89R15360 MCF-D     By: Lowe H.B. No. 3304       A BILL TO BE ENTITLED   AN ACT   relating to a prohibition on vaccination mandates.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  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, including for a   child who most recently attended a public school in this state, a   copy of the child's disciplinary record and any threat assessment   involving the child's behavior conducted under Section 37.115[; 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.  The heading to Section 38.001, Education Code,   is amended to read as follows:          Sec. 38.001.  RECOMMENDED IMMUNIZATIONS [IMMUNIZATION;   REQUIREMENTS; EXCEPTIONS].          SECTION 3.  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 4.  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 5.  The heading to Section 51.933, Education Code,   is amended to read as follows:          Sec. 51.933.  IMMUNIZATION INFORMATION [REQUIREMENTS;   EXCEPTION].          SECTION 6.  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 7.  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 8.  Section 526.0505(b), Government Code, as   effective April 1, 2025, 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 [the person's failure] to immunize or   vaccinate the child for any communicable disease [ensure that the   child receives the immunization series prescribed by Section   161.004, Health and Safety Code].          SECTION 9.  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 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 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 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 13.  Subchapter A, Chapter 161, Health and Safety   Code, is amended by adding Section 161.0055 to read as follows:          Sec. 161.0055.  PROHIBITED VACCINATION MANDATES. (a) A   governmental entity or official, including the governor, a state   agency, a political subdivision, or a political subdivision   official, may not require an individual to:                (1)  be vaccinated; or                (2)  participate 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 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]; and                (10)  include ways to increase provider participation   in the registry.          SECTION 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 16.  Section 224.002(b), Health and Safety Code, is   amended 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].          SECTION 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 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 19.  Section 42.04305(c), Human Resources Code, is   amended 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].          SECTION 20.  The following provisions are repealed:                (1)  Section 33.0832(m), Education Code;                (2)  Sections 38.001(a), (c), (c-1), (d), (e), and   (f), Education Code;                (3)  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;                (4)  Section 38.019(a-1), Education Code;                (5)  Section 51.9192, Education Code;                (6)  Sections 51.933(b), (b-1), (d), (d-1), and (e),   Education Code;                (7)  Section 526.0505(c), Government Code;                (8)  Section 81.023, Health and Safety Code;                (9)  Section 161.001, Health and Safety Code;                (10)  Section 161.004, Health and Safety Code;                (11)  Section 161.0041, Health and Safety Code;                (12)  Section 161.005, Health and Safety Code;                (13)  Section 161.007(h), Health and Safety Code;                (14)  Section 224.002(c), Health and Safety Code;                (15)  Section 224.003, Health and Safety Code;                (16)  Sections 31.031(d) and (e), Human Resources Code;                (17)  Sections 42.043(a), (c), (d-1), and (f), Human   Resources Code; and                (18)  Section 42.04305(d), Human Resources Code.          SECTION 21.  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, 2026.          SECTION 22.  (a) The changes in law made by this Act to Title   2, Education Code, apply starting with the 2025-2026 school year.          (b)  The changes in law made by this Act to Title 3, Education   Code, apply starting with the 2025-2026 academic year.          SECTION 23.  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, 2025.