Bill Text: TX HB1105 | 2023-2024 | 88th Legislature | Comm Sub
Bill Title: Relating to preventative health care and public health, including prohibited immunization and face-covering requirements, private business or school closures, and the ordering and administration of immunizations by a pharmacist.
Spectrum: Bipartisan Bill
Status: (Engrossed - Dead) 2023-05-26 - House appoints conferees-reported [HB1105 Detail]
Download: Texas-2023-HB1105-Comm_Sub.html
By: Price, et al. (Senate Sponsor - Kolkhorst) | H.B. No. 1105 | |
(In the Senate - Received from the House May 8, 2023; | ||
May 11, 2023, read first time and referred to Committee on Health & | ||
Human Services; May 21, 2023, reported adversely, with favorable | ||
Committee Substitute by the following vote: Yeas 7, Nays 2; | ||
May 21, 2023, sent to printer.) | ||
COMMITTEE SUBSTITUTE FOR H.B. No. 1105 | By: Kolkhorst |
|
||
|
||
relating to preventative health care and public health, including | ||
prohibited immunization and face-covering requirements, private | ||
business or school closures, and the ordering and administration of | ||
immunizations by a pharmacist. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Section 38.001, Education Code, is amended by | ||
amending Subsections (a) and (b-1) and adding Subsection (b-2) to | ||
read as follows: | ||
(a) Except as provided by Subsection (c), each [ |
||
student shall be fully immunized against the diseases listed in | ||
Section 161.004, Health and Safety Code [ |
||
(b-1) Each year, the Department of State Health Services | ||
shall prepare a list of the immunizations required [ |
||
The department shall prepare the list in English and Spanish and | ||
make the list available in a manner that permits a school district | ||
to easily post the list on the district's Internet website as | ||
required by Section 38.019. | ||
(b-2) An elementary or secondary school may not require a | ||
student, as a condition of the student's admission to or continued | ||
enrollment in the school, to be vaccinated against the 2019 novel | ||
coronavirus disease (COVID-19). | ||
SECTION 2. Section 38.019(a), Education Code, is amended to | ||
read as follows: | ||
(a) A school district that maintains an Internet website | ||
shall post prominently on the website: | ||
(1) a list, in English and Spanish, of: | ||
(A) the immunizations required for admission to | ||
public school in accordance with [ |
||
(B) [ |
||
[ |
||
the influenza vaccine, to the extent those clinics are known to the | ||
district; and | ||
(2) a link to the page on the Department of State | ||
Health Services Internet website that provides [ |
||
exemption from the immunization requirements of Section 38.001. | ||
SECTION 3. Subchapter Z, Chapter 51, Education Code, is | ||
amended by adding Section 51.91921 to read as follows: | ||
Sec. 51.91921. PROHIBITION ON PRIVATE OR INDEPENDENT | ||
INSTITUTIONS OF HIGHER EDUCATION MANDATING COVID-19 VACCINATION | ||
FOR STUDENTS. (a) In this section: | ||
(1) "COVID-19" means the 2019 novel coronavirus | ||
disease, including any variant. | ||
(2) "Private or independent institution of higher | ||
education" has the meaning assigned by Section 61.003. | ||
(b) A private or independent institution of higher | ||
education may not require a student, as a condition of the student's | ||
admission to or continued enrollment in the institution, to be | ||
vaccinated against COVID-19. | ||
SECTION 4. Section 51.933, Education Code, is amended by | ||
amending Subsections (b) and (b-1) and adding Subsection (b-2) to | ||
read as follows: | ||
(b) The executive commissioner of the Health and Human | ||
Services Commission may require a student at an institution of | ||
higher education who is pursuing a course of study in a human or | ||
animal health profession to be immunized [ |
||
the diseases listed in Subsection (a) and against hepatitis B, | ||
measles, rabies, and varicella, as applicable. The [ |
||
immunizations for any students in times of an emergency or epidemic | ||
in a county where the commissioner of state health services has | ||
declared such an emergency or epidemic. | ||
(b-1) A requirement [ |
||
[ |
||
[ |
||
course of study that involves potential exposure to human or animal | ||
blood or bodily fluids. | ||
(b-2) An institution of higher education may not require a | ||
student, as a condition of the student's admission to or continued | ||
enrollment in the institution, to be vaccinated against COVID-19 as | ||
defined by Section 51.91921. | ||
SECTION 5. Sections 81.023(a) and (c), Health and Safety | ||
Code, are amended to read as follows: | ||
(a) The executive commissioner may recommend to the | ||
legislature immunizations to include on the list of immunizations | ||
required [ |
||
children under Section 161.004. | ||
(c) The department shall cooperate with the State Board of | ||
Education in [ |
||
requirements for students admitted to public or private primary or | ||
secondary schools. | ||
SECTION 6. Subtitle D, Title 2, Health and Safety Code, is | ||
amended by adding Chapter 81B to read as follows: | ||
CHAPTER 81B. PROHIBITED CORONAVIRUS PREVENTATIVE MEASURES | ||
Sec. 81B.001. DEFINITIONS. In this chapter: | ||
(1) "COVID-19" means the 2019 novel coronavirus | ||
disease and any variants of the disease. | ||
(2) "Governmental entity" means this state, a local | ||
government entity as defined by Section 418.004, Government Code, | ||
or an agency of this state or a local government entity. | ||
Sec. 81B.002. PROHIBITED FACE-COVERING MANDATE. | ||
Notwithstanding any other law, including Chapter 81 of this code | ||
and Chapter 418, Government Code, a governmental entity may not | ||
implement, order, or otherwise impose a mandate requiring a person | ||
to wear a face mask or other face covering to prevent the spread of | ||
COVID-19. | ||
Sec. 81B.003. PROHIBITED VACCINE MANDATE. Notwithstanding | ||
any other law, including Chapter 81 of this code and Chapter 418, | ||
Government Code, a governmental entity may not implement, order, or | ||
otherwise impose a mandate requiring a person to be vaccinated | ||
against COVID-19. | ||
Sec. 81B.004. PROHIBITED CLOSURE MANDATE FOR PRIVATE | ||
BUSINESSES AND SCHOOLS. Notwithstanding any other law, including | ||
Chapter 81 of this code and Chapter 418, Government Code, a | ||
governmental entity may not implement, order, or otherwise impose a | ||
mandate requiring the closure of a private business, public school, | ||
open-enrollment charter school, or private school to prevent the | ||
spread of COVID-19. | ||
SECTION 7. Section 161.004(a), Health and Safety Code, is | ||
amended to read as follows: | ||
(a) Every child in the state shall be immunized against | ||
diphtheria, hepatitis A, hepatitis B, measles, meningococcal | ||
disease, mumps, pertussis, polio, rubella, tetanus, and varicella | ||
[ |
||
accordance with the [ |
||
in department rules. The executive commissioner may not require | ||
immunizations against any additional diseases for students | ||
admitted to a public or private primary or secondary school. | ||
SECTION 8. Subtitle H, Title 2, Health and Safety Code, is | ||
amended by adding Chapter 174 to read as follows: | ||
CHAPTER 174. PATIENT RIGHTS | ||
Sec. 174.001. DEFINITIONS. In this chapter: | ||
(1) "COVID-19" has the meaning assigned by Section | ||
81B.001. | ||
(2) "Health care facility" means a hospital, | ||
freestanding emergency medical care facility, urgent care or retail | ||
clinic, outpatient clinic, birthing center, ambulatory surgical | ||
center, or other facility that is licensed to provide health care | ||
services in this state. | ||
Sec. 174.002. PROHIBITED DISCRIMINATION BASED ON COVID-19 | ||
VACCINATION STATUS. (a) Except as provided by Subsection (b), a | ||
health care facility may not refuse to provide health care services | ||
to an individual based on the individual's vaccination status or | ||
post-transmission recovery of COVID-19. | ||
(b) The prohibition under Subsection (a) does not apply to a | ||
hospital that requires a COVID-19 vaccination in relation to | ||
oncology or transplant care. | ||
Sec. 174.003. MEDICAID REIMBURSEMENT PROHIBITED. (a) The | ||
commission: | ||
(1) may not provide Medicaid reimbursement to a health | ||
care facility that violates this chapter; and | ||
(2) shall disenroll the facility from participation as | ||
a Medicaid provider. | ||
(b) The executive commissioner may adopt rules as necessary | ||
to implement this section. | ||
SECTION 9. Chapter 21, Labor Code, is amended by adding | ||
Subchapter H-1 to read as follows: | ||
SUBCHAPTER H-1. DISCRIMINATION BASED ON COVID-19 VACCINATION | ||
STATUS | ||
Sec. 21.421. DEFINITION. In this subchapter, "COVID-19" | ||
has the meaning assigned by Section 81B.001, Health and Safety | ||
Code. | ||
Sec. 21.422. PROHIBITED DISCRIMINATION BASED ON COVID-19 | ||
VACCINATION STATUS. (a) Except as provided by Subsection (d), an | ||
employer commits an unlawful employment practice if the employer | ||
fails or refuses to hire, discharges, or otherwise discriminates | ||
against an individual with respect to the compensation or the | ||
terms, conditions, or privileges of employment because the | ||
individual has not been vaccinated against COVID-19. | ||
(b) A labor organization commits an unlawful employment | ||
practice if the labor organization excludes or expels from | ||
membership or otherwise discriminates against an individual | ||
because the individual has not been vaccinated against COVID-19. | ||
(c) An employment agency commits an unlawful employment | ||
practice if the employment agency classifies or refers for | ||
employment, fails or refuses to refer for employment, or otherwise | ||
discriminates against an individual because the individual has not | ||
been vaccinated against COVID-19. | ||
(d) This section does not apply to: | ||
(1) a health care facility, as defined by Section | ||
224.001, Health and Safety Code, that: | ||
(A) implements a policy or procedure to exempt | ||
from a required vaccination an individual described by this section | ||
who has a medical condition identified as a contraindication or | ||
precaution to the vaccination by the Centers for Disease Control | ||
and Prevention; | ||
(B) establishes procedures that an exempt | ||
individual is required to follow to protect facility patients from | ||
exposure to disease, including the use of gloves, face masks, or | ||
other protective medical equipment, based on the level of risk the | ||
individual presents to patients by the individual's routine and | ||
direct exposure to patients; and | ||
(C) prohibits discrimination or retaliatory | ||
action against an exempt individual, except that the required use | ||
of protective medical equipment under Paragraph (B) is not | ||
considered a retaliatory action for purposes of this paragraph; or | ||
(2) a private employer that: | ||
(A) implements a policy or procedure to exempt | ||
from a required vaccination an individual described by this section | ||
based on reasons of conscience or because the individual has a | ||
medical condition identified as a contraindication or precaution to | ||
the vaccination by the Centers for Disease Control and Prevention; | ||
(B) establishes procedures that an exempt | ||
individual is required to follow to protect employees and other | ||
individuals from exposure to disease, including the use of gloves, | ||
face masks, or other protective medical equipment, based on the | ||
level of risk the individual presents to employees and other | ||
individuals by the individual's routine and direct exposure to | ||
employees and other individuals; and | ||
(C) prohibits discrimination or retaliatory | ||
action against an exempt individual, except that the required use | ||
of protective medical equipment under Paragraph (B) is not | ||
considered a retaliatory action for purposes of this paragraph. | ||
SECTION 10. Section 551.003(33), Occupations Code, is | ||
amended to read as follows: | ||
(33) "Practice of pharmacy" means: | ||
(A) providing an act or service necessary to | ||
provide pharmaceutical care; | ||
(B) interpreting or evaluating a prescription | ||
drug order or medication order; | ||
(C) participating in drug or device selection as | ||
authorized by law, and participating in drug administration, drug | ||
regimen review, or drug or drug-related research; | ||
(D) providing patient counseling; | ||
(E) being responsible for: | ||
(i) dispensing a prescription drug order or | ||
distributing a medication order; | ||
(ii) compounding or labeling a drug or | ||
device, other than labeling by a manufacturer, repackager, or | ||
distributor of a nonprescription drug or commercially packaged | ||
prescription drug or device; | ||
(iii) properly and safely storing a drug or | ||
device; or | ||
(iv) maintaining proper records for a drug | ||
or device; | ||
(F) performing for a patient a specific act of | ||
drug therapy management delegated to a pharmacist by a written | ||
protocol from a physician licensed in this state in compliance with | ||
Subtitle B; [ |
||
(G) subject to Section 554.052(c-1), ordering or | ||
administering an immunization or vaccination to a patient who is at | ||
least three years of age; or | ||
(H) if the patient is younger than three years of | ||
age and is referred to a pharmacist by a physician, administering an | ||
immunization or vaccination to a patient under a physician's | ||
written protocol. | ||
SECTION 11. The heading to Section 554.004, Occupations | ||
Code, is amended to read as follows: | ||
Sec. 554.004. ADMINISTRATION OF MEDICATION; ORDERING AND | ||
ADMINISTRATION OF IMMUNIZATION OR VACCINATION. | ||
SECTION 12. Section 554.004(a), Occupations Code, is | ||
amended to read as follows: | ||
(a) The board shall specify conditions under which a | ||
pharmacist may administer medication and order or administer [ |
||
for ordering or administering an immunization or vaccination must | ||
ensure that: | ||
(1) [ |
||
[ |
||
[ |
||
education, and certification as specified by the board to order or | ||
administer the immunization or vaccination [ |
||
(2) [ |
||
administering an immunization or vaccination that is prescribed by | ||
a licensed health care provider [ |
||
notifies the licensed health care provider responsible for the | ||
patient's care that the immunization or vaccination [ |
||
was administered; | ||
[ |
||
[ |
||
(3) [ |
||
an immunization or vaccination [ |
||
to a certified pharmacy technician. | ||
SECTION 13. Sections 554.052(a), (b), (c), and (c-1), | ||
Occupations Code, are amended to read as follows: | ||
(a) The board by rule shall require a pharmacist to notify a | ||
physician who prescribes an immunization or vaccination not later | ||
than the 14th day [ |
||
administers the immunization or vaccination. | ||
(b) The board shall establish minimum education and | ||
continuing education standards for a pharmacist who orders or | ||
administers an immunization or vaccination. The standards must | ||
include federal Centers for Disease Control and Prevention | ||
training, basic life support training, and hands-on training in | ||
techniques for administering immunizations and vaccinations. | ||
(c) Supervision by a physician is adequate if the delegating | ||
physician: | ||
(1) is responsible for formulating or approving an | ||
order or protocol, including the physician's order, standing | ||
medical order, or standing delegation order, and periodically | ||
reviews the order or protocol and the services provided to a patient | ||
under the order or protocol; | ||
(2) [ |
||
established a physician-patient relationship with each patient who | ||
is younger than three [ |
||
patient to the pharmacist; | ||
(3) is geographically located to be easily accessible | ||
to the pharmacy where an immunization or vaccination is | ||
administered; | ||
(4) receives, as appropriate, a periodic status report | ||
on the patient, including any problem or complication encountered; | ||
and | ||
(5) is available through direct telecommunication for | ||
consultation, assistance, and direction. | ||
(c-1) A pharmacist may order or administer an immunization | ||
or [ |
||
relationship if the immunization or vaccination is: | ||
(1) authorized or approved by the United States Food | ||
and Drug Administration or listed in the routine immunization | ||
schedule recommended by the federal Advisory Committee on | ||
Immunization Practices published by the federal Centers for Disease | ||
Control and Prevention; and | ||
(2) ordered or administered in accordance with the | ||
federal Advisory Committee on Immunization Practices | ||
vaccine-specific recommendations. | ||
SECTION 14. Section 38.001(b), Education Code, as amended | ||
by Chapters 43 (H.B. 1098) and 94 (H.B. 1059), Acts of the 80th | ||
Legislature, Regular Session, 2007, is repealed. | ||
SECTION 15. (a) The changes in law made by this Act to | ||
Title 2, Education Code, apply beginning with the 2023-2024 school | ||
year. | ||
(b) The changes in law made by this Act to Title 3, Education | ||
Code, apply beginning with the 2023-2024 academic year. | ||
SECTION 16. Subchapter H-1, Chapter 21, Labor Code, as | ||
added by this Act, applies only to an unlawful employment practice | ||
that occurs on or after the effective date of this Act. | ||
SECTION 17. If before implementing any provision of this | ||
Act a state agency determines that a waiver or authorization from a | ||
federal agency is necessary for implementation of that provision, | ||
the agency affected by the provision shall request the waiver or | ||
authorization and may delay implementing that provision until the | ||
waiver or authorization is granted. | ||
SECTION 18. 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, 2023. | ||
* * * * * |