H.F. 2270 Section 1. Section 29C.6, subsection 1, Code 2022, is 1 amended to read as follows: 2 1. a. After finding a disaster exists or is threatened, 3 proclaim a state of disaster emergency. This proclamation 4 shall be in writing, indicate the area affected and the facts 5 upon which it is based, be signed by the governor, and be 6 filed with the secretary of state. If the state of disaster 7 emergency specifically constitutes a public health disaster 8 as defined in section 135.140 , the written proclamation shall 9 include a statement to that effect. A state of disaster 10 emergency shall continue for thirty days, unless sooner 11 terminated or rescinded, extended in writing , or amended by 12 the governor general assembly . The general assembly may, 13 by concurrent resolution, rescind , extend, or amend this 14 proclamation. Any initial extension of this proclamation by 15 the general assembly shall not exceed sixty days, and any 16 subsequent extension shall not exceed sixty-day increments. 17 If the general assembly is not in session, the legislative 18 council may, by majority vote, rescind , extend, or amend this 19 proclamation only once and any extension shall not exceed 20 thirty days . Rescission Following any rescission, extension, 21 or amendment of this proclamation by the legislative council, 22 any additional action may only be taken by the general 23 assembly. Any rescission, extension, or amendment shall be 24 effective upon the filing of the concurrent resolution or 25 resolution of the legislative council with the secretary of 26 state. A proclamation of disaster emergency shall activate the 27 disaster response and recovery aspect of the state, local, and 28 interjurisdictional disaster emergency plans applicable to the 29 political subdivision or area in question and be authority for 30 the deployment and use of any forces to which the plan applies, 31 and for use or distribution of any supplies, equipment, and 32 materials and facilities assembled, stockpiled, or arranged to 33 be made available. 34 b. A measure dictated in a state of disaster emergency 35 -1- LSB 5199YH (6) 89 pf/rh 1/ 9

H.F. 2270 proclamation shall not do any of the following: 1 (1) Infringe on a fundamental constitutionally protected 2 right unless the measure is justified by a compelling state 3 interest, is narrowly tailored to achieve its specific purpose, 4 and is achieved by the least restrictive means possible. 5 (2) Restrict rights, interests, or activities in a manner 6 that is not neutral or generally applicable. 7 (3) Prohibit in-person interactions between religious 8 leaders or individuals who are related by consanguinity or 9 affinity with patients or residents of hospitals or health care 10 facilities. 11 (4) Authorize the use of mobile, cellular, or any other 12 digital technologies to track or surveil persons without 13 providing prior notice to and receiving consent from such 14 persons. 15 (5) Authorize the use of any drones, unmanned 16 aerial vehicles, advanced robotics, or any artificial 17 intelligence-based systems to enforce the proclamation. 18 (6) Restrict the practice of a person holding a valid 19 license to practice a health-related profession regulated 20 by a board designated pursuant to section 147.13 or by the 21 department of public health, or restrict the scope of service 22 delivery of a hospital, clinic, or health care professional if 23 the person or entity is otherwise practicing within the scope 24 of a valid license. 25 (7) Allow a board designated pursuant to section 147.13 to 26 restrict the prescribing authority of a licensed health-related 27 professional in a way that acts as a deterrent for a prescriber 28 to use a medication or treatment in accordance with the 29 prescriber’s best professional judgment. 30 (8) Require identification and monitoring of persons 31 who may be at risk of contracting a contagious or infectious 32 disease by virtue of contact with a contagious person 33 in a manner consistent with known or suspected modes 34 of transmission; require a person to comply with such 35 -2- LSB 5199YH (6) 89 pf/rh 2/ 9

H.F. 2270 identification and monitoring efforts including efforts that 1 infringe on a person’s freedom of association; or establish, 2 authorize, or enforce penalties for a person’s refusal to 3 participate in the identification and monitoring efforts. 4 Sec. 2. Section 135.144, subsections 3, 5, 6, 7, and 8, Code 5 2022, are amended to read as follows: 6 3. Take reasonable measures as necessary to prevent 7 the transmission of infectious disease and to ensure that 8 all cases of communicable disease are properly identified, 9 controlled, and treated. However, such reasonable measures 10 shall not include requiring identification and monitoring of 11 persons who may be at risk of contracting a contagious or 12 infectious disease by virtue of contact with a contagious 13 person in a manner consistent with known or suspected modes 14 of transmission; requiring a person to comply with such 15 identification and monitoring efforts including efforts that 16 infringe on a person’s freedom of association; or establishing, 17 authorizing, or enforcing penalties for a person’s refusal 18 to participate in the identification and monitoring efforts 19 including efforts that infringe on a person’s freedom of 20 association. 21 5. Order Recommend physical examinations and tests and 22 collect the collection of specimens as necessary for the 23 diagnosis or treatment of individuals, to be performed by 24 any qualified person authorized to do so by the department. 25 An examination or test shall not be performed or ordered 26 recommended if the examination or test is reasonably likely 27 to lead to serious harm to the affected individual. The 28 department may isolate or quarantine , pursuant to chapter 139A 29 and the rules implementing chapter 139A and this subchapter , 30 any infected individual whose refusal of medical examination or 31 testing results in uncertainty regarding whether the individual 32 has been exposed to or is infected with a communicable or 33 potentially communicable disease or otherwise poses a danger 34 to public health. 35 -3- LSB 5199YH (6) 89 pf/rh 3/ 9

H.F. 2270 6. a. Vaccinate or order Recommend that individuals be 1 vaccinated against an infectious disease and to prevent the 2 spread of communicable or potentially communicable disease. 3 Vaccinations shall be administered by any qualified person 4 authorized to do so by the department. The vaccination shall 5 not be provided or ordered recommended if it is reasonably 6 likely to lead to serious harm to the affected individual. To 7 prevent the spread of communicable or potentially communicable 8 disease, the department may isolate or quarantine , pursuant to 9 chapter 139A and the rules implementing chapter 139A and this 10 subchapter , any infected person who is unable or unwilling to 11 undergo vaccination pursuant to this subsection . 12 b. Notwithstanding any provision to the contrary in 13 paragraph “a” , a vaccination shall not be recommended for a 14 person pursuant to this subsection and the department shall 15 not isolate an infected person who is unable or unwilling to 16 undergo vaccination pursuant to this subsection if either of 17 the following applies: 18 (1) The person, or if the person is a minor, the person’s 19 parent or legal guardian, submits to the department a statement 20 signed by a physician, advanced registered nurse practitioner, 21 or physician assistant who is licensed by the board of 22 medicine, board of nursing, or board of physician assistants 23 that the vaccination would be injurious to the health and 24 well-being of the person or any member of the person’s family. 25 (2) The person, or if the person is a minor, the person’s 26 parent or legal guardian, submits to the department an 27 affidavit signed by the person, or if the person is a minor, 28 the person’s parent or legal guardian, stating that the 29 vaccination conflicts with the sincerely held religious beliefs 30 of the applicant, or if the applicant is a minor, of the 31 applicant’s parent or legal guardian. 32 7. Treat or order Recommend that individuals exposed to 33 or infected with disease receive treatment or prophylaxis. 34 Treatment or prophylaxis shall be administered by any qualified 35 -4- LSB 5199YH (6) 89 pf/rh 4/ 9

H.F. 2270 person authorized to do so by the department. Treatment or 1 prophylaxis shall not be provided or ordered recommended if 2 the treatment or prophylaxis is reasonably likely to lead 3 to serious harm to the affected individual. To prevent the 4 spread of communicable or potentially communicable disease, the 5 department may isolate or quarantine , pursuant to chapter 139A 6 and the rules implementing chapter 139A and this subchapter , 7 any infected individual who is unable or unwilling to undergo 8 treatment or prophylaxis pursuant to this section . 9 8. Isolate or quarantine infected individuals or groups of 10 individuals pursuant to chapter 139A and the rules implementing 11 chapter 139A and this subchapter . 12 Sec. 3. Section 135.144, Code 2022, is amended by adding the 13 following new subsection: 14 NEW SUBSECTION . 14. Provide a link on the department’s 15 internet website for qualified individuals to submit 16 evidence-based information regarding a public health emergency 17 or public health disaster and for members of the public to 18 share their experiences. The department shall adopt rules 19 pursuant to chapter 17A to administer this subsection, 20 including the criteria a qualified individual must meet to 21 participate. 22 Sec. 4. Section 139A.8, subsection 4, paragraph a, 23 subparagraph (2), Code 2022, is amended to read as follows: 24 (2) The applicant, or if the applicant is a minor, the 25 applicant’s parent or legal guardian, submits an affidavit 26 signed by the applicant, or if the applicant is a minor, 27 the applicant’s parent or legal guardian, stating that the 28 immunization conflicts with the tenets and practices of a 29 recognized sincerely held religious denomination beliefs 30 of which the applicant is an adherent or member , or if the 31 applicant is a minor, of the applicant’s parent or legal 32 guardian . 33 Sec. 5. Section 139A.8, subsection 4, paragraph b, Code 34 2022, is amended to read as follows: 35 -5- LSB 5199YH (6) 89 pf/rh 5/ 9

H.F. 2270 b. The exemptions under this subsection do not apply in 1 times of emergency or epidemic as determined by the state board 2 of health and as declared by the director of public health. 3 EXPLANATION 4 The inclusion of this explanation does not constitute agreement with 5 the explanation’s substance by the members of the general assembly. 6 This bill relates to duties and powers relative to emergency 7 situations including a state of disaster emergency and public 8 health disasters. 9 The bill amends provisions relating to the proclamation of 10 a state of disaster emergency by the governor. Current law 11 provides that a state of disaster emergency shall continue for 12 30 days unless sooner terminated or extended by the governor 13 and that the general assembly, by concurrent resolution when 14 in session or through the legislative council by majority vote 15 if not in session, may rescind the proclamation. Under the 16 bill, a state of disaster emergency shall continue for 30 days 17 unless sooner rescinded, extended, or amended by the general 18 assembly, not the governor, and that any initial extension of 19 the proclamation by the general assembly shall not exceed 60 20 days, and any subsequent extension shall not exceed 60-day 21 increments. Any rescission, extension, or amendment by the 22 general assembly shall be effective upon the filing of the 23 concurrent resolution or resolution of the legislative council 24 with the secretary of state. The bill also provides that 25 if the general assembly is not in session, the legislative 26 council may, by majority vote, rescind, extend, or amend this 27 proclamation only once and any extension shall not exceed 30 28 days. Following any rescission, extension, or amendment of the 29 proclamation by the legislative council, any additional action 30 may only be taken by the general assembly. 31 The bill also provides that a measure dictated in a state 32 of disaster emergency proclamation shall not do any of the 33 following: infringe on a fundamental constitutionally 34 protected right unless the measure is justified by a compelling 35 -6- LSB 5199YH (6) 89 pf/rh 6/ 9

H.F. 2270 state interest, is narrowly tailored to achieve its specific 1 purpose, and is achieved by the least restrictive means 2 possible; restrict rights, interests, or activities in a manner 3 that is not neutral or generally applicable; prohibit in-person 4 interactions between religious leaders or individuals who are 5 related by consanguinity or affinity with patients or residents 6 of hospitals or health care facilities; authorize the use of 7 mobile, cellular, or any other digital technologies to track or 8 surveil persons without providing prior notice to and receiving 9 consent from such persons; authorize the use of any drones, 10 unmanned aerial vehicles, advanced robotics, or any artificial 11 intelligence-based systems to enforce the proclamation; 12 restrict the practice of a person holding a valid license to 13 practice a health-related profession, or restrict the scope 14 of service delivery of a hospital, clinic, or health care 15 professional if the person or entity is otherwise practicing 16 within the scope of a valid license; allow a health-related 17 professional board to restrict the prescribing authority of a 18 licensed health-related professional in a way that acts as a 19 deterrent for a prescriber to use a medication or treatment in 20 accordance with the prescriber’s best professional judgment; 21 or require identification and monitoring of persons who may 22 be at risk of contracting a contagious or infectious disease 23 by virtue of contact with a contagious person in a manner 24 consistent with known or suspected modes of transmission, 25 require a person to comply with such identification and 26 monitoring efforts including efforts that infringe on a 27 person’s freedom of association, or establish, authorize, or 28 enforce penalties for a person’s refusal to participate in the 29 identification and monitoring efforts. 30 The bill amends the duties of the department of public health 31 (DPH) relative to a public health disaster. The bill provides 32 that the reasonable measures taken by DPH to prevent the 33 transmission of infectious disease and to ensure that all cases 34 of communicable disease are properly identified, controlled, 35 -7- LSB 5199YH (6) 89 pf/rh 7/ 9

H.F. 2270 and treated shall not include requiring identification and 1 monitoring of persons who may be at risk of contracting a 2 contagious or infectious disease by virtue of contact with 3 a contagious person in a manner consistent with known or 4 suspected modes of transmission; requiring a person to comply 5 with such identification and monitoring efforts including 6 efforts that infringe on a person’s freedom of association; 7 or establishing, authorizing, or enforcing penalties for a 8 person’s refusal to participate in the identification and 9 monitoring efforts including efforts that infringe on a 10 person’s freedom of association. DPH may recommend, but not 11 order, physical examinations, testing, and the collection 12 of specimens necessary for the diagnosis and treatment of 13 individuals and may isolate only infected individuals who 14 refuse medical examination or testing and who pose a danger 15 to the public health. DPH may recommend, but not vaccinate 16 or order that individuals be vaccinated against an infectious 17 disease or to prevent the spread of communicable or potentially 18 communicable disease. Vaccination shall not be recommended if 19 it is reasonably likely to lead to serious harm to the affected 20 individual. DPH may isolate only infected individuals who 21 are unable or unwilling to undergo vaccination. However, the 22 bill provides that a vaccination shall not be recommended for 23 a person under this provision of the bill and that DPH shall 24 not isolate an infected person who is unable or unwilling 25 to undergo vaccination pursuant to the bill if either of 26 the following applies: the person, or if the person is a 27 minor, the person’s parent or legal guardian, submits to 28 DPH a statement signed by a physician, advanced registered 29 nurse practitioner, or physician assistant who is licensed 30 by the board of medicine, board of nursing, or board of 31 physician assistants that the vaccination would be injurious 32 to the health and well-being of the person or any member 33 of the person’s family; or the person, or if the person is 34 a minor, the person’s parent or legal guardian, submits to 35 -8- LSB 5199YH (6) 89 pf/rh 8/ 9

H.F. 2270 DPH an affidavit signed by the person, or if the person is 1 a minor, the person’s parent or legal guardian, stating that 2 the vaccination conflicts with the sincerely held religious 3 beliefs of the applicant, or if the applicant is a minor, of 4 the applicant’s parent or legal guardian. 5 DPH may recommend, but not treat or order, that individuals 6 infected with disease receive treatment or prophylaxis. 7 Treatment or prophylaxis shall not be recommended if the 8 treatment or prophylaxis is reasonably likely to lead to 9 serious harm to the affected individual. DPH may isolate only 10 individuals infected with disease who are unable or unwilling 11 to undergo treatment or prophylaxis and may isolate only 12 infected individuals or groups of individuals. 13 The bill requires DPH to provide a link on the department’s 14 internet website for qualified individuals to submit 15 evidence-based information regarding a public health emergency 16 or public health disaster and for members of the public to 17 share their experiences. The department shall adopt rules 18 pursuant to Code chapter 17A to administer the bill, including 19 the criteria a qualified individual must meet to participate. 20 The bill amends provisions relating to the immunization of 21 children to provide that if a child is exempt from vaccination, 22 the exemption applies during times of emergency or epidemic and 23 provides that the religious exemption is based on the sincerely 24 held religious beliefs of the applicant, or if the applicant is 25 a minor, of the applicant’s parent or legal guardian, rather 26 than based on a conflict with the tenets and practices of a 27 recognized religious denomination of which the applicant is an 28 adherent or member. 29 -9- LSB 5199YH (6) 89 pf/rh 9/ 9