S.F. 2093 Section 1. Section 29C.6, subsection 1, Code 2026, 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 amended by the governor. It may be extended 12 in writing by the governor for 60 days or less . The After 13 that, the general assembly may, by concurrent resolution, 14 rescind , extend, or amend this proclamation. Any initial 15 extension of this proclamation by the general assembly shall 16 not exceed sixty days, and any subsequent extension shall not 17 exceed sixty-day increments. If the general assembly is not 18 in session, the legislative council may, by majority vote, 19 rescind , extend, or amend this proclamation only once and the 20 extension shall not exceed sixty days . Rescission Following 21 any rescission, extension, or amendment of this proclamation 22 by the legislative council, any additional action may only be 23 taken by the general assembly. Any rescission, extension, or 24 amendment shall be effective upon the filing of the concurrent 25 resolution or resolution of the legislative council with the 26 secretary of state. A proclamation of disaster emergency shall 27 activate the disaster response and recovery aspect of the 28 state, local, and interjurisdictional disaster emergency plans 29 applicable to the political subdivision or area in question and 30 be authority for the deployment and use of any forces to which 31 the plan applies, and for use or distribution of any supplies, 32 equipment, and materials and facilities assembled, stockpiled, 33 or arranged to be made available. 34 b. A measure dictated in a state of disaster emergency 35 -1- LSB 5239XS (4) 91 ak/ko 1/ 9

S.F. 2093 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 5239XS (4) 91 ak/ko 2/ 9

S.F. 2093 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 2026, are amended to read as follows: 8 3. Take reasonable measures as necessary to prevent the 9 transmission of infectious disease and to ensure that all cases 10 of communicable disease are properly identified, controlled, 11 and treated. However, such reasonable measures shall not 12 include requiring monitoring of persons who may be at risk of 13 contracting a contagious or infectious disease by virtue of 14 contact with a contagious person in a manner consistent with 15 known or suspected modes of transmission; requiring a person 16 to comply with identification and monitoring efforts including 17 efforts that infringe on a person’s freedom of association; 18 or establishing, authorizing, or enforcing penalties for a 19 person’s refusal to participate in the identification and 20 monitoring efforts including efforts that infringe on a 21 person’s freedom of association. 22 5. Order Recommend physical examinations and tests and 23 collect the collection of specimens as necessary for the 24 diagnosis or treatment of individuals, to be performed by any 25 qualified person authorized to do so by the department. An A 26 physical examination or test shall not be performed or ordered 27 recommended if the physical examination or test is reasonably 28 likely to lead to serious harm to the affected individual. The 29 affected individual has the ultimate authority in determining 30 whether to submit to the recommended physical examination 31 or testing, and shall not be subject to undue pressure or 32 compulsion to submit to the recommendation. The department may 33 isolate or quarantine , pursuant to chapter 139A and the rules 34 implementing chapter 139A and this subchapter , any infected 35 -3- LSB 5239XS (4) 91 ak/ko 3/ 9

S.F. 2093 individual whose refusal of medical a physical examination or 1 testing results in uncertainty regarding whether the individual 2 has been exposed to or is infected with a communicable or 3 potentially communicable disease or otherwise poses a danger 4 to public health. The length of isolation shall not exceed 5 the longest usual period of communicability for the specific 6 communicable disease. 7 6. Vaccinate or order Recommend that individuals be 8 vaccinated with a vaccine approved by the United States food 9 and drug administration as safe and effective against an 10 infectious disease and to prevent the spread of communicable 11 or potentially communicable disease. Vaccinations shall be 12 administered by any qualified person authorized to do so by the 13 department. Prior to administration of a vaccine, an adult 14 or the parent or legal representative of a minor receiving 15 the vaccine shall be provided with the federal vaccine 16 information statement for the vaccine and verbally informed 17 of the known and potential benefits and risks of the vaccine. 18 The vaccination shall not be provided or ordered recommended 19 if it is reasonably likely to lead to serious harm to the 20 affected individual. The affected individual has the ultimate 21 authority in determining whether to submit to the recommended 22 vaccination, and shall not be subject to undue pressure or 23 compulsion to submit to the recommendation. To prevent the 24 spread of communicable or potentially communicable disease, the 25 department may isolate or quarantine , pursuant to chapter 139A 26 and the rules implementing chapter 139A and this subchapter , 27 any infected person who is unable or unwilling to undergo 28 vaccination pursuant to this subsection . 29 7. Treat or order Recommend that individuals exposed to 30 or infected with disease receive treatment or prophylaxis. 31 Treatment or prophylaxis shall be administered by any qualified 32 person authorized to do so by the department. Treatment or 33 prophylaxis shall not be provided or ordered recommended if 34 the treatment or prophylaxis is reasonably likely to lead to 35 -4- LSB 5239XS (4) 91 ak/ko 4/ 9

S.F. 2093 serious harm to the affected infected individual. The infected 1 individual has the ultimate authority in determining whether to 2 submit to the recommended treatment or prophylaxis, and shall 3 not be subject to undue pressure or compulsion to submit to 4 the recommendation. To prevent the spread of communicable or 5 potentially communicable disease, the department may isolate or 6 quarantine , pursuant to chapter 139A and the rules implementing 7 chapter 139A and this subchapter , any infected individual who 8 is unable or unwilling to undergo treatment or prophylaxis 9 pursuant to this section subsection . 10 8. Isolate or quarantine infected individuals or groups of 11 individuals pursuant to chapter 139A and the rules implementing 12 chapter 139A and this subchapter . 13 Sec. 3. Section 135.144, Code 2026, is amended by adding the 14 following new subsection: 15 NEW SUBSECTION . 14. Provide a link on the department’s 16 internet site for qualified individuals to submit 17 evidence-based information regarding a public health emergency 18 or public health disaster and for members of the public to 19 share their experiences. The department shall adopt rules 20 pursuant to chapter 17A to administer this subsection, 21 including the criteria a qualified individual must meet to 22 participate. 23 Sec. 4. Section 139A.4, subsection 1, Code 2026, is amended 24 to read as follows: 25 1. The type and length of isolation or quarantine imposed 26 for a specific communicable disease shall be in accordance 27 with rules adopted by the department. The length of isolation 28 or quarantine shall not exceed the longest usual period of 29 communicability for the specific communicable disease. 30 Sec. 5. Section 139A.8, subsection 4, paragraph a, 31 subparagraph (2), Code 2026, is amended to read as follows: 32 (2) The applicant, or if the applicant is a minor, the 33 applicant’s parent or legal guardian, submits an affidavit 34 signed by the applicant, or if the applicant is a minor, 35 -5- LSB 5239XS (4) 91 ak/ko 5/ 9

S.F. 2093 the applicant’s parent or legal guardian, stating that the 1 immunization conflicts with the tenets and practices of a 2 recognized sincerely held religious denomination beliefs 3 of which the applicant is an adherent or member , or if the 4 applicant is a minor, of the applicant’s parent or legal 5 guardian . 6 Sec. 6. Section 139A.8, subsection 4, paragraph b, Code 7 2026, is amended to read as follows: 8 b. The exemptions under this subsection do not apply in 9 times of emergency or epidemic as determined and declared by 10 the director. 11 EXPLANATION 12 The inclusion of this explanation does not constitute agreement with 13 the explanation’s substance by the members of the general assembly. 14 This bill relates to duties and powers relative to emergency 15 situations including a state of disaster emergency and a public 16 health disaster. 17 The bill amends provisions relating to the proclamation 18 of a state of disaster emergency by the governor under Code 19 chapter 29C (emergency management and security). Current law 20 provides that a state of disaster emergency shall continue for 21 30 days unless terminated or extended by the governor and that 22 the general assembly, by concurrent resolution when in session 23 or through the legislative council by majority vote if not in 24 session, may rescind the proclamation. Under the bill, a state 25 of disaster emergency shall continue for 60 days unless sooner 26 terminated or amended by the governor. The proclamation may 27 be extended in writing by the governor for 60 days or less. 28 After that, any initial extension of the proclamation through 29 a concurrent resolution of the general assembly shall not 30 exceed 60 days, and any subsequent extension shall not exceed 31 60-day increments. The bill also provides that if the general 32 assembly is not in session, the legislative council may, by 33 majority vote, rescind, extend, or amend this proclamation only 34 once and the extension shall not exceed 60 days. 35 -6- LSB 5239XS (4) 91 ak/ko 6/ 9

S.F. 2093 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 monitoring of a person 13 at risk of contracting a contagious or infectious disease 14 through contact with a contagious person or requiring a person 15 to comply with identification and monitoring efforts. 16 The department may recommend, but not order, physical 17 examinations, testing, and the collection of specimens 18 necessary for the diagnosis and treatment of individuals. An 19 affected individual has the ultimate authority to determine 20 whether to submit to the department’s recommendations, and 21 shall not be subject to undue pressure or compulsion to submit. 22 The department may isolate infected individuals who refuse a 23 physical examination or testing and who pose a danger to public 24 health. The length of isolation shall not exceed the longest 25 usual period of communicability for the specific communicable 26 disease. 27 The department may recommend a vaccine approved by the 28 United States food and drug administration as safe and 29 effective, but not vaccinate or order that individuals be 30 vaccinated against an infectious disease or to prevent the 31 spread of communicable or potentially communicable disease. 32 Prior to administration of a vaccine, an adult or the parent 33 or legal representative of a minor receiving the vaccine shall 34 be provided with the federal vaccine information statement 35 -7- LSB 5239XS (4) 91 ak/ko 7/ 9

S.F. 2093 and verbally informed of the known and potential benefits and 1 risks of the vaccine. Vaccination shall not be recommended if 2 it is reasonably likely to lead to serious harm. An affected 3 individual has the ultimate authority to determine whether to 4 submit to the recommended vaccination, and shall not be subject 5 to undue pressure or compulsion to submit. The department may 6 isolate infected individuals. 7 The department may recommend, but not treat or order, 8 individuals infected with disease receive treatment or 9 prophylaxis. Treatment or prophylaxis shall not be recommended 10 if the treatment or prophylaxis is reasonably likely to lead 11 to serious harm. The infected individual has the ultimate 12 authority to determine whether to submit to the recommendation, 13 and shall not be subject to undue pressure or compulsion to 14 submit. The department may isolate individuals infected with 15 disease who are unable or unwilling to undergo treatment or 16 prophylaxis. 17 The department may isolate infected individuals or groups of 18 individuals in accordance with Code chapter 139A (communicable 19 and infectious diseases and poisonings) and the subchapter of 20 Code chapter 135 relating to disaster preparedness. 21 The bill requires the department to provide a link on the 22 department’s internet site for qualified individuals to submit 23 evidence-based information regarding a public health emergency 24 or public health disaster and for members of the public to 25 share their experiences. The department shall adopt rules to 26 administer this provision, including the criteria a qualified 27 individual must meet to participate. 28 The bill provides that the type and length of isolation or 29 quarantine imposed for a specific communicable disease shall be 30 in accordance with rules adopted by the department, and that 31 the length of the isolation or quarantine shall not exceed 32 the longest usual period of communicability for the specific 33 communicable disease. 34 Under current law, immunization is not required for 35 -8- LSB 5239XS (4) 91 ak/ko 8/ 9

S.F. 2093 enrollment in an elementary or secondary school or licensed 1 child care center if a person, or, if the person is a minor, the 2 minor’s parent or guardian, submits an affidavit stating that 3 the immunization conflicts with the tenets and practices of a 4 recognized religious denomination of which the person or the 5 minor’s parent or guardian is an adherent or member. Under the 6 bill, the submitted affidavit shall be accepted if it states 7 the immunization conflicts with the sincerely held religious 8 beliefs of the person or, if the person is a minor, the beliefs 9 of the minor’s parent or guardian. 10 The bill provides that if a child is exempt from vaccination, 11 the exemption applies during times of emergency or epidemic. 12 -9- LSB 5239XS (4) 91 ak/ko 9/ 9