SF 2211 (LSB 5281XS (6) 91)

SENATE FILE 2211

BY  SALMON

A BILL FOR

An Act relating to the Iowa medical freedom Act, including limitations on requiring medical interventions by businesses, governmental entities, and educational institutions, modifying state authority during public health disasters, and including effective date provisions.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  Section 27C.2, Code 2026, is amended by striking the section and inserting in lieu thereof the following:
   27C.2  Medical intervention status —— liability.
   1.  For purposes of this section:
   a.  “Business” means any sole proprietorship, organization, association, corporation, partnership, joint venture, limited partnership, limited liability partnership, limited liability company, or other entity or business association, including retail establishments where goods and services are sold or are authorized to transact business in this state and possess a business license, permit, certificate, approval, registration, charter, or similar form of authorization issued by the state or any entity exempt by law from obtaining a business license or that is operating unlawfully without a business license.
   b.  “Educational institution” means all of the following:
   (1)  A school district as described in chapter 274 and the school district’s board of directors.
   (2)  A charter school established pursuant to chapter 256E and the charter school’s governing board.
   (3)  A charter school or innovation zone school established pursuant to chapter 256F and the authorities in charge of the charter school or innovation zone school.
   (4)  A nonpublic school accredited pursuant to section 256.11 and the authorities in charge of the nonpublic school.
   (5)  An institution of higher education governed by the state board of regents and the state board of regents.
   (6)  A community college as defined in section 260C.2 and the community college’s board of directors.
   (7)  An accredited private institution as defined in section 256.183 and the accredited private institution’s governing board.
   (8)  An eligible institution as defined in section 256.183 and the eligible institution’s governing board.
   c.  “Foreign jurisdiction” means any state, commonwealth, country, territory, or nation outside the state of Iowa. 
   d.  “Governmental entity” means any state, county, municipal, or local government, or any political subdivision thereof, including but not limited to any department, agency, authority, commission, board, council, committee, office, task force, working group, or other body established by or under the authority of the laws of such government or subdivision.
   e.  “Medical intervention” means a health care procedure, treatment, device, drug injection, medication, biologic, or action taken to diagnose, prevent, maintain, or treat the health or biological function of a person.
   f.  “Ticket issuer” means a person, including but not limited to venues, promoters, sports teams, performers, and their agents, who provides or distributes tickets to an entertainment or public event.
   2.  A business operating or transacting in the state shall not refuse to provide any service, product, admission to a venue, or transportation to a person based on whether the person has received a medical intervention.
   3.  a.  A business operating or transacting in the state shall not require a medical intervention as a term of employment except as provided in paragraph “b”.
   b.  A business that has an employee whose terms of employment include travel to foreign jurisdictions that require a medical intervention as the only means of entry, or where the terms of employment require entry into a place of business or facility in a foreign jurisdiction and such place of business or facility requires a medical intervention as the only means of entry, may require a medical intervention as a term of employment as long as the business:
   (1)  If the business and employee have a written employment contract, includes the medical intervention requirement in the written contract.
   (2)  In the absence of a written employment contract, provides advance written notice to an employee no less than fourteen days prior to requiring the employee to travel to a foreign jurisdiction that requires a medical intervention as the only means of entry, or to enter a business or facility in a foreign jurisdiction that requires medical intervention as the only means of entry.
   c.  A business described in paragraph “b” shall not impose a surcharge or wage reduction, or discriminate against a person in compensation or in term, condition, or privilege of employment based on the employee’s willingness to receive a medical intervention.
   4.  A ticket issuer shall not penalize, discriminate against, or deny a person access to an entertainment or public event based on whether the person has received a medical intervention.
   5.  a.  An educational institution shall not mandate a medical intervention for any person to attend the educational institution, enter the educational institution campus or buildings, or be employed by the educational institution except as provided by paragraph “b”.
   b.  An educational institution that has an employee whose terms of employment include travel to foreign jurisdictions that require a medical intervention as the only means of entry, or where the terms of employment require entry into a place of business or facility in a foreign jurisdiction and such place of business or facility requires a medical intervention as the only means of entry, may require a medical intervention as a term of employment as long as the educational institution:
   (1)  If the educational institution and employee have a written employment contract, includes the medical intervention requirement in the written contract.
   (2)  In the absence of a written employment contract, provides advance written notice to an employee no less than fourteen days prior to requiring the employee to travel to a foreign jurisdiction that requires a medical intervention as the only means of entry, or to enter a business or facility in a foreign jurisdiction that requires medical intervention as the only means of entry.
   6.  a.  A governmental entity shall not require any person to receive a medical intervention for any purpose, including but not limited to:
   (1)  Receipt of any government benefit.
   (2)  Receipt of any government services.
   (3)  Receipt of any government-issued license or permit.
   (4)  Entrance or use of any public buildings, facilities, infrastructure, or transportation.
   (5)  A term of employment, except as provided by paragraph “b”.
   b.  A governmental entity that has an employee whose terms of employment include travel to foreign jurisdictions that require a medical intervention as the only means of entry, or where the terms of employment require entry into a place of business or facility in a foreign jurisdiction and such place of business or facility requires a medical intervention as the only means of entry, may require a medical intervention as a term of employment as long as the governmental entity:
   (1)  If the governmental entity and employee have a written employment contract, includes the medical intervention requirement in the written contract.
   (2)  In the absence of a written employment contract, provides advance written notice to an employee no less than fourteen days prior to requiring the employee to travel to a foreign jurisdiction that requires a medical intervention as the only means of entry, or to enter a business or facility in a foreign jurisdiction that requires medical intervention as the only means of entry.
   7.  a.  A business, educational institution, or governmental entity shall not provide any different salary, hourly wage, or other ongoing compensation, treatment, or benefits to an employee based on whether the employee has received a medical intervention. However, a business, educational institution, or governmental entity may offer a one-time incentive related to medical interventions that do not result in any different salary, hourly wage, or ongoing compensation or benefits being provided to an employee based on whether the employee receives a medical intervention.
   b.  A business, educational institution, or governmental entity may release employees from work for the purpose of receiving a medical intervention.
   8.  A healthy person shall not be excluded from a public or private activity based on whether the person has received a medical intervention.
   9.  a.  A business, educational institution, or governmental entity may require personal protective equipment as part of occupational safety standards, provided such requirements are consistent with adopted federal and state workplace and occupational safety regulations, and do not discriminate based on whether a person has received a medical intervention.
   b.  Notwithstanding paragraph “a”, a person shall not be compelled to wear, use, or otherwise be subjected to personal protective equipment intended for a specific purpose that is authorized solely by emergency use authorization under the Federal Food, Drug, and Cosmetic Act, pursuant to 21 U.S.C. §360bbb-3 et seq.
   10.  The attorney general or a county attorney for the county where an alleged violation occurs may institute a civil action to enforce the provisions of this section. If a court determines a business, ticket issuer, educational institution, or governmental entity has violated this section, the attorney general or county attorney, as applicable, shall be awarded attorney fees and costs incurred in pursuing the enforcement action.
   11.  Each appropriate state agency shall ensure that a business, educational institution, or governmental entity in this state complies with this section as a condition of obtaining a license, permit, or other state authorization as necessary to conduct business in this state.
   12.  This section shall not be construed to prohibit compliance with child welfare laws.
   13.  The provisions of this section shall apply at all times and shall not be suspended, nullified, or otherwise disregarded during any declared emergency, public health crisis, or state of emergency issued by any local, state, or federal agency, including pursuant to section 29C.6.
    Sec. 2.  Section 96.7, subsection 12, Code 2026, is amended by striking the subsection.
    Sec. 3.  Section 135.144, subsections 5 and 6, Code 2026, are amended by striking the subsections.
    Sec. 4.  Section 135.144, subsections 7 and 8, Code 2026, are amended to read as follows:
   7.  Treat or order that individuals exposed to or infected with disease receive treatment or prophylaxis. Treatment or prophylaxis shall be administered by any qualified person authorized to do so by the department. Treatment or prophylaxis shall not be provided or ordered if the treatment or prophylaxis is reasonably likely to lead to serious harm to the affected individual. To prevent the spread of communicable or potentially communicable disease, the department may isolate or quarantine, pursuant to chapter 139A and the rules implementing chapter 139A and this subchapter, any individual who is infected with disease and unable or unwilling to undergo treatment or prophylaxis pursuant to this section.  The department may recommend an individual exposed to disease receive treatment, isolate, or quarantine.
   8.  Isolate or quarantine individuals or groups of individuals pursuant to chapter 139A and the rules implementing chapter 139A and this subchapter subsection 7.
    Sec. 5.  Section 239B.12, Code 2026, is amended to read as follows:
   239B.12  Immunization.
   1.  To the extent feasible, the department shall determine the immunization status of children receiving assistance under this chapter. The status shall be determined in accordance with the immunization recommendations adopted under section 139A.8, including the exemption provisions in section 139A.8, subsection 4. If the department determines a child is not in compliance with the immunization recommendations, the department shall refer the child’s parent or guardian to a local public health agency for immunization services for the child and other members of the child’s family.
   2.  The department shall to determine immunization rates of participants, evaluate family investment program efforts to encourage immunizations, and develop strategies to further encourage immunization of participants.
    Sec. 6.  Section 256.7, subsection 15, Code 2026, is amended by striking the subsection.
    Sec. 7.  Section 299.4, subsection 1, Code 2026, is amended to read as follows:
   1.  The parent, guardian, or legal custodian of a child who is of compulsory attendance age, who places the child under competent private instruction under section 299A.2, not in an accredited school or a home school assistance program operated by a school district or accredited nonpublic school, shall furnish a report in duplicate on forms provided by the public school district, to the district by September 1 of the school year in which the child will be under competent private instruction. The secretary shall retain and file one copy and forward the other copy to the district’s area education agency. The report shall state the name and age of the child, the period of time during which the child has been or will be under competent private instruction for the year, an outline of the course of study, texts used, and the name and address of the instructor. The parent, guardian, or legal custodian of a child, who is placing the child under competent private instruction for the first time, shall also provide the district with evidence that the child has had the immunizations required under section 139A.8, and, if the child is elementary school age, a blood lead test in accordance with section 135.105D.  The term “outline of course of study” shall include subjects covered, lesson plans, and time spent on the areas of study.
    Sec. 8.  REPEAL.  Chapter 94, Code 2026, is repealed.
    Sec. 9.  REPEAL.  Sections 96.5A, 139A.8, and 237A.3C, Code 2026, are repealed.
    Sec. 10.  CODE EDITOR DIRECTIVE.  The Code editor shall amend the title of chapter 27C, Code 2026, to read “Iowa Medical Freedom Act”.
    Sec. 11.  SEVERABILITY.  The provisions of this Act are severable pursuant to section 4.12.
    Sec. 12.  EFFECTIVE DATE.  This Act, being deemed of immediate importance, takes effect upon enactment.
EXPLANATION
The inclusion of this explanation does not constitute agreement with
the explanation’s substance by the members of the general assembly.
   This bill relates to the Iowa medical freedom Act.
   The bill amends Code chapter 27C (proof of vaccination for COVID-19). The bill strikes current provisions prohibiting the required furnishing of proof of a vaccination for COVID-19 and the prohibition against the awarding or renewal of grants or contracts funded by state revenue to a business or government entity that violates the provision.
   The bill instead broadens the scope beyond furnishing proof of having received a vaccination for COVID-19, and prohibits the discrimination of a person based on whether the person has received a medical intervention. A “medical intervention” is defined as a health care procedure, treatment, device, drug injection, medication, biologic, or action taken to diagnose, prevent, maintain, or treat the health or biological function of a person.
   The bill prohibits a business from refusing to provide a person a service, product, admission to a venue, or transportation based on whether the person has received a medical intervention. A business is also prohibited from requiring medical intervention as a term of employment, unless the business provides the employee notice as described in the bill. The bill prohibits a business from imposing a surcharge or wage reduction, or from discriminating against a person in compensation or in term, condition, or privilege or employment based on the employee’s willingness to receive a medical intervention.
   The bill prohibits a ticket issuer from penalizing, discriminating against, or denying a person access to an entertainment or public event based on whether the person has received a medical intervention.
   The bill prohibits an educational institution from mandating a medical intervention for any person to attend, enter, or be employed by the educational institution, unless the educational institution provides an employee with notice as described in the bill.
   The bill prohibits a governmental entity from requiring any person to receive a medical intervention. A governmental entity may require an employee to receive a medical intervention if the governmental entity provides notice to the employee as described in the bill.
   The bill prohibits a business, educational institution, or governmental entity from providing any different ongoing compensation, treatment, or benefits to an employee based on whether the employee has received a medical intervention. A business, educational institution, or governmental entity may offer a one-time incentive related to medical interventions that do not result in any different ongoing compensation or benefits being provided to an employee based on whether the employee receives a medical intervention.
   The bill prohibits a healthy person from being excluded from a public or private activity based on whether the person has received a medical intervention.
   The bill provides that a business, educational institution, or governmental entity may require personal protective equipment as part of occupational safety standards if certain requirements are met. The bill prohibits a person from being compelled to wear personal protective equipment for a purpose authorized solely by emergency use authorization under the Federal Food, Drug, and Cosmetic Act.
   The attorney general or the county attorney for the county where an alleged violation occurs may institute a civil action to enforce this bill. If a court determines a violation of this bill has occurred, the attorney general or the county attorney is awarded attorney fees and costs incurred in pursuing the action.
   The bill requires each appropriate state agency to ensure that a business, ticket issuer, educational institution, or government entity complies with this bill as a condition of obtaining a license, permit, or other state authorization as necessary to conduct business in Iowa.
   The bill shall not be construed to prohibit compliance with child welfare laws.
   The bill applies at all times and will not be suspended, nullified, or otherwise disregarded during any declared emergency, public health crisis, or state of emergency issued by any local, state, or federal agency.
   The bill strikes Code section 96.7, subsection 12 (employee discharge for refusal of COVID-19 vaccination and the effect on the contribution rate and unemployment experience), and Code section 135.144, subsections 5 and 6 (public health disaster authority to order physical examinations and vaccinate against infectious diseases). The bill also strikes the department of health and human services’ (HHS) authority to treat individuals in the event of a public health disaster. The bill specifies that HHS may isolate or quarantine an individual who is infected with disease if the individual is unable or unwilling to undergo treatment during a public health disaster. HHS may also recommend an individual exposed to disease receive treatment, isolate, or quarantine.
   The bill repeals Code chapter 94 (COVID-19 vaccination requirements by employers —— waiver), and Code sections 96.5A (refusal of COVID-19 vaccination —— no disqualification for unemployment benefits), 139A.8 (immunization of children —— required vaccinations), and 237A.3C (immunization information for child care facilities), and makes conforming changes. Under the bill, HHS also maintains the general authority to provide recommendations for childhood vaccine schedules.
   Provisions of the bill are severable pursuant to Code section 4.12. The bill takes effect upon enactment.