85R2853 DMS-D
 
  By: Howard H.B. No. 241
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to a health care practitioner counseling requirement for
  persons claiming an immunization exemption on the basis of
  conscience, including a religious belief.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 38.001(c), Education Code, is amended to
  read as follows:
         (c)  Immunization is not required for a person's admission to
  any elementary or secondary school if the person applying for
  admission:
               (1)  submits to the admitting official:
                     (A)  an affidavit or a certificate signed by a
  physician who is duly registered and licensed to practice medicine
  in the United States, in which it is stated that, in the physician's
  opinion, the immunization required poses a significant risk to the
  health and well-being of the applicant or any member of the
  applicant's family or household; or
                     (B)  an affidavit signed by the applicant or, if a
  minor, by the applicant's parent or guardian stating that the
  applicant declines immunization for reasons of conscience,
  including a religious belief, and a completed health care
  practitioner counseling certification stating that the
  practitioner has provided information on the risks and benefits of
  immunization; or
               (2)  is a member of the armed forces of the United
  States and is on active duty.
         SECTION 2.  Sections 51.9192(d) and (d-3), Education Code,
  are amended to read as follows:
         (d)  A student to whom this section applies or a parent or
  guardian of the student is not required to comply with Subsection
  (c) if the student or a parent or guardian of the student submits to
  the institution:
               (1)  an affidavit or a certificate signed by a
  physician who is duly registered and licensed to practice medicine
  in the United States in which it is stated that, in the physician's
  opinion, the vaccination required would be injurious to the health
  and well-being of the student; or
               (2)  an affidavit signed by the student stating that
  the student declines the vaccination for bacterial meningitis for
  reasons of conscience, including a religious belief, or
  confirmation that the student has completed the Internet-based
  process described by Subsection (d-3) for declining the vaccination
  on that basis, if applicable to the student, and a completed health
  care practitioner counseling certification stating that the
  practitioner has provided information on the risks and benefits of
  immunization.
         (d-3)  The Department of State Health Services shall develop
  and implement a secure, Internet-based process to be used
  exclusively at those public junior colleges that elect to use the
  process to allow an entering student to apply online for an
  exemption from the vaccination requirement under this section for
  reasons of conscience.  The online process portal must be designed
  to ensure that duplicate exemption requests are avoided to the
  greatest extent possible.  The exemption form used by a student to
  claim an exemption under the process must contain a statement
  indicating that the student understands the benefits and risks of
  the immunization and the benefits and risks of not receiving the
  immunization. A student who uses the Internet-based process under
  this section is required to submit, in the manner prescribed by the
  college, a completed health care practitioner counseling
  certification stating that the practitioner has provided
  information on the risks and benefits of immunization.
         SECTION 3.  Section 51.933(d), Education Code, is amended to
  read as follows:
         (d)  No form of immunization is required for a person's
  admission to an institution of higher education if the person
  applying for admission:
               (1)  submits to the admitting official:
                     (A)  an affidavit or a certificate signed by a
  physician who is duly registered and licensed to practice medicine
  within the United States in which it is stated that, in the
  physician's opinion, the immunization required poses a significant
  risk to the health and well-being of the applicant or any member of
  the applicant's family or household; or
                     (B)  an affidavit signed by the applicant or, if a
  minor, by the applicant's parent or guardian stating that the
  applicant declines immunization for reasons of conscience,
  including a religious belief, and a completed health care
  practitioner counseling certification stating that the
  practitioner has provided information on the risks and benefits of
  immunization; or
               (2)  is a member of the armed forces of the United
  States and is on active duty.
         SECTION 4.  Section 161.004(d), Health and Safety Code, is
  amended to read as follows:
         (d)  A child is exempt from an immunization required by this
  section if:
               (1)  a parent, managing conservator, or guardian states
  that:
                     (A)  the immunization is being declined for
  reasons of conscience, including a religious belief; and
                     (B)  the parent, managing conservator, or
  guardian has been counseled by a physician, advanced practice
  registered nurse, or physician assistant on the risks and benefits
  of immunization; or
               (2)  the immunization is medically contraindicated
  based on the opinion of a physician licensed by any state in the
  United States who has examined the child.
         SECTION 5.  The heading to Section 161.0041, Health and
  Safety Code, is amended to read as follows:
         Sec. 161.0041.  IMMUNIZATION EXEMPTION AFFIDAVIT FORM AND
  HEALTH CARE PRACTITIONER COUNSELING CERTIFICATION FORM.
         SECTION 6.  Section 161.0041, Health and Safety Code, is
  amended by amending Subsections (a) and (c) and adding Subsections
  (a-1), (d-1), and (d-2) to read as follows:
         (a)  A person claiming an exemption from a required
  immunization based on reasons of conscience, including a religious
  belief, under Section 161.004 of this code, Section 38.001,
  51.9192, or 51.933, Education Code, or Section 42.043, Human
  Resources Code, must:
               (1)  complete an affidavit on a form provided by the
  department stating the reason for the exemption; and
               (2)  submit a completed health care practitioner
  counseling certification.
         (a-1)  Subsection (a)(1) [This subsection] does not apply to
  a person claiming the exemption using the Internet-based process
  under Section 51.9192(d-3), Education Code.
         (c)  A person claiming an exemption from a required
  immunization under this section may only obtain the affidavit form
  by submitting a written request for the affidavit form to the
  department. The department shall include a blank copy of the health
  care practitioner counseling certification form described by
  Subsection (d-1) with each affidavit form sent to a person.
         (d-1)  The department shall develop a blank health care
  practitioner counseling certification form to be completed by a
  physician, advanced practice registered nurse, or physician
  assistant who has counseled a person and, if the person is a minor,
  the person's parent, managing conservator, or guardian, about the
  risks and benefits of immunization. The form must contain:
               (1)  spaces for:
                     (A)  the name, signature, and license number of
  the health care practitioner providing counsel;
                     (B)  the name of the person claiming the
  exemption, the name of the person's parent, managing conservator,
  or guardian, as applicable, and the signature of the person or the
  person's parent, managing conservator, or guardian, as applicable;
  and
                     (C)  the date; and
               (2)  the following statement or substantially similar
  language:
         "I certify that I have provided medically accurate
  information on the risks and benefits of immunization."
         (d-2)  The department shall make the printable health care
  practitioner counseling certification form available on the
  department's Internet website.
         SECTION 7.  Section 224.002(c), Health and Safety Code, is
  amended to read as follows:
         (c)  The policy may include procedures for a covered
  individual to be exempt from the required vaccines based on reasons
  of conscience, including a religious belief, provided that the
  policy requires an individual claiming an exemption based on
  reasons of conscience to certify that the individual has received
  counseling from a physician, advanced practice registered nurse, or
  physician assistant on the risks and benefits of vaccines.
         SECTION 8.  Section 42.043(d), Human Resources Code, is
  amended to read as follows:
         (d)  No immunization may be required for admission to a
  facility regulated under this chapter if a person applying for a
  child's admission submits [one of the following affidavits]:
               (1)  an affidavit signed by a licensed physician
  stating that the immunization poses a significant risk to the
  health and well-being of the child or a member of the child's family
  or household; or
               (2)  an affidavit signed by the child's parent or
  guardian stating that the applicant declines immunization for
  reasons of conscience, including a religious belief, and a
  completed health care practitioner counseling certification
  stating that the practitioner has provided information on the risks
  and benefits of immunization.
         SECTION 9.  Section 42.04305(d), Human Resources Code, is
  amended to read as follows:
         (d)  The policy shall include procedures for a facility
  employee to be exempt from the required vaccines based on reasons of
  conscience, including a religious belief, and those procedures must
  include the requirement that the employee claiming the exemption
  certify that the employee has received counseling from a physician,
  advanced practice registered nurse, or physician assistant on the
  risks and benefits of vaccines.
         SECTION 10.  (a) Not later than December 1, 2017, the
  Department of State Health Services shall make the health care
  practitioner counseling certification form required by Section
  161.0041, Health and Safety Code, as amended by this Act, available
  on the department's Internet website.
         (b)  A person claiming an immunization exemption on the basis
  of conscience, including a religious belief, on or after January 1,
  2018, is required to submit a completed health care practitioner
  counseling certification or otherwise affirm that the person has
  received counseling from a health care practitioner, as applicable.
         (c)  A person claiming an immunization exemption on the basis
  of conscience, including a religious belief, before January 1,
  2018, is required to submit a completed health care practitioner
  counseling certification or otherwise affirm that the person has
  received counseling from a health care practitioner, as applicable,
  before September 1, 2018, to continue to be eligible for the
  exemption.
         SECTION 11.  This Act takes effect immediately if it
  receives a vote of two-thirds of all the members elected to each
  house, as provided by Section 39, Article III, Texas Constitution.  
  If this Act does not receive the vote necessary for immediate
  effect, this Act takes effect September 1, 2017.