SRC-LBB, EPT S.B. 399 78(R) BILL ANALYSIS
Senate Research Center S.B. 399
78R49 MCK-DBy: Van de Putte
Infrastructure Development and Security
2/28/2003
As Filed
DIGEST AND PURPOSE
Currently, under Texas law the state has a duty to protect the public
health. As proposed, S.B. 399 is intended to provide the state with
stronger public health powers to enable the state to rapidly detect and
effectively respond to bio-terrorism and other emergency health threats.
This bill is based on the Model State Emergencies Health Powers Act
developed by the Center for Law and the Public's Health at Georgetown and
Johns Hopkins Universities.
RULEMAKING AUTHORITY
Rulemaking authority previously granted to the Texas Animal Health
Commission is modified in SECTION 25 (Section 161.101, Agriculture Code).
SECTION BY SECTION ANALYSIS
SECTION 1. Amends Section 418.004, Government Code, by adding Subdivision
(8) to define "public health emergency"
SECTION 2. Amends Section 418.014, Government Code, by amending
Subsection (e) and adding Subsections (f), (g), and (h), as follows:
(e) Requires the executive order or proclamation to be disseminated in
English and Spanish and in a manner accessible to people with
disabilities.
(f) Authorizes the governor, in consultation with the commissioner of
public health (commissioner), to declare that a state of disaster
constitutes a public health emergency to which the public health emergency
provisions of Chapter 81 (Communicable Diseases), Health and Safety Code,
and other laws apply. Provides that declaring a state of disaster that
constitutes a public health emergency activates the public health
emergency aspects of the state emergency management plan applicable to the
area subject to the declaration.
(g) Authorizes the governor in consultation with the commissioner to
renew a state of disaster that constitutes a public emergency, one time,
for 30 days. Authorizes the governor to make an additional renewal only
after consulting with the commissioner, the lieutenant governor, and the
speaker of the house.
(h) Requires an executive order or proclamation declaring a state of
disaster that constitutes a public health emergency "declaration" to
identify the primary public health authority responsible for responding to
the emergency.
SECTION 3. Amends Chapter 418C, Government Code, by adding Section
418.0425, as follows:
Sec. 418.0425. PUBLIC HEALTH EMERGENCY PLAN. (a) Requires the division
of emergency management in the office of the governor as part of the
comprehensive state emergency management plan under Section 418.042, to
prepare and keep current a public health emergency plan. Requires the
plan to include certain guidelines to be used during a state of public
health emergency.
(b) Requires the division to distribute the public health emergency plan
and guidelines to those who will be responsible for implementing the plan.
(c) Requires the division, in developing the public health emergency
plan, to take into consideration any cultural norms, values, and
traditions that may be relevant.
SECTION 4. Amends Chapter 418, Government Code by adding Subchapter I, as
follows:
SUBCHAPTER I. PUBLIC HEALTH EMERGENCY
Sec. 418.201. DUTIES OF PUBLIC HEALTH AUTHORITY. Requires the public
health authority designated by the governor to be responsible for
responding to the emergency during a state of disaster that constitutes a
public health emergency, to coordinate all matters relating to the state's
response during the emergency. Provides that the authority has primary
jurisdiction, responsibility, and authority for: planning and executing
public health emergency assessment, mitigation, preparedness response, and
recover for the state; coordinating public health emergency response
between state and local authorities, elected officials of other states,
private organizations, or private sector companies; coordinating recovery
operations and mitigation initiatives subsequent to public health
emergencies; and organizing public information activities regarding state
public health emergency response operations.
Sec. 418.202. IDENTIFICATION OF HEALTH PERSONNEL. (a) Requires the
public health authority, after the declaration, to issue special
identification for all public health personnel working during the
emergency.
(b) Requires the identification to indicate the authority of the bearer
to exercise public health functions and emergency powers during the state
of disaster that constitutes a public health emergency.
(c) Requires public health personnel to wear the identification in
plain view.
Sec. 418.203. SHARING INFORMATION BETWEEN HEALTH AUTHORITY AND PUBLIC
SAFETY AUTHORITY. Authorizes public health authority personnel and public
safety personnel to only share information relating to a reportable
disease, health condition, or other suspicious event to the extent the
information is needed for the treatment, control, investigation, and
prevention of a public health emergency.
Sec. 418.204. UNLICENSED HEALTH CARE PROFESSIONALS. Provides that
notwithstanding any other law, and subject to the terms of the public
health emergency declaration, a health care professional who does not hold
a license, certificate, or other permit issued by this state at the time a
public health emergency is declared, is authorized to provide medical or
health care services to a person in this state under certain conditions.
Sec. 418.205. DISCIPLINARY ACTION. Requires a regulatory agency of this
state to revoke or suspend the license, certificate, or other permit of an
individual or facility that is regulated by the agency if the individual
or entity does not assist the public health authority during a state of
disaster that constitutes a public health emergency declared under this
chapter.
Sec. 418.206. DISPOSAL OF CORPSE. (a) Requires the public health
authority to clearly label every corpse with a communicable disease before
the corpse is cremated or buried. Requires the label to clearly identify
the corpse as infected and include all available information to identify
the decedent and the circumstances of death, including the disease.
(b) Requires every person in charge of disposing of a corpse with a
communicable disease to maintain a written record of each corpse and all
available information to identify the decedent and the circumstances of
death and disposal. Requires a qualified person, if the corpse cannot be
identified before disposal, to follow certain procedures.
(c) Requires all information gathered under this section to be promptly
forwarded to the public health authority.
Sec. 418.207. LIABILITY EXEMPTION. (a) Provides that during a state of
disaster that constitutes a public health emergency, a person owning or
controlling real estate or other premises who voluntarily and without
compensation grants a license or privilege, or otherwise permits the
designation or use of the real estate or premises for the purpose of
sheltering persons, together with that person's successors in interest, if
any, is immune from civil liability for any act or omission resulting in
death, damage, or injury relating to the use of the real estate or
premises, except as provided by Subsection (d).
(b) Provides that during a state of disaster that constitutes a public
health emergency, a person or the person's agent performing a contract
with, and under the direction of, the state or a political subdivision of
the state, is immune from civil liability for any act or omission
resulting in death, damage, or injury relating to the performance of the
contract, except as provided by Subsection (d).
(c) Provides immunity from civil liability for a person or the person's
agent who provides assistance or advice at the request of the state or a
political subdivision of the state under this chapter for any act or
omission resulting in death, damage, or injury relating to the assistance
or advice during a state of disaster that constitutes a public health
emergency, except as provided by Subsection (d).
(d) Provides that this section does not apply to: an act or omission
that is intentional, wilfully or wantonly negligent, or done with
conscious indifference or reckless disregard for the safety of others; or
a person or the person's agent whose act or omission caused in whole or in
part the public health emergency and who would otherwise be liable for
that act or omission.
Sec. 418.208. INFECTIOUS WASTE. Requires public health authority
personnel working during a state of disaster that constitutes a public
health emergency who collect infectious waste to clearly label the waste
as infectious waste and to state on the label the type of infectious
waste, if known.
SECTION 5. Transfers Section 81.023(d), Health and Safety Code, to
Chapter 81A, Health and Safety Code, redesignates it as Section 81.011,
Health and Safety Code, and amends it as follows:
Sec. 81.011. Inserts heading: REQUEST FOR INFORMATION. Provides that in
times of emergency or epidemic declared by the commissioner, the Texas
Department of Health (TDH) rather than the Texas Board of Health (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 (DPS) 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 6. Amends Section 81.041, Health and Safety Code, by amending
Subsection (e) and adding Subsection (f), as follows:
(e) Provides that reportable diseases under this chapter for which the
board will require reports include: acquired immune deficiency syndrome
and human immunodeficiency virus infection; and diseases caused by the
biological agents listed in 42 C.F.R. Section 72, App. A.
(f) Authorizes the commissioner to require reports of communicable
diseases or other health conditions from providers without board rule or
action in a public health emergency
SECTION 7. Amends Section 81.042(e), Health and Safety Code, to add
emergency medical service personnel, a peace officer, or a firefighter to
the list of persons required to report to the local health authority or
the Texas Department of Health (TDH) a suspected case of a reportable
disease and all information known concerning the person who has or is
suspected of having the disease if a report is not made as required by
Subsections (a)-(d).
SECTION 8. Amends Section 81.044(b), Health and Safety Code, to require
the board to require the reports to contain any information relating to a
case that is necessary for the purposes of this chapter, including: the
patient's name, home and work address, including city and county, age,
date of birth, sex, race, and occupation; the name and address of the
attending physician or dentist; and for diseases transmitted by insect or
animal bites, the location of the insect or animal and the name and
address of the owner of the animal.
SECTION 9. Amends Section 81.046, Health and Safety Code, by amending
Subsection (b) and adding Subsection (f), as follows:
(b) Makes a conforming change.
(f) Authorizes reports, records, and information relating to cases or
suspected cases of diseases or health conditions to be released to the
extent necessary during a public health emergency to law enforcement
personnel solely for the purpose of protecting the health or life of the
person identified in the report, record, or information.
SECTION 10. Amends Section 81.048, Health and Safety Code, by adding
Subsection (g), as follows:
(g) Requires the TDH or a local health authority to immediately notify
DPS and federal health and public safety authorities if TDH or a local
health authority learns of a case of a reportable disease, health
condition, or other suspicious event that it reasonably believes has the
potential to be caused by bioterrorism.
SECTION 11. Amends Section 81.061, Health and Safety Code, by adding
Subsection (d) to authorize a health authority to investigate the
existence of communicable disease within the boundaries of the health
authority's jurisdiction to determine the nature and extent of the disease
and to formulate and evaluate the control measures used to protect the
public health. Requires a person to provide records and other information
to the health authority on request according to the health authority's
written instructions. Provides that confidential or privileged records or
other information remain confidential or privileged in the hands of the
health authority.
SECTION 12. Amends Section 81.062(a), Health and Safety Code, to
authorize TDH or a health authority, for the purpose of an investigation
under Section 81.061(c) or (d), to administer oaths, summon witnesses, and
compel the attendance of a witness or the production of a document.
Authorizes the TDH or a health authority to request the assistance of a
county or district court to compel the attendance of a summoned witness or
the production of a requested document at a hearing.
SECTION 13. Amends Section 81.083(e), Health and Safety Code, as follows:
(e) Provides that 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 either: (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 (2) a public
health emergency exists, regardless of whether the department or health
authority has issued a written order rather than 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.
SECTION 14. Amends Section 81.084, Health and Safety Code, by amending
Subsection (b) and adding Subsections (d-1) and (k), as follows:
(b) Requires TDH or a health authority to send notice of its action by
registered or certified mail or by personal delivery to the person who
owns or controls the property. Requires, if the property is land or a
structure or an animal or other property on the land, TDH or the health
authority to also post the notice on the land and at a place convenient to
the public in the county courthouse. Provides that if the property is
infected or contaminated as a result of a public health emergency, TDH or
the health authority is not required to provide notice under this
subsection.
(d-1) Authorizes TDH or a health authority, in a public health
emergency, by written order to 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, to 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) Authorizes TDH or a health authority in a public health emergency to
impose additional control measures TDH or the health authority considers
necessary and most appropriate to arrest, control, and eradicate the
threat to the public health.
SECTION 15. Amends Section 81.085, Health and Safety Code, by amending
Subsections (a), (b), (c), (e), (f), and (h) and adding Subsection (i), as
follows:
(a) Authorizes the commissioner or one or more health authorities to
impose an area quarantine coextensive with the area affected if an
outbreak of communicable disease occurs in this state. Authorizes the
commissioner to 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. Authorizes a health authority to impose the quarantine only
within the boundaries of the health authority's jurisdiction.
(b) Prohibits a health authority from imposing an area quarantine until
the authority consults with TDH. Deletes text regarding obtaining the
approval of the commissioner and of the governing body of each county and
municipality in the affected area.
(c) Authorizes TDH to impose additional disease control measures in a
quarantine area that it considers necessary and most appropriate to
arrest, control, and eradicate the threat to the public health.
Authorizes a health authority to 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, absent preemptive
action by TDH, rather than the board, under this chapter or by the
governor under Chapter 418, Government Code (Texas Disaster Act of 1975).
(e) Authorizes TDH or a health authority to use all reasonable means of
communication to inform persons in the quarantine area of TDH's, rather
than the board's, or the health authority's orders and instructions during
the period of area quarantine.
(f) Authorizes the TDH, rather than the commissioner, or with the
department's, rather than the commissioner's, consent, a health authority
to terminate an area quarantine.
(h) Provides that a person commits an offense if the person knowingly
fails or refuses to obey a rule, order, or instruction of the TDH rather
than the board, or an order or instruction of a health authority issued
under a department rule, rather than board rule, and published during an
area quarantine under this section. Provides that an offense under this
subsection is a felony of the third degree.
(i) Requires an area quarantine to be accomplished by the least
restrictive means necessary to protect the public health considering the
availability of resources.
SECTION 16. Amends Sections 81.086(b) and (i), Health and Safety Code, as
follows:
(b) Authorizes TDH or a health authority to order the owner, operator, or
authorized agent in control of the carrier or conveyance to provide
information on passengers and cargo manifests, rather than a statement in
a form approved by the board that includes information required by board
rules, that includes certain details, 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
(i) Makes a conforming change in reference to Section 81.083 rather than
81.084.
SECTION 17. Amends Section 81.088(a), Health and Safety Code, to provide
that 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 effectiveness of the device, notice, or item; or (2)
destroys an object the person knows is a quarantine device, notice, or
security item.
SECTION 18. Amends Section 81.151(d), Health and Safety Code, to require
a copy of written orders made under Section 81.083, if applicable, and a
medical evaluation to be filed with the application, except that a copy of
the written orders need not be filed with an application for outpatient
treatment.
SECTION 19. Amends Section 81.152(c), Health and Safety Code, to make a
conforming change.
SECTION 20. Amends Section 81.162(a), Health and Safety Code, to make a
conforming change.
SECTION 21. Amends Section 161.011, Health and Safety Code, to make a
conforming change
SECTION 22. Amends Article 49.10(d), Code of Criminal Procedure, to
prohibit a justice of the peace from ordering a person to perform an
autopsy on the body of a deceased person whose death was caused by a
communicable disease designated by order of the commissioner during a
public health emergency or disaster under Chapter 418, Government Code.
SECTION 23. Amends Sections 10 and 10a, Article 49.25, Code of Criminal
Procedure as follows:
Sec. 10. Provides that 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 designated by order of the commissioner during a
public health emergency or disaster under Chapter 418, Government Code.
Sec. 10a. Authorizes the commissioner by order in a disaster or public
health emergency under Chapter 418, Government Code, to designate other
communicable diseases for which cremation within 48 hours of the time of
death is authorized. Makes a nonsubstantive change.
SECTION 24. Amends Chapter 562 B, Occupations Code, by adding Section
562.055, to read as follows:
Sec. 562.055. REPORT TO TEXAS DEPARTMENT OF HEALTH. Requires a
pharmacist to report any unusual or increased prescription rates, unusual
types of prescriptions, or unusual trends in pharmacy visits that may be
caused by bioterrorism, epidemic or pandemic disease, or novel and
highly fatal infectious agents or biological toxins, that might pose a
substantial risk of a significant number of human fatalities or incidents
of permanent or long-term disability. Delineates prescription-related
events that require a report.
SECTION 25. Amends Sections 161.101(a), (b), and (c), Agriculture Code,
as follows:
(a) Requires a veterinarian, a veterinary diagnostic laboratory, or a
person having care, custody, or control of an animal to report the
existence of certain diseases among livestock, exotic livestock, bison,
domestic fowl, or exotic fowl to the Texas Animal Health Commission
(commission) within 24 hours after diagnosis of the diseases.
(b) Provides that in addition to reporting required by Subsection (a),
the commission may adopt rules that require a veterinarian, a veterinary
diagnostic laboratory, or a person having care, custody, or control of an
animal to report the existence of a disease other than bluetongue in an
animal to the commission within 24 hours after diagnosis if the disease
meets certain requirements.
(c) Authorizes the commission to adopt rules that require a veterinarian,
a veterinary diagnostic laboratory, or a person having care, custody, or
control of an animal to report a disease not covered by Subsection (a) or
(b) if the commission determines that action to be necessary for the
protection of animal health in this state.
SECTION 26. Requires the division of emergency management in the office
of the governor, not later than November 1, 2004, to review and develop,
as necessary, the public health emergency plan as required by Section
418.0425, Government Code, as added by this Act.
SECTION 27. Effective date: September 1, 2003.
SECTION 28. Makes application of the change in law made by this Act to
Section 81.085(h), Health and Safety Code, prospective.