73R7136 MLR-F
By Zaffirini, et al. S.B. No. 266
Substitute the following for S.B. No. 266:
By McDonald C.S.S.B. No. 266
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to immunizations.
1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-4 SECTION 1. Section 12.033, Health and Safety Code, is
1-5 amended to read as follows:
1-6 Sec. 12.033. <FEES FOR> DISTRIBUTION AND ADMINISTRATION OF
1-7 CERTAIN VACCINES AND SERA. (a) Except as otherwise provided by
1-8 this section, the <The> board by rule shall charge fees for the
1-9 distribution and administration of vaccines and sera provided
1-10 under:
1-11 (1) Section 2.09, Education Code;
1-12 (2) Section 42.043, Human Resources Code;
1-13 (3) Chapter 826 (Rabies Control Act of 1981); <and>
1-14 (4) Chapter 81 (Communicable Disease Prevention and
1-15 Control Act); and
1-16 (5) Section 161.005, Health and Safety Code.
1-17 (b) Except as otherwise provided by this section, the <The>
1-18 board by rule may require a department contractor to charge fees
1-19 for public health services provided by a contractor participating
1-20 in a department program under the laws specified by Subsection (a).
1-21 (c) The board by rule shall establish a fee schedule for
1-22 fees under this section. In establishing the fee schedule, the
1-23 board shall consider a person's financial ability to pay all or
1-24 part of the fee, including the availability of health insurance
2-1 coverage <shall set the fees in amounts reasonable and necessary to
2-2 defray the cost to the state of distributing and administering the
2-3 vaccines and sera>.
2-4 (d) The commissioner may waive the fee requirement for any
2-5 type of vaccine or serum if the commissioner determines that:
2-6 (1) a public health emergency exists; and
2-7 (2) the vaccine or serum is needed to meet the
2-8 emergency.
2-9 (e) The department may not deny an immunization to an
2-10 individual required to be immunized under a law specified by
2-11 Subsection (a) because of the individual's inability to pay for the
2-12 immunization. The department shall provide the immunization at a
2-13 reduced charge or no charge according to the financial ability of
2-14 the individual or a person with a legal obligation to support the
2-15 individual to pay for the immunization. The department shall give
2-16 priority to those persons least able to pay for immunization.
2-17 SECTION 2. Section 161.001, Health and Safety Code, is
2-18 amended to read as follows:
2-19 Sec. 161.001. LIABILITY OF PERSON WHO ORDERS OR ADMINISTERS
2-20 IMMUNIZATION. (a) A person who administers or authorizes the
2-21 administration of a vaccine or immunizing agent is not liable for
2-22 an injury caused by the vaccine or immunizing agent if the
2-23 immunization is required by the board or is otherwise required by
2-24 law or rule.
2-25 (b) A person who administers or authorizes the
2-26 administration of a vaccine or immunization agent is not liable or
2-27 responsible because of the failure or refusal of a parent, managing
3-1 conservator, or guardian to consent to the vaccination or
3-2 immunization required under this chapter.
3-3 (c) This section does not apply to a negligent act in
3-4 administering the vaccine or immunizing agent.
3-5 SECTION 3. Subchapter A, Chapter 161, Health and Safety
3-6 Code, is amended by adding Sections 161.004-161.006 to read as
3-7 follows:
3-8 Sec. 161.004. STATEWIDE IMMUNIZATION OF CHILDREN.
3-9 (a) Every child in the state shall be immunized against vaccine
3-10 preventable diseases in accordance with the immunization schedule
3-11 adopted by the board.
3-12 (b) Hospitals shall be responsible for:
3-13 (1) referring newborns for immunization at the time
3-14 the newborn screening test is performed;
3-15 (2) reviewing the immunization history of every child
3-16 admitted to the hospital or examined in the hospital's emergency
3-17 room or outpatient clinic; and
3-18 (3) administering needed vaccinations or referring the
3-19 child for immunization.
3-20 (c) Physicians shall be responsible for reviewing the
3-21 immunization history of every child examined and administering any
3-22 needed vaccinations or referring the child for immunization.
3-23 (d) A child is exempt from an immunization required by this
3-24 section if:
3-25 (1) immunization conflicts with the tenets of an
3-26 organized religion to which a parent, managing conservator, or
3-27 guardian belongs; or
4-1 (2) the immunization is medically contraindicated
4-2 based on an examination of the child by a physician licensed in the
4-3 United States.
4-4 (e) For purposes of this section, "child" means a person
4-5 under 18 years of age.
4-6 (f) The board shall adopt rules that are necessary to
4-7 administer this section.
4-8 Sec. 161.005. IMMUNIZATIONS REQUIRED. (a) On admission of
4-9 a child to a facility of the Texas Department of Mental Health and
4-10 Mental Retardation or the Texas Youth Commission, the facility
4-11 physician shall review the immunization history of the child and
4-12 administer any needed vaccinations or refer the child for
4-13 immunization.
4-14 (b) The Texas Department of Health and the Texas Board of
4-15 Health have the same powers and duties under this section as those
4-16 entities have under Section 2.09, Education Code. In addition, the
4-17 provisions of that section relating to provisional admissions and
4-18 exceptions apply to this section.
4-19 (c) A facility covered by this section shall keep an
4-20 individual immunization record during the individual's period of
4-21 admission, detention, or commitment in the facility, and the
4-22 records shall be open for inspection at all reasonable times by a
4-23 representative of the local health department or the Texas
4-24 Department of Health.
4-25 (d) This section does not affect the requirements of Section
4-26 2.09, Education Code, or Section 42.043, Human Resources Code.
4-27 Sec. 161.006. DEPARTMENT IMMUNIZATION SERVICE. The
5-1 department, to the extent permitted by law, is authorized to pay
5-2 employees who are exempt or not exempt for purposes of the Fair
5-3 Labor Standards Act of 1938 (29 U.S.C. Sec. 201 et seq.) on a
5-4 straight-time basis for work on a holiday or for regular
5-5 compensatory time hours when the taking of regular compensatory
5-6 time off would be disruptive to normal business operation.
5-7 SECTION 4. Section 15.003, Agriculture Code, is amended to
5-8 read as follows:
5-9 Sec. 15.003. Eligibility; Amount of Allotment. (a) A
5-10 person is eligible to participate in the special nutrition program
5-11 if the person is enrolled in the W.I.C. program, <and> resides in
5-12 an area in which the special nutrition program is implemented, and
5-13 provides any proof required by the Texas Department of Health under
5-14 Subsection (b). The Texas Department of Health shall determine the
5-15 eligibility of potential participants.
5-16 (b) The Texas Department of Health by rule shall require
5-17 that a person who has a dependent child and who applies to
5-18 participate in the special nutrition program provide proof to the
5-19 department that each dependent child living with the person:
5-20 (1) has been immunized;
5-21 (2) is currently receiving an immunization series in
5-22 accordance with Section 161.004, Health and Safety Code, if the
5-23 child is of sufficient age; or
5-24 (3) is exempted under Section 161.004(d), Health and
5-25 Safety Code.
5-26 (c) Only the Texas Department of Health may determine the
5-27 dollar amount of each participant's monthly allotment of food
6-1 coupons.
6-2 SECTION 5. Subchapter A, Chapter 31, Human Resources Code,
6-3 is amended by adding Section 31.013 to read as follows:
6-4 Sec. 31.013. IMMUNIZATION REQUIREMENT. The department by
6-5 rule shall require a person receiving financial assistance and
6-6 services on behalf of a dependent child to provide proof to the
6-7 department that each dependent child for whom the person is
6-8 receiving assistance:
6-9 (1) has been immunized;
6-10 (2) is currently receiving an immunization series in
6-11 accordance with Section 161.004, Health and Safety Code, if the
6-12 child is of sufficient age; or
6-13 (3) is exempted under Section 161.004(d), Health and
6-14 Safety Code.
6-15 SECTION 6. (a) If before implementing Section 15.003(b),
6-16 Agriculture Code, as amended by this Act, the Texas Department of
6-17 Health determines that a waiver or authorization from a federal
6-18 agency is necessary for implementation, the department shall
6-19 request the waiver or authorization and may delay implementing
6-20 those provisions until the waiver or authorization is granted.
6-21 (b) If before implementing Section 31.013, Human Resources
6-22 Code, as added by this Act, the Texas Department of Human Services
6-23 determines that a waiver or authorization from a federal agency is
6-24 necessary for implementation, the department shall request the
6-25 waiver or authorization and may delay implementing those provisions
6-26 until the waiver or authorization is granted.
6-27 SECTION 7. (a) Except as provided by Subsection (b) of this
7-1 section, this Act takes effect September 1, 1993, and applies only
7-2 to a person who applies for participation in the special nutrition
7-3 program or who applies for assistance under Chapter 31, Human
7-4 Resources Code, on or after that date.
7-5 (b) A person who is participating in the special nutrition
7-6 program or who is receiving assistance under Chapter 31, Human
7-7 Resources Code, on the effective date of this Act is not required
7-8 to provide proof under Section 15.003(b), Agriculture Code, as
7-9 amended by this Act, or Section 31.013, Human Resources Code, as
7-10 added by this Act, before January 1, 1994.
7-11 SECTION 8. The importance of this legislation and the
7-12 crowded condition of the calendars in both houses create an
7-13 emergency and an imperative public necessity that the
7-14 constitutional rule requiring bills to be read on three several
7-15 days in each house be suspended, and this rule is hereby suspended.