Senate File 2211 - Introduced SENATE FILE 2211 BY SALMON A BILL FOR An Act relating to the Iowa medical freedom Act, including 1 limitations on requiring medical interventions by 2 businesses, governmental entities, and educational 3 institutions, modifying state authority during public health 4 disasters, and including effective date provisions. 5 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 6 TLSB 5281XS (6) 91 lh/jh

S.F. 2211 Section 1. Section 27C.2, Code 2026, is amended by striking 1 the section and inserting in lieu thereof the following: 2 27C.2 Medical intervention status —— liability. 3 1. For purposes of this section: 4 a. “Business” means any sole proprietorship, organization, 5 association, corporation, partnership, joint venture, limited 6 partnership, limited liability partnership, limited liability 7 company, or other entity or business association, including 8 retail establishments where goods and services are sold or are 9 authorized to transact business in this state and possess a 10 business license, permit, certificate, approval, registration, 11 charter, or similar form of authorization issued by the state 12 or any entity exempt by law from obtaining a business license 13 or that is operating unlawfully without a business license. 14 b. “Educational institution” means all of the following: 15 (1) A school district as described in chapter 274 and the 16 school district’s board of directors. 17 (2) A charter school established pursuant to chapter 256E 18 and the charter school’s governing board. 19 (3) A charter school or innovation zone school established 20 pursuant to chapter 256F and the authorities in charge of the 21 charter school or innovation zone school. 22 (4) A nonpublic school accredited pursuant to section 23 256.11 and the authorities in charge of the nonpublic school. 24 (5) An institution of higher education governed by the state 25 board of regents and the state board of regents. 26 (6) A community college as defined in section 260C.2 and the 27 community college’s board of directors. 28 (7) An accredited private institution as defined in section 29 256.183 and the accredited private institution’s governing 30 board. 31 (8) An eligible institution as defined in section 256.183 32 and the eligible institution’s governing board. 33 c. “Foreign jurisdiction” means any state, commonwealth, 34 country, territory, or nation outside the state of Iowa. 35 -1- LSB 5281XS (6) 91 lh/jh 1/ 11

S.F. 2211 d. “Governmental entity” means any state, county, municipal, 1 or local government, or any political subdivision thereof, 2 including but not limited to any department, agency, authority, 3 commission, board, council, committee, office, task force, 4 working group, or other body established by or under the 5 authority of the laws of such government or subdivision. 6 e. “Medical intervention” means a health care procedure, 7 treatment, device, drug injection, medication, biologic, or 8 action taken to diagnose, prevent, maintain, or treat the 9 health or biological function of a person. 10 f. “Ticket issuer” means a person, including but not limited 11 to venues, promoters, sports teams, performers, and their 12 agents, who provides or distributes tickets to an entertainment 13 or public event. 14 2. A business operating or transacting in the state shall 15 not refuse to provide any service, product, admission to a 16 venue, or transportation to a person based on whether the 17 person has received a medical intervention. 18 3. a. A business operating or transacting in the state 19 shall not require a medical intervention as a term of 20 employment except as provided in paragraph “b” . 21 b. A business that has an employee whose terms of employment 22 include travel to foreign jurisdictions that require a medical 23 intervention as the only means of entry, or where the terms 24 of employment require entry into a place of business or 25 facility in a foreign jurisdiction and such place of business 26 or facility requires a medical intervention as the only means 27 of entry, may require a medical intervention as a term of 28 employment as long as the business: 29 (1) If the business and employee have a written employment 30 contract, includes the medical intervention requirement in the 31 written contract. 32 (2) In the absence of a written employment contract, 33 provides advance written notice to an employee no less than 34 fourteen days prior to requiring the employee to travel to a 35 -2- LSB 5281XS (6) 91 lh/jh 2/ 11

S.F. 2211 foreign jurisdiction that requires a medical intervention as 1 the only means of entry, or to enter a business or facility in 2 a foreign jurisdiction that requires medical intervention as 3 the only means of entry. 4 c. A business described in paragraph “b” shall not impose 5 a surcharge or wage reduction, or discriminate against a 6 person in compensation or in term, condition, or privilege of 7 employment based on the employee’s willingness to receive a 8 medical intervention. 9 4. A ticket issuer shall not penalize, discriminate 10 against, or deny a person access to an entertainment or public 11 event based on whether the person has received a medical 12 intervention. 13 5. a. An educational institution shall not mandate a 14 medical intervention for any person to attend the educational 15 institution, enter the educational institution campus or 16 buildings, or be employed by the educational institution except 17 as provided by paragraph “b” . 18 b. An educational institution that has an employee whose 19 terms of employment include travel to foreign jurisdictions 20 that require a medical intervention as the only means of entry, 21 or where the terms of employment require entry into a place of 22 business or facility in a foreign jurisdiction and such place 23 of business or facility requires a medical intervention as the 24 only means of entry, may require a medical intervention as a 25 term of employment as long as the educational institution: 26 (1) If the educational institution and employee have a 27 written employment contract, includes the medical intervention 28 requirement in the written contract. 29 (2) In the absence of a written employment contract, 30 provides advance written notice to an employee no less than 31 fourteen days prior to requiring the employee to travel to a 32 foreign jurisdiction that requires a medical intervention as 33 the only means of entry, or to enter a business or facility in 34 a foreign jurisdiction that requires medical intervention as 35 -3- LSB 5281XS (6) 91 lh/jh 3/ 11

S.F. 2211 the only means of entry. 1 6. a. A governmental entity shall not require any person 2 to receive a medical intervention for any purpose, including 3 but not limited to: 4 (1) Receipt of any government benefit. 5 (2) Receipt of any government services. 6 (3) Receipt of any government-issued license or permit. 7 (4) Entrance or use of any public buildings, facilities, 8 infrastructure, or transportation. 9 (5) A term of employment, except as provided by paragraph 10 “b” . 11 b. A governmental entity that has an employee whose terms of 12 employment include travel to foreign jurisdictions that require 13 a medical intervention as the only means of entry, or where the 14 terms of employment require entry into a place of business or 15 facility in a foreign jurisdiction and such place of business 16 or facility requires a medical intervention as the only means 17 of entry, may require a medical intervention as a term of 18 employment as long as the governmental entity: 19 (1) If the governmental entity and employee have a written 20 employment contract, includes the medical intervention 21 requirement in the written contract. 22 (2) In the absence of a written employment contract, 23 provides advance written notice to an employee no less than 24 fourteen days prior to requiring the employee to travel to a 25 foreign jurisdiction that requires a medical intervention as 26 the only means of entry, or to enter a business or facility in 27 a foreign jurisdiction that requires medical intervention as 28 the only means of entry. 29 7. a. A business, educational institution, or governmental 30 entity shall not provide any different salary, hourly wage, 31 or other ongoing compensation, treatment, or benefits to an 32 employee based on whether the employee has received a medical 33 intervention. However, a business, educational institution, 34 or governmental entity may offer a one-time incentive related 35 -4- LSB 5281XS (6) 91 lh/jh 4/ 11

S.F. 2211 to medical interventions that do not result in any different 1 salary, hourly wage, or ongoing compensation or benefits being 2 provided to an employee based on whether the employee receives 3 a medical intervention. 4 b. A business, educational institution, or governmental 5 entity may release employees from work for the purpose of 6 receiving a medical intervention. 7 8. A healthy person shall not be excluded from a public 8 or private activity based on whether the person has received 9 a medical intervention. 10 9. a. A business, educational institution, or governmental 11 entity may require personal protective equipment as part of 12 occupational safety standards, provided such requirements 13 are consistent with adopted federal and state workplace and 14 occupational safety regulations, and do not discriminate based 15 on whether a person has received a medical intervention. 16 b. Notwithstanding paragraph “a” , a person shall not be 17 compelled to wear, use, or otherwise be subjected to personal 18 protective equipment intended for a specific purpose that is 19 authorized solely by emergency use authorization under the 20 Federal Food, Drug, and Cosmetic Act, pursuant to 21 U.S.C. 21 §360bbb-3 et seq. 22 10. The attorney general or a county attorney for the 23 county where an alleged violation occurs may institute a civil 24 action to enforce the provisions of this section. If a court 25 determines a business, ticket issuer, educational institution, 26 or governmental entity has violated this section, the attorney 27 general or county attorney, as applicable, shall be awarded 28 attorney fees and costs incurred in pursuing the enforcement 29 action. 30 11. Each appropriate state agency shall ensure that a 31 business, educational institution, or governmental entity 32 in this state complies with this section as a condition of 33 obtaining a license, permit, or other state authorization as 34 necessary to conduct business in this state. 35 -5- LSB 5281XS (6) 91 lh/jh 5/ 11

S.F. 2211 12. This section shall not be construed to prohibit 1 compliance with child welfare laws. 2 13. The provisions of this section shall apply at all times 3 and shall not be suspended, nullified, or otherwise disregarded 4 during any declared emergency, public health crisis, or state 5 of emergency issued by any local, state, or federal agency, 6 including pursuant to section 29C.6. 7 Sec. 2. Section 96.7, subsection 12, Code 2026, is amended 8 by striking the subsection. 9 Sec. 3. Section 135.144, subsections 5 and 6, Code 2026, are 10 amended by striking the subsections. 11 Sec. 4. Section 135.144, subsections 7 and 8, Code 2026, are 12 amended to read as follows: 13 7. Treat or order that individuals exposed to or infected 14 with disease receive treatment or prophylaxis. Treatment 15 or prophylaxis shall be administered by any qualified 16 person authorized to do so by the department. Treatment or 17 prophylaxis shall not be provided or ordered if the treatment 18 or prophylaxis is reasonably likely to lead to serious harm to 19 the affected individual. To prevent the spread of communicable 20 or potentially communicable disease, the department may 21 isolate or quarantine, pursuant to chapter 139A and the rules 22 implementing chapter 139A and this subchapter , any individual 23 who is infected with disease and unable or unwilling to 24 undergo treatment or prophylaxis pursuant to this section . 25 The department may recommend an individual exposed to disease 26 receive treatment, isolate, or quarantine. 27 8. Isolate or quarantine individuals or groups of 28 individuals pursuant to chapter 139A and the rules implementing 29 chapter 139A and this subchapter subsection 7 . 30 Sec. 5. Section 239B.12, Code 2026, is amended to read as 31 follows: 32 239B.12 Immunization. 33 1. To the extent feasible, the department shall determine 34 the immunization status of children receiving assistance under 35 -6- LSB 5281XS (6) 91 lh/jh 6/ 11

S.F. 2211 this chapter . The status shall be determined in accordance 1 with the immunization recommendations adopted under section 2 139A.8 , including the exemption provisions in section 139A.8, 3 subsection 4 . If the department determines a child is not 4 in compliance with the immunization recommendations, the 5 department shall refer the child’s parent or guardian to a 6 local public health agency for immunization services for the 7 child and other members of the child’s family. 8 2. The department shall to determine immunization rates 9 of participants , evaluate family investment program efforts 10 to encourage immunizations, and develop strategies to further 11 encourage immunization of participants . 12 Sec. 6. Section 256.7, subsection 15, Code 2026, is amended 13 by striking the subsection. 14 Sec. 7. Section 299.4, subsection 1, Code 2026, is amended 15 to read as follows: 16 1. The parent, guardian, or legal custodian of a child 17 who is of compulsory attendance age, who places the child 18 under competent private instruction under section 299A.2 , not 19 in an accredited school or a home school assistance program 20 operated by a school district or accredited nonpublic school, 21 shall furnish a report in duplicate on forms provided by the 22 public school district, to the district by September 1 of the 23 school year in which the child will be under competent private 24 instruction. The secretary shall retain and file one copy 25 and forward the other copy to the district’s area education 26 agency. The report shall state the name and age of the child, 27 the period of time during which the child has been or will be 28 under competent private instruction for the year, an outline 29 of the course of study, texts used, and the name and address 30 of the instructor. The parent, guardian, or legal custodian 31 of a child, who is placing the child under competent private 32 instruction for the first time, shall also provide the district 33 with evidence that the child has had the immunizations required 34 under section 139A.8 , and , if the child is elementary school 35 -7- LSB 5281XS (6) 91 lh/jh 7/ 11

S.F. 2211 age, a blood lead test in accordance with section 135.105D . 1 The term “outline of course of study” shall include subjects 2 covered, lesson plans, and time spent on the areas of study. 3 Sec. 8. REPEAL. Chapter 94, Code 2026, is repealed. 4 Sec. 9. REPEAL. Sections 96.5A, 139A.8, and 237A.3C, Code 5 2026, are repealed. 6 Sec. 10. CODE EDITOR DIRECTIVE. The Code editor shall amend 7 the title of chapter 27C, Code 2026, to read “Iowa Medical 8 Freedom Act”. 9 Sec. 11. SEVERABILITY. The provisions of this Act are 10 severable pursuant to section 4.12. 11 Sec. 12. EFFECTIVE DATE. This Act, being deemed of 12 immediate importance, takes effect upon enactment. 13 EXPLANATION 14 The inclusion of this explanation does not constitute agreement with 15 the explanation’s substance by the members of the general assembly. 16 This bill relates to the Iowa medical freedom Act. 17 The bill amends Code chapter 27C (proof of vaccination for 18 COVID-19). The bill strikes current provisions prohibiting the 19 required furnishing of proof of a vaccination for COVID-19 and 20 the prohibition against the awarding or renewal of grants or 21 contracts funded by state revenue to a business or government 22 entity that violates the provision. 23 The bill instead broadens the scope beyond furnishing proof 24 of having received a vaccination for COVID-19, and prohibits 25 the discrimination of a person based on whether the person has 26 received a medical intervention. A “medical intervention” is 27 defined as a health care procedure, treatment, device, drug 28 injection, medication, biologic, or action taken to diagnose, 29 prevent, maintain, or treat the health or biological function 30 of a person. 31 The bill prohibits a business from refusing to provide 32 a person a service, product, admission to a venue, or 33 transportation based on whether the person has received a 34 medical intervention. A business is also prohibited from 35 -8- LSB 5281XS (6) 91 lh/jh 8/ 11

S.F. 2211 requiring medical intervention as a term of employment, unless 1 the business provides the employee notice as described in the 2 bill. The bill prohibits a business from imposing a surcharge 3 or wage reduction, or from discriminating against a person in 4 compensation or in term, condition, or privilege or employment 5 based on the employee’s willingness to receive a medical 6 intervention. 7 The bill prohibits a ticket issuer from penalizing, 8 discriminating against, or denying a person access to an 9 entertainment or public event based on whether the person has 10 received a medical intervention. 11 The bill prohibits an educational institution from mandating 12 a medical intervention for any person to attend, enter, or be 13 employed by the educational institution, unless the educational 14 institution provides an employee with notice as described in 15 the bill. 16 The bill prohibits a governmental entity from requiring 17 any person to receive a medical intervention. A governmental 18 entity may require an employee to receive a medical 19 intervention if the governmental entity provides notice to the 20 employee as described in the bill. 21 The bill prohibits a business, educational institution, 22 or governmental entity from providing any different ongoing 23 compensation, treatment, or benefits to an employee based on 24 whether the employee has received a medical intervention. A 25 business, educational institution, or governmental entity may 26 offer a one-time incentive related to medical interventions 27 that do not result in any different ongoing compensation or 28 benefits being provided to an employee based on whether the 29 employee receives a medical intervention. 30 The bill prohibits a healthy person from being excluded from 31 a public or private activity based on whether the person has 32 received a medical intervention. 33 The bill provides that a business, educational institution, 34 or governmental entity may require personal protective 35 -9- LSB 5281XS (6) 91 lh/jh 9/ 11

S.F. 2211 equipment as part of occupational safety standards if certain 1 requirements are met. The bill prohibits a person from being 2 compelled to wear personal protective equipment for a purpose 3 authorized solely by emergency use authorization under the 4 Federal Food, Drug, and Cosmetic Act. 5 The attorney general or the county attorney for the county 6 where an alleged violation occurs may institute a civil action 7 to enforce this bill. If a court determines a violation of 8 this bill has occurred, the attorney general or the county 9 attorney is awarded attorney fees and costs incurred in 10 pursuing the action. 11 The bill requires each appropriate state agency to ensure 12 that a business, ticket issuer, educational institution, or 13 government entity complies with this bill as a condition of 14 obtaining a license, permit, or other state authorization as 15 necessary to conduct business in Iowa. 16 The bill shall not be construed to prohibit compliance with 17 child welfare laws. 18 The bill applies at all times and will not be suspended, 19 nullified, or otherwise disregarded during any declared 20 emergency, public health crisis, or state of emergency issued 21 by any local, state, or federal agency. 22 The bill strikes Code section 96.7, subsection 12 (employee 23 discharge for refusal of COVID-19 vaccination and the effect on 24 the contribution rate and unemployment experience), and Code 25 section 135.144, subsections 5 and 6 (public health disaster 26 authority to order physical examinations and vaccinate against 27 infectious diseases). The bill also strikes the department of 28 health and human services’ (HHS) authority to treat individuals 29 in the event of a public health disaster. The bill specifies 30 that HHS may isolate or quarantine an individual who is 31 infected with disease if the individual is unable or unwilling 32 to undergo treatment during a public health disaster. HHS 33 may also recommend an individual exposed to disease receive 34 treatment, isolate, or quarantine. 35 -10- LSB 5281XS (6) 91 lh/jh 10/ 11

S.F. 2211 The bill repeals Code chapter 94 (COVID-19 vaccination 1 requirements by employers —— waiver), and Code sections 96.5A 2 (refusal of COVID-19 vaccination —— no disqualification for 3 unemployment benefits), 139A.8 (immunization of children —— 4 required vaccinations), and 237A.3C (immunization information 5 for child care facilities), and makes conforming changes. 6 Under the bill, HHS also maintains the general authority to 7 provide recommendations for childhood vaccine schedules. 8 Provisions of the bill are severable pursuant to Code 9 section 4.12. The bill takes effect upon enactment. 10 -11- LSB 5281XS (6) 91 lh/jh 11/ 11