85R2853 DMS-D     By: Howard H.B. No. 241       A BILL TO BE ENTITLED   AN ACT   relating to a health care practitioner counseling requirement for   persons claiming an immunization exemption on the basis of   conscience, including a religious belief.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Section 38.001(c), Education Code, is amended to   read as follows:          (c)  Immunization is not required for a person's admission to   any elementary or secondary school if the person applying for   admission:                (1)  submits to the admitting official:                      (A)  an affidavit or a certificate signed by a   physician who is duly registered and licensed to practice medicine   in the United States, in which it is stated that, in the physician's   opinion, the immunization required poses a significant risk to the   health and well-being of the applicant or any member of the   applicant's family or household; or                      (B)  an affidavit signed by the applicant or, if a   minor, by the applicant's parent or guardian stating that the   applicant declines immunization for reasons of conscience,   including a religious belief, and a completed health care   practitioner counseling certification stating that the   practitioner has provided information on the risks and benefits of   immunization; or                (2)  is a member of the armed forces of the United   States and is on active duty.          SECTION 2.  Sections 51.9192(d) and (d-3), Education Code,   are amended to read as follows:          (d)  A student to whom this section applies or a parent or   guardian of the student is not required to comply with Subsection   (c) if the student or a parent or guardian of the student submits to   the institution:                (1)  an affidavit or a certificate signed by a   physician who is duly registered and licensed to practice medicine   in the United States in which it is stated that, in the physician's   opinion, the vaccination required would be injurious to the health   and well-being of the student; or                (2)  an affidavit signed by the student stating that   the student declines the vaccination for bacterial meningitis for   reasons of conscience, including a religious belief, or   confirmation that the student has completed the Internet-based   process described by Subsection (d-3) for declining the vaccination   on that basis, if applicable to the student, and a completed health   care practitioner counseling certification stating that the   practitioner has provided information on the risks and benefits of   immunization.          (d-3)  The Department of State Health Services shall develop   and implement a secure, Internet-based process to be used   exclusively at those public junior colleges that elect to use the   process to allow an entering student to apply online for an   exemption from the vaccination requirement under this section for   reasons of conscience.  The online process portal must be designed   to ensure that duplicate exemption requests are avoided to the   greatest extent possible.  The exemption form used by a student to   claim an exemption under the process must contain a statement   indicating that the student understands the benefits and risks of   the immunization and the benefits and risks of not receiving the   immunization. A student who uses the Internet-based process under   this section is required to submit, in the manner prescribed by the   college, a completed health care practitioner counseling   certification stating that the practitioner has provided   information on the risks and benefits of immunization.          SECTION 3.  Section 51.933(d), Education Code, is amended to   read as follows:          (d)  No form of immunization is required for a person's   admission to an institution of higher education if the person   applying for admission:                (1)  submits to the admitting official:                      (A)  an affidavit or a certificate signed by a   physician who is duly registered and licensed to practice medicine   within the United States in which it is stated that, in the   physician's opinion, the immunization required poses a significant   risk to the health and well-being of the applicant or any member of   the applicant's family or household; or                      (B)  an affidavit signed by the applicant or, if a   minor, by the applicant's parent or guardian stating that the   applicant declines immunization for reasons of conscience,   including a religious belief, and a completed health care   practitioner counseling certification stating that the   practitioner has provided information on the risks and benefits of   immunization; or                (2)  is a member of the armed forces of the United   States and is on active duty.          SECTION 4.  Section 161.004(d), Health and Safety Code, is   amended to read as follows:          (d)  A child is exempt from an immunization required by this   section if:                (1)  a parent, managing conservator, or guardian states   that:                      (A)  the immunization is being declined for   reasons of conscience, including a religious belief; and                      (B)  the parent, managing conservator, or   guardian has been counseled by a physician, advanced practice   registered nurse, or physician assistant on the risks and benefits   of immunization; or                (2)  the immunization is medically contraindicated   based on the opinion of a physician licensed by any state in the   United States who has examined the child.          SECTION 5.  The heading to Section 161.0041, Health and   Safety Code, is amended to read as follows:          Sec. 161.0041.  IMMUNIZATION EXEMPTION AFFIDAVIT FORM AND   HEALTH CARE PRACTITIONER COUNSELING CERTIFICATION FORM.          SECTION 6.  Section 161.0041, Health and Safety Code, is   amended by amending Subsections (a) and (c) and adding Subsections   (a-1), (d-1), and (d-2) to read as follows:          (a)  A person claiming an exemption from a required   immunization based on reasons of conscience, including a religious   belief, under Section 161.004 of this code, Section 38.001,   51.9192, or 51.933, Education Code, or Section 42.043, Human   Resources Code, must:                (1)  complete an affidavit on a form provided by the   department stating the reason for the exemption; and                (2)  submit a completed health care practitioner   counseling certification.          (a-1)  Subsection (a)(1) [This subsection] does not apply to   a person claiming the exemption using the Internet-based process   under Section 51.9192(d-3), Education Code.          (c)  A person claiming an exemption from a required   immunization under this section may only obtain the affidavit form   by submitting a written request for the affidavit form to the   department. The department shall include a blank copy of the health   care practitioner counseling certification form described by   Subsection (d-1) with each affidavit form sent to a person.          (d-1)  The department shall develop a blank health care   practitioner counseling certification form to be completed by a   physician, advanced practice registered nurse, or physician   assistant who has counseled a person and, if the person is a minor,   the person's parent, managing conservator, or guardian, about the   risks and benefits of immunization. The form must contain:                (1)  spaces for:                      (A)  the name, signature, and license number of   the health care practitioner providing counsel;                      (B)  the name of the person claiming the   exemption, the name of the person's parent, managing conservator,   or guardian, as applicable, and the signature of the person or the   person's parent, managing conservator, or guardian, as applicable;   and                      (C)  the date; and                (2)  the following statement or substantially similar   language:          "I certify that I have provided medically accurate   information on the risks and benefits of immunization."          (d-2)  The department shall make the printable health care   practitioner counseling certification form available on the   department's Internet website.          SECTION 7.  Section 224.002(c), Health and Safety Code, is   amended to read as follows:          (c)  The policy may include procedures for a covered   individual to be exempt from the required vaccines based on reasons   of conscience, including a religious belief, provided that the   policy requires an individual claiming an exemption based on   reasons of conscience to certify that the individual has received   counseling from a physician, advanced practice registered nurse, or   physician assistant on the risks and benefits of vaccines.          SECTION 8.  Section 42.043(d), Human Resources Code, is   amended to read as follows:          (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, and a   completed health care practitioner counseling certification   stating that the practitioner has provided information on the risks   and benefits of immunization.          SECTION 9.  Section 42.04305(d), Human Resources Code, is   amended to read as follows:          (d)  The policy shall include procedures for a facility   employee to be exempt from the required vaccines based on reasons of   conscience, including a religious belief, and those procedures must   include the requirement that the employee claiming the exemption   certify that the employee has received counseling from a physician,   advanced practice registered nurse, or physician assistant on the   risks and benefits of vaccines.          SECTION 10.  (a) Not later than December 1, 2017, the   Department of State Health Services shall make the health care   practitioner counseling certification form required by Section   161.0041, Health and Safety Code, as amended by this Act, available   on the department's Internet website.          (b)  A person claiming an immunization exemption on the basis   of conscience, including a religious belief, on or after January 1,   2018, is required to submit a completed health care practitioner   counseling certification or otherwise affirm that the person has   received counseling from a health care practitioner, as applicable.          (c)  A person claiming an immunization exemption on the basis   of conscience, including a religious belief, before January 1,   2018, is required to submit a completed health care practitioner   counseling certification or otherwise affirm that the person has   received counseling from a health care practitioner, as applicable,   before September 1, 2018, to continue to be eligible for the   exemption.          SECTION 11.  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, 2017.