H.F. _____ 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 A state of disaster 20 emergency shall continue for thirty fifteen days, unless sooner 21 terminated or rescinded, extended , or amended in writing by 22 the governor general assembly .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 6866YC (2) 91 ak/ko 1/ 8

H.F. _____ 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) Require that a private business operating within the 22 state cease the business’s lawful operations. 23 (5) Authorize a change to established laws, policies, or 24 regulations governing a local, county, or state election for 25 public office absent prior approval of the general assembly. 26 (6) Restrict the practice of a person holding a valid 27 license to practice a health-related profession regulated 28 by a board designated pursuant to section 147.13 or by the 29 department of inspections, appeals, and licensing, or restrict 30 the scope of service delivery of a hospital, clinic, or 31 health care professional if the person or entity is otherwise 32 practicing within the scope of a valid license. 33 (7) Allow a board designated pursuant to section 147.13 to 34 restrict the prescribing authority of a licensed health-related 35 -2- LSB 6866YC (2) 91 ak/ko 2/ 8

H.F. _____ professional in a way that deters the professional from 1 prescribing medication or treatment in accordance with the 2 professional’s best professional judgment. 3 c. Notwithstanding paragraph “b” , the governor may recommend 4 that a private business operating within the state cease the 5 business’s lawful operations in a measure dictated in a state 6 of disaster proclamation. 7 Sec. 3. Section 135.144, subsections 5, 6, 7, and 8, Code 8 2026, are amended to read as follows: 9 5. Order Recommend physical examinations and tests and 10 collect the collection of specimens as necessary for the 11 diagnosis or treatment of individuals, to be performed by any 12 qualified person authorized to do so by the department. An A 13 physical examination or test shall not be performed or ordered 14 recommended if the physical examination or test is reasonably 15 likely to lead to serious harm to the affected individual. The 16 affected individual has the ultimate authority to determine 17 whether to submit to the recommended physical examination 18 or testing, and shall not be subject to undue pressure or 19 compulsion to submit to the recommendation. The department may 20 isolate or quarantine , pursuant to chapter 139A and the rules 21 implementing chapter 139A and this subchapter , any infected 22 individual whose refusal of medical a physical examination or 23 testing results in uncertainty regarding whether the individual 24 has been exposed to or is infected with a communicable or 25 potentially communicable disease or otherwise poses a danger to 26 public health. The length of isolation shall not exceed the 27 longest usual incubation period for the specific communicable 28 disease. 29 6. Vaccinate or order Recommend that individuals be 30 vaccinated with a vaccine approved by the United States food 31 and drug administration as safe and effective against an 32 infectious disease and to prevent the spread of communicable 33 or potentially communicable disease. Vaccinations shall be 34 administered by any qualified person authorized to do so by the 35 -3- LSB 6866YC (2) 91 ak/ko 3/ 8

H.F. _____ department. Prior to administration of a vaccine, an adult 1 or the parent or legal representative of a minor receiving 2 the vaccine shall be provided with the federal vaccine 3 information statement for the vaccine and verbally informed 4 of the known and potential benefits and risks of the vaccine. 5 The vaccination shall not be provided or ordered recommended 6 if it is reasonably likely to lead to serious harm to the 7 affected individual. The affected individual has the ultimate 8 authority to determine whether to submit to the recommended 9 vaccination, and shall not be subject to undue pressure or 10 compulsion to submit to the recommendation. To prevent the 11 spread of communicable or potentially communicable disease, the 12 department may isolate or quarantine , pursuant to chapter 139A 13 and the rules implementing chapter 139A and this subchapter , 14 any infected person who is unable or unwilling to undergo 15 vaccination pursuant to this subsection . 16 7. Treat or order Recommend that individuals exposed to 17 or infected with disease receive treatment or prophylaxis. 18 Treatment or prophylaxis shall be administered by any qualified 19 person authorized to do so by the department. Treatment or 20 prophylaxis shall not be provided or ordered recommended if 21 the treatment or prophylaxis is reasonably likely to lead to 22 serious harm to the affected infected individual. The infected 23 individual has the ultimate authority to determine whether to 24 submit to the recommended treatment or prophylaxis, and shall 25 not be subject to undue pressure or compulsion to submit to 26 the recommendation. To prevent the spread of communicable or 27 potentially communicable disease, the department may isolate or 28 quarantine , pursuant to chapter 139A and the rules implementing 29 chapter 139A and this subchapter , any infected individual who 30 is unable or unwilling to undergo treatment or prophylaxis 31 pursuant to this section subsection . 32 8. Isolate or quarantine infected individuals or groups of 33 individuals pursuant to chapter 139A and the rules implementing 34 chapter 139A and this subchapter . 35 -4- LSB 6866YC (2) 91 ak/ko 4/ 8

H.F. _____ Sec. 4. Section 139A.4, subsection 1, Code 2026, is amended 1 to read as follows: 2 1. The type and length of isolation or quarantine imposed 3 for a specific communicable disease shall be in accordance with 4 rules adopted by the department. The length of isolation or 5 quarantine shall not exceed the longest usual incubation period 6 for the specific communicable disease. 7 Sec. 5. Section 139A.8, subsection 4, paragraph a, 8 subparagraph (2), Code 2026, is amended to read as follows: 9 (2) The applicant, or if the applicant is a minor, the 10 applicant’s parent or legal guardian, submits an affidavit 11 signed by the applicant, or if the applicant is a minor, 12 the applicant’s parent or legal guardian, stating that the 13 immunization conflicts with the tenets and practices of a 14 recognized sincerely held religious denomination beliefs 15 of which the applicant is an adherent or member , or if the 16 applicant is a minor, of the applicant’s parent or legal 17 guardian . 18 Sec. 6. Section 139A.8, subsection 4, paragraph b, Code 19 2026, is amended to read as follows: 20 b. The exemptions under this subsection do not apply in 21 times of emergency or epidemic as determined and declared by 22 the director. 23 EXPLANATION 24 The inclusion of this explanation does not constitute agreement with 25 the explanation’s substance by the members of the general assembly. 26 This bill relates to the powers and duties applicable during 27 a state of disaster emergency or a public health disaster 28 and prohibits the governor’s ability to regulate religious 29 institutions and practices during these emergencies. 30 The bill prohibits the governor from dictating a measure in 31 a proclamation of a state of disaster emergency (proclamation) 32 that unduly interferes with operations of a religious 33 institution or otherwise impedes an individual’s practice of 34 religion. “Religious institution” is defined in the bill. 35 -5- LSB 6866YC (2) 91 ak/ko 5/ 8

H.F. _____ Current law provides that a state of disaster emergency 1 shall continue for 30 days unless terminated or extended by 2 the governor. The general assembly, by concurrent resolution 3 when in session, or through the legislative council by majority 4 vote if not in session, may rescind the proclamation. Under 5 the bill, a state of disaster emergency shall continue for 15 6 days unless rescinded, extended, or amended by the general 7 assembly, any initial extension of the proclamation shall not 8 exceed 15 days, and any subsequent extension shall not exceed 9 15-day increments. The bill also provides that if the general 10 assembly is not in session, the legislative council may, by 11 majority vote, rescind, extend, or amend the proclamation only 12 once and the extension shall not exceed 15 days. 13 The bill places certain restrictions on measures dictated 14 in a proclamation relating to constitutional rights, religious 15 rights, patient rights, operations of private businesses, 16 voting in public elections, health-related profession licensing 17 and prescribing authority. 18 Under current law, HHS can take or order certain disease 19 prevention actions be taken during a public health disaster. 20 The bill instead provides that the department may only 21 recommend vaccines approved by the United States food and 22 drug administration and not reasonably likely to lead to 23 serious harm to the individual. Under the bill, HHS may only 24 recommend physical examinations, testing, and the collection of 25 specimens necessary for the diagnosis and treatment of infected 26 individuals and not reasonably likely to harm the individual. 27 An affected individual has the ultimate authority to determine 28 whether to submit to the department’s recommendations, and 29 shall not be subject to undue pressure or compulsion to submit. 30 Under current law, during a public health disaster, HHS can 31 quarantine or isolate certain infected individuals. The bill 32 instead allows HHS to isolate certain infected individuals for 33 a period not to exceed the longest usual incubation period for 34 the specific communicable disease. 35 -6- LSB 6866YC (2) 91 ak/ko 6/ 8

H.F. _____ The bill provides that prior to administration of a vaccine, 1 an adult or the parent or legal representative of a minor 2 receiving the vaccine shall be provided with the federal 3 vaccine information statement and verbally informed of the 4 known and potential benefits and risks of the vaccine. The 5 department may isolate infected individuals. 6 Under current law, during a public health disaster, HHS 7 can order exposed or infected individuals to receive certain 8 treatments or prophylaxis. Under the bill, HHS may only 9 recommend that exposed or infected individuals receive 10 treatment or prophylaxis if not reasonably likely to lead to 11 serious harm to the individual. The infected individual has 12 the ultimate authority to determine whether to submit to the 13 recommendation, and shall not be subject to undue pressure or 14 compulsion to submit. Under current law, HHS can quarantine 15 or isolate infected individuals unwilling to undergo treatment 16 or prophylaxis. Under the bill, HHS may isolate infected 17 individuals unable or unwilling to undergo treatment or 18 prophylaxis. 19 The bill provides that the type and length of isolation or 20 quarantine imposed for a specific communicable disease shall be 21 in accordance with rules adopted by the department, and that 22 the length of the isolation or quarantine shall not exceed the 23 longest usual incubation period for the specific communicable 24 disease. 25 Under current law, immunization is not required for 26 enrollment in an elementary or secondary school or licensed 27 child care center if a person, or, if the person is a minor, the 28 minor’s parent or guardian, submits an affidavit stating that 29 the immunization conflicts with the tenets and practices of a 30 recognized religious denomination of which the person or the 31 minor’s parent or guardian is an adherent or member. Under the 32 bill, the submitted affidavit shall be accepted if it states 33 the immunization conflicts with the sincerely held religious 34 beliefs of the person or, if the person is a minor, the beliefs 35 -7- LSB 6866YC (2) 91 ak/ko 7/ 8