S.B. No. 968
 
 
 
 
AN ACT
  relating to public health disaster and public health emergency
  preparedness and response; providing a civil penalty.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subchapter B, Chapter 418, Government Code, is
  amended by adding Section 418.0125 to read as follows:
         Sec. 418.0125.  LIMITATIONS ON MEDICAL PROCEDURES. (a)  In
  this section, "nonelective medical procedure" means a medical
  procedure, including a surgery, a physical exam, a diagnostic test,
  a screening, the performance of a laboratory test, and the
  collection of a specimen to perform a laboratory test, that if not
  performed within a reasonable time may, as determined in good faith
  by a patient's physician, result in:
               (1)  the patient's loss of life; or
               (2)  a deterioration, complication, or progression of
  the patient's current or potential medical condition or disorder,
  including a physical condition or mental disorder.
         (b)  The Texas Medical Board during a declared state of
  disaster may not issue an order or adopt a regulation that limits or
  prohibits a nonelective medical procedure.
         (c)  The Texas Medical Board during a declared state of
  disaster may issue an order or adopt a regulation imposing a
  temporary limitation or prohibition on a medical procedure other
  than a nonelective medical procedure only if the limitation or
  prohibition is reasonably necessary to conserve resources for
  nonelective medical procedures or resources needed for disaster
  response.  An order issued or regulation adopted under this
  subsection may not continue for more than 15 days unless renewed by
  the board.
         (d)  A person subject to an order issued or regulation
  adopted under this section who in good faith acts or fails to act in
  accordance with that order or regulation is not civilly or
  criminally liable and is not subject to disciplinary action for
  that act or failure to act.
         (e)  The immunity provided by Subsection (d) is in addition
  to any other immunity or limitation of liability provided by law.
         (f)  Notwithstanding any other law, this section does not
  create a civil, criminal, or administrative cause of action or
  liability or create a standard of care, obligation, or duty that
  provides the basis for a cause of action for an act or omission
  under this section.
         SECTION 2.  Subchapter C, Chapter 418, Government Code, is
  amended by adding Section 418.0435 to read as follows:
         Sec. 418.0435.  PERSONAL PROTECTIVE EQUIPMENT CONTRACTS.
  (a) The division shall enter into a contract with a manufacturer or
  wholesale distributor of personal protective equipment that
  guarantees a set amount and stocked supply of the equipment for use
  during a public health disaster declared under Section 81.0813,
  Health and Safety Code.
         (b)  The division may purchase personal protective equipment
  under a contract described by Subsection (a) only if the division
  determines the state's supply of personal protective equipment will
  be insufficient based on an evaluation of the personal protective
  equipment:
               (1)  held in reserve in this state; and
               (2)  supplied by or expected to be supplied by the
  federal government.
         (c)  The division shall pursue all available federal funding
  to cover the costs of personal protective equipment purchased under
  a contract described by Subsection (a).
         (d)  In entering into a contract under Subsection (a), the
  division shall ensure that the manufacturer is located in the
  United States to the extent practicable.
         SECTION 3.  Subchapter E, Chapter 418, Government Code, is
  amended by adding Section 418.1085 to read as follows:
         Sec. 418.1085.  LIMITATIONS ON CONSTRUCTION AND RELATED
  SERVICES. The presiding officer of the governing body of a
  political subdivision may not issue an order during a declared
  state of disaster or local disaster to address a pandemic disaster
  that would limit or prohibit:
               (1)  housing and commercial construction activities,
  including related activities involving the sale, transportation,
  and installation of manufactured homes;
               (2)  the provision of governmental services for title
  searches, notary services, and recording services in support of
  mortgages and real estate services and transactions;
               (3)  residential and commercial real estate services,
  including settlement services; or
               (4)  essential maintenance, manufacturing, design,
  operation, inspection, security, and construction services for
  essential products, services, and supply chain relief efforts.
         SECTION 4.  Subchapter H, Chapter 418, Government Code, is
  amended by adding Section 418.1861 to read as follows:
         Sec. 418.1861.  DISEASE PREVENTION INFORMATION SYSTEM. (a)
  The Department of State Health Services, using existing resources,
  shall develop and implement a disease prevention information system
  for dissemination of immunization information during a declared
  state of disaster or local state of disaster.
         (b)  During a declared state of disaster or local state of
  disaster, the Department of State Health Services shall ensure that
  educational materials regarding immunizations are available to
  local health authorities in this state for distribution to:
               (1)  public and private schools;
               (2)  child-care facilities as defined by Section
  42.002, Human Resources Code;
               (3)  community centers offering youth services and
  programs;
               (4)  community centers offering services and programs
  to vulnerable populations, including communities of color,
  low-income individuals, and elderly individuals;
               (5)  local health care providers; and
               (6)  veterans homes as defined by Section 164.002,
  Natural Resources Code.
         (c)  The educational materials must include:
               (1)  the most recent immunization schedules by age as
  recommended by the Centers for Disease Control and Prevention; and
               (2)  locations, if any, of local health care providers
  that offer immunizations.
         SECTION 5.  Chapter 418, Government Code, is amended by
  adding Subchapter J to read as follows:
  SUBCHAPTER J.  WELLNESS CHECKS FOR MEDICALLY FRAGILE INDIVIDUALS
  DURING CERTAIN EMERGENCIES
         Sec. 418.301.  DEFINITIONS. In this subchapter:
               (1)  "Commission" means the Health and Human Services
  Commission.
               (2)  "Department" means the Department of State Health
  Services.
               (3)  "Emergency assistance registry" means the
  registry maintained by the division that provides local emergency
  planners and emergency responders with additional information on
  the needs of certain individuals in their communities.
               (4)  "First responder" means any federal, state, or
  local personnel who may respond to a disaster, including:
                     (A)  public health and public safety personnel;
                     (B)  commissioned law enforcement personnel;
                     (C)  fire protection personnel, including
  volunteer firefighters;
                     (D)  emergency medical services personnel,
  including hospital emergency facility staff;
                     (E)  a member of the National Guard; or
                     (F)  a member of the Texas State Guard.
               (5)  "Medically fragile individual" means any
  individual who, during a time of disaster or emergency, would be
  particularly vulnerable because of a medical condition, including
  individuals:
                     (A)  with Alzheimer's disease and other related
  disorders;
                     (B)  receiving dialysis services;
                     (C)  who are diagnosed with a debilitating chronic
  illness;
                     (D)  who are dependent on oxygen treatment; and
                     (E)  who have medical conditions that require
  24-hour supervision from a skilled nurse.
         Sec. 418.302.  MEDICALLY FRAGILE INDIVIDUAL DESIGNATION.
  The division shall develop a process for designating individuals
  who are included in the emergency assistance registry as medically
  fragile for the purposes of this chapter.
         Sec. 418.303.  EMERGENCY ASSISTANCE REGISTRY ACCESS. The
  division shall authorize the following persons to access the
  emergency assistance registry to assist medically fragile
  individuals during an event described by Section 418.305:
               (1)  the commission;
               (2)  the department;
               (3)  first responders;
               (4)  local governments; and
               (5)  local health departments.
         Sec. 418.304.  REQUIRED WELLNESS CHECK. The division shall
  collaborate with the persons authorized to access the emergency
  assistance registry under Section 418.303 and with applicable
  municipalities and counties to ensure that a wellness check is
  conducted on each medically fragile individual listed in the
  emergency assistance registry and located in an area that
  experiences an event described by Section 418.305 to ensure the
  individual has:
               (1)  continuity of care; and
               (2)  the ability to continue using electrically powered
  medical equipment, if applicable.
         Sec. 418.305.  EVENTS REQUIRING WELLNESS CHECKS. (a)  The
  division, in collaboration with the commission and the department,
  shall adopt rules regarding which events require a wellness check,
  including:
               (1)  an extended power, water, or gas outage;
               (2)  a state of disaster declared under this chapter;
  or
               (3)  any other event considered necessary by the
  commission, the department, or the division.
         (b)  If more than one disaster is declared for the same
  event, or the same event qualifies as an event requiring a wellness
  check for multiple reasons under Subsection (a), only one wellness
  check is required to be conducted under this subchapter.
         Sec. 418.306.  REQUIREMENTS FOR WELLNESS CHECK. (a)  The
  division, in collaboration with the commission and the department,
  by rule shall develop minimum standards for conducting wellness
  checks.  Each county and municipality shall adopt procedures for
  conducting wellness checks in compliance with the minimum
  standards.
         (b)  A wellness check on a medically fragile individual under
  this subchapter must:
               (1)  include:
                     (A)  an automated telephone call and text to the
  individual;
                     (B)  a personalized telephone call to the
  individual; and
                     (C)  if the individual is unresponsive to a
  telephone call under Paragraph (B), an in-person wellness check;
  and
               (2)  be conducted in accordance with the minimum
  standards prescribed by division rule and the procedures of the
  applicable county or municipality.
         (c)  A wellness check must be conducted as soon as
  practicable but not later than 24 hours after the event requiring a
  wellness check occurs.
         Sec. 418.307.  RULES. The division, in collaboration with
  the commission and the department, shall adopt rules to implement
  this subchapter.
         SECTION 6.  The heading to Subtitle D, Title 2, Health and
  Safety Code, is amended to read as follows:
  SUBTITLE D. PREVENTION, CONTROL, AND REPORTS OF DISEASES; PUBLIC
  HEALTH DISASTERS AND EMERGENCIES
         SECTION 7.  The heading to Chapter 81, Health and Safety
  Code, is amended to read as follows:
  CHAPTER 81. COMMUNICABLE DISEASES; PUBLIC HEALTH DISASTERS; PUBLIC
  HEALTH EMERGENCIES
         SECTION 8.  Section 81.003, Health and Safety Code, is
  amended by amending Subdivision (7) and adding Subdivision (7-a) to
  read as follows:
               (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,
  health condition, or chemical, biological, radiological, or
  electromagnetic exposure that:
                           (i)  poses a high risk of death or serious
  harm [long-term disability] to the public [a large number of
  people]; and
                           (ii)  creates a substantial risk of harmful
  public exposure [because of the disease's high level of contagion
  or the method by which the disease is transmitted].
               (7-a)  "Public health emergency" means a determination
  by the commissioner, evidenced in an emergency order issued by the
  commissioner, that there exists an immediate threat from a
  communicable disease, health condition, or chemical, biological,
  radiological, or electromagnetic exposure that:
                     (A)  potentially poses a risk of death or severe
  illness or harm to the public; and
                     (B)  potentially creates a substantial risk of
  harmful exposure to the public.
         SECTION 9.  The heading to Subchapter B, Chapter 81, Health
  and Safety Code, is amended to read as follows:
  SUBCHAPTER B. PREVENTION AND PREPAREDNESS
         SECTION 10.  Section 81.044, Health and Safety Code, is
  amended by adding Subsection (b-1) to read as follows:
         (b-1)  In this subsection, "cycle threshold value" means for
  a communicable disease test the number of thermal cycles required
  for the fluorescent signal to exceed that of the background and
  cross the threshold for a positive test. The executive
  commissioner shall require the reports of polymerase chain reaction
  tests from clinical or hospital laboratories to contain the cycle
  threshold values and their reference ranges.
         SECTION 11.  Section 81.081, Health and Safety Code, is
  amended to read as follows:
         Sec. 81.081.  DEPARTMENT'S DUTY. The department is the
  preemptive authority for purposes of this chapter and shall
  coordinate statewide or regional efforts to protect public health.  
  The department shall collaborate with local elected officials,
  including county and municipal officials, [impose control
  measures] to prevent the spread of disease and [in the exercise of
  its power to] protect the public health.
         SECTION 12.  Subchapter E, Chapter 81, Health and Safety
  Code, is amended by adding Sections 81.0813, 81.0814, and 81.0815
  to read as follows:
         Sec. 81.0813.  AUTHORITY TO DECLARE PUBLIC HEALTH DISASTER
  OR ORDER PUBLIC HEALTH EMERGENCY. (a) The commissioner may declare
  a statewide or regional public health disaster or order a statewide
  or regional public health emergency if the commissioner determines
  an occurrence or threat to public health is imminent. The
  commissioner may declare a public health disaster only if the
  governor declares a state of disaster under Chapter 418, Government
  Code, for the occurrence or threat.
         (b)  Except as provided by Subsection (c), a public health
  disaster or public health emergency continues until the governor or
  commissioner terminates the disaster or emergency on a finding
  that:
               (1)  the threat or danger has passed; or
               (2)  the disaster or emergency has been managed to the
  extent emergency conditions no longer exist.
         (c)  A public health disaster or public health emergency
  expires on the 30th day after the date the disaster or emergency is
  declared or ordered by the commissioner. A public health disaster
  may only be renewed by the legislature or by the commissioner with
  the approval of a designated legislative oversight board that has
  been granted authority under a statute enacted by the legislature
  to approve the renewal of a public health disaster declaration.  
  Each renewal period may not exceed 30 days.
         (d)  A declaration or order issued under this section must
  include:
               (1)  a description of the nature of the disaster or
  emergency;
               (2)  a designation of the area threatened by the
  disaster or emergency;
               (3)  a description of the condition that created the
  disaster or emergency; and
               (4)  if applicable:
                     (A)  the reason for renewing the disaster or
  emergency; or
                     (B)  the reason for terminating the disaster or
  emergency.
         (e)  A declaration or order issued under this section must be
  disseminated promptly by means intended to bring its contents to
  the public's attention. A statewide or regional declaration or
  order shall be filed promptly with the office of the governor and
  the secretary of state. A regional declaration or order shall be
  filed with the county clerk or municipal secretary in each area to
  which it applies, unless the circumstances attendant on the
  disaster or emergency prevent or impede the filing.
         Sec. 81.0814.  CONSULTATION WITH TASK FORCE ON INFECTIOUS
  DISEASE PREPAREDNESS AND RESPONSE. After declaring a public health
  disaster or ordering a public health emergency, the commissioner
  shall consult with the Task Force on Infectious Disease
  Preparedness and Response, including any subcommittee the task
  force forms to aid in the rapid assessment of response efforts.
         Sec. 81.0815.  FAILURE TO REPORT; CIVIL PENALTY. (a) A
  health care facility that fails to submit a report required by the
  department under a public health disaster is liable to this state
  for a civil penalty of not more than $1,000 for each failure.
         (b)  The attorney general at the request of the department
  may bring an action to collect a civil penalty imposed under this
  section.
         SECTION 13.  Sections 161.00705(a) and (c), Health and
  Safety Code, are amended to read as follows:
         (a)  The department shall maintain a registry of persons who
  receive an immunization or[,] antiviral[, and other medication]
  administered to prepare for a potential disaster, public health
  disaster [emergency], terrorist attack, hostile military or
  paramilitary action, or extraordinary law enforcement emergency or
  in response to a declared disaster, public health disaster
  [emergency], terrorist attack, hostile military or paramilitary
  action, or extraordinary law enforcement emergency.  A health care
  provider who administers an immunization or[,] antiviral[, or other
  medication] shall provide the data elements to the department.  At
  the request and with the authorization of the health care provider,
  the data elements may be provided through a health information
  exchange as defined by Section 182.151.
         (c)  The department shall track adverse reactions to an
  immunization or[,] antiviral[, and other medication] administered
  to prepare for a potential disaster, public health disaster
  [emergency], terrorist attack, hostile military or paramilitary
  action, or extraordinary law enforcement emergency or in response
  to a declared disaster, public health disaster [emergency],
  terrorist attack, hostile military or paramilitary action, or
  extraordinary law enforcement emergency.  A health care provider
  who administers an immunization or[,] antiviral[, or other
  medication] may provide data related to adverse reactions to the
  department.
         SECTION 14.  Subchapter A, Chapter 161, Health and Safety
  Code, is amended by adding Section 161.0085 to read as follows:
         Sec. 161.0085.  COVID-19 VACCINE PASSPORTS PROHIBITED. (a)  
  In this section, "COVID-19" means the 2019 novel coronavirus
  disease.
         (b)  A governmental entity in this state may not issue a
  vaccine passport, vaccine pass, or other standardized
  documentation to certify an individual's COVID-19 vaccination
  status to a third party for a purpose other than health care or
  otherwise publish or share any individual's COVID-19 immunization
  record or similar health information for a purpose other than
  health care.
         (c)  A business in this state may not require a customer to
  provide any documentation certifying the customer's COVID-19
  vaccination or post-transmission recovery on entry to, to gain
  access to, or to receive service from the business. A business that
  fails to comply with this subsection is not eligible to receive a
  grant or enter into a contract payable with state funds.
         (d)  Notwithstanding any other law, each appropriate state
  agency shall ensure that businesses in this state comply with
  Subsection (c) and may require compliance with that subsection as a
  condition for a license, permit, or other state authorization
  necessary for conducting business in this state.
         (e)  This section may not be construed to:
               (1)  restrict a business from implementing COVID-19
  screening and infection control protocols in accordance with state
  and federal law to protect public health; or
               (2)  interfere with an individual's right to access the
  individual's personal health information under federal law.
         SECTION 15.  Subchapter C, Chapter 1001, Health and Safety
  Code, is amended by adding Section 1001.0515 to read as follows:
         Sec. 1001.0515.  OFFICE OF CHIEF STATE EPIDEMIOLOGIST. (a)
  The commissioner shall:
               (1)  establish an Office of Chief State Epidemiologist
  within the department to provide expertise in public health
  activities and policy in this state by:
                     (A)  evaluating epidemiologic, medical, and
  health care information; and
                     (B)  identifying pertinent research and
  evidence-based best practices; and
               (2)  appoint a physician licensed to practice medicine
  in this state as the chief state epidemiologist to administer the
  Office of Chief State Epidemiologist.
         (b)  The chief state epidemiologist must:
               (1)  be board certified in a medical specialty; and
               (2)  have significant experience in public health and
  an advanced degree in public health, epidemiology, or a related
  field.
         (c)  The chief state epidemiologist serves as:
               (1)  the department expert on epidemiological matters
  and on communicable and noncommunicable diseases; and
               (2)  the department's senior science representative and
  primary contact for the Centers for Disease Control and Prevention
  and other federal agencies related to epidemiologic science and
  disease surveillance.
         (d)  The chief state epidemiologist may provide professional
  and scientific consultation regarding epidemiology and disease
  control, harmful exposure, and injury prevention to state agencies,
  health facilities, health service regions, local health
  authorities, local health departments, and other entities.
         (e)  Notwithstanding any other law, the chief state
  epidemiologist may access information from the department to
  implement duties of the epidemiologist's office. Reports, records,
  and information provided to the Office of Chief State
  Epidemiologist that relate to an epidemiologic or toxicologic
  investigation of human illness or conditions and of environmental
  exposure that are harmful or believed to be harmful to the public
  health are confidential and not subject to disclosure under Chapter
  552, Government Code, and may not be released or made public on
  subpoena or otherwise, except for statistical purposes if released
  in a manner that prevents identification of any person.
         SECTION 16.  Section 1001.089(a)(2), Health and Safety Code,
  is amended to read as follows:
               (2)  "Local public health entity" means a local health
  authority, local health unit, local health department, or public
  health district.
         SECTION 17.  Section 81.082(e), Health and Safety Code, is
  repealed.
         SECTION 18.  (a) In this section, "council" means the
  Preparedness Coordinating Council advisory committee established
  by the Health and Human Services Commission under Section 1001.035,
  Health and Safety Code, for the Department of State Health
  Services.
         (b)  In coordination with the emergency management council
  established by the governor under Section 418.013, Government Code,
  the council shall conduct a study on this state's response to the
  2019 novel coronavirus disease. The council shall examine the
  roles of the Department of State Health Services, the Health and
  Human Services Commission, and the Texas Division of Emergency
  Management relating to public health disaster and emergency
  planning and response efforts and determine the efficacy of the
  state emergency operations plan in appropriately identifying
  agency responsibilities.  The council may collaborate with an
  institution of higher education in this state to conduct the study.
         (c)  Not later than nine months after the date the declared
  public health disaster related to the 2019 novel coronavirus
  disease is terminated, or September 1, 2023, whichever is earlier,
  the council shall prepare and submit a written report to the
  governor, the lieutenant governor, the speaker of the house of
  representatives, and the members of the legislature on the results
  of the study conducted under Subsection (b) of this section. The
  report must include recommendations for legislative improvements
  for public health disaster and public health emergency response and
  preparedness.
         (d)  This section expires September 1, 2023.
         SECTION 19.  Section 418.0125, Government Code, as added by
  this Act, applies only to an order issued or regulation adopted on
  or after the effective date of this Act.
         SECTION 20.  As soon as practicable, but not later than
  August 31, 2022, the Department of State Health Services shall
  implement the disease prevention information system as required by
  Section 418.1861, Government Code, as added by this Act.
         SECTION 21.  As soon as practicable after the effective date
  of this Act, the Texas Division of Emergency Management shall adopt
  the rules necessary to implement Subchapter J, Chapter 418,
  Government Code, as added by this Act.
         SECTION 22.  (a)  The Department of State Health Services
  and the Preparedness Coordinating Council advisory committee are
  required to implement this Act only if the legislature appropriates
  money specifically for that purpose. If the legislature does not
  appropriate money specifically for that purpose, the department and
  council may, but are not required to, implement this Act using other
  appropriations available for that purpose.
         (b)  The Department of State Health Services shall use any
  available federal money to implement this Act.
         SECTION 23.  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, 2021.
 
 
 
 
 
  ______________________________ ______________________________
     President of the Senate Speaker of the House     
 
         I hereby certify that S.B. No. 968 passed the Senate on
  April 21, 2021, by the following vote: Yeas 31, Nays 0; and that
  the Senate concurred in House amendments on May 30, 2021, by the
  following vote: Yeas 28, Nays 3.
 
 
  ______________________________
  Secretary of the Senate    
 
         I hereby certify that S.B. No. 968 passed the House, with
  amendments, on May 26, 2021, by the following vote: Yeas 146,
  Nays 2, one present not voting.
 
 
  ______________________________
  Chief Clerk of the House   
 
 
 
  Approved:
 
  ______________________________ 
              Date
 
 
  ______________________________ 
            Governor