178	history or immunity status for a communicable disease of enrollees
179	179	as a factor in providing a financial incentive or assessing a
180	180	financial or other penalty against a participating provider.
181	181	Sec. 544.706. EFFECT ON OTHER LAW. This subchapter
182	182	prevails to the extent of a conflict between this subchapter and any
183	183	other law.
184	184	SECTION 1.04. Chapter 21, Labor Code, is amended by adding
185	185	Subchapter H-1 to read as follows:
186	186	SUBCHAPTER H-1. DISCRIMINATION BASED ON IMMUNIZATION STATUS
187	187	Sec. 21.421. PROHIBITED DISCRIMINATION BASED ON
188	188	IMMUNIZATION STATUS. (a) An employer commits an unlawful
189	189	employment practice if the employer fails or refuses to hire,
190	190	discharges, or otherwise discriminates against an individual with
191	191	respect to the compensation or the terms, conditions, or privileges
192	192	of employment based on the individual's vaccination history or
193	193	immunity status for a communicable disease.
194	194	(b) A labor organization commits an unlawful employment
195	195	practice if the labor organization excludes or expels from
196	196	membership or otherwise discriminates against an individual based
197	197	on the individual's vaccination history or immunity status for a
198	198	communicable disease.
199	199	(c) An employment agency commits an unlawful employment
200	200	practice if the employment agency classifies or refers for
201	201	employment, fails or refuses to refer for employment, or otherwise
202	202	discriminates against an individual based on the individual's
203	203	vaccination history or immunity status for a communicable disease.
204	204	(d) An employer, labor organization, or employment agency
205	205	commits an unlawful employment practice if the employer, labor
206	206	organization, or employment agency limits, segregates, or
207	207	classifies an employee, member, or applicant for employment or
208	208	membership in a way that would deprive or tend to deprive the
209	209	employee, member, or applicant of employment opportunities or
210	210	otherwise adversely affect the status of the employee, member, or
211	211	applicant based on the employee's, member's, or applicant's
212	212	vaccination history or immunity status for a communicable disease.
213	213	Sec. 21.422. EFFECT ON OTHER LAW. This subchapter prevails
214	214	to the extent of a conflict between this subchapter and any other
215	215	law.
216	216	SECTION 1.05. Title 2, Occupations Code, is amended by
217	217	adding Chapter 60 to read as follows:
218	218	CHAPTER 60. IMMUNIZATION DISCRIMINATION
219	219	Sec. 60.001. PROHIBITED IMMUNIZATION DISCRIMINATION. A
220	220	licensing authority may not deny an application for an occupational
221	221	license, suspend, revoke, or refuse to renew an occupational
222	222	license, or take any other disciplinary action against an
223	223	individual based on:
224	224	(1) the individual's vaccination history or immunity
225	225	status for a communicable disease; or
226	226	(2) the individual's refusal to be vaccinated or
227	227	participate in administering a vaccine.
228	228	Sec. 60.002. EFFECT ON OTHER LAW. This chapter prevails to
229	229	the extent of a conflict between this chapter and any other law.
230	230	SECTION 1.06. Subtitle A, Title 3, Occupations Code, is
231	231	amended by adding Chapter 103A to read as follows:
232	232	CHAPTER 103A. RIGHT TO OBJECT TO VACCINATIONS; PROHIBITED
233	233	IMMUNIZATION DISCRIMINATION
234	234	Sec. 103A.001. RIGHT TO OBJECT. A hospital or other health
235	235	care facility may not require as a condition of employment that an
236	236	employee, including a physician, nurse, or staff member:
237	237	(1) be vaccinated; or
238	238	(2) participate in administering a vaccine.
239	239	Sec. 103A.002. PROHIBITED IMMUNIZATION DISCRIMINATION.
240	240	(a) A hospital or other health care facility may not discriminate
241	241	against an employee, including a physician, nurse, or staff member,
242	242	or an applicant who:
243	243	(1) refuses to:
244	244	(A) be vaccinated; or
245	245	(B) participate in administering a vaccine; or
246	246	(2) is not immune to a communicable disease.
247	247	(b) An educational institution may not discriminate against
248	248	an applicant for admission or employment as a student, intern, or
249	249	resident based on:
250	250	(1) the applicant's vaccination history or immunity
251	251	status for a communicable disease; or
252	252	(2) the applicant's refusal to be vaccinated or
253	253	participate in administering a vaccine.
254	254	Sec. 103A.003. REMEDIES. A person aggrieved by a violation
255	255	of this chapter may bring an action against a hospital, other health
256	256	care facility, or educational institution that administers a
257	257	hospital or other health care facility in a district court in the
258	258	county where the hospital, facility, or institution is located for:
259	259	(1) an injunction against any further violation;
260	260	(2) appropriate equitable relief, including:
261	261	(A) admission or reinstatement of employment;
262	262	and
263	263	(B) back pay and 10 percent interest on the back
264	264	pay; and
265	265	(3) any other relief necessary to ensure compliance
266	266	with this chapter.
267	267	Sec. 103A.004. EFFECT ON OTHER LAW. This chapter prevails
268	268	to the extent of a conflict between this chapter and any other law.
269	269	SECTION 1.07. Subchapter A, Chapter 521, Transportation
270	270	Code, is amended by adding Section 521.015 to read as follows:
271	271	Sec. 521.015. PROHIBITED IMMUNIZATION DISCRIMINATION. (a)
272	272	The department may not use an individual's vaccination history or
273	273	immunity status for a communicable disease as a requirement for the
274	274	issuance or renewal of a driver's license, election identification
275	275	certificate, or personal identification certificate.
276	276	(b) The department may not discriminate against, deny
277	277	services or access to, or otherwise penalize any individual based
278	278	on the individual's vaccination history or immunity status or
279	279	refusal to provide proof of vaccination or immunity to a
280	280	communicable disease.
281	281	(c) This section prevails to the extent of a conflict
282	282	between this section and any other law.
283	283	ARTICLE 2. PROHIBITED VACCINATION MANDATES
284	284	SECTION 2.01. Section 25.002(a), Education Code, is amended
285	285	to read as follows:
286	286	(a) If a parent or other person with legal control of a child
287	287	under a court order enrolls the child in a public school, the parent
288	288	or other person or the school district in which the child most
289	289	recently attended school shall furnish to the school district:
290	290	(1) the child's birth certificate or another document
291	291	suitable as proof of the child's identity; and
292	292	(2) a copy of the child's records from the school the
293	293	child most recently attended if the child has been previously
294	294	enrolled in a school in this state or another state[; and
295	295	[(3) a record showing that the child has the
296	296	immunizations as required under Section 38.001, in the case of a
297	297	child required under that section to be immunized, proof as
298	298	required by that section showing that the child is not required to
299	299	be immunized, or proof that the child is entitled to provisional
300	300	admission under that section and under rules adopted under that
301	301	section].
302	302	SECTION 2.02. The heading to Section 38.001, Education
303	303	Code, is amended to read as follows:
304	304	Sec. 38.001. RECOMMENDED IMMUNIZATIONS AND VACCINES
305	305	[IMMUNIZATION; REQUIREMENTS; EXCEPTIONS].
306	306	SECTION 2.03. Section 38.001(b-1), Education Code, is
307	307	amended to read as follows:
308	308	(b-1) Each year, the Department of State Health Services
309	309	shall prepare a list of the immunizations and vaccines [required
310	310	under this section for admission to public schools and of any
311	311	additional immunizations] the department recommends for school-age
312	312	children. The department shall prepare the list in English and
313	313	Spanish and make the list available in a manner that permits a
314	314	school district to easily post the list on the district's Internet
315	315	website as required by Section 38.019. A school district or a
316	316	school, including a private school, may not require any
317	317	immunization or vaccine as a condition of admission to or
318	318	attendance at an elementary or secondary school.
319	319	SECTION 2.04. Sections 38.019(a) and (b), Education Code,
320	320	are amended to read as follows:
321	321	(a) A school district that maintains an Internet website
322	322	shall post prominently on the website[:
323	323	[(1)] a list, in English and Spanish, of:
324	324	(1) [(A) the immunizations required for admission to
325	325	public school by rules of the Department of State Health Services
326	326	adopted under Section 38.001;
327	327	[(B)] any immunizations or vaccines recommended
328	328	for public school students by the Department of State Health
329	329	Services; and
330	330	(2) [(C)] health clinics in the district that offer
331	331	the influenza vaccine, to the extent those clinics are known to the
332	332	district[; and
333	333	[(2) a link to the Department of State Health Services
334	334	Internet website where a person may obtain information relating to
335	335	the procedures for claiming an exemption from the immunization
336	336	requirements of Section 38.001].
337	337	(b) The list of recommended immunizations or vaccines under
338	338	Subsection (a)(1) [(a)(2)] must include the influenza vaccine[,
339	339	unless the Department of State Health Services requires the
340	340	influenza vaccine for admission to public school].
341	341	SECTION 2.05. The heading to Section 51.933, Education
342	342	Code, is amended to read as follows:
343	343	Sec. 51.933. IMMUNIZATION INFORMATION [REQUIREMENTS;
344	344	EXCEPTION].
345	345	SECTION 2.06. Section 51.933(a), Education Code, is amended
346	346	to read as follows:
347	347	(a) An institution of higher education may not require
348	348	students or applicants for admission to be immunized against any
349	349	communicable disease [diphtheria, rubeola, rubella, mumps,
350	350	tetanus, and poliomyelitis, except as provided in Subsection (d)].
351	351	SECTION 2.07. Section 264.1076(d), Family Code, is amended
352	352	to read as follows:
353	353	(d) A physician or other health care provider conducting an
354	354	examination under Subsection (b) may not administer a vaccination
355	355	as part of the examination without parental consent[, except that a
356	356	physician or other health care provider may administer a tetanus
357	357	vaccination to a child in a commercially available preparation if
358	358	the physician or other health care provider determines that an
359	359	emergency circumstance requires the administration of the
360	360	vaccination]. The prohibition on the administration of a
361	361	vaccination under this subsection does not apply after the
362	362	department has been named managing conservator of the child after a
363	363	hearing conducted under Subchapter C, Chapter 262.
364	364	SECTION 2.08. Section 531.0335(b), Government Code, is
365	365	amended to read as follows:
366	366	(b) The executive commissioner by rule shall prohibit a
367	367	health and human services agency from taking a punitive action
368	368	against a person responsible for a child's care, custody, or
369	369	welfare for declining [failure of the person] to immunize or
370	370	vaccinate the child for any communicable disease [ensure that the
371	371	child receives the immunization series prescribed by Section
372	372	161.004, Health and Safety Code].
373	373	SECTION 2.09. Section 12.033(a), Health and Safety Code, is
374	374	amended to read as follows:
375	375	(a) Except as otherwise provided by this section, the
376	376	executive commissioner by rule shall adopt fees to be collected by
377	377	the department for the distribution and administration of vaccines
378	378	and sera provided under[:
379	379	[(1) Section 38.001, Education Code;
380	380	[(2) Section 42.043, Human Resources Code;
381	381	[(3)] Chapter 826 (Rabies Control Act of 1981)[;
382	382	[(4) Chapter 81 (Communicable Disease Prevention and
383	383	Control Act); and
384	384	[(5) Section 161.005].
385	385	SECTION 2.10. Section 81.082(f), Health and Safety Code, is
386	386	amended to read as follows:
387	387	(f) In this section, "control measures" does not include
388	388	administration of a vaccine and includes:
389	389	(1) [immunization;
390	390	[(2)] detention;
391	391	(2) [(3)] restriction;
392	392	(3) [(4)] disinfection;
393	393	(4) [(5)] decontamination;
394	394	(5) [(6)] isolation;
395	395	(6) [(7)] quarantine;
396	396	(7) [(8)] disinfestation;
397	397	(8) [(9)] chemoprophylaxis;
398	398	(9) [(10)] preventive therapy;
399	399	(10) [(11)] prevention; and
400	400	(11) [(12)] education.
401	401	SECTION 2.11. Section 81.085(i), Health and Safety Code, is
402	402	amended to read as follows:
403	403	(i) On request of the department during a public health
404	404	disaster, an individual shall disclose the individual's
405	405	immunization information. If the individual does not have updated
406	406	or appropriate immunizations, the department may take appropriate
407	407	action during a quarantine to protect that individual and the
408	408	public from the communicable disease, but the department may not
409	409	administer a vaccine to the individual without the individual's
410	410	consent.
411	411	SECTION 2.12. The heading to Section 161.0051, Health and
412	412	Safety Code, is amended to read as follows:
413	413	Sec. 161.0051. REQUIRED OFFER OF IMMUNIZATIONS FOR NURSING
414	414	HOMES.
415	415	SECTION 2.13. Subchapter A, Chapter 161, Health and Safety
416	416	Code, is amended by adding Section 161.0055 to read as follows:
417	417	Sec. 161.0055. PROHIBITED VACCINE MANDATES AND
418	418	DISCRIMINATION. (a) A governmental entity or official, including
419	419	the governor, a state agency, a political subdivision, or a
420	420	political subdivision official, may not:
421	421	(1) require an individual to be vaccinated;
422	422	(2) require an individual to participate in the
423	423	administration of a vaccine; or
424	424	(3) discriminate or impose a civil or criminal penalty
425	425	against an individual who refuses vaccination or participation in
426	426	the administration of a vaccine.
427	427	(b) This section applies to all other law, including a state
428	428	agency rule, executive order, or emergency order.
429	429	(c) This section prevails to the extent of a conflict
430	430	between this section and any other law.
431	431	SECTION 2.14. Section 161.0074(c), Health and Safety Code,
432	432	is amended to read as follows:
433	433	(c) The report must:
434	434	(1) include the current immunization rates by
435	435	geographic region of the state, where available;
436	436	(2) focus on the geographic regions of the state with
437	437	immunization rates below the state average for preschool children;
438	438	(3) describe the approaches identified to increase
439	439	immunization rates in underserved areas and the estimated cost for
440	440	each;
441	441	(4) identify changes to department procedures needed
442	442	to increase immunization rates;
443	443	(5) identify the services provided under and
444	444	provisions of contracts entered into by the department to increase
445	445	immunization rates in underserved areas;
446	446	(6) identify performance measures used in contracts
447	447	described by Subdivision (5);
448	448	(7) include the number and type of exemptions used in
449	449	the past year;
450	450	(8) include the number of complaints received by the
451	451	department related to the department's failure to comply with
452	452	requests for exclusion of individuals from the registry;
453	453	(9) identify all reported incidents of discrimination
454	454	for requesting exclusion from the registry [or for using an
455	455	exemption for a required immunization]; and
456	456	(10) include ways to increase provider participation
457	457	in the registry.
458	458	SECTION 2.15. Section 161.0105(c), Health and Safety Code,
459	459	is amended to read as follows:
460	460	(c) The immunity created by this section is in addition to
461	461	any immunity created by Section [Sections 161.001 and] 161.007(i).
462	462	SECTION 2.16. Section 224.002, Health and Safety Code, is
463	463	amended by amending Subsection (b) and adding Subsection (b-1) to
464	464	read as follows:
465	465	(b) The policy must:
466	466	(1) encourage [require] covered individuals to
467	467	receive vaccines for the vaccine preventable diseases specified by
468	468	the facility based on the level of risk the individual presents to
469	469	patients by the individual's routine and direct exposure to
470	470	patients;
471	471	(2) specify the recommended vaccines a covered
472	472	individual is encouraged [required] to receive based on the level
473	473	of risk the individual presents to patients by the individual's
474	474	routine and direct exposure to patients;
475	475	(3) [include procedures for verifying whether a
476	476	covered individual has complied with the policy;
477	477	[(4) include procedures for a covered individual to be
478	478	exempt from the required vaccines for the medical conditions
479	479	identified as contraindications or precautions by the Centers for
480	480	Disease Control and Prevention;
481	481	[(5)] for a covered individual who declines to receive
482	482	[is exempt from] the recommended [required] vaccines, include
483	483	procedures the individual must follow to protect facility patients
484	484	from exposure to disease, such as the use of protective medical
485	485	equipment, such as gloves and masks, based on the level of risk the
486	486	individual presents to patients by the individual's routine and
487	487	direct exposure to patients;
488	488	(4) [(6)] prohibit discrimination or retaliatory
489	489	action against a covered individual who declines to receive [is
490	490	exempt from] the recommended [required] vaccines [for the medical
491	491	conditions identified as contraindications or precautions by the
492	492	Centers for Disease Control and Prevention], except that required
493	493	use of protective medical equipment, such as gloves and masks, may
494	494	not be considered retaliatory action for purposes of this
495	495	subdivision; and
496	496	(5) [(7)] require the health care facility to maintain
497	497	a written or electronic record of each covered individual's
498	498	immunization history [compliance with or exemption from the policy;
499	499	and
500	500	[(8) include disciplinary actions the health care
501	501	facility is authorized to take against a covered individual who
502	502	fails to comply with the policy].
503	503	(b-1) A health care facility shall maintain as confidential
504	504	an immunization history described by Subsection (b)(5) and may not
505	505	disclose the history to any other person unless the disclosure is
506	506	otherwise required by law.
507	507	SECTION 2.17. Section 31.0031(d), Human Resources Code, is
508	508	amended to read as follows:
509	509	(d) The responsibility agreement shall require that:
510	510	(1) the parent of a dependent child cooperate with the
511	511	commission and the Title IV-D agency if necessary to establish the
512	512	paternity of the dependent child and to establish or enforce child
513	513	support;
514	514	(2) if adequate and accessible providers of the
515	515	services are available in the geographic area and subject to the
516	516	availability of funds, each dependent child, as appropriate,
517	517	complete early and periodic screening, diagnosis, and treatment
518	518	checkups on schedule [and receive the immunization series
519	519	prescribed by Section 161.004, Health and Safety Code, unless the
520	520	child is exempt under that section];
521	521	(3) each adult recipient, or teen parent recipient who
522	522	has completed the requirements regarding school attendance in
523	523	Subdivision (6), not voluntarily terminate paid employment of at
524	524	least 30 hours each week without good cause in accordance with rules
525	525	adopted by the executive commissioner;
526	526	(4) each adult recipient for whom a needs assessment
527	527	is conducted participate in an activity to enable that person to
528	528	become self-sufficient by:
529	529	(A) continuing the person's education or
530	530	becoming literate;
531	531	(B) entering a job placement or employment skills
532	532	training program;
533	533	(C) serving as a volunteer in the person's
534	534	community; or
535	535	(D) serving in a community work program or other
536	536	work program approved by the commission;
537	537	(5) each caretaker relative or parent receiving
538	538	assistance not use, sell, or possess marihuana or a controlled
539	539	substance in violation of Chapter 481, Health and Safety Code, or
540	540	abuse alcohol;
541	541	(6) each dependent child younger than 18 years of age
542	542	or teen parent younger than 19 years of age attend school regularly,
543	543	unless the child has a high school diploma or high school
544	544	equivalency certificate or is specifically exempted from school
545	545	attendance under Section 25.086, Education Code;
546	546	(7) each recipient comply with commission rules
547	547	regarding proof of school attendance; and
548	548	(8) each recipient attend appropriate parenting
549	549	skills training classes, as determined by the needs assessment.
550	550	SECTION 2.18. Sections 42.043(b) and (d), Human Resources
551	551	Code, are amended to read as follows:
552	552	(b) The department shall require that each child at an
553	553	appropriate age have a test for tuberculosis [and be immunized
554	554	against diphtheria, tetanus, poliomyelitis, mumps, rubella,
555	555	rubeola, invasive pneumococcal disease, and hepatitis A and against
556	556	any other communicable disease as recommended by the Department of
557	557	State Health Services. The immunization must be effective on the
558	558	date of first entry into the facility. However, a child may be
559	559	provisionally admitted if the required immunizations have begun and
560	560	are completed as rapidly as medically feasible].
561	561	(d) No immunization may be required for admission to a
562	562	facility regulated under this chapter [if a person applying for a
563	563	child's admission submits one of the following affidavits:
564	564	[(1) an affidavit signed by a licensed physician
565	565	stating that the immunization poses a significant risk to the
566	566	health and well-being of the child or a member of the child's family
567	567	or household; or
568	568	[(2) an affidavit signed by the child's parent or
569	569	guardian stating that the applicant declines immunization for
570	570	reasons of conscience, including a religious belief].
571	571	SECTION 2.19. Section 42.04305, Human Resources Code, is
572	572	amended by amending Subsection (c) and adding Subsection (c-1) to
573	573	read as follows:
574	574	(c) The policy must:
575	575	(1) encourage [require] each facility employee to
576	576	receive vaccines for the vaccine-preventable diseases specified by
577	577	the child-care facility based on the level of risk the employee
578	578	presents to children by the employee's routine and direct exposure
579	579	to children;
580	580	(2) specify the recommended vaccines a facility
581	581	employee is encouraged [required] to receive based on the level of
582	582	risk the employee presents to children by the employee's routine
583	583	and direct exposure to children;
584	584	(3) [include procedures for verifying whether a
585	585	facility employee has complied with the policy;
586	586	[(4) include procedures for a facility employee to be
587	587	exempt from the required vaccines for the medical conditions
588	588	identified as contraindications or precautions by the Centers for
589	589	Disease Control and Prevention;
590	590	[(5)] for a facility employee who declines to receive
591	591	[is exempt from] the recommended [required] vaccines, include
592	592	procedures the employee must follow to protect children in the
593	593	facility's care from exposure to disease, such as the use of
594	594	protective medical equipment, including gloves and masks, based on
595	595	the level of risk the employee presents to children by the
596	596	employee's routine and direct exposure to children;
597	597	(4) [(6)] prohibit discrimination or retaliatory
598	598	action against a facility employee who declines to receive [is
599	599	exempt from] the recommended [required] vaccines [for the medical
600	600	conditions identified as contraindications or precautions by the
601	601	Centers for Disease Control and Prevention], except that required
602	602	use of protective medical equipment, including gloves and masks,
603	603	may not be considered retaliatory action for purposes of this
604	604	subdivision; and
605	605	(5) [(7)] require the child-care facility to maintain
606	606	a written or electronic record of each facility employee's
607	607	immunization history [compliance with or exemption from the policy;
608	608	and
609	609	[(8) state the disciplinary actions the child-care
610	610	facility is authorized to take against a facility employee who
611	611	fails to comply with the policy].
612	612	(c-1) A facility shall maintain as confidential an
613	613	immunization history described by Subsection (c)(5) and may not
614	614	disclose the history to any other person unless the disclosure is
615	615	otherwise required by law.
616	616	SECTION 2.20. The following provisions are repealed:
617	617	(1) Sections 38.001(a), (c), (c-1), (d), (e), and
618	618	(f), Education Code;
619	619	(2) Section 38.001(b), Education Code, as amended by
620	620	Chapters 43 (H.B. 1098) and 94 (H.B. 1059), Acts of the 80th
621	621	Legislature, Regular Session, 2007;
622	622	(3) Section 38.019(a-1), Education Code;
623	623	(4) Section 51.9192, Education Code;
624	624	(5) Sections 51.933(b), (b-1), (d), (d-1), and (e),
625	625	Education Code;
626	626	(6) Section 531.0335(c), Government Code;
627	627	(7) Section 81.023, Health and Safety Code;
628	628	(8) Section 161.001, Health and Safety Code;
629	629	(9) Section 161.004, Health and Safety Code;
630	630	(10) Section 161.0041, Health and Safety Code;
631	631	(11) Section 161.005, Health and Safety Code;
632	632	(12) Section 161.007(h), Health and Safety Code;
633	633	(13) Section 224.002(c), Health and Safety Code;
634	634	(14) Section 224.003, Health and Safety Code;
635	635	(15) Sections 31.031(d) and (e), Human Resources Code;
636	636	(16) Sections 42.043(c), (d-1), and (f), Human
637	637	Resources Code; and
638	638	(17) Section 42.04305(d), Human Resources Code.
639	639	ARTICLE 3. TRANSITION AND EFFECTIVE DATE
640	640	SECTION 3.01. Each facility subject to Chapter 224, Health
641	641	and Safety Code, as amended by this Act, or Section 42.04305, Human
642	642	Resources Code, as amended by this Act, shall modify the facility's
643	643	vaccine-preventable disease policy to conform with the changes in
644	644	law made by this Act not later than January 1, 2024.
645	645	SECTION 3.02. (a) Subchapter O, Chapter 544, Insurance
646	646	Code, as added by this Act, applies only to a health benefit plan or
647	647	insurance policy delivered, issued for delivery, or renewed on or
648	648	after January 1, 2024.
649	649	(b) Section 544.705, Insurance Code, as added by this Act,
650	650	applies only to a contract entered into on or after the effective
651	651	date of this Act.
652	652	SECTION 3.03. (a) The changes in law made by this Act to
653	653	Title 2, Education Code, apply starting with the 2023-2024 school
654	654	year.
655	655	(b) The changes in law made by this Act to Title 3, Education
656	656	Code, apply starting with the 2023-2024 academic year.
657	657	SECTION 3.04. This Act takes effect immediately if it
658	658	receives a vote of two-thirds of all the members elected to each
659	659	house, as provided by Section 39, Article III, Texas Constitution.
660	660	If this Act does not receive the vote necessary for immediate
661	661	effect, this Act takes effect September 1, 2023.