1-1 By: Zaffirini, et al. S.B. No. 266
1-2 (In the Senate - Filed February 4, 1993; February 8, 1993,
1-3 read first time and referred to Committee on Health and Human
1-4 Services; March 9, 1993, reported adversely, with favorable
1-5 Committee Substitute by the following vote: Yeas 9, Nays 0;
1-6 March 9, 1993, sent to printer.)
1-7 COMMITTEE VOTE
1-8 Yea Nay PNV Absent
1-9 Zaffirini x
1-10 Ellis x
1-11 Madla x
1-12 Moncrief x
1-13 Nelson x
1-14 Patterson x
1-15 Shelley x
1-16 Truan x
1-17 Wentworth x
1-18 COMMITTEE SUBSTITUTE FOR S.B. No. 266 By: Zaffirini
1-19 A BILL TO BE ENTITLED
1-20 AN ACT
1-21 relating to mandatory immunizations and to the provision of those
1-22 immunizations.
1-23 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-24 SECTION 1. Section 161.001, Health and Safety Code, is
1-25 amended to read as follows:
1-26 Sec. 161.001. LIABILITY OF PERSON WHO ORDERS OR ADMINISTERS
1-27 IMMUNIZATION. (a) A person who administers or authorizes the
1-28 administration of a vaccine or immunizing agent is not liable for
1-29 an injury caused by the vaccine or immunizing agent if the
1-30 immunization is required by the board or is otherwise required by
1-31 law or rule.
1-32 (b) A person who administers or authorizes the
1-33 administration of a vaccine or immunization agent is not liable or
1-34 responsible because of the failure or refusal of a parent, managing
1-35 conservator, or guardian to consent to the vaccination or
1-36 immunization required under this chapter.
1-37 (c) This section does not apply to a negligent act in
1-38 administering the vaccine or immunizing agent.
1-39 SECTION 2. Subchapter A, Chapter 161, Health and Safety
1-40 Code, is amended by adding Sections 161.004 and 161.005 to read as
1-41 follows:
1-42 Sec. 161.004. STATEWIDE IMMUNIZATION OF CHILDREN.
1-43 (a) Every child in the state shall be immunized against vaccine
1-44 preventable diseases in accordance with the immunization schedule
1-45 adopted by the board.
1-46 (b) Hospitals shall be responsible for:
1-47 (1) referring newborns for immunization at the time
1-48 the newborn screening test is performed;
1-49 (2) reviewing the immunization history of every child
1-50 admitted to the hospital or examined in the hospital's emergency
1-51 room or outpatient clinic; and
1-52 (3) administering needed vaccinations or referring the
1-53 child for immunization.
1-54 (c) Physicians shall be responsible for reviewing the
1-55 immunization history of every child examined and administering any
1-56 needed vaccinations or referring the child for immunization.
1-57 (d) A child is exempt from an immunization required by this
1-58 section if:
1-59 (1) immunization conflicts with the tenets of an
1-60 organized religion to which a parent, managing conservator, or
1-61 guardian belongs; or
1-62 (2) the immunization is medically contraindicated
1-63 based on an examination of the child by a physician licensed in the
1-64 United States.
1-65 (e) For purposes of this section, "child" means a person
1-66 under 18 years of age.
1-67 (f) The board shall adopt rules that are necessary to
1-68 administer this section.
2-1 Sec. 161.005. IMMUNIZATIONS REQUIRED. (a) On admission of
2-2 a child to a facility of the Texas Department of Mental Health and
2-3 Mental Retardation, or the Texas Youth Commission, the facility
2-4 physician shall review the immunization history of the child and
2-5 administer any needed vaccinations or refer the child for
2-6 immunization.
2-7 (b) The Texas Department of Health and the Texas Board of
2-8 Health have the same powers and duties under this section as those
2-9 entities have under Section 2.09, Education Code. In addition, the
2-10 provisions of that section relating to provisional admissions and
2-11 exceptions apply to this section.
2-12 (c) A facility covered by this section shall keep an
2-13 individual immunization record during the individual's period of
2-14 admission, detention, or commitment in the facility, and the
2-15 records shall be open for inspection at all reasonable times by a
2-16 representative of the local health department or the Texas
2-17 Department of Health.
2-18 (d) This section does not affect the requirements of Section
2-19 2.09, Education Code, or Section 42.043, Human Resources Code.
2-20 SECTION 3. Section 12.033, Health and Safety Code, is
2-21 amended to read as follows:
2-22 Sec. 12.033. <FEES FOR> DISTRIBUTION AND ADMINISTRATION OF
2-23 CERTAIN VACCINES AND SERA. (a) Except as otherwise provided by
2-24 this section, the <The> board by rule shall charge fees for the
2-25 distribution and administration of vaccines and sera provided
2-26 under:
2-27 (1) Section 2.09, Education Code;
2-28 (2) Section 42.043, Human Resources Code;
2-29 (3) Chapter 826 (Rabies Control Act of 1981); <and>
2-30 (4) Chapter 81 (Communicable Disease Prevention and
2-31 Control Act); and
2-32 (5) Section 161.005, Health and Safety Code.
2-33 (b) Except as otherwise provided by this section, the <The>
2-34 board by rule may require a department contractor to charge fees
2-35 for public health services provided by a contractor participating
2-36 in a department program under the laws specified by Subsection (a).
2-37 (c) The board by rule shall establish a fee schedule for
2-38 fees under this section. In establishing the fee schedule, the
2-39 board shall consider a person's financial ability to pay the entire
2-40 amount of the fee <shall set the fees in amounts reasonable and
2-41 necessary to defray the cost to the state of distributing and
2-42 administering the vaccines and sera>.
2-43 (d) The commissioner may waive the fee requirement for any
2-44 type of vaccine or serum if the commissioner determines that:
2-45 (1) a public health emergency exists; and
2-46 (2) the vaccine or serum is needed to meet the
2-47 emergency.
2-48 (e) The department may not deny an immunization to an
2-49 individual required to be immunized under a law specified by
2-50 Subsection (a) because of the individual's inability to pay for the
2-51 immunization. The department shall provide the immunization at a
2-52 reduced charge or no charge according to the financial ability of
2-53 the individual or a person with a legal obligation to support the
2-54 individual to pay for the immunization.
2-55 SECTION 4. (a) The Texas Department of Health shall study
2-56 new and innovative ways to reach the goal of 100 percent
2-57 immunization of children under the age of 18 at the earliest
2-58 possible date and in the most cost-effective manner, including
2-59 seeking discretionary funding from the United States Department of
2-60 Health and Human Services or from foundations for an emergency
2-61 immunization demonstration program that would target five counties
2-62 in Texas with the lowest immunization rates and create model
2-63 programs for those counties, seeking discretionary funding from the
2-64 United States Department of Health and Human Services or from
2-65 foundations to develop models for building public awareness
2-66 concerning the importance of preschool immunization among high-risk
2-67 populations, contracting with the United States Armed Forces, the
2-68 public medical schools, health science centers, and other state
2-69 agencies, and instituting programs on a statewide or local level or
2-70 through mobile outreach clinics utilizing volunteer health care
3-1 providers.
3-2 (b) The Texas Department of Health shall also study the
3-3 development and implementation of a statewide immunization
3-4 registry.
3-5 (c) The Texas Department of Health shall use existing staff
3-6 and resources to conduct studies under this section and shall
3-7 report its findings and recommendations to the governor and to the
3-8 presiding officer of each house of the legislature not later than
3-9 June 1, 1994.
3-10 SECTION 5. This Act takes effect September 1, 1993.
3-11 SECTION 6. The importance of this legislation and the
3-12 crowded condition of the calendars in both houses create an
3-13 emergency and an imperative public necessity that the
3-14 constitutional rule requiring bills to be read on three several
3-15 days in each house be suspended, and this rule is hereby suspended.
3-16 * * * * *
3-17 Austin,
3-18 Texas
3-19 March 9, 1993
3-20 Hon. Bob Bullock
3-21 President of the Senate
3-22 Sir:
3-23 We, your Committee on Health and Human Services to which was
3-24 referred S.B. No. 266, have had the same under consideration, and I
3-25 am instructed to report it back to the Senate with the
3-26 recommendation that it do not pass, but that the Committee
3-27 Substitute adopted in lieu thereof do pass and be printed.
3-28 Ellis,
3-29 Vice-Chair
3-30 * * * * *
3-31 WITNESSES
3-32 FOR AGAINST ON
3-33 ___________________________________________________________________
3-34 Name: Bill Cox x
3-35 Representing: TX Public Non-Profit
3-36 Hospitals
3-37 City: Austin
3-38 -------------------------------------------------------------------
3-39 Name: Dr. David McFarling x
3-40 Representing: U.S. Army
3-41 City: San Antonio
3-42 -------------------------------------------------------------------
3-43 Name: James J. Young x
3-44 Representing: UTHSC
3-45 City: San Antonio
3-46 -------------------------------------------------------------------
3-47 Name: Mariano Camarillo x
3-48 Representing: EDS
3-49 City: Austin
3-50 -------------------------------------------------------------------
3-51 Name: Sharron Cox x
3-52 Representing: Children's Hosp. Association
3-53 City: Houston
3-54 -------------------------------------------------------------------
3-55 Name: Neil Nichols x
3-56 Representing: TX Youth Commission
3-57 City: Austin
3-58 -------------------------------------------------------------------
3-59 Name: Jon Hilsabeck x
3-60 Representing: TX Hospital Assn
3-61 City: Austin
3-62 -------------------------------------------------------------------
3-63 FOR AGAINST ON
3-64 ___________________________________________________________________
3-65 Name: Sandy Kibby x
3-66 Representing: TX PTA
3-67 City: Austin
3-68 -------------------------------------------------------------------
3-69 Name: Sara Rusk McGonagle x
3-70 Representing: TX Nurses Assn.
4-1 City: Austin
4-2 -------------------------------------------------------------------
4-3 Name: Rusty Kelly x
4-4 Representing: Children's Hospital
4-5 City: Austin
4-6 -------------------------------------------------------------------
4-7 Name: Karen Lindell x
4-8 Representing: TX Rural Health Assn.
4-9 City: Austin
4-10 -------------------------------------------------------------------
4-11 Name: Susan Steeg x
4-12 Representing: Texas Dept. of Health
4-13 City: Austin
4-14 -------------------------------------------------------------------
4-15 Name: Diane Simpson x
4-16 Representing: Texas Dept. of Health
4-17 City: Austin
4-18 -------------------------------------------------------------------
4-19 Name: Pam Beachley x
4-20 Representing: Bus. Insurance Consumer
4-21 Assn.
4-22 City: Austin
4-23 -------------------------------------------------------------------
4-24 Name: Lisa McGiffert x
4-25 Representing: Consumers Union
4-26 City: Austin
4-27 -------------------------------------------------------------------
4-28 Name: Dr. Clift Price x
4-29 Representing: TX Nurse Assn.
4-30 City: Austin
4-31 -------------------------------------------------------------------
4-32 Name: Karen Hale x
4-33 Representing: TX MHMR
4-34 City: Austin
4-35 -------------------------------------------------------------------
4-36 Name: Bee Moorhead x
4-37 Representing: Comptroller
4-38 City: Austin
4-39 -------------------------------------------------------------------
4-40 Name: Jacqueline Lyons x
4-41 Representing: Comptroller
4-42 City: Austin
4-43 -------------------------------------------------------------------