S.B. No. 266
                                        AN ACT
    1-1  relating to immunizations.
    1-2        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
    1-3        SECTION 1.  Section 12.033, Health and Safety Code, is
    1-4  amended to read as follows:
    1-5        Sec. 12.033.  <FEES FOR> DISTRIBUTION AND ADMINISTRATION OF
    1-6  CERTAIN VACCINES AND SERA.  (a)  Except as otherwise provided by
    1-7  this section, the <The> board by rule shall charge fees for the
    1-8  distribution and administration of vaccines and sera provided
    1-9  under:
   1-10              (1)  Section 2.09, Education Code;
   1-11              (2)  Section 42.043, Human Resources Code;
   1-12              (3)  Chapter 826 (Rabies Control Act of 1981); <and>
   1-13              (4)  Chapter 81 (Communicable Disease Prevention and
   1-14  Control Act); and
   1-15              (5)  Section 161.005, Health and Safety Code.
   1-16        (b)  Except as otherwise provided by this section, the <The>
   1-17  board by rule may require a department contractor to charge fees
   1-18  for public health services provided by a contractor participating
   1-19  in a department program under the laws specified by Subsection (a).
   1-20        (c)  Provided the board finds that the monetary savings of
   1-21  this subsection are greater than any costs associated with
   1-22  administering it, the <The> board by rule shall establish a fee
   1-23  schedule for fees under this section.  In establishing the fee
   1-24  schedule, the board shall consider a person's financial ability to
    2-1  pay all or part of the fee, including the availability of health
    2-2  insurance coverage.  In the event the fee schedule conflicts with
    2-3  any federal law or regulation, the board shall seek a waiver from
    2-4  the applicable federal law or regulation to permit the fee
    2-5  schedule.  In the event the waiver is denied, the fee schedule
    2-6  shall not go into effect <shall set the fees in amounts reasonable
    2-7  and necessary to defray the cost to the state of distributing and
    2-8  administering the vaccines and sera>.
    2-9        (d)  The commissioner may waive the fee requirement for any
   2-10  type of vaccine or serum if the commissioner determines that:
   2-11              (1)  a public health emergency exists; and
   2-12              (2)  the vaccine or serum is needed to meet the
   2-13  emergency.
   2-14        (e)  The department may not deny an immunization to an
   2-15  individual required to be immunized under a law specified by
   2-16  Subsection (a) because of the individual's inability to pay for the
   2-17  immunization.  The department shall provide the immunization at a
   2-18  reduced charge or no charge according to the financial ability of
   2-19  the individual or a person with a legal obligation to support the
   2-20  individual to pay for the immunization.  The department shall give
   2-21  priority to those persons least able to pay for immunization.
   2-22        SECTION 2.  Section 161.001, Health and Safety Code, is
   2-23  amended to read as follows:
   2-24        Sec. 161.001.  LIABILITY OF PERSON WHO ORDERS OR ADMINISTERS
   2-25  IMMUNIZATION.  (a)  A person who administers or authorizes the
   2-26  administration of a vaccine or immunizing agent is not liable for
   2-27  an injury caused by the vaccine or immunizing agent if the
    3-1  immunization is required by the board or is otherwise required by
    3-2  law or rule.
    3-3        (b)  A person who administers or authorizes the
    3-4  administration of a vaccine or immunizing agent is not liable or
    3-5  responsible for the failure to immunize a child because of the
    3-6  failure or refusal of a parent, managing conservator, or guardian
    3-7  to consent to the vaccination or immunization required under this
    3-8  chapter.  Consent to the vaccination or immunization must be given
    3-9  in the manner authorized by Sections 35.011 through 35.015, Family
   3-10  Code.
   3-11        (c)  A person who fails to comply with Section 161.004 is not
   3-12  liable or responsible for that failure, and that failure does not
   3-13  create a cause of action.
   3-14        (d)  This section does not apply to a negligent act in
   3-15  administering the vaccine or immunizing agent.
   3-16        SECTION 3.  Subchapter A, Chapter 161, Health and Safety
   3-17  Code, is amended by adding Sections 161.004 through 161.006 to read
   3-18  as follows:
   3-19        Sec. 161.004.  STATEWIDE IMMUNIZATION OF CHILDREN.
   3-20  (a)  Every child in the state shall be immunized against vaccine
   3-21  preventable diseases caused by infectious agents in accordance with
   3-22  the immunization schedule adopted by the board.
   3-23        (b)  Hospitals shall be responsible for:
   3-24              (1)  referring newborns for immunization at the time
   3-25  the newborn screening test is performed;
   3-26              (2)  reviewing the immunization history of every child
   3-27  admitted to the hospital or examined in the hospital's emergency
    4-1  room or outpatient clinic; and
    4-2              (3)  administering needed vaccinations or referring the
    4-3  child for immunization.
    4-4        (c)  Physicians shall be responsible for reviewing the
    4-5  immunization history of every child examined and administering any
    4-6  needed vaccinations or referring the child for immunization.
    4-7        (d)  A child is exempt from an immunization required by this
    4-8  section if:
    4-9              (1)  immunization conflicts with the tenets of an
   4-10  organized religion to which a parent, managing conservator, or
   4-11  guardian belongs; or
   4-12              (2)  the immunization is medically contraindicated
   4-13  based on an examination of the child by a physician licensed by any
   4-14  state in the United States.
   4-15        (e)  For purposes of this section, "child" means a person
   4-16  under 18 years of age.
   4-17        (f)  The board shall adopt rules that are necessary to
   4-18  administer this section.
   4-19        (g)  A parent, managing conservator, or guardian may choose
   4-20  the health care provider who administers the vaccine or immunizing
   4-21  agent under this chapter.
   4-22        Sec. 161.005.  IMMUNIZATIONS REQUIRED.  (a)  On admission of
   4-23  a child to a facility of the Texas Department of Mental Health and
   4-24  Mental Retardation, the Texas Department of Criminal Justice, or
   4-25  the Texas Youth Commission, the facility physician shall review the
   4-26  immunization history of the child and administer any needed
   4-27  vaccinations or refer the child for immunization.
    5-1        (b)  The department and the board have the same powers and
    5-2  duties under this section as those entities have under Section
    5-3  2.09, Education Code.  In addition, the provisions of that section
    5-4  relating to provisional admissions and exceptions apply to this
    5-5  section.
    5-6        (c)  A facility covered by this section shall keep an
    5-7  individual immunization record during the individual's period of
    5-8  admission, detention, or commitment in the facility, and the
    5-9  records shall be open for inspection at all reasonable times by a
   5-10  representative of the local health department or the department.
   5-11        (d)  This section does not affect the requirements of Section
   5-12  2.09, Education Code, or Section 42.043, Human Resources Code.
   5-13        Sec. 161.006.  DEPARTMENT IMMUNIZATION SERVICE.  The
   5-14  department, to the extent permitted by law, is authorized to pay
   5-15  employees who are exempt or not exempt for purposes of the Fair
   5-16  Labor Standards Act of 1938 (29 U.S.C. Section 201 et seq.) on a
   5-17  straight-time basis for work on a holiday or for regular
   5-18  compensatory time hours when the taking of regular compensatory
   5-19  time off would be disruptive to normal business operations.
   5-20  Authorization for payment under this section is limited to work
   5-21  directly related to immunizations.
   5-22        SECTION 4.  An agency is not required to carry out the duties
   5-23  relating to this Act except to the extent that funds for those
   5-24  purposes are appropriated to the agency or are otherwise available.
   5-25        SECTION 5.  Subsection (b), Section 42.043, Human Resources
   5-26  Code, is amended to read as follows:
   5-27        (b)  The department shall require that each child at an
    6-1  appropriate age have a test for tuberculosis and be immunized
    6-2  against diphtheria, tetanus, poliomyelitis, mumps, rubella, and
    6-3  rubeola.  The immunization must be effective on the date of first
    6-4  entry into the facility.  However, a child may be provisionally
    6-5  admitted if the required immunizations have begun and are completed
    6-6  as rapidly as medically feasible.
    6-7        SECTION 6.  (a)  Except as provided by Subsection (b) of this
    6-8  section, Subsection (b), Section 42.043, Human Resources Code, as
    6-9  amended by this Act, takes effect September 1, 1993, and the
   6-10  changes made by this Act to that section apply to a child admitted
   6-11  to a child-care facility as defined by Section 42.002, Human
   6-12  Resources Code, on or after that date.
   6-13        (b)  A child-care facility as defined by Section 42.002,
   6-14  Human Resources Code, may not be required to comply with the
   6-15  changes made by this Act to Subsection (b), Section 42.043, Human
   6-16  Resources Code, for a child admitted to the facility before
   6-17  September 1, 1993, earlier than January 1, 1994.
   6-18        SECTION 7.  This Act takes effect September 1, 1993.
   6-19        SECTION 8.  The importance of this legislation and the
   6-20  crowded condition of the calendars in both houses create an
   6-21  emergency and an imperative public necessity that the
   6-22  constitutional rule requiring bills to be read on three several
   6-23  days in each house be suspended, and this rule is hereby suspended.