Bill Text: IA SF193 | 2021-2022 | 89th General Assembly | Introduced


Bill Title: A bill for an act relating to requirements and prohibitions relating to vaccines and immunizations, and providing civil remedies.(See SF 555.)

Spectrum: Partisan Bill (Republican 5-0)

Status: (Introduced) 2021-03-04 - Committee report approving bill, renumbered as SF 555. S.J. 524. [SF193 Detail]

Download: Iowa-2021-SF193-Introduced.html
Senate File 193 - Introduced SENATE FILE 193 BY GUTH , JOHNSON , SCHULTZ , WHITING , and CARLIN A BILL FOR An Act relating to requirements and prohibitions relating to 1 vaccines and immunizations, and providing civil remedies. 2 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 3 TLSB 1343XS (13) 89 pf/rh
S.F. 193 DIVISION I 1 PROHIBITION OF VACCINE MANDATES BY EMPLOYERS 2 Section 1. NEW SECTION . 94.1 Definitions. 3 As used in this chapter, unless the context otherwise 4 requires: 5 1. “Applicant” means a natural person who applies to be an 6 employee. 7 2. “Employee” means a natural person who is employed in this 8 state for wages by an employer. 9 3. “Employer” means a person, as defined in chapter 4, who 10 in this state employs for wages, natural persons. 11 Sec. 2. NEW SECTION . 94.2 Vaccination requirements or 12 history —— prohibited acts by employer. 13 An employer shall not fail or refuse to hire, discharge, 14 penalize, or otherwise discriminate against an employee with 15 respect to compensation or the terms, conditions, or privileges 16 of employment based on either of the following: 17 1. The employee’s vaccination history. 18 2. The refusal of the employee to receive a vaccine or 19 provide proof of immunity. 20 Sec. 3. NEW SECTION . 94.3 Civil remedies. 21 An employee whose rights are violated under this chapter may 22 bring an action against an employer in the district court in 23 the county where the employer is located for injunctive relief, 24 actual damages, admission or reinstatement of the employee with 25 back pay plus ten percent interest, or any other appropriate 26 relief necessary to ensure compliance with this chapter. 27 DIVISION II 28 PROHIBITION AGAINST VACCINE MANDATES RELATIVE TO FACILITIES, 29 PROVIDERS, AND INSURERS 30 Sec. 4. NEW SECTION . 135Q.1 Definitions. 31 As used in this chapter, unless the content otherwise 32 requires: 33 1. “Assisted living program” means the same as defined in 34 section 231C.2. 35 -1- LSB 1343XS (13) 89 pf/rh 1/ 14
S.F. 193 2. “Communicable disease” means the same as defined in 1 section 139A.2. 2 3. “Health care facility” means the same as defined in 3 section 135C.1. 4 4. “Health care provider” means a person licensed or 5 certified by and subject to the authority of a board as defined 6 in section 147.2 who provides professional health care services 7 to a patient during that patient’s medical care, treatment, or 8 confinement. 9 5. “Hospital” means the same as defined in section 135B.1. 10 6. “Insurer” means an entity providing a plan of health 11 insurance, health care benefits, or health care services, or 12 an entity subject to the jurisdiction of the commissioner 13 of insurance performing utilization review, including an 14 insurance company offering sickness and accident plans, a 15 health maintenance organization, a nonprofit health service 16 corporation, a plan established pursuant to chapter 509A 17 for public employees, or any other entity providing a plan 18 of health insurance, health care benefits, or health care 19 services. 20 7. “Patient” means a person who has received or is receiving 21 professional health care services from a health care facility, 22 health care provider, or hospital. 23 8. “Resident” means a resident of a health care facility. 24 9. “Tenant” means a tenant of an assisted living program. 25 Sec. 5. NEW SECTION . 135Q.2 Immunizations —— prohibited 26 discrimination —— civil remedies. 27 1. A hospital or health care facility shall not do any of 28 the following: 29 a. Require a health care provider, staff member, employee, 30 or applicant for one of these positions to be immunized. 31 b. Discriminate against or terminate the employment of a 32 health care provider, staff member, employee, or applicant for 33 one of these positions based on the person’s refusal to receive 34 an immunization. 35 -2- LSB 1343XS (13) 89 pf/rh 2/ 14
S.F. 193 2. A hospital, health care facility, or a health care 1 provider, staff member, or employee of a hospital or health 2 care facility shall not discriminate against or terminate 3 treatment of a patient based upon the patient’s refusal to 4 receive an immunization. 5 3. A health care facility or assisted living program shall 6 not discriminate against or terminate treatment of a resident 7 or tenant solely on the basis of the resident or tenant not 8 having received, or refusing to receive, an immunization for a 9 specific communicable disease. 10 4. A hospital, health care facility, or educational 11 institution providing clinical experience to satisfy the 12 professional degree requirements of a student, intern, or 13 resident shall not discriminate against the student, intern, or 14 resident, or prohibit admission, enrollment, or employment as a 15 student, intern, or resident based on the immunization status 16 of the student, intern, or resident. 17 5. A person aggrieved under this section may petition the 18 district court in the county where the hospital, health care 19 facility, assisted living program, or educational institution 20 is located for any of the following: 21 a. Injunctive relief against any further violation. 22 b. Affirmative relief, including reinstatement of employment 23 with back pay and interest, or any other equitable relief the 24 court deems appropriate. 25 c. Other appropriate relief necessary to ensure compliance 26 with this section. 27 6. A hospital, health care facility, health care provider, 28 educational institution, or assisted living program that 29 violates this section is not eligible to receive state funding 30 for reimbursement of services provided to patients, residents, 31 or tenants. 32 Sec. 6. NEW SECTION . 135Q.3 Immunization —— health care 33 providers —— prohibited discrimination. 34 The licensing authority for a health care provider shall not 35 -3- LSB 1343XS (13) 89 pf/rh 3/ 14
S.F. 193 deny an applicant for a license or suspend, revoke, or refuse 1 to renew a license, and shall not take disciplinary action 2 against a licensee based on the applicant’s or licensee’s 3 immunization history or refusal to submit to an immunization. 4 Sec. 7. NEW SECTION . 135Q.4 Immunizations —— prohibited 5 actions —— insurers and insurer ratings —— cease and desist 6 orders and penalties. 7 1. An insurer providing a group policy, contract, or plan 8 for health insurance shall not use the immunization status of 9 a person as a basis to reject; deny; limit; cancel; refuse to 10 renew; increase the premiums for; limit the amount, extent, or 11 kind of coverage available to; or otherwise adversely affect 12 eligibility or coverage for the group health policy, contract, 13 or plan for health insurance. 14 2. An insurer providing a group policy, contract, or plan 15 for health insurance shall not use the immunization status of a 16 person as a qualification or requirement for contracting with 17 the person’s health care provider or as a basis for terminating 18 a contract with the person’s health care provider. 19 3. An insurer providing a group policy, contract, or 20 plan for health insurance shall not do any of the following 21 regarding the administration of immunizations to covered 22 persons: 23 a. Provide financial or other incentives to a participating 24 health care provider based upon attaining a certain 25 immunization administration rate. 26 b. Impose a financial or other penalty on a participating 27 health care provider who does not attain a certain immunization 28 administration rate. 29 4. The immunization status of a person covered by a group 30 policy, contract, or plan for health insurance shall not be 31 used as a factor in the rating of a group policy, contract, or 32 plan for health insurance in this state. 33 5. An insurer issuing a group policy, contract, or plan for 34 health insurance who violates this section is subject to the 35 -4- LSB 1343XS (13) 89 pf/rh 4/ 14
S.F. 193 summary cease and desist order, cease and desist order, and 1 penalty provisions pursuant to chapter 507B. 2 DIVISION III 3 CHILDREN AND STUDENTS —— VACCINE MANDATES 4 Sec. 8. Section 139A.8, subsection 4, Code 2021, is amended 5 to read as follows: 6 4. a. Immunization is not required for a person’s 7 enrollment in any elementary or secondary school or licensed 8 child care center if either any of the following applies: 9 (1) The applicant, or if the applicant is a minor, the 10 applicant’s parent or legal guardian, submits to the admitting 11 official a statement signed by a physician, advanced registered 12 nurse practitioner, or physician assistant who is licensed by 13 the board of medicine, board of nursing, or board of physician 14 assistants that the immunizations required would be injurious 15 to the health and well-being of the applicant or any member of 16 the applicant’s family. 17 (2) The applicant, or if the applicant is a minor, the 18 applicant’s parent or legal guardian, submits an affidavit 19 signed by the applicant, or if the applicant is a minor, 20 the applicant’s parent or legal guardian, stating that the 21 immunization conflicts with the tenets and practices of a 22 recognized religious denomination of which the applicant is 23 an adherent or member sincerely held religious beliefs of the 24 applicant, or if the applicant is a minor, of the applicant’s 25 parent or legal guardian . 26 (3) The applicant, or if the applicant is a minor, the 27 applicant’s parent or legal guardian, submits an affidavit 28 signed by the applicant, or if the applicant is a minor, signed 29 by the applicant’s parent or legal guardian, stating that the 30 immunization conflicts with the conscientiously held beliefs 31 of the applicant, or if the applicant is a minor, of the 32 applicant’s parent or legal guardian. 33 b. The exemptions under this subsection do not also apply in 34 times of emergency or epidemic as determined by the state board 35 -5- LSB 1343XS (13) 89 pf/rh 5/ 14
S.F. 193 of health and as declared by the director of public health. 1 DIVISION IV 2 PROHIBITING DISCRIMINATION AND RIGHT-OF-ACCESS RESTRICTIONS 3 BASED ON VACCINE STATUS OR PROOF OF IMMUNITY 4 Sec. 9. Section 216.2, subsection 15, Code 2021, is amended 5 to read as follows: 6 15. “Unfair practice” or “discriminatory practice” means 7 those practices specified as unfair or discriminatory in 8 sections 216.6 , 216.6A , 216.7 , 216.7A, 216.8 , 216.8A , 216.8B , 9 216.9 , 216.10 , 216.11 , and 216.11A . 10 Sec. 10. NEW SECTION . 216.7A Unfair practices —— public 11 accommodations —— vaccination status. 12 It shall be an unfair or discriminatory practice for 13 any owner, lessee, sublessee, proprietor, manager, or 14 superintendent of any public accommodation or any agent or 15 employee thereof to do any of the following on the basis of a 16 person’s vaccination or immunity status: 17 1. Provide any disposition, service, financial aid, or 18 benefit to the person which is different, or is provided in a 19 different manner, from that provided to other members of the 20 general public. 21 2. Subject the person to segregation or separate treatment 22 in any matter related to that person’s receipt of any 23 disposition, service, financial aid, or benefit provided to 24 other members of the general public. 25 3. Restrict the person in any way in the enjoyment of any 26 advantage or privilege enjoyed by other persons receiving any 27 disposition, service, financial aid, or benefit provided to 28 other members of the general public. 29 4. Treat the person differently from other persons in 30 determining whether that person satisfies any admission, 31 enrollment, quota, eligibility, membership, or other 32 requirement or condition which a person must meet in order to 33 be provided any disposition, service, financial aid, function, 34 or benefit available to other members of the general public. 35 -6- LSB 1343XS (13) 89 pf/rh 6/ 14
S.F. 193 5. Deny the person an opportunity to participate in a 1 program through the provision of service or otherwise afford 2 that person an opportunity to do so which is different from 3 that afforded to other members of the general public. 4 DIVISION V 5 PROHIBITING THE CONNECTION OF VACCINATION OR IMMUNITY STATUS TO 6 A STATE-ISSUED DRIVER’S LICENSE 7 Sec. 11. Section 321.189, subsection 2, Code 2021, is 8 amended by adding the following new paragraph: 9 NEW PARAGRAPH . e. A driver’s license shall not include the 10 vaccination or immunization status, immunity status, or test 11 results relating to a communicable disease of the holder of any 12 class of driver’s license. 13 Sec. 12. Section 321.190, subsection 1, paragraph a, Code 14 2021, is amended to read as follows: 15 a. The department shall, upon application and payment 16 of the required fee, issue to an applicant a nonoperator’s 17 identification card. To be valid the card shall bear a 18 distinguishing number other than a social security number 19 assigned to the cardholder, the full name, date of birth, 20 sex, residence address, a physical description and a color 21 photograph of the cardholder, the usual signature of the 22 cardholder, and such other information as the department 23 may require by rule. An applicant for a nonoperator’s 24 identification card shall apply for the card in the manner 25 provided in section 321.182, subsections 1 through 3 . The card 26 shall be issued to the applicant at the time of application 27 pursuant to procedures established by rule. An applicant for a 28 nonoperator’s identification card who is required by 50 U.S.C. 29 app. §451 et seq. to register with the United States selective 30 service system shall be registered by the department with the 31 selective service system as provided in section 321.183 . An 32 applicant for a nonoperator’s identification card shall not 33 be required to receive the SARS-CoV-2 vaccine in order to be 34 issued a card and the card shall not include the vaccination or 35 -7- LSB 1343XS (13) 89 pf/rh 7/ 14
S.F. 193 immunization status, immunity status, or test results relating 1 to a communicable disease of the holder of the card. 2 DIVISION VI 3 STATEWIDE IMMUNIZATION REGISTRY AND IOWA HEALTH INFORMATION 4 NETWORK —— INFORMED CONSENT 5 Sec. 13. NEW SECTION . 139A.8B Statewide immunization 6 registry and Iowa health information network —— informed consent. 7 The department shall require that a health care provider 8 who administers vaccines and immunizations and is required to 9 consult and review or report the administration of vaccines 10 or immunizations to the statewide immunization registry or 11 Iowa health information network obtain written, informed 12 consent from a patient, or if the patient is a minor, the 13 patient’s parent or legal guardian, prior to reporting the 14 administration of the vaccine or immunization to the statewide 15 immunization registry or Iowa health information network. 16 The written, informed consent shall also provide the patient 17 with the option of consenting to the sharing of the patient’s 18 information with any entity with access to the information 19 contained in the statewide immunization registry or Iowa 20 health information network. The health care provider shall 21 submit a copy of the completed written, informed consent 22 form to the statewide immunization registry or Iowa health 23 information network. A patient, or if the patient is a minor, 24 the patient’s parent or legal guardian, may withdraw or amend 25 the written, informed consent at any time. If informed consent 26 is subsequently withdrawn, the patient’s information shall be 27 deleted from the statewide immunization registry or Iowa health 28 information network database. Only the information regarding 29 the administration of vaccines or immunizations of a patient 30 from whom written, informed consent has been obtained shall be 31 reported to and included in the statewide immunization registry 32 or Iowa health information network. No information, report, or 33 record relating to a person from whom written, informed consent 34 has not been obtained shall be maintained by the department or 35 -8- LSB 1343XS (13) 89 pf/rh 8/ 14
S.F. 193 included in the statewide immunization registry or Iowa health 1 information network. 2 EXPLANATION 3 The inclusion of this explanation does not constitute agreement with 4 the explanation’s substance by the members of the general assembly. 5 This bill relates to vaccinations and immunizations. The 6 bill is drafted in divisions. 7 DIVISION I. Division I of the bill relates to prohibitions 8 against vaccine mandates by employers. Division I prohibits an 9 employer from failing or refusing to hire, discharge, penalize, 10 or otherwise discriminate against an employee with respect 11 to compensation or the terms, conditions, or privileges of 12 employment based on the employee’s vaccination history or the 13 refusal of the employee to receive a vaccine or provide proof 14 of immunity. An employee whose rights are violated under the 15 division of the bill may bring an action against an employer 16 in the district court in the county where the employer is 17 located for injunctive relief, actual damages, admission or 18 reinstatement of the employee with back pay plus 10 percent 19 interest, or any other appropriate relief necessary to ensure 20 compliance with the division of the bill. 21 DIVISION II. Division II of the bill relates to vaccination 22 safety and the right of refusal. Division II provides 23 definitions used in the Code chapter. Division II of the bill 24 prohibits a hospital or health care facility from requiring a 25 health care provider, staff member, employee, or applicant for 26 one of these positions to be immunized or from discriminating 27 against or terminating the employment of a health care 28 provider, staff member, employee, or applicant for one of 29 these positions, based on the person’s refusal to receive an 30 immunization. The division prohibits a hospital, health care 31 facility, or a health care provider, staff member, or employee 32 of a hospital or health care facility from discriminating 33 against or terminating treatment of a patient based upon the 34 patient’s refusal to receive an immunization, and a health 35 -9- LSB 1343XS (13) 89 pf/rh 9/ 14
S.F. 193 care facility or assisted living program is also prohibited 1 from discriminating against or terminating treatment of a 2 resident or tenant due to the resident or tenant failing or 3 refusing to receive an immunization for a specific communicable 4 disease. Under this division of the bill, a hospital, health 5 care facility, or educational institution providing clinical 6 experience to satisfy the professional degree requirements of a 7 student, intern, or resident is prohibited from discriminating 8 against the student, intern, or resident, or prohibiting 9 admission, enrollment, or employment as a student, intern, 10 or resident based on the immunization status of the student, 11 intern, or resident. A person aggrieved under this portion of 12 the bill may petition the district court in the county where 13 the hospital, health care facility, assisted living program, 14 or educational institution is located for injunctive relief; 15 affirmative relief, including reinstatement of employment with 16 back pay and interest or any other equitable relief the court 17 deems appropriate; or other appropriate relief necessary to 18 ensure compliance with this division of the bill. A hospital, 19 health care facility, health care provider, educational 20 institution, or assisted living program that violates this 21 portion of the bill is ineligible to receive state funding for 22 reimbursement of services. 23 Division II of the bill also prohibits a health care provider 24 licensing authority from denying an applicant for a license 25 or suspending, revoking, or refusing to renew a license, or 26 from taking disciplinary action against a licensee based on an 27 applicant’s or licensee’s immunization history or refusal to 28 submit to an immunization. 29 Division II of the bill prohibits an insurer providing a 30 group policy, contract, or plan for health insurance from 31 using the immunization status of a person as a basis to 32 reject; deny; limit; cancel; refuse to renew; increase the 33 premiums for; limit the amount, extent, or kind of coverage 34 available to; or otherwise adversely affect eligibility or 35 -10- LSB 1343XS (13) 89 pf/rh 10/ 14
S.F. 193 coverage for the group health policy, contract, or plan for 1 health insurance. Division II also prohibits an insurer 2 providing a group policy, contract, or plan for health 3 insurance from using the immunization status of a person 4 as a qualification or requirement for contracting with the 5 person’s provider or as a basis for terminating a contract 6 with the person’s provider. Division II of the bill prohibits 7 an insurer providing a group policy, contract, or plan for 8 health insurance from providing financial or other incentives 9 to a participating provider based upon attaining a certain 10 immunization administration rate or from imposing financial or 11 other penalties on a participating provider who does not attain 12 a certain immunization administration rate. Division II of the 13 bill prohibits the immunization status of a person covered by a 14 group policy, contract, or plan for health insurance from being 15 used as a factor in the rating of a group policy, contract, or 16 plan for health insurance in Iowa. An insurer issuing a group 17 policy, contract, or plan for health insurance who violates 18 any of these provisions of the bill is subject to the summary 19 cease and desist order, cease and desist order, and penalty 20 provisions pursuant to Code chapter 507B (insurance trade 21 practices). 22 DIVISION III. Division III of the bill relates to exemptions 23 from immunizations and vaccinations. 24 Division III includes as a new exemption from immunizations 25 otherwise required for a person’s enrollment in any elementary 26 or secondary school or licensed child care center, an exemption 27 based on the submission of a signed affidavit by the applicant, 28 or if the applicant is a minor, by the applicant’s parent 29 or legal guardian, stating that the immunization conflicts 30 with the conscientiously held beliefs of the applicant, or if 31 the applicant is a minor, of the applicant’s parent or legal 32 guardian. Existing provisions direct the department of public 33 health, in consultation with the director of the department of 34 education, to adopt rules to implement this provision. 35 -11- LSB 1343XS (13) 89 pf/rh 11/ 14
S.F. 193 This division of the bill also amends the current provision 1 relating to an exemption based on religious beliefs of the 2 applicant, or if the applicant is a minor, the applicant’s 3 parent or legal guardian. 4 DIVISION IV. Division IV of the bill relates to unfair 5 or discriminatory practices based on a person’s vaccine 6 status. Division IV amends Code chapter 216 (civil rights 7 commission) to provide that it is an unfair or discriminatory 8 practice for any owner, lessee, sublessee, proprietor, 9 manager, or superintendent of any public accommodation or 10 any agent or employee thereof to do certain things based 11 on the basis of a person’s vaccination or immunity status. 12 These unfair or discriminatory practices include: providing 13 any disposition, service, financial aid, or benefit to the 14 person which is different, or is provided in a different 15 manner, from that provided to other members of the general 16 public; subjecting the person to segregation or separate 17 treatment in any matter related to that person’s receipt of 18 any disposition, service, financial aid, or benefit provided 19 to other members of the general public; restricting the person 20 in any way in the enjoyment of any advantage or privilege 21 enjoyed by other persons receiving any disposition, service, 22 financial aid, or benefit provided to other members of the 23 general public; treating the person differently from other 24 persons in determining whether that person satisfies any 25 admission, enrollment, quota, eligibility, membership, or other 26 requirement or condition which a person must meet in order to 27 be provided any disposition, service, financial aid, function, 28 or benefit available to other members of the general public; 29 and denying the person an opportunity to participate in a 30 program through the provision of service or otherwise afford 31 that person an opportunity to do so which is different from 32 that afforded to other members of the general public. The 33 delineation of the actions under this division of the bill 34 as unfair or discriminatory practices provides a basis under 35 -12- LSB 1343XS (13) 89 pf/rh 12/ 14
S.F. 193 Code chapter 216 for a person claiming to be aggrieved by the 1 actions to file a complaint with the civil rights commission 2 and to seek relief, judicial review, and enforcement. 3 DIVISION V. Division V of the bill relates to prohibiting 4 the connection of a person’s vaccination or immunity status 5 to a state-issued driver’s license or state identification. 6 Division V prohibits a driver’s license or a nonoperator’s 7 identification card from including the vaccination or 8 immunization status, immunity status, or test results relating 9 to a communicable disease of the holder of any class of 10 driver’s license or a nonoperator’s identification card. 11 DIVISION VI. Division VI of the bill relates to the 12 statewide immunization registry and the Iowa health information 13 network (IHIN) and informed consent. Division VI requires 14 the department of public health to require that a health care 15 provider who administers vaccines and immunizations and is 16 required to consult and review or report the administration 17 of vaccines or immunizations to the statewide immunization 18 registry or IHIN obtain written, informed consent from a 19 patient, or if the patient is a minor, the patient’s parent or 20 legal guardian, prior to reporting the administration of the 21 vaccine or immunization to the statewide immunization registry 22 or IHIN. The written, informed consent shall also provide 23 the patient with the option of consenting to the sharing of 24 the patient’s information with any entity with access to the 25 information contained in the statewide immunization registry 26 or IHIN. The health care provider shall submit a copy of the 27 completed written, informed consent form to the statewide 28 immunization registry or IHIN. A patient, or if the patient is 29 a minor, the patient’s parent or legal guardian, may withdraw 30 or amend the informed consent at any time. If informed consent 31 is subsequently withdrawn, the patient’s information shall be 32 deleted from the statewide immunization registry or IHIN. 33 Additionally, only the information regarding the 34 administration of vaccines or immunizations of a patient from 35 -13- LSB 1343XS (13) 89 pf/rh 13/ 14
S.F. 193 whom written, informed consent has been obtained shall be 1 reported to and included in the statewide immunization registry 2 or IHIN. No other information, report, or record relating 3 to a person from whom written, informed consent has not been 4 obtained shall be maintained by the department or included in 5 the statewide immunization registry or IHIN. 6 -14- LSB 1343XS (13) 89 pf/rh 14/ 14
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