By: Zaffirini, et al. S.B. No. 266
A BILL TO BE ENTITLED
AN ACT
1-1 relating to mandatory immunizations and to the provision of those
1-2 immunizations.
1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-4 SECTION 1. Section 161.001, Health and Safety Code, is
1-5 amended to read as follows:
1-6 Sec. 161.001. LIABILITY OF PERSON WHO ORDERS OR ADMINISTERS
1-7 IMMUNIZATION. (a) A person who administers or authorizes the
1-8 administration of a vaccine or immunizing agent is not liable for
1-9 an injury caused by the vaccine or immunizing agent if the
1-10 immunization is required by the board or is otherwise required by
1-11 law or rule.
1-12 (b) A person who administers or authorizes the
1-13 administration of a vaccine or immunization agent is not liable or
1-14 responsible because of the failure or refusal of a parent, managing
1-15 conservator, or guardian to consent to the vaccination or
1-16 immunization required under this chapter.
1-17 (c) This section does not apply to a negligent act in
1-18 administering the vaccine or immunizing agent.
1-19 SECTION 2. Subchapter A, Chapter 161, Health and Safety
1-20 Code, is amended by adding Sections 161.004 and 161.005 to read as
1-21 follows:
1-22 Sec. 161.004. STATEWIDE IMMUNIZATION OF CHILDREN.
1-23 (a) Every child in the state shall be immunized against vaccine
1-24 preventable diseases in accordance with the immunization schedule
2-1 adopted by the board.
2-2 (b) Hospitals shall be responsible for:
2-3 (1) referring newborns for immunization at the time
2-4 the newborn screening test is performed;
2-5 (2) reviewing the immunization history of every child
2-6 admitted to the hospital or examined in the hospital's emergency
2-7 room or outpatient clinic; and
2-8 (3) administering needed vaccinations or referring the
2-9 child for immunization.
2-10 (c) Physicians shall be responsible for reviewing the
2-11 immunization history of every child examined and administering any
2-12 needed vaccinations or referring the child for immunization.
2-13 (d) A child is exempt from an immunization required by this
2-14 section if:
2-15 (1) immunization conflicts with the tenets of an
2-16 organized religion to which a parent, managing conservator, or
2-17 guardian belongs; or
2-18 (2) the immunization is medically contraindicated
2-19 based on an examination of the child by a physician licensed in the
2-20 United States.
2-21 (e) For purposes of this section, "child" means a person
2-22 under 18 years of age.
2-23 (f) The board shall adopt rules that are necessary to
2-24 administer this section.
2-25 Sec. 161.005. IMMUNIZATIONS REQUIRED. (a) On admission of
2-26 a child to a facility of the Texas Department of Mental Health and
2-27 Mental Retardation, or the Texas Youth Commission, the facility
3-1 physician shall review the immunization history of the child and
3-2 administer any needed vaccinations or refer the child for
3-3 immunization.
3-4 (b) The Texas Department of Health and the Texas Board of
3-5 Health have the same powers and duties under this section as those
3-6 entities have under Section 2.09, Education Code. In addition, the
3-7 provisions of that section relating to provisional admissions and
3-8 exceptions apply to this section.
3-9 (c) A facility covered by this section shall keep an
3-10 individual immunization record during the individual's period of
3-11 admission, detention, or commitment in the facility, and the
3-12 records shall be open for inspection at all reasonable times by a
3-13 representative of the local health department or the Texas
3-14 Department of Health.
3-15 (d) This section does not affect the requirements of Section
3-16 2.09, Education Code, or Section 42.043, Human Resources Code.
3-17 SECTION 3. Section 12.033, Health and Safety Code, is
3-18 amended to read as follows:
3-19 Sec. 12.033. <FEES FOR> DISTRIBUTION AND ADMINISTRATION OF
3-20 CERTAIN VACCINES AND SERA. (a) Except as otherwise provided by
3-21 this section, the <The> board by rule shall charge fees for the
3-22 distribution and administration of vaccines and sera provided
3-23 under:
3-24 (1) Section 2.09, Education Code;
3-25 (2) Section 42.043, Human Resources Code;
3-26 (3) Chapter 826 (Rabies Control Act of 1981); <and>
3-27 (4) Chapter 81 (Communicable Disease Prevention and
4-1 Control Act); and
4-2 (5) Section 161.005, Health and Safety Code.
4-3 (b) Except as otherwise provided by this section, the <The>
4-4 board by rule may require a department contractor to charge fees
4-5 for public health services provided by a contractor participating
4-6 in a department program under the laws specified by Subsection (a).
4-7 (c) The board by rule shall establish a fee schedule for
4-8 fees under this section. In establishing the fee schedule, the
4-9 board shall consider a person's financial ability to pay the entire
4-10 amount of the fee <shall set the fees in amounts reasonable and
4-11 necessary to defray the cost to the state of distributing and
4-12 administering the vaccines and sera>.
4-13 (d) The commissioner may waive the fee requirement for any
4-14 type of vaccine or serum if the commissioner determines that:
4-15 (1) a public health emergency exists; and
4-16 (2) the vaccine or serum is needed to meet the
4-17 emergency.
4-18 (e) The department may not deny an immunization to an
4-19 individual required to be immunized under a law specified by
4-20 Subsection (a) because of the individual's inability to pay for the
4-21 immunization. The department shall provide the immunization at a
4-22 reduced charge or no charge according to the financial ability of
4-23 the individual or a person with a legal obligation to support the
4-24 individual to pay for the immunization.
4-25 SECTION 4. (a) The Texas Department of Health shall study
4-26 new and innovative ways to reach the goal of 100 percent
4-27 immunization of children under the age of 18 at the earliest
5-1 possible date and in the most cost-effective manner, including
5-2 seeking discretionary funding from the United States Department of
5-3 Health and Human Services or from foundations for an emergency
5-4 immunization demonstration program that would target five counties
5-5 in Texas with the lowest immunization rates and create model
5-6 programs for those counties, seeking discretionary funding from the
5-7 United States Department of Health and Human Services or from
5-8 foundations to develop models for building public awareness
5-9 concerning the importance of preschool immunization among high-risk
5-10 populations, contracting with the United States Armed Forces, the
5-11 public medical schools, health science centers, and other state
5-12 agencies, and instituting programs on a statewide or local level or
5-13 through mobile outreach clinics utilizing volunteer health care
5-14 providers.
5-15 (b) The Texas Department of Health shall also study the
5-16 development and implementation of a statewide immunization
5-17 registry.
5-18 (c) The Texas Department of Health shall use existing staff
5-19 and resources to conduct studies under this section and shall
5-20 report its findings and recommendations to the governor and to the
5-21 presiding officer of each house of the legislature not later than
5-22 June 1, 1994.
5-23 SECTION 5. This Act takes effect September 1, 1993.
5-24 SECTION 6. The importance of this legislation and the
5-25 crowded condition of the calendars in both houses create an
5-26 emergency and an imperative public necessity that the
5-27 constitutional rule requiring bills to be read on three several
6-1 days in each house be suspended, and this rule is hereby suspended.