89R23839 KRM-D     By: Kolkhorst, et al. S.B. No. 25     (Hull, Frank, VanDeaver, Bucy, Pierson, et al.)     Substitute the following for S.B. No. 25:  No.       A BILL TO BE ENTITLED   AN ACT   relating to health and nutrition standards to promote healthy   living; authorizing a civil penalty.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Section 28.002, Education Code, is amended by   amending Subsections (l) and (l-1) and adding Subsections (l-4) and   (u) to read as follows:          (l)  A school district or open-enrollment charter school   shall require a student enrolled in full-day prekindergarten, in   kindergarten, or in a grade level below grade six to participate in   moderate or vigorous daily physical activity for at least 30   minutes throughout the school year as part of the district's or   school's physical education curriculum or through structured   activity during a school campus's daily recess. To the extent   practicable, a school district or open-enrollment charter school   shall require a student enrolled in prekindergarten on less than a   full-day basis to participate in the same type and amount of   physical activity as a student enrolled in full-day   prekindergarten. A school district or open-enrollment charter   school shall require students enrolled in grade levels six, seven,   and eight to participate in moderate or vigorous daily physical   activity for at least 30 minutes for at least six [four] semesters   during those grade levels as part of the district's or school's   physical education curriculum. If a school district or   open-enrollment charter school determines, for any particular   grade level below grade six, that requiring moderate or vigorous   daily physical activity is impractical due to scheduling concerns   or other factors, the district or school may as an alternative   require a student in that grade level to participate in moderate or   vigorous physical activity for at least 135 minutes during each   school week. Additionally, a school district or open-enrollment   charter school may as an alternative require a student enrolled in a   grade level for which the district or school uses block scheduling   to participate in moderate or vigorous physical activity for at   least 225 minutes during each period of two school weeks. A school   district or open-enrollment charter school must provide for an   exemption for:                (1)  any student who is unable to participate in the   required physical activity because of illness or disability; and                (2)  a middle school or junior high school student who   participates in an extracurricular activity with a moderate or   vigorous physical activity component that is considered a   structured activity under rules adopted by the commissioner.          (l-1)  In adopting rules relating to an activity described by   Subsection (l)(2), the commissioner shall [may] permit an exemption   for a student who participates in a school-related activity or an   activity sponsored by a private league or club [only] if the student   provides proof of participation in the activity.          (l-4)  In providing a physical education curriculum under   Subsection (l), a school employee may not restrict participation   in:                (1)  recess or other physical activity offered as part   of the district's or school's physical education curriculum for a   student enrolled in kindergarten or in a grade level below grade six   as a penalty for the student's academic performance or behavior; or                (2)  physical activity offered as part of the   district's or school's physical education curriculum for a student   enrolled in grade level six, seven, or eight as a penalty for the   student's academic performance or behavior.          (u)  In adopting the essential knowledge and skills for the   health curriculum under Subsection (a)(2)(B) for a grade level from   kindergarten through grade eight, the State Board of Education   shall adopt essential knowledge and skills that include nutrition   instruction based on nutritional guidelines recommended by the   Texas Nutrition Advisory Committee established under Chapter 119B,   Health and Safety Code.          SECTION 2.  Subchapter A, Chapter 28, Education Code, is   amended by adding Section 28.0115 to read as follows:          Sec. 28.0115.  ELECTIVE COURSE ON NUTRITION AND WELLNESS.   Each school district and open-enrollment charter school offering a   high school program shall provide an elective course in nutrition   and wellness that meets the requirements for a one-half elective   credit under Section 28.025, using materials the State Board of   Education approves.  The nutrition instruction:                (1)  must include curriculum requirements based on   nutritional guidelines recommended by the Texas Nutrition Advisory   Committee established under Chapter 119B, Health and Safety Code;   and                (2)  may incorporate other relevant material,   including culinary skills, horticulture, and consumer economics.          SECTION 3.  Subchapter F, Chapter 51, Education Code, is   amended by adding Section 51.3025 to read as follows:          Sec. 51.3025.  NUTRITION EDUCATION COURSEWORK. (a) In this   section, "institution of higher education" has the meaning assigned   by Section 61.003.          (b)  The Texas Higher Education Coordinating Board by rule   shall require institutions of higher education to require each   student enrolled in an associate or baccalaureate degree program at   the institution to complete a course of instruction in nutrition   education. The course must include curriculum requirements based   on nutritional guidelines recommended by the Texas Nutrition   Advisory Committee established under Chapter 119B, Health and   Safety Code.          SECTION 4.  Subchapter A, Chapter 63, Education Code, is   amended by adding Section 63.0025 to read as follows:          Sec. 63.0025.  REQUIRED NUTRITION CURRICULUM. A   health-related institution of higher education listed in Section   63.002(c) is eligible for distribution of money under this   subchapter only if the institution:                (1)  develops nutrition curriculum requirements based   on nutritional guidelines recommended by the Texas Nutrition   Advisory Committee established under Chapter 119B, Health and   Safety Code; and                (2)  requires all medical students or students in other   majors related to health care service provision who are enrolled at   the institution to successfully complete the curriculum   requirements developed under Subdivision (1).          SECTION 5.  Subchapter B, Chapter 63, Education Code, is   amended by adding Section 63.103 to read as follows:          Sec. 63.103.  REQUIRED NUTRITION CURRICULUM. A   health-related institution of higher education listed in Section   63.101(a) is eligible for distribution of money from a fund   established under this subchapter only if the institution:                (1)  develops nutrition curriculum requirements based   on nutritional guidelines recommended by the Texas Nutrition   Advisory Committee established under Chapter 119B, Health and   Safety Code; and                (2)  requires all medical students or students in other   majors related to health care service provision who are enrolled at   the institution to successfully complete the curriculum   requirements developed under Subdivision (1).          SECTION 6.  Subchapter C, Chapter 63, Education Code, is   amended by adding Section 63.2025 to read as follows:          Sec. 63.2025.  REQUIRED NUTRITION CURRICULUM. A   health-related institution providing graduate medical education is   eligible for a grant award under this subchapter only if the   institution:                (1)  develops nutrition curriculum requirements based   on nutritional guidelines recommended by the Texas Nutrition   Advisory Committee established under Chapter 119B, Health and   Safety Code; and                (2)  requires all students in nursing, allied health,   or other majors related to health care service provision who are   enrolled at the institution to successfully complete the curriculum   requirements developed under Subdivision (1).          SECTION 7.  Subchapter D, Chapter 63, Education Code, is   amended by adding Section 63.303 to read as follows:          Sec. 63.303.  REQUIRED NUTRITION CURRICULUM. A   health-related institution providing graduate medical education is   eligible for a grant award under this subchapter only if the   institution:                (1)  develops nutrition curriculum requirements based   on nutritional guidelines recommended by the Texas Nutrition   Advisory Committee established under Chapter 119B, Health and   Safety Code; and                (2)  requires all medical students or students in other   majors related to health care service provision who are enrolled at   the institution to successfully complete the curriculum   requirements developed under Subdivision (1).          SECTION 8.  Subtitle E, Title 2, Health and Safety Code, is   amended by adding Chapter 119B to read as follows:   CHAPTER 119B. TEXAS NUTRITION ADVISORY COMMITTEE          Sec. 119B.001.  DEFINITION. In this chapter, "advisory   committee" means the Texas Nutrition Advisory Committee.          Sec. 119B.002.  ADVISORY COMMITTEE ESTABLISHED. The Texas   Nutrition Advisory Committee is established to develop nutritional   guidelines for residents of this state. The advisory committee is   administratively attached to the department.          Sec. 119B.003.  MEMBERSHIP. (a)  The advisory committee is   composed of seven members appointed by the governor, including at   least:                (1)  one expert in metabolic health, culinary medicine,   lifestyle medicine, or integrative medicine;                (2)  one licensed physician certified in functional   medicine;                (3)  one member representing the Texas Department of   Agriculture;                (4)  one member representing a rural community;                (5)  one member representing an urban community; and                (6)  one pediatrician specializing in metabolic   health.          (b)  In appointing the advisory committee members, the   governor must:                (1)  consider recommendations provided by:                      (A)  the chair of the senate committee on health   and human services;                      (B)  the chair of the house of representatives   committee on public health; and                      (C)  the chair of the house of representatives   committee on human services; and                (2)  ensure not more than two members are affiliated   with an academic or health-related institution of higher education   if the appointment could reasonably create a conflict of interest   between the goals of the advisory committee and the goals of the   institution.          (c)  An individual is ineligible for appointment to the   advisory committee if the individual:                (1)  owns or controls an ownership interest in a food,   beverage, dietary supplement, or pharmaceutical manufacturing   company; or                (2)  is related within the third degree of   consanguinity or affinity, as determined by Chapter 573, Government   Code, to an individual who owns or controls an ownership interest in   a food, beverage, dietary supplement, or pharmaceutical   manufacturing company.          (d)  Before accepting an appointment under this section, an   individual must disclose all past or existing affiliations with a   food, beverage, dietary supplement, or pharmaceutical   manufacturing company or any other affiliation that could   reasonably create a conflict of interest with the goals of the   advisory committee.  An advisory committee member who fails to   disclose an affiliation described by this subsection is subject to   removal by the governor.          (e)  Advisory committee members serve staggered four-year   terms.          Sec. 119B.004.  ADVISORY COMMITTEE DUTIES. The advisory   committee shall:                (1)  examine the impact of nutrition on human health   and examine the connection between ultra-processed foods,   including foods containing artificial color and food additives, and   the prevalence of chronic diseases and other chronic health issues;                (2)  provide an independent review of scientific   studies analyzing the effects of ultra-processed foods on human   health;                (3)  provide education on the effects of   ultra-processed foods on human health; and                (4)  develop and maintain dietary and nutritional   guidelines based on the consensus of available scientific studies   and information concerning diet and nutrition.          Sec. 119B.005.  ANNUAL REPORT. Not later than September 1 of   each year, the advisory committee shall prepare and submit to the   department, the governor, the lieutenant governor, the speaker of   the house of representatives, and each standing committee of the   legislature with primary jurisdiction over health and safety a   written report that includes:                (1)  a summary of the scientific studies;                (2)  nutritional guidelines incorporating any new   scientific findings; and                (3)  any other recommendations the advisory committee   considers appropriate based on new scientific studies.          Sec. 119B.006.  DEPARTMENT NUTRITIONAL GUIDELINES WEB PAGE.   (a)  The department shall post on a publicly available web page on   the department's Internet website the guidelines developed under   Section 119B.004 in a manner that is easily accessible and readily   understandable.          (b)  The department shall annually update information posted   under this section based on the report submitted under Section   119B.005.          Sec. 119B.007.  EXPIRATION. The advisory committee is   abolished and this chapter expires December 31, 2032.          Sec. 119B.008.  RULES. The executive commissioner of the   Health and Human Services Commission may adopt rules as necessary   to implement this chapter.          SECTION 9.  Subchapter D, Chapter 431, Health and Safety   Code, is amended by adding Sections 431.0815 and 431.0816 to read as   follows:          Sec. 431.0815.  FOOD CONTAINING ARTIFICIAL COLOR,   ADDITIVES, OR CERTAIN BANNED CHEMICALS. (a) A food manufacturer   shall ensure each food product the manufacturer offers for sale in   this state includes a warning label disclosing the use of any of the   following ingredients in a product intended for human consumption:                (1)  acesulfame potassium;                (2)  acetylated esters of mono- and diglycerides   (acetic acid ester);                (3)  anisole;                (4)  aspartame;                (5)  atrazine;                (6)  azodicarbonamide (ADA);                (7)  butylated hydroxyanisole (BHA);                (8)  butylated hydroxytoluene (BHT);                (9)  bleached flour;                (10)  blue 1 (CAS 3844-45-9);                (11)  blue 2 (CAS 860-22-0);                (12)  bromated flour;                (13)  calcium bromate;                (14)  canthaxanthin;                (15)  certified food colors by the United States Food   and Drug Administration;                (16)  citrus red 2 (CAS 6358-53-8);                (17)  diacetyl;                (18)  diacetyl tartaric and fatty acid esters of mono-   and diglycerides (DATEM);                (19)  dimethylamylamine (DMAA);                (20)  dioctyl sodium sulfosuccinate (DSS);                (21)  ficin;                (22)  glyphosate;                (23)  green 3 (CAS 2353-45-9);                (24)  high fructose corn syrup;                (25)  interesterified palm oil;                (26)  interesterified soybean oil;                (27)  lactylated fatty acid esters of glycerol and   propylene glycol;                (28)  lye;                (29)  morpholine;                (30)  olestra;                (31)  partially hydrogenated oil (PHO);                (32)  potassium aluminum sulfate;                (33)  potassium bromate;                (34)  potassium iodate;                (35)  potassium sorbate;                (36)  propylene oxide;                (37)  propylparaben;                (38)  red 3 (CAS 16423-68-0);                (39)  red 4 (CAS 4548-53-2);                (40)  red 40 (CAS 25956-17-6);                (41)  saccharine;                (42)  sodium aluminum sulfate;                (43)  sodium lauryl sulfate;                (44)  sodium stearyl fumarate;                (45)  stearyl tartrate;                (46)  synthetic or artificial vanillin;                (47)  synthetic trans fatty acid;                (48)  thiodipropionic acid;                (49)  titanium dioxide;                (50)  toluene;                (51)  yellow 5 (CAS 1934-21-0); and                (52)  yellow 6 (CAS 2783-94-0).          (b)  The warning label must:                (1)  include the following statement if the food   contains an ingredient listed in Subsection (a), printed in a font   size not smaller than the smallest font used to disclose other   consumer information required by the United States Food and Drug   Administration:                "WARNING: This product contains an ingredient that is   not recommended for human consumption by the appropriate authority   in Australia, Canada, the European Union, or the United Kingdom.";                (2)  be placed in a prominent and reasonably visible   location; and                (3)  have sufficiently high contrast with the immediate   background to ensure the warning is likely to be seen and understood   by the ordinary individual under customary conditions of purchase   and use.          (c)  A food manufacturer or retailer that offers a product   described by Subsection (a) for sale in this state on the   manufacturer's or retailer's Internet website shall disclose to the   consumer all labeling information required under Subsection (b) and   department rule by:                (1)  posting a legible statement on the manufacturer's   or retailer's Internet website on which the product is offered for   sale; or                (2)  otherwise communicating the information to the   consumer.          (d)  This section does not apply to:                (1)  an ingredient used in a product not intended for   human consumption; or                (2)  food labeled, prepared, served, or sold in a   restaurant or retail establishment.          (e)  This section does not create a private cause of action   for a violation of this section.          (f)  For the purposes of this section, "food manufacturer"    includes any manufacturer that offers a food product for sale in   this state, regardless of where the product was originally   produced.          Sec. 431.0816.  ENFORCEMENT BY ATTORNEY GENERAL. (a)  If the   attorney general believes a manufacturer has violated or is   violating Section 431.0815, the attorney general may bring an   action on behalf of this state to enjoin the manufacturer from   violating that section.          (b)  In addition to seeking an injunction under Subsection   (a), the attorney general may request and the court may order any   other relief that may be in the public interest, including:                (1)  the imposition of a civil penalty in an amount not   to exceed $50,000 per day for each distinct food product in   violation of Section 431.0815; and                (2)  an order requiring reimbursement to this state for   the reasonable value of investigating and bringing an enforcement   action for a violation of Section 431.0815.          SECTION 10.  Subchapter B, Chapter 156, Occupations Code, is   amended by adding Section 156.061 to read as follows:          Sec. 156.061.  CONTINUING EDUCATION IN NUTRITION AND   METABOLIC HEALTH. (a)  A physician licensed under this subtitle who   submits an application for renewal of a license to practice   medicine must complete, in accordance with this section and rules   adopted under this section, continuing medical education regarding   nutrition and metabolic health.          (b)  The board shall adopt rules to implement this section.     The rules must prescribe:                (1)  the number of hours of the continuing medical   education required by this section; and                (2)  the content of the continuing medical education   required by this section based on the nutritional guidelines   recommended by the Texas Nutrition Advisory Committee under Chapter   119B, Health and Safety Code.          SECTION 11.  Subchapter D, Chapter 204, Occupations Code, is   amended by adding Section 204.1563 to read as follows:          Sec. 204.1563.  CONTINUING MEDICAL EDUCATION IN NUTRITION   AND METABOLIC HEALTH. (a) As part of continuing medical education   requirements under Section 204.1562, a license holder shall   complete, in accordance with this section and rules adopted under   this section, continuing medical education regarding nutrition and   metabolic health.          (b)  The medical board, on recommendations of the physician   assistant board, shall adopt rules to implement this section. The   rules must prescribe:                (1)  the number of hours of the continuing medical   education required by this section; and                (2)  the content of the continuing medical education   required by this section based on the nutritional guidelines   recommended by the Texas Nutrition Advisory Committee under Chapter   119B, Health and Safety Code.          SECTION 12.  Subchapter G, Chapter 301, Occupations Code, is   amended by adding Section 301.309 to read as follows:          Sec. 301.309.  CONTINUING EDUCATION IN NUTRITION AND   METABOLIC HEALTH. (a) As part of continuing education   requirements under Section 301.303, a license holder shall   complete, in accordance with this section and rules adopted under   this section, continuing education regarding nutrition and   metabolic health.          (b)  The board shall adopt rules to implement this section.     The rules must prescribe:                (1)  the number of hours of the continuing education   required by this section; and                (2)  the content of the continuing education required   by this section based on the nutritional guidelines recommended by   the Texas Nutrition Advisory Committee under Chapter 119B, Health   and Safety Code.          SECTION 13.  Subchapter G, Chapter 701, Occupations Code, is   amended by adding Sections 701.302 and 701.303 to read as follows:          Sec. 701.302.  CONTINUING EDUCATION REQUIREMENTS. The   commission by rule shall adopt and the department shall monitor and   enforce a program for the continuing education of license holders   as a condition for license renewal.  The rules must:                (1)  require a license holder to complete not more than   12 hours of continuing education as a prerequisite to renewal of the   license under this chapter; and                (2)  prescribe a process to assess a license holder's   participation in continuing education courses.          Sec. 701.303.  CONTINUING EDUCATION IN NUTRITION AND   METABOLIC HEALTH. (a)  As part of the continuing education   requirements under Section 701.302, a license holder shall   complete, in accordance with this section and rules adopted under   this section, continuing education regarding nutrition and   metabolic health.          (b)  The commission shall adopt rules to implement this   section. The rules must prescribe:                (1)  the number of hours of the continuing education   required by this section; and                (2)  the content of the continuing education required   by this section based on the nutritional guidelines recommended by   the Texas Nutrition Advisory Committee under Chapter 119B, Health   and Safety Code.          SECTION 14.  Section 701.304, Occupations Code, is amended   to read as follows:          Sec. 701.304.  GROUNDS FOR REFUSING RENEWAL.  The   commission or department may refuse to renew the license of a person   who fails to:                (1)  pay an administrative penalty imposed under   Subchapter K, unless enforcement of the penalty is stayed or a court   has ordered that the administrative penalty is not owed; or                (2)  complete the continuing education requirements   under Section 701.302.          SECTION 15.  (a) Section 28.002(l), Education Code, as   amended by this Act, applies only to students entering the sixth   grade during the 2026-2027 school year or a later school year. For   students entering a grade above sixth grade during the 2026-2027   school year, Section 28.002(l), Education Code, as that section   existed before amendment by this Act, applies, and that section is   continued in effect for that purpose.          (b)  Sections 28.002(u) and 28.0115, Education Code, as   added by this Act, apply beginning with the 2027-2028 school year.          SECTION 16.  Section 51.3025, Education Code, as added by   this Act, applies beginning with entering students enrolling in an   associate or baccalaureate degree program at a public institution   of higher education on or after July 1, 2027.          SECTION 17.  (a)  Not later than July 1, 2027, a   health-related institution of higher education shall develop and   implement curriculum required by Sections 63.0025, 63.103,   63.2025, and 63.303, Education Code, as added by this Act, to remain   eligible for funding under those sections.          (b)  A health-related institution of higher education is not   required to comply with Sections 63.0025, 63.103, 63.2025, and   63.303, Education Code, as added by this Act, until July 1, 2027.          SECTION 18.  (a)  Not later than December 31, 2025, the   governor shall appoint the members of the Texas Nutrition Advisory   Committee established under Chapter 119B, Health and Safety Code,   as added by this Act, and shall provide for staggered member terms   as required by that chapter.          (b)  Not later than September 1, 2026, the Texas Nutrition   Advisory Committee shall prepare and submit to the Department of   State Health Services, the governor, the lieutenant governor, the   speaker of the house of representatives, and each standing   committee of the legislature with primary jurisdiction over health   and safety the initial report required under Section 119B.005,   Health and Safety Code, as added by this Act.          (c)  As soon as practicable after the submission of the   report under Subsection (b) of this section, the Department of   State Health Services shall post information required under Section   119B.006, Health and Safety Code, as added by this Act, on the   department's Internet website.          SECTION 19.  (a)  Not later than December 31, 2025, the   executive commissioner of the Health and Human Services Commission   shall adopt rules to implement changes made by Section 431.0815,   Health and Safety Code, as added by this Act.          (b)  Section 431.0815, Health and Safety Code, as added by   this Act, applies only to a food product label developed or   copyrighted on or after January 1, 2027.          SECTION 20.  (a)  Section 156.061, Occupations Code, as   added by this Act, applies only to an application for license   renewal filed on or after January 1, 2027.  An application for   license renewal filed before that date is governed by the law in   effect on the date the application was filed, and the former law is   continued in effect for that purpose.          (b)  Not later than December 31, 2026, the Texas Medical   Board shall adopt the rules required by Section 156.061,   Occupations Code, as added by this Act.          SECTION 21.  (a)  Section 204.1563, Occupations Code, as   added by this Act, applies only to an application for license   renewal filed on or after January 1, 2027.  An application for   license renewal filed before that date is governed by the law in   effect on the date the application was filed, and the former law is   continued in effect for that purpose.          (b)  Not later than December 31, 2026, the Texas Medical   Board shall adopt the rules required by Section 204.1563,   Occupations Code, as added by this Act.          SECTION 22.  (a)  Section 301.309, Occupations Code, as   added by this Act, applies only to an application for license   renewal filed on or after January 1, 2027.  An application for   license renewal filed before that date is governed by the law in   effect on the date the application was filed, and the former law is   continued in effect for that purpose.          (b)  Not later than December 31, 2026, the Texas Board of   Nursing shall adopt the rules required by Section 301.309,   Occupations Code, as added by this Act.          SECTION 23.  (a)  Sections 701.302 and 701.303, Occupations   Code, as added by this Act, apply only to an application for license   renewal filed on or after January 1, 2027.  An application for   license renewal filed before that date is governed by the law in   effect on the date the application was filed, and the former law is   continued in effect for that purpose.          (b)  Not later than December 31, 2026, the Texas Commission   of Licensing and Regulation shall adopt the rules required by   Sections 701.302 and 701.303, Occupations Code, as added by this   Act.          SECTION 24.  This Act takes effect September 1, 2025.