Bill Text: TX SB1669 | 2021-2022 | 87th Legislature | Introduced


Bill Title: Relating to prohibited discrimination regarding vaccination status and mandates for receiving or participating in the administration of vaccines; authorizing administrative penalties.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Introduced) 2021-05-06 - Left pending in committee [SB1669 Detail]

Download: Texas-2021-SB1669-Introduced.html
  87R9468 SCL-F
 
  By: Hall S.B. No. 1669
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to prohibited discrimination regarding vaccination status
  and mandates for receiving or participating in the administration
  of vaccines; authorizing administrative penalties.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
  ARTICLE 1. VACCINATION STATUS DISCRIMINATION PROHIBITED
         SECTION 1.01.  Subtitle C, Title 5, Business & Commerce
  Code, is amended by adding Chapter 113 to read as follows:
  CHAPTER 113. PROHIBITED DISCRIMINATION BASED ON 
  VACCINATION STATUS
         Sec. 113.001.  DEFINITION. In this chapter, "public
  accommodation" means a disposition, service, financial aid, or
  benefit provided to members of the public.
         Sec. 113.002.  DISCRIMINATION PROHIBITED. A person may not
  discriminate against or refuse to provide a public accommodation to
  an individual based on the individual's vaccination history or
  immunity status for a communicable disease by:
               (1)  providing to the individual a public accommodation
  that is different or provided in a different manner than the
  accommodation provided or manner of providing the accommodation to
  other members of the public;
               (2)  subjecting the individual to segregation or
  separate treatment in any matter related to providing the public
  accommodation to the individual;
               (3)  restricting in any way the individual's enjoyment
  of a public accommodation in a manner that distinguishes the
  individual's enjoyment from the enjoyment of other members of the
  public;
               (4)  treating the individual differently from other
  members of the public in determining whether the individual
  satisfies any admission, enrollment, quota, eligibility,
  membership, or other requirement or condition that individuals must
  satisfy before a public accommodation is provided; or
               (5)  denying the individual an opportunity to
  participate in a program in a manner that differs from the manner
  the opportunity is provided to other members of the public.
         Sec. 113.003.  COMPLAINT; EQUITABLE RELIEF. (a) A person may
  file a complaint with the attorney general if the person asserts
  facts supporting an allegation that another person has violated
  Section 113.002. The person filing the complaint must include a
  sworn affidavit stating that to the person's knowledge, all of the
  facts asserted in the complaint are true and correct.
         (b)  If the attorney general determines that a complaint
  filed under Subsection (a) is valid, the attorney general may file a
  petition for a writ of mandamus or apply for other appropriate
  equitable relief in a district court in Travis County or in a county
  in which the person against whom relief is sought resides to compel
  the person to comply with Section 113.002.
         Sec. 113.004.  EFFECT ON OTHER LAW. This chapter prevails to
  the extent of a conflict between this chapter and any other law.
         SECTION 1.02.  Subchapter A, Chapter 161, Health and Safety
  Code, is amended by adding Sections 161.0057 and 161.0085 to read as
  follows:
         Sec. 161.0057.  LONG-TERM CARE FACILITY IMMUNIZATION
  DISCRIMINATION PROHIBITED. (a) In this section, "long-term care
  facility" means a facility licensed or regulated under Chapter 242,
  247, or 252.
         (b)  A long-term care facility may not refuse to provide
  services to a resident based on the resident's immunization record
  or immunity status for a communicable disease.
         (c)  A long-term care facility that violates this section is
  ineligible to receive state money for services provided to
  residents.
         (d)  A violation of this section is a violation of the
  long-term care facility's applicable licensing law and subjects the
  facility to disciplinary action and the imposition of
  administrative penalties under that law.
         (e)  This section prevails to the extent of a conflict
  between this section and any other law.
         Sec. 161.0085.  IMMUNIZATION RECORD DISCRIMINATION
  PROHIBITED. (a) A health care provider or health care facility may
  not refuse to provide a health care service to a patient because a
  patient is unvaccinated or not immune to a communicable disease.
         (b)  A health care facility providing clinical experience to
  satisfy a student's degree requirements may not discriminate
  against a student or prohibit admission, enrollment, or employment
  as a student, intern, or resident because of the student's
  immunization record or immunity status for a communicable disease.
         (c)  Notwithstanding any other law, a health care provider or
  health care facility that violates this section is ineligible to
  receive state money for health care services provided to patients.
         (d)  A violation of this section is a violation of the health
  care provider's or health care facility's applicable licensing law
  and subjects the facility or provider to disciplinary action and
  the imposition of administrative penalties under that law.
         (e)  This section prevails to the extent of a conflict
  between this section and any other law.
         SECTION 1.03.  Chapter 544, Insurance Code, is amended by
  adding Subchapter M to read as follows:
  SUBCHAPTER M. VACCINATION STATUS
         Sec. 544.601.  DEFINITIONS. In this subchapter:
               (1)  "Health benefit plan issuer" means an issuer,
  administrator, or sponsor of a health benefit plan described by
  Section 544.602.
               (2)  "Participating provider" means a health care
  provider who has contracted with a health benefit plan issuer to
  provide services to enrollees.
         Sec. 544.602.  APPLICABILITY OF SUBCHAPTER. (a) This
  subchapter applies only to a health benefit plan that provides
  benefits for medical or surgical expenses incurred as a result of a
  health condition, accident, or sickness, including a group,
  blanket, or franchise insurance policy or insurance agreement, a
  group hospital service contract, or a group evidence of coverage or
  similar coverage document that is offered by:
               (1)  an insurance company;
               (2)  a group hospital service corporation operating
  under Chapter 842;
               (3)  a health maintenance organization operating under
  Chapter 843;
               (4)  an approved nonprofit health corporation that
  holds a certificate of authority under Chapter 844;
               (5)  a multiple employer welfare arrangement that holds
  a certificate of authority under Chapter 846;
               (6)  a stipulated premium company operating under
  Chapter 884;
               (7)  a fraternal benefit society operating under
  Chapter 885;
               (8)  a Lloyd's plan operating under Chapter 941; or
               (9)  an exchange operating under Chapter 942.
         (b)  Notwithstanding any other law, this subchapter applies
  to:
               (1)  a small employer health benefit plan subject to
  Chapter 1501, including coverage provided through a health group
  cooperative under Subchapter B of that chapter;
               (2)  a standard health benefit plan issued under
  Chapter 1507;
               (3)  a basic coverage plan under Chapter 1551;
               (4)  a basic plan under Chapter 1575;
               (5)  a primary care coverage plan under Chapter 1579;
               (6)  a plan providing basic coverage under Chapter
  1601;
               (7)  health benefits provided by or through a church
  benefits board under Subchapter I, Chapter 22, Business
  Organizations Code;
               (8)  the state Medicaid program, including the Medicaid
  managed care program operated under Chapter 533, Government Code;
               (9)  the child health plan program under Chapter 62,
  Health and Safety Code;
               (10)  a regional or local health care program operated
  under Section 75.104, Health and Safety Code;
               (11)  a self-funded health benefit plan sponsored by a
  professional employer organization under Chapter 91, Labor Code;
               (12)  county employee group health benefits provided
  under Chapter 157, Local Government Code; and
               (13)  health and accident coverage provided by a risk
  pool created under Chapter 172, Local Government Code.
         (c)  This subchapter applies to a life insurance company
  that:
               (1)  issues or delivers a life insurance policy in this
  state; or
               (2)  is organized under the laws of this state.
         Sec. 544.603.  PROHIBITED DISCRIMINATION AGAINST
  INDIVIDUAL. A group health benefit plan issuer or a life insurance
  company may not use an individual's vaccination history or immunity
  status for a communicable disease to:
               (1)  reject, deny, limit, cancel, refuse to renew, or
  increase the premiums for coverage of the individual under a plan
  offered by the issuer or company;
               (2)  limit the amount, extent, or kind of coverage
  available to the individual; or 
               (3)  otherwise adversely affect the individual's
  eligibility for coverage.
         Sec. 544.604.  PROHIBITED DISCRIMINATION IN GROUP PLAN
  RATING. The vaccination history or immunity status for a
  communicable disease of individuals covered under a group health
  benefit plan that provides coverage in this state may not be used as
  a factor in the rating of the plan.
         Sec. 544.605.  PROHIBITED DISCRIMINATION AGAINST
  PARTICIPATING PROVIDER. (a) A health benefit plan issuer may not
  use the vaccination history of a health care provider's patients as
  a qualification or requirement for contracting with the provider or
  as a basis for terminating a contract with the provider.
         (b)  A health benefit plan issuer may not use the vaccination
  history or immunity status for a communicable disease of enrollees
  as a factor in providing a financial incentive or assessing a
  financial or other penalty against a participating provider.
         Sec. 544.606.  EFFECT ON OTHER LAW. This subchapter
  prevails to the extent of a conflict between this subchapter and any
  other law.
         SECTION 1.04.  Chapter 21, Labor Code, is amended by adding
  Subchapter H-1 to read as follows:
         SUBCHAPTER H-1. DISCRIMINATION BASED ON VACCINATION STATUS
         Sec. 21.421.  PROHIBITED DISCRIMINATION BASED ON
  VACCINATION STATUS. (a) 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 is unvaccinated or not immune to a
  communicable disease.
         (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 is unvaccinated or not immune to a
  communicable disease.
         (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 is
  unvaccinated or not immune to a communicable disease.
         (d)  An employer, labor organization, or employment agency
  commits an unlawful employment practice if the employer, labor
  organization, or employment agency limits, segregates, or
  classifies an employee, member, or applicant for employment or
  membership in a way that would deprive or tend to deprive the
  employee, member, or applicant of employment opportunities or
  otherwise adversely affect the status of the employee, member, or
  applicant because the employee, member, or applicant is
  unvaccinated or not immune to a communicable disease.
         Sec. 21.422.  EFFECT ON OTHER LAW. This subchapter prevails
  to the extent of a conflict between this subchapter and any other
  law.
         SECTION 1.05.  Title 2, Occupations Code, is amended by
  adding Chapter 60 to read as follows:
  CHAPTER 60. IMMUNIZATION DISCRIMINATION
         Sec. 60.001.  PROHIBITED DISCRIMINATION BASED ON
  IMMUNIZATION. A licensing authority may not deny an application
  for an occupational license, suspend, revoke, or refuse to renew an
  occupational license, or take any other disciplinary action against
  an individual based on:
               (1)  the individual's vaccination history or immunity
  status for a communicable disease; or
               (2)  the individual's refusal to be vaccinated or
  participate in administering a vaccine.
         Sec. 60.002.  EFFECT ON OTHER LAW. This chapter prevails to
  the extent of a conflict between this chapter and any other law.
         SECTION 1.06.  Subtitle A, Title 3, Occupations Code, is
  amended by adding Chapter 103A to read as follows:
  CHAPTER 103A. RIGHT TO OBJECT TO VACCINATIONS
         Sec. 103A.001.  RIGHT TO OBJECT. A hospital or other health
  care facility may not require as a condition of employment that an
  employee, including a physician, nurse, or staff member:
               (1)  be vaccinated; or
               (2)  participate in administering a vaccine.
         Sec. 103A.002.  DISCRIMINATION PROHIBITED. (a) A hospital
  or other health care facility may not discriminate against an
  employee, including a physician, nurse, or staff member, or an
  applicant who:
               (1)  refuses to:
                     (A)  be vaccinated; or
                     (B)  participate in administering a vaccine; or
               (2)  is not immune to a communicable disease.
         (b)  An educational institution may not discriminate against
  an applicant for admission or employment as a student, intern, or
  resident based on:
               (1)  the applicant's vaccination history or immunity
  status for a communicable disease; or
               (2)  the applicant's refusal to be vaccinated or
  participate in administering a vaccine.
         Sec. 103A.003.  REMEDIES. A person aggrieved by a violation
  of this chapter may bring an action against a hospital, other health
  care facility, or educational institution that administers a
  hospital or other health care facility in a district court in the
  county where the hospital, facility, or institution is located for:
               (1)  an injunction against any further violation;
               (2)  appropriate equitable relief, including:
                     (A)  admission or reinstatement of employment;
  and 
                     (B)  back pay and 10 percent interest on the back
  pay; and
               (3)  any other relief necessary to ensure compliance
  with this chapter.
         Sec. 103A.004.  EFFECT ON OTHER LAW. This chapter prevails
  to the extent of a conflict between this chapter and any other law.
         SECTION 1.07.  Subchapter A, Chapter 521, Transportation
  Code, is amended by adding Section 521.013 to read as follows:
         Sec. 521.013.  PROHIBITED VACCINATION DISCRIMINATION. (a)
  The department may not use an individual's vaccination history or
  proof of immunity to a communicable disease as a requirement for the
  issuance or renewal of a driver's license, election identification
  certificate, or personal identification certificate.
         (b)  The department may not discriminate against, deny
  services or access to, or otherwise penalize any individual for
  being unvaccinated or not providing proof of vaccination or
  immunity to a communicable disease.
         (c)  This section prevails to the extent of a conflict
  between this section and any other law.
  ARTICLE 2. VACCINATION MANDATES PROHIBITED
         SECTION 2.01.  Section 25.002(a), Education Code, is amended
  to read as follows:
         (a)  If a parent or other person with legal control of a child
  under a court order enrolls the child in a public school, the parent
  or other person or the school district in which the child most
  recently attended school shall furnish to the school district:
               (1)  the child's birth certificate or another document
  suitable as proof of the child's identity; and
               (2)  a copy of the child's records from the school the
  child most recently attended if the child has been previously
  enrolled in a school in this state or another state[; and
               [(3) a record showing that the child has the
  immunizations as required under Section 38.001, in the case of a
  child required under that section to be immunized, proof as
  required by that section showing that the child is not required to
  be immunized, or proof that the child is entitled to provisional
  admission under that section and under rules adopted under that
  section].
         SECTION 2.02.  The heading to Section 38.001, Education
  Code, is amended to read as follows:
         Sec. 38.001.  RECOMMENDED IMMUNIZATIONS [IMMUNIZATION;
  REQUIREMENTS; EXCEPTIONS].
         SECTION 2.03.  Section 38.001(b-1), Education Code, is
  amended to read as follows:
         (b-1)  Each year, the Department of State Health Services
  shall prepare a list of the immunizations [required under this
  section for admission to public schools and of any additional
  immunizations] the department recommends for school-age children.
  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. A school district or a school,
  including a private school, may not require any immunizations as a
  condition of admission to or attendance at an elementary or
  secondary school.
         SECTION 2.04.  Sections 38.019(a) and (b), Education Code,
  are 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:
               (1)  [(A) the immunizations required for admission to
  public school by rules of the Department of State Health Services
  adopted under Section 38.001;
                     [(B)] any immunizations or vaccines recommended
  for public school students by the Department of State Health
  Services; and
               (2) [(C)]  health clinics in the district that offer
  the influenza vaccine, to the extent those clinics are known to the
  district[; and
               [(2) a link to the Department of State Health Services
  Internet website where a person may obtain information relating to
  the procedures for claiming an exemption from the immunization
  requirements of Section 38.001].
         (b)  The list of recommended immunizations or vaccines under
  Subsection (a)(1) [(a)(2)] must include the influenza vaccine[,
  unless the Department of State Health Services requires the
  influenza vaccine for admission to public school].
         SECTION 2.05.  The heading to Section 51.933, Education
  Code, is amended to read as follows:
         Sec. 51.933.  IMMUNIZATION INFORMATION [REQUIREMENTS;
  EXCEPTION].
         SECTION 2.06.  Section 51.933(a), Education Code, is amended
  to read as follows:
         (a)  An institution of higher education may not require
  students or applicants for admission to be immunized against any
  communicable disease [diphtheria, rubeola, rubella, mumps,
  tetanus, and poliomyelitis, except as provided in Subsection (d)].
         SECTION 2.07.  Section 264.1076(d), Family Code, is amended
  to read as follows:
         (d)  A physician or other health care provider conducting an
  examination under Subsection (b) may not administer a vaccination
  as part of the examination without parental consent[, except that a
  physician or other health care provider may administer a tetanus
  vaccination to a child in a commercially available preparation if
  the physician or other health care provider determines that an
  emergency circumstance requires the administration of the
  vaccination]. The prohibition on the administration of a
  vaccination under this subsection does not apply after the
  department has been named managing conservator of the child after a
  hearing conducted under Subchapter C, Chapter 262.
         SECTION 2.08.  Section 531.0335(b), Government Code, is
  amended to read as follows:
         (b)  The executive commissioner by rule shall prohibit a
  health and human services agency from taking a punitive action
  against a person responsible for a child's care, custody, or
  welfare for declining [failure of the person] to immunize the child
  against any communicable disease [ensure that the child receives
  the immunization series prescribed by Section 161.004, Health and
  Safety Code].
         SECTION 2.09.  Section 12.033(a), Health and Safety Code, is
  amended to read as follows:
         (a)  Except as otherwise provided by this section, the
  executive commissioner by rule shall adopt fees to be collected by
  the department for the distribution and administration of vaccines
  and sera provided under[:
               [(1) Section 38.001, Education Code;
               [(2) Section 42.043, Human Resources Code;
               [(3)] Chapter 826 (Rabies Control Act of 1981)[;
               [(4) Chapter 81 (Communicable Disease Prevention and
  Control Act); and
               [(5) Section 161.005].
         SECTION 2.10.  Section 81.082(f), Health and Safety Code, is
  amended to read as follows:
         (f)  In this section, "control measures" does not include an
  immunization or vaccine and includes:
               (1)  [immunization;
               [(2)] detention;
               (2) [(3)]  restriction;
               (3) [(4)]  disinfection;
               (4) [(5)]  decontamination;
               (5) [(6)]  isolation;
               (6) [(7)]  quarantine;
               (7) [(8)]  disinfestation;
               (8) [(9)]  chemoprophylaxis;
               (9) [(10)]  preventive therapy;
               (10) [(11)]  prevention; and
               (11) [(12)]  education.
         SECTION 2.11.  Section 81.085(i), Health and Safety Code, is
  amended to read as follows:
         (i)  On request of the department during a public health
  disaster, an individual shall disclose the individual's
  immunization information. If the individual does not have updated
  or appropriate immunizations, the department may take appropriate
  action during a quarantine to protect that individual and the
  public from the communicable disease, but the department may not
  administer a vaccine to the individual without the individual's
  consent.
         SECTION 2.12.  The heading to Section 161.0051, Health and
  Safety Code, is amended to read as follows:
         Sec. 161.0051.  REQUIRED OFFER OF IMMUNIZATIONS FOR NURSING
  HOMES.
         SECTION 2.13.  Subchapter A, Chapter 161, Health and Safety
  Code, is amended by adding Section 161.0055 to read as follows:
         Sec. 161.0055.  VACCINATION MANDATES AND DISCRIMINATION
  PROHIBITED. (a) A governmental entity or official, including the
  governor, a state agency, a political subdivision, or a political
  subdivision official, may not:
               (1)  require an individual to be vaccinated;
               (2)  require an individual to participate in the
  administration of a vaccine; or
               (3)  discriminate or impose a civil or criminal penalty
  against an individual who refuses vaccination or participation in
  the administration of a vaccine.
         (b)  This section applies to all other law, including an
  agency rule, executive order, or emergency order.
         (c)  This section prevails to the extent of a conflict
  between this section and any other law.
         SECTION 2.14.  Section 161.0074(c), Health and Safety Code,
  is amended to read as follows:
         (c)  The report must:
               (1)  include the current immunization rates by
  geographic region of the state, where available;
               (2)  focus on the geographic regions of the state with
  immunization rates below the state average for preschool children;
               (3)  describe the approaches identified to increase
  immunization rates in underserved areas and the estimated cost for
  each;
               (4)  identify changes to department procedures needed
  to increase immunization rates;
               (5)  identify the services provided under and
  provisions of contracts entered into by the department to increase
  immunization rates in underserved areas;
               (6)  identify performance measures used in contracts
  described by Subdivision (5);
               (7)  include the number and type of exemptions used in
  the past year;
               (8)  include the number of complaints received by the
  department related to the department's failure to comply with
  requests for exclusion of individuals from the registry;
               (9)  identify all reported incidents of discrimination
  for requesting exclusion from the registry [or for using an
  exemption for a required immunization];
               (10)  include department recommendations about the
  best way to use, and communicate with, local registries in the
  state; and
               (11)  include ways to increase provider participation
  in the registry.
         SECTION 2.15.  Section 161.0105(c), Health and Safety Code,
  is amended to read as follows:
         (c)  The immunity created by this section is in addition to
  any immunity created by Section [Sections 161.001 and] 161.007(i).
         SECTION 2.16.  Section 224.002, Health and Safety Code, is
  amended by amending Subsection (b) and adding Subsection (b-1) to
  read as follows:
         (b)  The policy must:
               (1)  encourage [require] covered individuals to
  receive vaccines for the vaccine preventable diseases specified by
  the facility based on the level of risk the individual presents to
  patients by the individual's routine and direct exposure to
  patients;
               (2)  specify the recommended vaccines a covered
  individual is encouraged [required] to receive based on the level
  of risk the individual presents to patients by the individual's
  routine and direct exposure to patients;
               (3)  [include procedures for verifying whether a
  covered individual has complied with the policy;
               [(4) include procedures for a covered individual to be
  exempt from the required vaccines for the medical conditions
  identified as contraindications or precautions by the Centers for
  Disease Control and Prevention;
               [(5)] for a covered individual who declines to receive
  [is exempt from] the recommended [required] vaccines, include
  procedures the individual must follow to protect facility patients
  from exposure to disease, such as the use of protective medical
  equipment, such as gloves and masks, based on the level of risk the
  individual presents to patients by the individual's routine and
  direct exposure to patients;
               (4) [(6)]  prohibit discrimination or retaliatory
  action against a covered individual who declines to receive [is
  exempt from] the recommended [required] vaccines [for the medical
  conditions identified as contraindications or precautions by the
  Centers for Disease Control and Prevention], except that required
  use of protective medical equipment, such as gloves and masks, may
  not be considered retaliatory action for purposes of this
  subdivision; and
               (5) [(7)]  require the health care facility to maintain
  a written or electronic record of each covered individual's
  immunization record [compliance with or exemption from the policy;
  and
               [(8) include disciplinary actions the health care
  facility is authorized to take against a covered individual who
  fails to comply with the policy].
         (b-1)  A health care facility shall maintain as confidential
  an immunization record described by Subsection (b)(5) and may not
  disclose the record to any other person unless the disclosure is
  otherwise required by law.
         SECTION 2.17.  Section 31.0031(d), Human Resources Code, is
  amended to read as follows:
         (d)  The responsibility agreement shall require that:
               (1)  the parent of a dependent child cooperate with the
  commission and the Title IV-D agency if necessary to establish the
  paternity of the dependent child and to establish or enforce child
  support;
               (2)  if adequate and accessible providers of the
  services are available in the geographic area and subject to the
  availability of funds, each dependent child, as appropriate,
  complete early and periodic screening, diagnosis, and treatment
  checkups on schedule [and receive the immunization series
  prescribed by Section 161.004, Health and Safety Code, unless the
  child is exempt under that section];
               (3)  each adult recipient, or teen parent recipient who
  has completed the requirements regarding school attendance in
  Subdivision (6), not voluntarily terminate paid employment of at
  least 30 hours each week without good cause in accordance with rules
  adopted by the executive commissioner;
               (4)  each adult recipient for whom a needs assessment
  is conducted participate in an activity to enable that person to
  become self-sufficient by:
                     (A)  continuing the person's education or
  becoming literate;
                     (B)  entering a job placement or employment skills
  training program;
                     (C)  serving as a volunteer in the person's
  community; or
                     (D)  serving in a community work program or other
  work program approved by the commission;
               (5)  each caretaker relative or parent receiving
  assistance not use, sell, or possess marihuana or a controlled
  substance in violation of Chapter 481, Health and Safety Code, or
  abuse alcohol;
               (6)  each dependent child younger than 18 years of age
  or teen parent younger than 19 years of age attend school regularly,
  unless the child has a high school diploma or high school
  equivalency certificate or is specifically exempted from school
  attendance under Section 25.086, Education Code;
               (7)  each recipient comply with commission rules
  regarding proof of school attendance; and
               (8)  each recipient attend appropriate parenting
  skills training classes, as determined by the needs assessment.
         SECTION 2.18.  Sections 42.043(b) and (d), Human Resources
  Code, are amended to read as follows:
         (b)  The department shall require that each child at an
  appropriate age have a test for tuberculosis [and be immunized
  against diphtheria, tetanus, poliomyelitis, mumps, rubella,
  rubeola, invasive pneumococcal disease, and hepatitis A and against
  any other communicable disease as recommended by the Department of
  State Health Services. The immunization must be effective on the
  date of first entry into the facility. However, a child may be
  provisionally admitted if the required immunizations have begun and
  are completed as rapidly as medically feasible].
         (d)  No immunization may be required for admission to a
  facility regulated under this chapter [if a person applying for a
  child's admission submits one of the following affidavits:
               [(1) an affidavit signed by a licensed physician
  stating that the immunization poses a significant risk to the
  health and well-being of the child or a member of the child's family
  or household; or
               [(2) an affidavit signed by the child's parent or
  guardian stating that the applicant declines immunization for
  reasons of conscience, including a religious belief].
         SECTION 2.19.  Section 42.04305, Human Resources Code, is
  amended by amending Subsection (c) and adding Subsection (c-1) to
  read as follows:
         (c)  The policy must:
               (1)  encourage [require] each facility employee to
  receive vaccines for the vaccine-preventable diseases specified by
  the child-care facility based on the level of risk the employee
  presents to children by the employee's routine and direct exposure
  to children;
               (2)  specify the recommended vaccines a facility
  employee is encouraged [required] to receive based on the level of
  risk the employee presents to children by the employee's routine
  and direct exposure to children;
               (3)  [include procedures for verifying whether a
  facility employee has complied with the policy;
               [(4) include procedures for a facility employee to be
  exempt from the required vaccines for the medical conditions
  identified as contraindications or precautions by the Centers for
  Disease Control and Prevention;
               [(5)] for a facility employee who declines to receive
  [is exempt from] the recommended [required] vaccines, include
  procedures the employee must follow to protect children in the
  facility's care from exposure to disease, such as the use of
  protective medical equipment, including gloves and masks, based on
  the level of risk the employee presents to children by the
  employee's routine and direct exposure to children;
               (4) [(6)]  prohibit discrimination or retaliatory
  action against a facility employee who declines to receive [is
  exempt from] the recommended [required] vaccines [for the medical
  conditions identified as contraindications or precautions by the
  Centers for Disease Control and Prevention], except that required
  use of protective medical equipment, including gloves and masks,
  may not be considered retaliatory action for purposes of this
  subdivision; and
               (5) [(7)]  require the child-care facility to maintain
  a written or electronic record of each facility employee's
  immunization record [compliance with or exemption from the policy;
  and
               [(8) state the disciplinary actions the child-care
  facility is authorized to take against a facility employee who
  fails to comply with the policy].
         (c-1)  A facility shall maintain as confidential an
  immunization record described by Subsection (c)(5) and may not
  disclose the record to any other person unless the disclosure is
  otherwise required by law.
         SECTION 2.20.  The following provisions are repealed:
               (1)  Sections 38.001(a), (c), (c-1), (d), (e), and
  (f), Education Code;
               (2)  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;
               (3)  Section 38.019(a-1), Education Code;
               (4)  Section 51.9192, Education Code;
               (5)  Sections 51.933(b), (b-1), (d), (d-1), and (e),
  Education Code;
               (6)  Section 531.0335(c), Government Code;
               (7)  Section 81.023, Health and Safety Code;
               (8)  Section 161.001, Health and Safety Code;
               (9)  Section 161.004, Health and Safety Code;
               (10)  Section 161.0041, Health and Safety Code;
               (11)  Section 161.005, Health and Safety Code;
               (12)  Section 161.007(h), Health and Safety Code;
               (13)  Section 224.002(c), Health and Safety Code;
               (14)  Section 224.003, Health and Safety Code;
               (15)  Sections 31.031(d) and (e), Human Resources Code;
               (16)  Sections 42.043(c), (d-1), and (f), Human
  Resources Code; and
               (17)  Section 42.04305(d), Human Resources Code.
  ARTICLE 3. TRANSITION AND EFFECTIVE DATE
         SECTION 3.01.  Each facility subject to Chapter 224, Health
  and Safety Code, as amended by this Act, or Section 42.04305, Human
  Resources Code, as amended by this Act, shall modify the facility's
  vaccine-preventable disease policy to conform with the changes in
  law made by this Act not later than January 1, 2022.
         SECTION 3.02.  (a) Subchapter M, Chapter 544, Insurance
  Code, as added by this Act, applies only to a health benefit plan or
  insurance policy delivered, issued for delivery, or renewed on or
  after January 1, 2022.
         (b)  Section 544.605, Insurance Code, as added by this Act,
  applies only to a contract entered into on or after the effective
  date of this Act.
         SECTION 3.03.  (a) The changes in law made by this Act to
  Title 2, Education Code, apply starting with the 2021-2022 school
  year.
         (b)  The changes in law made by this Act to Title 3, Education
  Code, apply starting with the 2021-2022 academic year.
         SECTION 3.04.  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.
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