S.F. 118 Section 1. Section 29C.6, subsection 1, Code 2025, 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 A state of disaster 10 emergency shall continue for thirty sixty days, unless sooner 11 terminated or rescinded, extended in writing , or amended by 12 the governor general assembly .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 the extension shall not exceed 20 sixty 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 1304XS (7) 91 lh/ko 1/ 9

S.F. 118 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. The consent request regarding the specific terms of 15 surveillance shall be presented as a separate request and not 16 combined with any other terms requiring consent. 17 (5) Authorize the use of any drones, unmanned 18 aerial vehicles, advanced robotics, or any artificial 19 intelligence-based systems to enforce the proclamation. 20 (6) Restrict the practice of a person holding a valid 21 license to practice a health-related profession regulated 22 by a board designated pursuant to section 147.13 or by the 23 department of inspections, appeals, and licensing, or restrict 24 the scope of service delivery of a hospital, clinic, or 25 health care professional if the person or entity is otherwise 26 practicing within the scope of a valid license. 27 (7) Allow a board designated pursuant to section 147.13 to 28 restrict the prescribing authority of a licensed health-related 29 professional in a way that acts as a deterrent for the 30 professional to prescribe a medication or treatment in 31 accordance with the professional’s best professional judgment. 32 (8) Require identification and monitoring of persons 33 who may be at risk of contracting a contagious or infectious 34 disease by virtue of contact with a contagious person 35 -2- LSB 1304XS (7) 91 lh/ko 2/ 9

S.F. 118 in a manner consistent with known or suspected modes 1 of transmission; require a person to comply with such 2 identification and monitoring efforts including efforts that 3 infringe on a person’s freedom of association; or establish, 4 authorize, or enforce penalties for a person’s refusal to 5 participate in the identification and monitoring efforts. 6 Sec. 2. Section 135.144, subsections 3, 5, 6, 7, and 8, Code 7 2025, are amended to read as follows: 8 3. Take reasonable measures as necessary to prevent 9 the transmission of infectious disease and to ensure that 10 all cases of communicable disease are properly identified, 11 controlled, and treated. However, such reasonable measures 12 shall not include requiring identification and monitoring of 13 persons who may be at risk of contracting a contagious or 14 infectious disease by virtue of contact with a contagious 15 person in a manner consistent with known or suspected modes 16 of transmission; requiring a person to comply with such 17 identification and monitoring efforts including efforts that 18 infringe on a person’s freedom of association; or establishing, 19 authorizing, or enforcing penalties for a person’s refusal 20 to participate in the identification and monitoring efforts 21 including efforts that infringe on a person’s freedom of 22 association. 23 5. Order Recommend physical examinations and tests and 24 collect the collection of specimens as necessary for the 25 diagnosis or treatment of individuals, to be performed by any 26 qualified person authorized to do so by the department. An A 27 physical examination or test shall not be performed or ordered 28 recommended if the physical examination or test is reasonably 29 likely to lead to serious harm to the affected individual. The 30 affected individual has the ultimate authority in determining 31 whether to submit to the recommended physical examination 32 or testing, and shall not be subject to undue pressure or 33 compulsion to submit to the recommendation. The department may 34 isolate or quarantine , pursuant to chapter 139A and the rules 35 -3- LSB 1304XS (7) 91 lh/ko 3/ 9

S.F. 118 implementing chapter 139A and this subchapter , any infected 1 individual whose refusal of medical a physical examination or 2 testing results in uncertainty regarding whether the individual 3 has been exposed to or is infected with a communicable or 4 potentially communicable disease or otherwise poses a danger to 5 public health. The length of isolation shall not exceed the 6 longest usual incubation period for the specific communicable 7 disease. 8 6. Vaccinate or order Recommend that individuals be 9 vaccinated with a vaccine approved by the United States food 10 and drug administration as safe and effective against an 11 infectious disease and to prevent the spread of communicable 12 or potentially communicable disease. Vaccinations shall be 13 administered by any qualified person authorized to do so by the 14 department. Prior to administration of a vaccine, an adult 15 or the parent or legal representative of a minor receiving 16 the vaccine shall be provided with the federal vaccine 17 information statement for the vaccine and verbally informed 18 of the known and potential benefits and risks of the vaccine. 19 The vaccination shall not be provided or ordered recommended 20 if it is reasonably likely to lead to serious harm to the 21 affected individual. The affected individual has the ultimate 22 authority in determining whether to submit to the recommended 23 vaccination, and shall not be subject to undue pressure or 24 compulsion to submit to the recommendation. To prevent the 25 spread of communicable or potentially communicable disease, the 26 department may isolate or quarantine , pursuant to chapter 139A 27 and the rules implementing chapter 139A and this subchapter , 28 any infected person who is unable or unwilling to undergo 29 vaccination pursuant to this subsection . 30 7. Treat or order Recommend that individuals exposed to 31 or infected with disease receive treatment or prophylaxis. 32 Treatment or prophylaxis shall be administered by any qualified 33 person authorized to do so by the department. Treatment or 34 prophylaxis shall not be provided or ordered recommended if 35 -4- LSB 1304XS (7) 91 lh/ko 4/ 9

S.F. 118 the treatment or prophylaxis is reasonably likely to lead to 1 serious harm to the affected infected individual. The infected 2 individual has the ultimate authority in determining whether to 3 submit to the recommended treatment or prophylaxis, and shall 4 not be subject to undue pressure or compulsion to submit to 5 the recommendation. To prevent the spread of communicable or 6 potentially communicable disease, the department may isolate or 7 quarantine , pursuant to chapter 139A and the rules implementing 8 chapter 139A and this subchapter , any infected individual who 9 is unable or unwilling to undergo treatment or prophylaxis 10 pursuant to this section subsection . 11 8. Isolate or quarantine infected individuals or groups of 12 individuals pursuant to chapter 139A and the rules implementing 13 chapter 139A and this subchapter . 14 Sec. 3. Section 135.144, Code 2025, is amended by adding the 15 following new subsection: 16 NEW SUBSECTION . 14. Provide a link on the department’s 17 internet site for qualified individuals to submit 18 evidence-based information regarding a public health emergency 19 or public health disaster and for members of the public to 20 share their experiences. The department shall adopt rules 21 pursuant to chapter 17A to administer this subsection, 22 including the criteria a qualified individual must meet to 23 participate. 24 Sec. 4. Section 139A.4, subsection 1, Code 2025, is amended 25 to read as follows: 26 1. The type and length of isolation or quarantine imposed 27 for a specific communicable disease shall be in accordance with 28 rules adopted by the department. The length of isolation or 29 quarantine shall not exceed the longest usual incubation period 30 for the specific communicable disease. 31 Sec. 5. Section 139A.8, subsection 4, paragraph a, 32 subparagraph (2), Code 2025, is amended to read as follows: 33 (2) The applicant, or if the applicant is a minor, the 34 applicant’s parent or legal guardian, submits an affidavit 35 -5- LSB 1304XS (7) 91 lh/ko 5/ 9

S.F. 118 signed by the applicant, or if the applicant is a minor, 1 the applicant’s parent or legal guardian, stating that the 2 immunization conflicts with the tenets and practices of a 3 recognized sincerely held religious denomination beliefs 4 of which the applicant is an adherent or member , or if the 5 applicant is a minor, of the applicant’s parent or legal 6 guardian . 7 Sec. 6. Section 139A.8, subsection 4, paragraph b, Code 8 2025, is amended to read as follows: 9 b. The exemptions under this subsection do not apply in 10 times of emergency or epidemic as determined and declared by 11 the director. 12 EXPLANATION 13 The inclusion of this explanation does not constitute agreement with 14 the explanation’s substance by the members of the general assembly. 15 This bill relates to duties and powers relative to emergency 16 situations including a state of disaster emergency and a public 17 health disaster. 18 The bill amends provisions relating to the proclamation 19 of a state of disaster emergency by the governor under Code 20 chapter 29C (emergency management and security). Current law 21 provides that a state of disaster emergency shall continue for 22 30 days unless terminated or extended by the governor and that 23 the general assembly, by concurrent resolution when in session 24 or through the legislative council by majority vote if not 25 in session, may rescind the proclamation. Under the bill, a 26 state of disaster emergency shall continue for 60 days unless 27 rescinded, extended, or amended by the general assembly, not 28 the governor, and any initial extension of the proclamation 29 by the general assembly shall not exceed 60 days, and any 30 subsequent extension shall not exceed 60-day increments. 31 The bill also provides that if the general assembly is not 32 in session, the legislative council may, by majority vote, 33 rescind, extend, or amend this proclamation only once and the 34 extension shall not exceed 60 days. 35 -6- LSB 1304XS (7) 91 lh/ko 6/ 9

S.F. 118 As described in the bill, a measure dictated in a state of 1 disaster emergency proclamation shall have certain restrictions 2 relating to constitutional rights, religious rights, patient 3 rights, surveillance, health-related profession licensing and 4 prescribing authority, and disease contraction monitoring. 5 The bill amends the duties of the department of health and 6 human services (HHS or the department) relative to a public 7 health disaster under Code chapter 135 (department of health 8 and human services —— public health). The bill provides 9 that the reasonable measures taken by HHS to prevent the 10 transmission of infectious disease and to ensure that all cases 11 of communicable disease are properly identified, controlled, 12 and treated shall not include requiring identification and 13 monitoring of a person at risk of contracting a contagious or 14 infectious disease through contact with a contagious person 15 or requiring a person to comply with such identification and 16 monitoring efforts. 17 The department may recommend, but not order, physical 18 examinations, testing, and the collection of specimens 19 necessary for the diagnosis and treatment of individuals. An 20 affected individual has the ultimate authority to determine 21 whether to submit to the department’s recommendations, and 22 shall not be subject to undue pressure or compulsion to submit. 23 The department may isolate infected individuals who refuse a 24 physical examination or testing and who pose a danger to the 25 public health. The length of isolation shall not exceed the 26 longest usual incubation period for the specific communicable 27 disease. 28 The department may recommend a vaccine approved by the 29 United States food and drug administration as safe and 30 effective, but not vaccinate or order that individuals be 31 vaccinated against an infectious disease or to prevent the 32 spread of communicable or potentially communicable disease. 33 Prior to administration of a vaccine, an adult or the parent 34 or legal representative of a minor receiving the vaccine shall 35 -7- LSB 1304XS (7) 91 lh/ko 7/ 9

S.F. 118 be provided with the federal vaccine information statement 1 and verbally informed of the known and potential benefits and 2 risks of the vaccine. Vaccination shall not be recommended if 3 it is reasonably likely to lead to serious harm. An affected 4 individual has the ultimate authority to determine whether to 5 submit to the recommended vaccination, and shall not be subject 6 to undue pressure or compulsion to submit. The department may 7 isolate infected individuals. 8 The department may recommend, but not treat or order, 9 individuals infected with disease receive treatment or 10 prophylaxis. Treatment or prophylaxis shall not be recommended 11 if the treatment or prophylaxis is reasonably likely to lead 12 to serious harm. The infected individual has the ultimate 13 authority to determine whether to submit to the recommendation, 14 and shall not be subject to undue pressure or compulsion to 15 submit. The department may isolate individuals infected with 16 disease who are unable or unwilling to undergo treatment or 17 prophylaxis. 18 The department may isolate infected individuals or groups of 19 individuals in accordance with Code chapter 139A (communicable 20 and infectious diseases and poisonings) and the subchapter of 21 Code chapter 135 relating to disaster preparedness. 22 The bill requires the department to provide a link on the 23 department’s internet site for qualified individuals to submit 24 evidence-based information regarding a public health emergency 25 or public health disaster and for members of the public to 26 share their experiences. The department shall adopt rules to 27 administer this provision, including the criteria a qualified 28 individual must meet to participate. 29 The bill provides that the type and length of isolation or 30 quarantine imposed for a specific communicable disease shall be 31 in accordance with rules adopted by the department, and that 32 the length of the isolation or quarantine shall not exceed the 33 longest usual incubation period for the specific communicable 34 disease. 35 -8- LSB 1304XS (7) 91 lh/ko 8/ 9

S.F. 118 Under current law, immunization is not required for 1 enrollment in an elementary or secondary school or licensed 2 child care center if a person, or, if the person is a minor, the 3 minor’s parent or guardian, submits an affidavit stating that 4 the immunization conflicts with the tenets and practices of a 5 recognized religious denomination of which the person or the 6 minor’s parent or guardian is an adherent or member. Under the 7 bill, the submitted affidavit shall be accepted if it states 8 the immunization conflicts with the sincerely held religious 9 beliefs of the person or, if the person is a minor, the beliefs 10 of the minor’s parent or guardian. 11 The bill provides that if a child is exempt from vaccination, 12 the exemption applies during times of emergency or epidemic. 13 -9- LSB 1304XS (7) 91 lh/ko 9/ 9