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.