Amend CSHB 2292 by adding the following appropriately
numbered Sections to Article 2 of the bill and renumbering the
remaining Sections of Article 2 as appropriate:
SECTION ____. Subdivisions (2) and (7), Section 81.003,
Health and Safety Code, are amended to read as follows:
(2) "Health authority" means:
(A) a physician appointed as a health authority
[such] under Chapter 121 (Local Public Health Reorganization Act)
or the health authority's designee; or
(B) a physician appointed as a regional director
under Chapter 121 (Local Public Health Reorganization Act) who
performs the duties of a health authority or the regional
director's designee.
(7) "Public health disaster" means:
(A) a declaration by the governor of a state of
disaster; and
(B) a determination by the commissioner that
there exists an immediate threat from a communicable disease that:
(i) poses a high risk of death or serious
long-term disability to a large number of people; and
(ii) creates a substantial risk of public
exposure because of the disease's high level of contagion or the
method by which the disease is transmitted ["Regional director"
means a physician appointed as such under Chapter 121 (Local Public
Health Reorganization Act)].
SECTION ____. Section 81.004, Health and Safety Code, is
amended by adding Subsection (d) to read as follows:
(d) A designee of the commissioner may exercise a power
granted to or perform a duty imposed on the commissioner under this
chapter except as otherwise required by law.
SECTION ____. Subsection (d), Section 81.023, Health and
Safety Code, is transferred to Subchapter A, Chapter 81, Health and
Safety Code, redesignated as Section 81.011, Health and Safety
Code, and amended to read as follows:
Sec. 81.011. REQUEST FOR INFORMATION. [(d)] In times of
emergency or epidemic declared by the commissioner, the department
[board] is authorized to request information pertaining to names,
dates of birth, and most recent addresses of individuals from the
driver's license records of the Department of Public Safety for the
purpose of notification to individuals of the need to receive
certain immunizations or diagnostic, evaluation, or treatment
services for suspected communicable diseases.
SECTION ____. Section 81.041, Health and Safety Code, is
amended by adding Subsection (f) to read as follows:
(f) In a public health disaster, the commissioner may
require reports of communicable diseases or other health conditions
from providers without board rule or action. The commissioner
shall issue appropriate instructions relating to complying with the
reporting requirements of this section.
SECTION ____. Subsection (a), Section 81.042, Health and
Safety Code, is amended to read as follows:
(a) A report under Subsection (b), (c), or (d) shall be made
to the local health authority [or, if there is no local health
authority, the regional director].
SECTION ____. Section 81.043, Health and Safety Code, is
amended to read as follows:
Sec. 81.043. RECORDS AND REPORTS OF HEALTH AUTHORITY [AND
REGIONAL DIRECTOR]. (a) Each health authority [or regional
director] shall keep a record of each case of a reportable disease
that is reported to the authority [or director].
(b) A health authority [or regional director] shall report
reportable diseases to the department's central office at least as
frequently as the interval set by board rule.
SECTION ____. Section 81.046, Health and Safety Code, is
amended by amending Subsection (b) and adding Subsection (f) to
read as follows:
(b) Reports, records, and information relating to cases or
suspected cases of diseases or health conditions are not public
information under Chapter 552, Government Code, and may not be
released or made public on subpoena or otherwise except as provided
by Subsections (c), [and] (d), and (f).
(f) Reports, records, and information relating to cases or
suspected cases of diseases or health conditions may be released to
the extent necessary during a public health disaster to law
enforcement personnel solely for the purpose of protecting the
health or life of the person identified in the report, record, or
information. Only the minimum necessary information may be
released under this subsection, as determined by the health
authority or the department.
SECTION ____. Section 81.064, Health and Safety Code, is
amended by amending Subsection (a) and adding Subsection (c) to
read as follows:
(a) The department or [commissioner, the commissioner's
designee,] a health authority[, or a health authority's designee]
may enter at reasonable times and inspect within reasonable limits
a public place in the performance of that person's duty to prevent
or control the entry into or spread in this state of communicable
disease by enforcing this chapter or the rules of the board adopted
under this chapter.
(c) Evidence gathered during an inspection by the
department or health authority under this section may not be used in
a criminal proceeding other than a proceeding to assess a criminal
penalty under this chapter.
SECTION ____. Section 81.065, Health and Safety Code, is
amended to read as follows:
Sec. 81.065. RIGHT OF ENTRY. (a) For an investigation or
inspection, the commissioner, an employee of the department, or a
health authority has the right of entry on land or in a building,
vehicle, watercraft, or aircraft and the right of access to an
individual, animal, or object that is in isolation, detention,
restriction, or quarantine instituted by the commissioner, an
employee of the department, or a health authority or instituted
voluntarily on instructions of a private physician.
(b) Evidence gathered during an entry by the commissioner,
department, or health authority under this section may not be used
in a criminal proceeding other than a proceeding to assess a
criminal penalty under this chapter.
SECTION ____. Subsection (a), Section 81.066, Health and
Safety Code, is amended to read as follows:
(a) A person commits an offense if the person knowingly
conceals or attempts to conceal from the department [board], a
health authority, or a peace officer, during the course of an
investigation under this chapter, the fact that:
(1) the person has, has been exposed to, or is the
carrier of a communicable disease that is a threat to the public
health; or
(2) a minor child or incompetent adult of whom the
person is a parent, managing conservator, or guardian has, has been
exposed to, or is the carrier of a communicable disease that is a
threat to the public health.
SECTION ____. Subsection (a), Section 81.067, Health and
Safety Code, is amended to read as follows:
(a) A person commits an offense if the person knowingly
conceals, removes, or disposes of an infected or contaminated
animal, object, vehicle, watercraft, or aircraft that is the
subject of an investigation under this chapter by the department
[board], a health authority, or a peace officer.
SECTION ____. Section 81.068, Health and Safety Code, is
amended to read as follows:
Sec. 81.068. REFUSING ENTRY OR INSPECTION; CRIMINAL
PENALTY. (a) A person commits an offense if the person knowingly
refuses or attempts to refuse entry to the department [board], a
health authority, or a peace officer on presentation of a valid
search warrant to investigate, inspect, or take samples on premises
controlled by the person or by an agent of the person acting on the
person's instruction.
(b) A person commits an offense if the person knowingly
refuses or attempts to refuse inspection under Section 81.064 or
entry or access under Section 81.065.
(c) An offense under this section is a Class A misdemeanor.
SECTION ____. Section 81.082, Health and Safety Code, is
amended to read as follows:
Sec. 81.082. ADMINISTRATION OF CONTROL MEASURES. (a) A
health authority has supervisory authority and control over the
administration of communicable disease control measures in the
health authority's jurisdiction unless specifically preempted by
the department [board]. Control measures imposed by a health
authority must be consistent with, and at least as stringent as, the
control measure standards in rules adopted by the board.
(b) A communicable disease control measure imposed by a
health authority in the health authority's jurisdiction may be
amended, revised, or revoked by the department [board] if the
department [board] finds that the modification is necessary or
desirable in the administration of a regional or statewide public
health program or policy. A control measure imposed by the
department may not be modified or discontinued until the department
authorizes the action.
(c) The control measures may be imposed on an individual,
animal, place, or object, as appropriate.
(d) A declaration of a public health disaster may continue
for not more than 30 days. A public health disaster may be renewed
one time by the commissioner for an additional 30 days.
(e) The governor may terminate a declaration of a public
health disaster at any time.
(f) In this section, "control measures" includes:
(1) immunization;
(2) detention;
(3) restriction;
(4) disinfection;
(5) decontamination;
(6) isolation;
(7) quarantine;
(8) disinfestation;
(9) chemoprophylaxis;
(10) preventive therapy;
(11) prevention; and
(12) education.
SECTION ____. Subsection (e), Section 81.083, Health and
Safety Code, is amended to read as follows:
(e) An individual may be subject to court orders under
Subchapter G if the individual is infected or is reasonably
suspected of being infected with a communicable disease that
presents an immediate threat to the public health and:
(1) the individual, or the individual's parent, legal
guardian, or managing conservator if the individual is a minor,
does not comply with the written orders of the department or a
health authority under this section; or [and]
(2) a public health disaster exists, regardless of
whether the department or health authority has issued a written
order and the individual has indicated that the individual will not
voluntarily comply with control measures [is infected or is
reasonably suspected of being infected with a communicable disease
that presents an immediate threat to the public health].
SECTION ____. Section 81.084, Health and Safety Code, is
amended by amending Subsection (b) and adding Subsections (d-1) and
(k) to read as follows:
(b) The department or health authority shall send notice of
its action by registered or certified mail or by personal delivery
to the person who owns or controls the property. If the property is
land or a structure or an animal or other property on the land, the
department or health authority shall also post the notice on the
land and at a place convenient to the public in [on] the county
courthouse [door]. If the property is infected or contaminated as a
result of a public health disaster, the department or health
authority is not required to provide notice under this subsection.
(d-1) In a public health disaster, the department or health
authority by written order may require a person who owns or controls
property to impose control measures that are technically feasible
to disinfect or decontaminate the property or, if technically
feasible control measures are not available, may order the person
who owns or controls the property:
(1) to destroy the property, other than land, in a
manner that disinfects or decontaminates the property to prevent
the spread of infection or contamination;
(2) if the property is land, to securely fence the
perimeter of the land or any part of the land that is infected or
contaminated; or
(3) to securely seal off an infected or contaminated
structure or other property on land to prevent entry into the
infected or contaminated area until the department or health
authority authorizes entry into the structure or property.
(k) In a public health disaster, the department or a health
authority may impose additional control measures the department or
health authority considers necessary and most appropriate to
arrest, control, and eradicate the threat to the public health.
SECTION ____. Subsections (a), (b), (c), (e), (f), and (h),
Section 81.085, Health and Safety Code, are amended to read as
follows:
(a) If an outbreak of communicable disease occurs in this
state, the commissioner or one or more health authorities may
impose an area quarantine coextensive with the area affected. The
commissioner may impose an area quarantine, if the commissioner has
reasonable cause to believe that individuals or property in the
area may be infected or contaminated with a communicable disease,
for the period necessary to determine whether an outbreak of
communicable disease has occurred. A health authority may impose
the quarantine only within the boundaries of the health authority's
jurisdiction.
(b) A health authority may not impose an area quarantine
until the authority consults with [and obtains the approval of] the
department. A health authority that imposes an area quarantine
shall give written notice to and shall consult with [commissioner
and of] the governing body of each county and municipality in the
health authority's jurisdiction that has territory in the affected
area as soon as practicable.
(c) The department may impose additional disease control
measures in a quarantine area that the department considers
necessary and most appropriate to arrest, control, and eradicate
the threat to the public health. Absent preemptive action by the
department [board] under this chapter or by the governor under
Chapter 418, Government Code (Texas Disaster Act of 1975), a health
authority may impose in a quarantine area under the authority's
jurisdiction additional disease control measures that the health
authority considers necessary and most appropriate to arrest,
control, and eradicate the threat to the public health.
(e) The department or health authority may use all
reasonable means of communication to inform persons in the
quarantine area of the department's [board's] or health authority's
orders and instructions during the period of area quarantine. The
department or health authority shall publish at least once each
week during the area quarantine period, in a newspaper of general
circulation in the area, a notice of the orders or instructions in
force with a brief explanation of their meaning and effect. Notice
by publication is sufficient to inform persons in the area of their
rights, duties, and obligations under the orders or instructions.
(f) The department [commissioner] or, with the department's
[commissioner's] consent, a health authority may terminate an area
quarantine.
(h) A person commits an offense if the person knowingly
fails or refuses to obey a rule, order, or instruction of the
department [board] or an order or instruction of a health authority
issued under a department [board] rule and published during an area
quarantine under this section. An offense under this subsection is
a felony of the third degree.
SECTION ____. Subsections (b) and (i), Section 81.086,
Health and Safety Code, are amended to read as follows:
(b) If the department or health authority has reasonable
cause to believe that a carrier or conveyance has departed from or
traveled through an area infected or contaminated with a
communicable disease, the department or health authority may order
the owner, operator, or authorized agent in control of the carrier
or conveyance to:
(1) stop the carrier or conveyance at a port of entry
or place of first landing or first arrival in this state; and
(2) provide [a statement in a form approved by the
board that includes information required by board rules, including]
information on passengers and cargo manifests[, and] that includes
the details of:
(A) any illness suspected of being communicable
that occurred during the journey;
(B) any condition on board the carrier or
conveyance during the journey that may lead to the spread of
disease; and
(C) any control measures imposed on the carrier
or conveyance, its passengers or crew, or its cargo or any other
object on board during the journey.
(i) The department or health authority may require an
individual transported by carrier or conveyance who the department
or health authority has reasonable cause to believe has been
exposed to or is the carrier of a communicable disease to be
isolated from other travelers and to disembark with the
individual's personal effects and baggage at the first location
equipped with adequate investigative and disease control
facilities, whether the person is in transit through this state or
to an intermediate or ultimate destination in this state. The
department or health authority may investigate and, if necessary,
isolate or involuntarily hospitalize the individual until the
department or health authority approves the discharge as authorized
by Section 81.083 [81.084].
SECTION ____. Subsection (a), Section 81.088, Health and
Safety Code, is amended to read as follows:
(a) A person commits an offense if the person knowingly or
intentionally:
(1) removes, alters, or attempts to remove or alter an
object the person knows is a quarantine device, notice, or security
item in a manner that diminishes the [device's] effectiveness of
the device, notice, or item; or
(2) destroys an object the person knows is a
quarantine device, notice, or security item.
SECTION ____. Subsection (a), Section 81.089, Health and
Safety Code, is amended to read as follows:
(a) A person commits an offense if, before notifying the
department [board] or health authority at a port of entry or a place
of first landing or first arrival in this state, the person
knowingly or intentionally:
(1) transports or causes to be transported into this
state an object the person knows or suspects may be infected or
contaminated with a communicable disease that is a threat to the
public health;
(2) transports or causes to be transported into this
state an individual who the person knows has or is the carrier of a
communicable disease that is a threat to the public health; or
(3) transports or causes to be transported into this
state a person, animal, or object in a private or common carrier or
a private conveyance that the person knows is or suspects may be
infected or contaminated with a communicable disease that is a
threat to the public health.
SECTION ____. Subsection (d), Section 81.151, Health and
Safety Code, is amended to read as follows:
(d) A copy of written orders made under Section 81.083, if
applicable, and a medical evaluation must be filed with the
application, except that a copy of the written orders need not be
filed with an application for outpatient treatment.
SECTION ____. Subsection (c), Section 81.152, Health and
Safety Code, is amended to read as follows:
(c) Any application must contain the following information
according to the applicant's information and belief:
(1) the person's name and address;
(2) the person's county of residence in this state;
(3) a statement that the person is infected with or is
reasonably suspected of being infected with a communicable disease
that presents a threat to public health and that the person meets
the criteria of this chapter for court orders for the management of
a person with a communicable disease; and
(4) a statement, to be included only in an application
for inpatient treatment, that the person fails or refuses to comply
with written orders of the department or health authority under
Section 81.083, if applicable.
SECTION ____. Subsection (a), Section 81.162, Health and
Safety Code, is amended to read as follows:
(a) The judge or designated magistrate may issue a
protective custody order if the judge or magistrate determines:
(1) that the health authority or department has stated
its opinion and the detailed basis for its opinion that the person
is infected with or is reasonably suspected of being infected with a
communicable disease that presents an immediate threat to the
public health; and
(2) that the person fails or refuses to comply with the
written orders of the health authority or the department under
Section 81.083, if applicable.
SECTION ____. Section 161.011, Health and Safety Code, is
amended to read as follows:
Sec. 161.011. PERMISSION REQUIRED. A person, including an
officer or agent of this state or of an instrumentality or political
subdivision of this state, may not enter a private residence to
conduct a health inspection without first receiving:
(1) permission obtained from a lawful adult occupant
of the residence; or
(2) an authorization to inspect the residence for a
specific public health purpose by a magistrate or by an order of a
court of competent jurisdiction on a showing of a probable
violation of a state health law, a control measure under Chapter 81,
or a health ordinance of a political subdivision.
SECTION ____. Subsection (d), Article 49.10, Code of
Criminal Procedure, is amended to read as follows:
(d) A justice of the peace may not order a person to perform
an autopsy on the body of a deceased person whose death was caused
by Asiatic cholera, bubonic plague, typhus fever, or smallpox. A
justice of the peace may not order a person to perform an autopsy on
the body of a deceased person whose death was caused by a
communicable disease during a public health disaster.
SECTION ____. Sections 10 and 10a, Article 49.25, Code of
Criminal Procedure, are amended to read as follows:
Sec. 10. DISINTERMENTS AND CREMATIONS. When a body upon
which an inquest ought to have been held has been interred, the
medical examiner may cause it to be disinterred for the purpose of
holding such inquest.
Before any body, upon which an inquest is authorized by the
provisions of this Article, can be lawfully cremated, an autopsy
shall be performed thereon as provided in this Article, or a
certificate that no autopsy was necessary shall be furnished by the
medical examiner. Before any dead body can be lawfully cremated,
the owner or operator of the crematory shall demand and be furnished
with a certificate, signed by the medical examiner of the county in
which the death occurred showing that an autopsy was performed on
said body or that no autopsy thereon was necessary. It shall be the
duty of the medical examiner to determine whether or not, from all
the circumstances surrounding the death, an autopsy is necessary
prior to issuing a certificate under the provisions of this
section. No autopsy shall be required by the medical examiner as a
prerequisite to cremation in case death is caused by the
pestilential diseases of Asiatic cholera, bubonic plague, typhus
fever, or smallpox. All certificates furnished to the owner or
operator of a crematory by any medical examiner, under the terms of
this Article, shall be preserved by such owner or operator of such
crematory for a period of two years from the date of the cremation
of said body. A medical examiner is not required to perform an
autopsy on the body of a deceased person whose death was caused by a
communicable disease during a public health disaster.
Sec. 10a. The body of a deceased person shall not be
cremated within 48 [forty-eight] hours after the time of death as
indicated on the regular death certificate, unless the death
certificate indicates death was caused by the pestilential diseases
of Asiatic cholera, bubonic plague, typhus fever, or smallpox, or
unless the time requirement is waived in writing by the county
medical examiner or, in counties not having a county medical
examiner, a justice of the peace. In a public health disaster, the
commissioner of public health may designate other communicable
diseases for which cremation within 48 hours of the time of death is
authorized.