H.F. 2087 Section 1. NEW SECTION . 7.19 Regulation of religious 1 institutions and practices —— limitation. 2 Notwithstanding any provision of law to the contrary, the 3 governor shall not dictate a measure in a proclamation of a 4 state of disaster emergency issued pursuant to section 29C.6 5 that unduly interferes with the operations of a religious 6 institution or otherwise impedes an individual’s practice 7 of religion. For purposes of this section, a “religious 8 institution” means a building in which individuals engage in 9 religious practices. 10 Sec. 2. Section 29C.6, subsection 1, Code 2026, is amended 11 to read as follows: 12 1. a. After finding a disaster exists or is threatened, 13 proclaim a state of disaster emergency. This proclamation 14 shall be in writing, indicate the area affected and the facts 15 upon which it is based, be signed by the governor, and be 16 filed with the secretary of state. If the state of disaster 17 emergency specifically constitutes a public health disaster 18 as defined in section 135.140 , the written proclamation shall 19 include a statement to that effect. A state of disaster 20 emergency shall continue for thirty fifteen days, unless sooner 21 terminated or rescinded, extended , or amended in writing by 22 the governor general assembly . The general assembly may, 23 by concurrent resolution, rescind , extend, or amend this 24 proclamation. An initial extension of this proclamation by 25 the general assembly shall not exceed fifteen days, and any 26 subsequent extension shall not exceed fifteen-day increments. 27 If the general assembly is not in session, the legislative 28 council may, by majority vote, rescind , extend, or amend this 29 proclamation only once and the extension shall not exceed 30 fifteen days . Rescission Following any rescission, extension, 31 or amendment of this proclamation by the legislative council, 32 only the general assembly may take any additional action. Any 33 rescission, extension, or amendment shall be effective upon 34 filing of the concurrent resolution of the general assembly or 35 -1- LSB 5163YH (10) 91 ak/ko 1/ 9

H.F. 2087 resolution of the legislative council with the secretary of 1 state. A proclamation of disaster emergency shall activate the 2 disaster response and recovery aspect of the state, local, and 3 interjurisdictional disaster emergency plans applicable to the 4 political subdivision or area in question and be authority for 5 the deployment and use of any forces to which the each disaster 6 emergency plan applies, and for use or distribution of any 7 supplies, equipment, and materials and facilities assembled, 8 stockpiled, or arranged to be made available. 9 b. A measure dictated in a state of disaster emergency 10 proclamation shall not do any of the following: 11 (1) Infringe on a fundamental constitutionally protected 12 right unless the measure is justified by a compelling state 13 interest, is narrowly tailored to achieve its specific purpose, 14 and is achieved by the least restrictive means possible. 15 (2) Restrict rights, interests, or activities in a manner 16 that is not neutral or generally applicable. 17 (3) Prohibit in-person interactions between religious 18 leaders or individuals who are related by consanguinity or 19 affinity with patients or residents of hospitals or health care 20 facilities. 21 (4) Authorize the use of mobile, cellular, or any 22 other digital technologies to track or surveil persons 23 without providing prior notice to and receiving consent 24 from such persons. A request to consent to specific terms 25 of surveillance shall not be combined with any other terms 26 requiring consent. 27 (5) Authorize the use of any drones, unmanned 28 aerial vehicles, advanced robotics, or any artificial 29 intelligence-based systems to enforce the proclamation. 30 (6) Restrict the practice of a person holding a valid 31 license to practice a health-related profession regulated 32 by a board designated pursuant to section 147.13 or by the 33 department of inspections, appeals, and licensing, or restrict 34 the scope of service delivery of a hospital, clinic, or 35 -2- LSB 5163YH (10) 91 ak/ko 2/ 9

H.F. 2087 health care professional if the person or entity is otherwise 1 practicing within the scope of a valid license. 2 (7) Allow a board designated pursuant to section 147.13 to 3 restrict the prescribing authority of a licensed health-related 4 professional in a way that deters the professional from 5 prescribing medication or treatment in accordance with the 6 professional’s best professional judgment. 7 (8) Require identification and monitoring of persons 8 who may be at risk of contracting a contagious or infectious 9 disease by virtue of contact with a contagious person 10 in a manner consistent with known or suspected modes of 11 transmission. 12 (9) Establish, authorize, or enforce penalties for 13 a person’s refusal to participate in identification and 14 monitoring efforts. 15 Sec. 3. Section 135.144, subsections 3, 5, 6, 7, and 8, Code 16 2026, are amended to read as follows: 17 3. Take reasonable measures as necessary to prevent the 18 transmission of infectious disease and to ensure that all cases 19 of communicable disease are properly identified, controlled, 20 and treated. Reasonable measures shall not include any of the 21 following: 22 a. Requiring identification and monitoring of persons 23 who may be at risk of contracting a contagious or infectious 24 disease by virtue of contact with a contagious person 25 in a manner consistent with known or suspected modes of 26 transmission. 27 b. Requiring a person to comply with such identification 28 and monitoring efforts including efforts that infringe on a 29 person’s freedom of association. 30 c. Establishing, authorizing, or enforcing penalties for 31 a person’s refusal to participate in the identification and 32 monitoring efforts. 33 5. Order Recommend physical examinations and tests and 34 collect the collection of specimens as necessary for the 35 -3- LSB 5163YH (10) 91 ak/ko 3/ 9

H.F. 2087 diagnosis or treatment of individuals, to be performed by any 1 qualified person authorized to do so by the department. An A 2 physical examination or test shall not be performed or ordered 3 recommended if the physical examination or test is reasonably 4 likely to lead to serious harm to the affected individual. The 5 affected individual has the ultimate authority to determine 6 whether to submit to the recommended physical examination 7 or testing, and shall not be subject to undue pressure or 8 compulsion to submit to the recommendation. The department may 9 isolate or quarantine , pursuant to chapter 139A and the rules 10 implementing chapter 139A and this subchapter , any infected 11 individual whose refusal of medical a physical examination or 12 testing results in uncertainty regarding whether the individual 13 has been exposed to or is infected with a communicable or 14 potentially communicable disease or otherwise poses a danger to 15 public health. The length of isolation shall not exceed the 16 longest usual incubation period for the specific communicable 17 disease. 18 6. Vaccinate or order Recommend that individuals be 19 vaccinated with a vaccine approved by the United States food 20 and drug administration as safe and effective against an 21 infectious disease and to prevent the spread of communicable 22 or potentially communicable disease. Vaccinations shall be 23 administered by any qualified person authorized to do so by the 24 department. Prior to administration of a vaccine, an adult 25 or the parent or legal representative of a minor receiving 26 the vaccine shall be provided with the federal vaccine 27 information statement for the vaccine and verbally informed 28 of the known and potential benefits and risks of the vaccine. 29 The vaccination shall not be provided or ordered recommended 30 if it is reasonably likely to lead to serious harm to the 31 affected individual. The affected individual has the ultimate 32 authority to determine whether to submit to the recommended 33 vaccination, and shall not be subject to undue pressure or 34 compulsion to submit to the recommendation. To prevent the 35 -4- LSB 5163YH (10) 91 ak/ko 4/ 9

H.F. 2087 spread of communicable or potentially communicable disease, the 1 department may isolate or quarantine , pursuant to chapter 139A 2 and the rules implementing chapter 139A and this subchapter , 3 any infected person who is unable or unwilling to undergo 4 vaccination pursuant to this subsection . 5 7. Treat or order Recommend that individuals exposed to 6 or infected with disease receive treatment or prophylaxis. 7 Treatment or prophylaxis shall be administered by any qualified 8 person authorized to do so by the department. Treatment or 9 prophylaxis shall not be provided or ordered recommended if 10 the treatment or prophylaxis is reasonably likely to lead to 11 serious harm to the affected infected individual. The infected 12 individual has the ultimate authority to determine whether to 13 submit to the recommended treatment or prophylaxis, and shall 14 not be subject to undue pressure or compulsion to submit to 15 the recommendation. To prevent the spread of communicable or 16 potentially communicable disease, the department may isolate or 17 quarantine , pursuant to chapter 139A and the rules implementing 18 chapter 139A and this subchapter , any infected individual who 19 is unable or unwilling to undergo treatment or prophylaxis 20 pursuant to this section subsection . 21 8. Isolate or quarantine infected individuals or groups of 22 individuals pursuant to chapter 139A and the rules implementing 23 chapter 139A and this subchapter . 24 Sec. 4. Section 135.144, Code 2026, is amended by adding the 25 following new subsection: 26 NEW SUBSECTION . 14. Provide a link on the department’s 27 internet site for qualified individuals to submit 28 evidence-based information regarding a public health emergency 29 or public health disaster and for members of the public to 30 share their experiences. The department shall adopt rules 31 pursuant to chapter 17A to administer this subsection, 32 including the criteria a qualified individual must meet to 33 participate. 34 Sec. 5. Section 139A.4, subsection 1, Code 2026, is amended 35 -5- LSB 5163YH (10) 91 ak/ko 5/ 9

H.F. 2087 to read as follows: 1 1. The type and length of isolation or quarantine imposed 2 for a specific communicable disease shall be in accordance with 3 rules adopted by the department. The length of isolation or 4 quarantine shall not exceed the longest usual incubation period 5 for the specific communicable disease. 6 Sec. 6. Section 139A.8, subsection 4, paragraph a, 7 subparagraph (2), Code 2026, is amended to read as follows: 8 (2) The applicant, or if the applicant is a minor, the 9 applicant’s parent or legal guardian, submits an affidavit 10 signed by the applicant, or if the applicant is a minor, 11 the applicant’s parent or legal guardian, stating that the 12 immunization conflicts with the tenets and practices of a 13 recognized sincerely held religious denomination beliefs 14 of which the applicant is an adherent or member , or if the 15 applicant is a minor, of the applicant’s parent or legal 16 guardian . 17 Sec. 7. Section 139A.8, subsection 4, paragraph b, Code 18 2026, is amended to read as follows: 19 b. The exemptions under this subsection do not apply in 20 times of emergency or epidemic as determined and declared by 21 the director. 22 EXPLANATION 23 The inclusion of this explanation does not constitute agreement with 24 the explanation’s substance by the members of the general assembly. 25 This bill relates to the powers and duties applicable during 26 a state of disaster emergency or a public health disaster 27 and prohibits the governor’s ability to regulate religious 28 institutions and practices during these emergencies. 29 The bill prohibits the governor from dictating a measure in 30 a proclamation of a state of disaster emergency (proclamation) 31 that unduly interferes with operations of a religious 32 institution or otherwise impedes an individual’s practice of 33 religion. “Religious institution” is defined in the bill. 34 Current law provides that a state of disaster emergency 35 -6- LSB 5163YH (10) 91 ak/ko 6/ 9

H.F. 2087 shall continue for 30 days unless terminated or extended by 1 the governor. The general assembly, by concurrent resolution 2 when in session, or through the legislative council by majority 3 vote if not in session, may rescind the proclamation. Under 4 the bill, a state of disaster emergency shall continue for 15 5 days unless rescinded, extended, or amended by the general 6 assembly, any initial extension of the proclamation shall not 7 exceed 15 days, and any subsequent extension shall not exceed 8 15-day increments. The bill also provides that if the general 9 assembly is not in session, the legislative council may, by 10 majority vote, rescind, extend, or amend the proclamation only 11 once and the extension shall not exceed 15 days. 12 The bill places certain restrictions on measures dictated 13 in a proclamation relating to constitutional rights, religious 14 rights, patient rights, surveillance, health-related profession 15 licensing and prescribing authority, and disease contraction 16 monitoring. 17 Current law allows the department of health and human 18 services (HHS) to take reasonable measures to prevent the 19 transmission of and ensure proper identification, control, 20 and treatment of infectious diseases. The bill provides that 21 requiring identification and monitoring of a person at risk of 22 contracting a contagious or infectious disease through contact 23 with a contagious person or requiring a person to comply with 24 such identification and monitoring efforts are not reasonable 25 measures. 26 Under current law, HHS can take or order certain disease 27 prevention actions be taken during a public health disaster. 28 The bill instead provides that the department may only 29 recommend vaccines approved by the United States food and 30 drug administration and not reasonably likely to lead to 31 serious harm to the individual. Under the bill, HHS may only 32 recommend physical examinations, testing, and the collection of 33 specimens necessary for the diagnosis and treatment of infected 34 individuals and not reasonably likely to harm the individual. 35 -7- LSB 5163YH (10) 91 ak/ko 7/ 9

H.F. 2087 An affected individual has the ultimate authority to determine 1 whether to submit to the department’s recommendations, and 2 shall not be subject to undue pressure or compulsion to submit. 3 Under current law, during a public health disaster, HHS can 4 quarantine or isolate certain infected individuals. The bill 5 instead allows HHS to isolate certain infected individuals for 6 a period not to exceed the longest usual incubation period for 7 the specific communicable disease. 8 The bill provides that prior to administration of a vaccine, 9 an adult or the parent or legal representative of a minor 10 receiving the vaccine shall be provided with the federal 11 vaccine information statement and verbally informed of the 12 known and potential benefits and risks of the vaccine. The 13 department may isolate infected individuals. 14 Under current law, during a public health disaster, HHS 15 can order infected individuals to receive certain treatments 16 or prophylaxes. Under the bill, HHS may only recommend that 17 infected individuals receive treatment or prophylaxis if not 18 reasonably likely to lead to serious harm to the individual. 19 The infected individual has the ultimate authority to determine 20 whether to submit to the recommendation, and shall not be 21 subject to undue pressure or compulsion to submit. Under 22 current law, HHS can quarantine or isolate infected individuals 23 unwilling to undergo treatment or prophylaxis. Under the bill, 24 HHS may isolate infected individuals unable or unwilling to 25 undergo treatment or prophylaxis. 26 The bill requires HHS to provide a link on the department’s 27 internet site for qualified individuals to submit 28 evidence-based information regarding a public health emergency 29 or public health disaster and for members of the public to 30 share their experiences. The department shall adopt rules to 31 administer this provision, including the criteria a qualified 32 individual must meet to participate. 33 The bill provides that the type and length of isolation or 34 quarantine imposed for a specific communicable disease shall be 35 -8- LSB 5163YH (10) 91 ak/ko 8/ 9

H.F. 2087 in accordance with rules adopted by the department, and that 1 the length of the isolation or quarantine shall not exceed the 2 longest usual incubation period for the specific communicable 3 disease. 4 Under current law, immunization is not required for 5 enrollment in an elementary or secondary school or licensed 6 child care center if a person, or, if the person is a minor, the 7 minor’s parent or guardian, submits an affidavit stating that 8 the immunization conflicts with the tenets and practices of a 9 recognized religious denomination of which the person or the 10 minor’s parent or guardian is an adherent or member. Under the 11 bill, the submitted affidavit shall be accepted if it states 12 the immunization conflicts with the sincerely held religious 13 beliefs of the person or, if the person is a minor, the beliefs 14 of the minor’s parent or guardian. 15 The bill provides that if a child is exempt from vaccination, 16 the exemption applies during times of emergency or epidemic. 17 -9- LSB 5163YH (10) 91 ak/ko 9/ 9