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Senate File 193 - IntroducedA Bill ForAn Act 1relating to requirements and prohibitions relating to
2vaccines and immunizations, and providing civil remedies.
3BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1DIVISION I
2Prohibition of Vaccine Mandates by Employers
3 Section 1. NEW SECTION. 94.1 Definitions.
4As used in this chapter, unless the context otherwise
5requires:
61. “Applicant” means a natural person who applies to be an
7employee.
82. “Employee” means a natural person who is employed in this
9state for wages by an employer.
103. “Employer” means a person, as defined in chapter 4, who
11in this state employs for wages, natural persons.
12 Sec. 2. NEW SECTION. 94.2 Vaccination requirements or
13history — prohibited acts by employer.
14An employer shall not fail or refuse to hire, discharge,
15penalize, or otherwise discriminate against an employee with
16respect to compensation or the terms, conditions, or privileges
17of employment based on either of the following:
181. The employee’s vaccination history.
192. The refusal of the employee to receive a vaccine or
20provide proof of immunity.
21 Sec. 3. NEW SECTION. 94.3 Civil remedies.
22An employee whose rights are violated under this chapter may
23bring an action against an employer in the district court in
24the county where the employer is located for injunctive relief,
25actual damages, admission or reinstatement of the employee with
26back pay plus ten percent interest, or any other appropriate
27relief necessary to ensure compliance with this chapter.
28DIVISION II
29Prohibition against Vaccine Mandates relative to facilities,
30providers, and insurers
31 Sec. 4. NEW SECTION. 135Q.1 Definitions.
32As used in this chapter, unless the content otherwise
33requires:
341. “Assisted living program” means the same as defined in
35section 231C.2.
-1- 12. “Communicable disease” means the same as defined in
2section 139A.2.
33. “Health care facility” means the same as defined in
4section 135C.1.
54. “Health care provider” means a person licensed or
6certified by and subject to the authority of a board as defined
7in section 147.2 who provides professional health care services
8to a patient during that patient’s medical care, treatment, or
9confinement.
105. “Hospital” means the same as defined in section 135B.1.
116. “Insurer” means an entity providing a plan of health
12insurance, health care benefits, or health care services, or
13an entity subject to the jurisdiction of the commissioner
14of insurance performing utilization review, including an
15insurance company offering sickness and accident plans, a
16health maintenance organization, a nonprofit health service
17corporation, a plan established pursuant to chapter 509A
18for public employees, or any other entity providing a plan
19of health insurance, health care benefits, or health care
20services.
217. “Patient” means a person who has received or is receiving
22professional health care services from a health care facility,
23health care provider, or hospital.
248. “Resident” means a resident of a health care facility.
259. “Tenant” means a tenant of an assisted living program.
26 Sec. 5. NEW SECTION. 135Q.2 Immunizations — prohibited
27discrimination — civil remedies.
281. A hospital or health care facility shall not do any of
29the following:
30a. Require a health care provider, staff member, employee,
31or applicant for one of these positions to be immunized.
32b. Discriminate against or terminate the employment of a
33health care provider, staff member, employee, or applicant for
34one of these positions based on the person’s refusal to receive
35an immunization.
-2- 12. A hospital, health care facility, or a health care
2provider, staff member, or employee of a hospital or health
3care facility shall not discriminate against or terminate
4treatment of a patient based upon the patient’s refusal to
5receive an immunization.
63. A health care facility or assisted living program shall
7not discriminate against or terminate treatment of a resident
8or tenant solely on the basis of the resident or tenant not
9having received, or refusing to receive, an immunization for a
10specific communicable disease.
114. A hospital, health care facility, or educational
12institution providing clinical experience to satisfy the
13professional degree requirements of a student, intern, or
14resident shall not discriminate against the student, intern, or
15resident, or prohibit admission, enrollment, or employment as a
16student, intern, or resident based on the immunization status
17of the student, intern, or resident.
185. A person aggrieved under this section may petition the
19district court in the county where the hospital, health care
20facility, assisted living program, or educational institution
21is located for any of the following:
22a. Injunctive relief against any further violation.
23b. Affirmative relief, including reinstatement of employment
24with back pay and interest, or any other equitable relief the
25court deems appropriate.
26c. Other appropriate relief necessary to ensure compliance
27with this section.
286. A hospital, health care facility, health care provider,
29educational institution, or assisted living program that
30violates this section is not eligible to receive state funding
31for reimbursement of services provided to patients, residents,
32or tenants.
33 Sec. 6. NEW SECTION. 135Q.3 Immunization — health care
34providers — prohibited discrimination.
35The licensing authority for a health care provider shall not
-3-1deny an applicant for a license or suspend, revoke, or refuse
2to renew a license, and shall not take disciplinary action
3against a licensee based on the applicant’s or licensee’s
4immunization history or refusal to submit to an immunization.
5 Sec. 7. NEW SECTION. 135Q.4 Immunizations — prohibited
6actions — insurers and insurer ratings — cease and desist
7orders and penalties.
81. An insurer providing a group policy, contract, or plan
9for health insurance shall not use the immunization status of
10a person as a basis to reject; deny; limit; cancel; refuse to
11renew; increase the premiums for; limit the amount, extent, or
12kind of coverage available to; or otherwise adversely affect
13eligibility or coverage for the group health policy, contract,
14or plan for health insurance.
152. An insurer providing a group policy, contract, or plan
16for health insurance shall not use the immunization status of a
17person as a qualification or requirement for contracting with
18the person’s health care provider or as a basis for terminating
19a contract with the person’s health care provider.
203. An insurer providing a group policy, contract, or
21plan for health insurance shall not do any of the following
22regarding the administration of immunizations to covered
23persons:
24a. Provide financial or other incentives to a participating
25health care provider based upon attaining a certain
26immunization administration rate.
27b. Impose a financial or other penalty on a participating
28health care provider who does not attain a certain immunization
29administration rate.
304. The immunization status of a person covered by a group
31policy, contract, or plan for health insurance shall not be
32used as a factor in the rating of a group policy, contract, or
33plan for health insurance in this state.
345. An insurer issuing a group policy, contract, or plan for
35health insurance who violates this section is subject to the
-4-1summary cease and desist order, cease and desist order, and
2penalty provisions pursuant to chapter 507B.
3DIVISION III
4Children and Students — Vaccine Mandates
5 Sec. 8. Section 139A.8, subsection 4, Code 2021, is amended
6to read as follows:
74. a. Immunization is not required for a person’s
8enrollment in any elementary or secondary school or licensed
9child care center if either any of the following applies:
10(1) The applicant, or if the applicant is a minor, the
11applicant’s parent or legal guardian, submits to the admitting
12official a statement signed by a physician, advanced registered
13nurse practitioner, or physician assistant who is licensed by
14the board of medicine, board of nursing, or board of physician
15assistants that the immunizations required would be injurious
16to the health and well-being of the applicant or any member of
17the applicant’s family.
18(2) The applicant, or if the applicant is a minor, the
19applicant’s parent or legal guardian, submits an affidavit
20signed by the applicant, or if the applicant is a minor,
21the applicant’s parent or legal guardian, stating that the
22immunization conflicts with the tenets and practices of a
23recognized religious denomination of which the applicant is
24an adherent or member sincerely held religious beliefs of the
25applicant, or if the applicant is a minor, of the applicant’s
26parent or legal guardian.
27(3) The applicant, or if the applicant is a minor, the
28applicant’s parent or legal guardian, submits an affidavit
29signed by the applicant, or if the applicant is a minor, signed
30by the applicant’s parent or legal guardian, stating that the
31immunization conflicts with the conscientiously held beliefs
32of the applicant, or if the applicant is a minor, of the
33applicant’s parent or legal guardian.
34b. The exemptions under this subsection do not also apply in
35times of emergency or epidemic as determined by the state board
-5-1of health and as declared by the director of public health.
2DIVISION IV
3ProhibitING Discrimination and Right-of-Access Restrictions
4Based on Vaccine Status or Proof of Immunity
5 Sec. 9. Section 216.2, subsection 15, Code 2021, is amended
6to read as follows:
715. “Unfair practice” or “discriminatory practice” means
8those practices specified as unfair or discriminatory in
9sections 216.6, 216.6A, 216.7, 216.7A, 216.8, 216.8A, 216.8B,
10216.9, 216.10, 216.11, and 216.11A.
11 Sec. 10. NEW SECTION. 216.7A Unfair practices — public
12accommodations — vaccination status.
13It shall be an unfair or discriminatory practice for
14any owner, lessee, sublessee, proprietor, manager, or
15superintendent of any public accommodation or any agent or
16employee thereof to do any of the following on the basis of a
17person’s vaccination or immunity status:
181. Provide any disposition, service, financial aid, or
19benefit to the person which is different, or is provided in a
20different manner, from that provided to other members of the
21general public.
222. Subject the person to segregation or separate treatment
23in any matter related to that person’s receipt of any
24disposition, service, financial aid, or benefit provided to
25other members of the general public.
263. Restrict the person in any way in the enjoyment of any
27advantage or privilege enjoyed by other persons receiving any
28disposition, service, financial aid, or benefit provided to
29other members of the general public.
304. Treat the person differently from other persons in
31determining whether that person satisfies any admission,
32enrollment, quota, eligibility, membership, or other
33requirement or condition which a person must meet in order to
34be provided any disposition, service, financial aid, function,
35or benefit available to other members of the general public.
-6- 15. Deny the person an opportunity to participate in a
2program through the provision of service or otherwise afford
3that person an opportunity to do so which is different from
4that afforded to other members of the general public.
5DIVISION V
6Prohibiting the Connection of Vaccination or Immunity Status to
7a State-Issued Driver’s License
8 Sec. 11. Section 321.189, subsection 2, Code 2021, is
9amended by adding the following new paragraph:
10 NEW PARAGRAPH. e. A driver’s license shall not include the
11vaccination or immunization status, immunity status, or test
12results relating to a communicable disease of the holder of any
13class of driver’s license.
14 Sec. 12. Section 321.190, subsection 1, paragraph a, Code
152021, is amended to read as follows:
16a. The department shall, upon application and payment
17of the required fee, issue to an applicant a nonoperator’s
18identification card. To be valid the card shall bear a
19distinguishing number other than a social security number
20assigned to the cardholder, the full name, date of birth,
21sex, residence address, a physical description and a color
22photograph of the cardholder, the usual signature of the
23cardholder, and such other information as the department
24may require by rule. An applicant for a nonoperator’s
25identification card shall apply for the card in the manner
26provided in section 321.182, subsections 1 through 3. The card
27shall be issued to the applicant at the time of application
28pursuant to procedures established by rule. An applicant for a
29nonoperator’s identification card who is required by 50 U.S.C.
30app.§451 et seq.to register with the United States selective
31service system shall be registered by the department with the
32selective service system as provided in section 321.183. An
33applicant for a nonoperator’s identification card shall not
34be required to receive the SARS-CoV-2 vaccine in order to be
35issued a card and the card shall not include the vaccination or
-7-1immunization status, immunity status, or test results relating
2to a communicable disease of the holder of the card.
3DIVISION VI
4STATEWIDE Immunization registry and iowa health information
5network — informed consent
6 Sec. 13. NEW SECTION. 139A.8B Statewide immunization
7registry and Iowa health information network — informed consent.
8The department shall require that a health care provider
9who administers vaccines and immunizations and is required to
10consult and review or report the administration of vaccines
11or immunizations to the statewide immunization registry or
12Iowa health information network obtain written, informed
13consent from a patient, or if the patient is a minor, the
14patient’s parent or legal guardian, prior to reporting the
15administration of the vaccine or immunization to the statewide
16immunization registry or Iowa health information network.
17The written, informed consent shall also provide the patient
18with the option of consenting to the sharing of the patient’s
19information with any entity with access to the information
20contained in the statewide immunization registry or Iowa
21health information network. The health care provider shall
22submit a copy of the completed written, informed consent
23form to the statewide immunization registry or Iowa health
24information network. A patient, or if the patient is a minor,
25the patient’s parent or legal guardian, may withdraw or amend
26the written, informed consent at any time. If informed consent
27is subsequently withdrawn, the patient’s information shall be
28deleted from the statewide immunization registry or Iowa health
29information network database. Only the information regarding
30the administration of vaccines or immunizations of a patient
31from whom written, informed consent has been obtained shall be
32reported to and included in the statewide immunization registry
33or Iowa health information network. No information, report, or
34record relating to a person from whom written, informed consent
35has not been obtained shall be maintained by the department or
-8-1included in the statewide immunization registry or Iowa health
2information network.
3EXPLANATION
4The inclusion of this explanation does not constitute agreement with
5the explanation’s substance by the members of the general assembly.
6This bill relates to vaccinations and immunizations. The
7bill is drafted in divisions.
8DIVISION I. Division I of the bill relates to prohibitions
9against vaccine mandates by employers. Division I prohibits an
10employer from failing or refusing to hire, discharge, penalize,
11or otherwise discriminate against an employee with respect
12to compensation or the terms, conditions, or privileges of
13employment based on the employee’s vaccination history or the
14refusal of the employee to receive a vaccine or provide proof
15of immunity. An employee whose rights are violated under the
16division of the bill may bring an action against an employer
17in the district court in the county where the employer is
18located for injunctive relief, actual damages, admission or
19reinstatement of the employee with back pay plus 10 percent
20interest, or any other appropriate relief necessary to ensure
21compliance with the division of the bill.
22DIVISION II. Division II of the bill relates to vaccination
23safety and the right of refusal. Division II provides
24definitions used in the Code chapter. Division II of the bill
25prohibits a hospital or health care facility from requiring a
26health care provider, staff member, employee, or applicant for
27one of these positions to be immunized or from discriminating
28against or terminating the employment of a health care
29provider, staff member, employee, or applicant for one of
30these positions, based on the person’s refusal to receive an
31immunization. The division prohibits a hospital, health care
32facility, or a health care provider, staff member, or employee
33of a hospital or health care facility from discriminating
34against or terminating treatment of a patient based upon the
35patient’s refusal to receive an immunization, and a health
-9-1care facility or assisted living program is also prohibited
2from discriminating against or terminating treatment of a
3resident or tenant due to the resident or tenant failing or
4refusing to receive an immunization for a specific communicable
5disease. Under this division of the bill, a hospital, health
6care facility, or educational institution providing clinical
7experience to satisfy the professional degree requirements of a
8student, intern, or resident is prohibited from discriminating
9against the student, intern, or resident, or prohibiting
10admission, enrollment, or employment as a student, intern,
11or resident based on the immunization status of the student,
12intern, or resident. A person aggrieved under this portion of
13the bill may petition the district court in the county where
14the hospital, health care facility, assisted living program,
15or educational institution is located for injunctive relief;
16affirmative relief, including reinstatement of employment with
17back pay and interest or any other equitable relief the court
18deems appropriate; or other appropriate relief necessary to
19ensure compliance with this division of the bill. A hospital,
20health care facility, health care provider, educational
21institution, or assisted living program that violates this
22portion of the bill is ineligible to receive state funding for
23reimbursement of services.
24Division II of the bill also prohibits a health care provider
25licensing authority from denying an applicant for a license
26or suspending, revoking, or refusing to renew a license, or
27from taking disciplinary action against a licensee based on an
28applicant’s or licensee’s immunization history or refusal to
29submit to an immunization.
30Division II of the bill prohibits an insurer providing a
31group policy, contract, or plan for health insurance from
32using the immunization status of a person as a basis to
33reject; deny; limit; cancel; refuse to renew; increase the
34premiums for; limit the amount, extent, or kind of coverage
35available to; or otherwise adversely affect eligibility or
-10-1coverage for the group health policy, contract, or plan for
2health insurance. Division II also prohibits an insurer
3providing a group policy, contract, or plan for health
4insurance from using the immunization status of a person
5as a qualification or requirement for contracting with the
6person’s provider or as a basis for terminating a contract
7with the person’s provider. Division II of the bill prohibits
8an insurer providing a group policy, contract, or plan for
9health insurance from providing financial or other incentives
10to a participating provider based upon attaining a certain
11immunization administration rate or from imposing financial or
12other penalties on a participating provider who does not attain
13a certain immunization administration rate. Division II of the
14bill prohibits the immunization status of a person covered by a
15group policy, contract, or plan for health insurance from being
16used as a factor in the rating of a group policy, contract, or
17plan for health insurance in Iowa. An insurer issuing a group
18policy, contract, or plan for health insurance who violates
19any of these provisions of the bill is subject to the summary
20cease and desist order, cease and desist order, and penalty
21provisions pursuant to Code chapter 507B (insurance trade
22practices).
23DIVISION III. Division III of the bill relates to exemptions
24from immunizations and vaccinations.
25Division III includes as a new exemption from immunizations
26otherwise required for a person’s enrollment in any elementary
27or secondary school or licensed child care center, an exemption
28based on the submission of a signed affidavit by the applicant,
29or if the applicant is a minor, by the applicant’s parent
30or legal guardian, stating that the immunization conflicts
31with the conscientiously held beliefs of the applicant, or if
32the applicant is a minor, of the applicant’s parent or legal
33guardian. Existing provisions direct the department of public
34health, in consultation with the director of the department of
35education, to adopt rules to implement this provision.
-11- 1This division of the bill also amends the current provision
2relating to an exemption based on religious beliefs of the
3applicant, or if the applicant is a minor, the applicant’s
4parent or legal guardian.
5DIVISION IV. Division IV of the bill relates to unfair
6or discriminatory practices based on a person’s vaccine
7status. Division IV amends Code chapter 216 (civil rights
8commission) to provide that it is an unfair or discriminatory
9practice for any owner, lessee, sublessee, proprietor,
10manager, or superintendent of any public accommodation or
11any agent or employee thereof to do certain things based
12on the basis of a person’s vaccination or immunity status.
13These unfair or discriminatory practices include: providing
14any disposition, service, financial aid, or benefit to the
15person which is different, or is provided in a different
16manner, from that provided to other members of the general
17public; subjecting the person to segregation or separate
18treatment in any matter related to that person’s receipt of
19any disposition, service, financial aid, or benefit provided
20to other members of the general public; restricting the person
21in any way in the enjoyment of any advantage or privilege
22enjoyed by other persons receiving any disposition, service,
23financial aid, or benefit provided to other members of the
24general public; treating the person differently from other
25persons in determining whether that person satisfies any
26admission, enrollment, quota, eligibility, membership, or other
27requirement or condition which a person must meet in order to
28be provided any disposition, service, financial aid, function,
29or benefit available to other members of the general public;
30and denying the person an opportunity to participate in a
31program through the provision of service or otherwise afford
32that person an opportunity to do so which is different from
33that afforded to other members of the general public. The
34delineation of the actions under this division of the bill
35as unfair or discriminatory practices provides a basis under
-12-1Code chapter 216 for a person claiming to be aggrieved by the
2actions to file a complaint with the civil rights commission
3and to seek relief, judicial review, and enforcement.
4DIVISION V. Division V of the bill relates to prohibiting
5the connection of a person’s vaccination or immunity status
6to a state-issued driver’s license or state identification.
7Division V prohibits a driver’s license or a nonoperator’s
8identification card from including the vaccination or
9immunization status, immunity status, or test results relating
10to a communicable disease of the holder of any class of
11driver’s license or a nonoperator’s identification card.
12DIVISION VI. Division VI of the bill relates to the
13statewide immunization registry and the Iowa health information
14network (IHIN) and informed consent. Division VI requires
15the department of public health to require that a health care
16provider who administers vaccines and immunizations and is
17required to consult and review or report the administration
18of vaccines or immunizations to the statewide immunization
19registry or IHIN obtain written, informed consent from a
20patient, or if the patient is a minor, the patient’s parent or
21legal guardian, prior to reporting the administration of the
22vaccine or immunization to the statewide immunization registry
23or IHIN. The written, informed consent shall also provide
24the patient with the option of consenting to the sharing of
25the patient’s information with any entity with access to the
26information contained in the statewide immunization registry
27or IHIN. The health care provider shall submit a copy of the
28completed written, informed consent form to the statewide
29immunization registry or IHIN. A patient, or if the patient is
30a minor, the patient’s parent or legal guardian, may withdraw
31or amend the informed consent at any time. If informed consent
32is subsequently withdrawn, the patient’s information shall be
33deleted from the statewide immunization registry or IHIN.
34Additionally, only the information regarding the
35administration of vaccines or immunizations of a patient from
-13-1whom written, informed consent has been obtained shall be
2reported to and included in the statewide immunization registry
3or IHIN. No other information, report, or record relating
4to a person from whom written, informed consent has not been
5obtained shall be maintained by the department or included in
6the statewide immunization registry or IHIN.
-14-pf/rh
2vaccines and immunizations, and providing civil remedies.
3BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1DIVISION I
2Prohibition of Vaccine Mandates by Employers
3 Section 1. NEW SECTION. 94.1 Definitions.
4As used in this chapter, unless the context otherwise
5requires:
61. “Applicant” means a natural person who applies to be an
7employee.
82. “Employee” means a natural person who is employed in this
9state for wages by an employer.
103. “Employer” means a person, as defined in chapter 4, who
11in this state employs for wages, natural persons.
12 Sec. 2. NEW SECTION. 94.2 Vaccination requirements or
13history — prohibited acts by employer.
14An employer shall not fail or refuse to hire, discharge,
15penalize, or otherwise discriminate against an employee with
16respect to compensation or the terms, conditions, or privileges
17of employment based on either of the following:
181. The employee’s vaccination history.
192. The refusal of the employee to receive a vaccine or
20provide proof of immunity.
21 Sec. 3. NEW SECTION. 94.3 Civil remedies.
22An employee whose rights are violated under this chapter may
23bring an action against an employer in the district court in
24the county where the employer is located for injunctive relief,
25actual damages, admission or reinstatement of the employee with
26back pay plus ten percent interest, or any other appropriate
27relief necessary to ensure compliance with this chapter.
28DIVISION II
29Prohibition against Vaccine Mandates relative to facilities,
30providers, and insurers
31 Sec. 4. NEW SECTION. 135Q.1 Definitions.
32As used in this chapter, unless the content otherwise
33requires:
341. “Assisted living program” means the same as defined in
35section 231C.2.
-1- 12. “Communicable disease” means the same as defined in
2section 139A.2.
33. “Health care facility” means the same as defined in
4section 135C.1.
54. “Health care provider” means a person licensed or
6certified by and subject to the authority of a board as defined
7in section 147.2 who provides professional health care services
8to a patient during that patient’s medical care, treatment, or
9confinement.
105. “Hospital” means the same as defined in section 135B.1.
116. “Insurer” means an entity providing a plan of health
12insurance, health care benefits, or health care services, or
13an entity subject to the jurisdiction of the commissioner
14of insurance performing utilization review, including an
15insurance company offering sickness and accident plans, a
16health maintenance organization, a nonprofit health service
17corporation, a plan established pursuant to chapter 509A
18for public employees, or any other entity providing a plan
19of health insurance, health care benefits, or health care
20services.
217. “Patient” means a person who has received or is receiving
22professional health care services from a health care facility,
23health care provider, or hospital.
248. “Resident” means a resident of a health care facility.
259. “Tenant” means a tenant of an assisted living program.
26 Sec. 5. NEW SECTION. 135Q.2 Immunizations — prohibited
27discrimination — civil remedies.
281. A hospital or health care facility shall not do any of
29the following:
30a. Require a health care provider, staff member, employee,
31or applicant for one of these positions to be immunized.
32b. Discriminate against or terminate the employment of a
33health care provider, staff member, employee, or applicant for
34one of these positions based on the person’s refusal to receive
35an immunization.
-2- 12. A hospital, health care facility, or a health care
2provider, staff member, or employee of a hospital or health
3care facility shall not discriminate against or terminate
4treatment of a patient based upon the patient’s refusal to
5receive an immunization.
63. A health care facility or assisted living program shall
7not discriminate against or terminate treatment of a resident
8or tenant solely on the basis of the resident or tenant not
9having received, or refusing to receive, an immunization for a
10specific communicable disease.
114. A hospital, health care facility, or educational
12institution providing clinical experience to satisfy the
13professional degree requirements of a student, intern, or
14resident shall not discriminate against the student, intern, or
15resident, or prohibit admission, enrollment, or employment as a
16student, intern, or resident based on the immunization status
17of the student, intern, or resident.
185. A person aggrieved under this section may petition the
19district court in the county where the hospital, health care
20facility, assisted living program, or educational institution
21is located for any of the following:
22a. Injunctive relief against any further violation.
23b. Affirmative relief, including reinstatement of employment
24with back pay and interest, or any other equitable relief the
25court deems appropriate.
26c. Other appropriate relief necessary to ensure compliance
27with this section.
286. A hospital, health care facility, health care provider,
29educational institution, or assisted living program that
30violates this section is not eligible to receive state funding
31for reimbursement of services provided to patients, residents,
32or tenants.
33 Sec. 6. NEW SECTION. 135Q.3 Immunization — health care
34providers — prohibited discrimination.
35The licensing authority for a health care provider shall not
-3-1deny an applicant for a license or suspend, revoke, or refuse
2to renew a license, and shall not take disciplinary action
3against a licensee based on the applicant’s or licensee’s
4immunization history or refusal to submit to an immunization.
5 Sec. 7. NEW SECTION. 135Q.4 Immunizations — prohibited
6actions — insurers and insurer ratings — cease and desist
7orders and penalties.
81. An insurer providing a group policy, contract, or plan
9for health insurance shall not use the immunization status of
10a person as a basis to reject; deny; limit; cancel; refuse to
11renew; increase the premiums for; limit the amount, extent, or
12kind of coverage available to; or otherwise adversely affect
13eligibility or coverage for the group health policy, contract,
14or plan for health insurance.
152. An insurer providing a group policy, contract, or plan
16for health insurance shall not use the immunization status of a
17person as a qualification or requirement for contracting with
18the person’s health care provider or as a basis for terminating
19a contract with the person’s health care provider.
203. An insurer providing a group policy, contract, or
21plan for health insurance shall not do any of the following
22regarding the administration of immunizations to covered
23persons:
24a. Provide financial or other incentives to a participating
25health care provider based upon attaining a certain
26immunization administration rate.
27b. Impose a financial or other penalty on a participating
28health care provider who does not attain a certain immunization
29administration rate.
304. The immunization status of a person covered by a group
31policy, contract, or plan for health insurance shall not be
32used as a factor in the rating of a group policy, contract, or
33plan for health insurance in this state.
345. An insurer issuing a group policy, contract, or plan for
35health insurance who violates this section is subject to the
-4-1summary cease and desist order, cease and desist order, and
2penalty provisions pursuant to chapter 507B.
3DIVISION III
4Children and Students — Vaccine Mandates
5 Sec. 8. Section 139A.8, subsection 4, Code 2021, is amended
6to read as follows:
74. a. Immunization is not required for a person’s
8enrollment in any elementary or secondary school or licensed
9child care center if either any of the following applies:
10(1) The applicant, or if the applicant is a minor, the
11applicant’s parent or legal guardian, submits to the admitting
12official a statement signed by a physician, advanced registered
13nurse practitioner, or physician assistant who is licensed by
14the board of medicine, board of nursing, or board of physician
15assistants that the immunizations required would be injurious
16to the health and well-being of the applicant or any member of
17the applicant’s family.
18(2) The applicant, or if the applicant is a minor, the
19applicant’s parent or legal guardian, submits an affidavit
20signed by the applicant, or if the applicant is a minor,
21the applicant’s parent or legal guardian, stating that the
22immunization conflicts with the tenets and practices of a
23recognized religious denomination of which the applicant is
24an adherent or member sincerely held religious beliefs of the
25applicant, or if the applicant is a minor, of the applicant’s
26parent or legal guardian.
27(3) The applicant, or if the applicant is a minor, the
28applicant’s parent or legal guardian, submits an affidavit
29signed by the applicant, or if the applicant is a minor, signed
30by the applicant’s parent or legal guardian, stating that the
31immunization conflicts with the conscientiously held beliefs
32of the applicant, or if the applicant is a minor, of the
33applicant’s parent or legal guardian.
34b. The exemptions under this subsection do not also apply in
35times of emergency or epidemic as determined by the state board
-5-1of health and as declared by the director of public health.
2DIVISION IV
3ProhibitING Discrimination and Right-of-Access Restrictions
4Based on Vaccine Status or Proof of Immunity
5 Sec. 9. Section 216.2, subsection 15, Code 2021, is amended
6to read as follows:
715. “Unfair practice” or “discriminatory practice” means
8those practices specified as unfair or discriminatory in
9sections 216.6, 216.6A, 216.7, 216.7A, 216.8, 216.8A, 216.8B,
10216.9, 216.10, 216.11, and 216.11A.
11 Sec. 10. NEW SECTION. 216.7A Unfair practices — public
12accommodations — vaccination status.
13It shall be an unfair or discriminatory practice for
14any owner, lessee, sublessee, proprietor, manager, or
15superintendent of any public accommodation or any agent or
16employee thereof to do any of the following on the basis of a
17person’s vaccination or immunity status:
181. Provide any disposition, service, financial aid, or
19benefit to the person which is different, or is provided in a
20different manner, from that provided to other members of the
21general public.
222. Subject the person to segregation or separate treatment
23in any matter related to that person’s receipt of any
24disposition, service, financial aid, or benefit provided to
25other members of the general public.
263. Restrict the person in any way in the enjoyment of any
27advantage or privilege enjoyed by other persons receiving any
28disposition, service, financial aid, or benefit provided to
29other members of the general public.
304. Treat the person differently from other persons in
31determining whether that person satisfies any admission,
32enrollment, quota, eligibility, membership, or other
33requirement or condition which a person must meet in order to
34be provided any disposition, service, financial aid, function,
35or benefit available to other members of the general public.
-6- 15. Deny the person an opportunity to participate in a
2program through the provision of service or otherwise afford
3that person an opportunity to do so which is different from
4that afforded to other members of the general public.
5DIVISION V
6Prohibiting the Connection of Vaccination or Immunity Status to
7a State-Issued Driver’s License
8 Sec. 11. Section 321.189, subsection 2, Code 2021, is
9amended by adding the following new paragraph:
10 NEW PARAGRAPH. e. A driver’s license shall not include the
11vaccination or immunization status, immunity status, or test
12results relating to a communicable disease of the holder of any
13class of driver’s license.
14 Sec. 12. Section 321.190, subsection 1, paragraph a, Code
152021, is amended to read as follows:
16a. The department shall, upon application and payment
17of the required fee, issue to an applicant a nonoperator’s
18identification card. To be valid the card shall bear a
19distinguishing number other than a social security number
20assigned to the cardholder, the full name, date of birth,
21sex, residence address, a physical description and a color
22photograph of the cardholder, the usual signature of the
23cardholder, and such other information as the department
24may require by rule. An applicant for a nonoperator’s
25identification card shall apply for the card in the manner
26provided in section 321.182, subsections 1 through 3. The card
27shall be issued to the applicant at the time of application
28pursuant to procedures established by rule. An applicant for a
29nonoperator’s identification card who is required by 50 U.S.C.
30app.§451 et seq.to register with the United States selective
31service system shall be registered by the department with the
32selective service system as provided in section 321.183. An
33applicant for a nonoperator’s identification card shall not
34be required to receive the SARS-CoV-2 vaccine in order to be
35issued a card and the card shall not include the vaccination or
-7-1immunization status, immunity status, or test results relating
2to a communicable disease of the holder of the card.
3DIVISION VI
4STATEWIDE Immunization registry and iowa health information
5network — informed consent
6 Sec. 13. NEW SECTION. 139A.8B Statewide immunization
7registry and Iowa health information network — informed consent.
8The department shall require that a health care provider
9who administers vaccines and immunizations and is required to
10consult and review or report the administration of vaccines
11or immunizations to the statewide immunization registry or
12Iowa health information network obtain written, informed
13consent from a patient, or if the patient is a minor, the
14patient’s parent or legal guardian, prior to reporting the
15administration of the vaccine or immunization to the statewide
16immunization registry or Iowa health information network.
17The written, informed consent shall also provide the patient
18with the option of consenting to the sharing of the patient’s
19information with any entity with access to the information
20contained in the statewide immunization registry or Iowa
21health information network. The health care provider shall
22submit a copy of the completed written, informed consent
23form to the statewide immunization registry or Iowa health
24information network. A patient, or if the patient is a minor,
25the patient’s parent or legal guardian, may withdraw or amend
26the written, informed consent at any time. If informed consent
27is subsequently withdrawn, the patient’s information shall be
28deleted from the statewide immunization registry or Iowa health
29information network database. Only the information regarding
30the administration of vaccines or immunizations of a patient
31from whom written, informed consent has been obtained shall be
32reported to and included in the statewide immunization registry
33or Iowa health information network. No information, report, or
34record relating to a person from whom written, informed consent
35has not been obtained shall be maintained by the department or
-8-1included in the statewide immunization registry or Iowa health
2information network.
3EXPLANATION
4The inclusion of this explanation does not constitute agreement with
5the explanation’s substance by the members of the general assembly.
6This bill relates to vaccinations and immunizations. The
7bill is drafted in divisions.
8DIVISION I. Division I of the bill relates to prohibitions
9against vaccine mandates by employers. Division I prohibits an
10employer from failing or refusing to hire, discharge, penalize,
11or otherwise discriminate against an employee with respect
12to compensation or the terms, conditions, or privileges of
13employment based on the employee’s vaccination history or the
14refusal of the employee to receive a vaccine or provide proof
15of immunity. An employee whose rights are violated under the
16division of the bill may bring an action against an employer
17in the district court in the county where the employer is
18located for injunctive relief, actual damages, admission or
19reinstatement of the employee with back pay plus 10 percent
20interest, or any other appropriate relief necessary to ensure
21compliance with the division of the bill.
22DIVISION II. Division II of the bill relates to vaccination
23safety and the right of refusal. Division II provides
24definitions used in the Code chapter. Division II of the bill
25prohibits a hospital or health care facility from requiring a
26health care provider, staff member, employee, or applicant for
27one of these positions to be immunized or from discriminating
28against or terminating the employment of a health care
29provider, staff member, employee, or applicant for one of
30these positions, based on the person’s refusal to receive an
31immunization. The division prohibits a hospital, health care
32facility, or a health care provider, staff member, or employee
33of a hospital or health care facility from discriminating
34against or terminating treatment of a patient based upon the
35patient’s refusal to receive an immunization, and a health
-9-1care facility or assisted living program is also prohibited
2from discriminating against or terminating treatment of a
3resident or tenant due to the resident or tenant failing or
4refusing to receive an immunization for a specific communicable
5disease. Under this division of the bill, a hospital, health
6care facility, or educational institution providing clinical
7experience to satisfy the professional degree requirements of a
8student, intern, or resident is prohibited from discriminating
9against the student, intern, or resident, or prohibiting
10admission, enrollment, or employment as a student, intern,
11or resident based on the immunization status of the student,
12intern, or resident. A person aggrieved under this portion of
13the bill may petition the district court in the county where
14the hospital, health care facility, assisted living program,
15or educational institution is located for injunctive relief;
16affirmative relief, including reinstatement of employment with
17back pay and interest or any other equitable relief the court
18deems appropriate; or other appropriate relief necessary to
19ensure compliance with this division of the bill. A hospital,
20health care facility, health care provider, educational
21institution, or assisted living program that violates this
22portion of the bill is ineligible to receive state funding for
23reimbursement of services.
24Division II of the bill also prohibits a health care provider
25licensing authority from denying an applicant for a license
26or suspending, revoking, or refusing to renew a license, or
27from taking disciplinary action against a licensee based on an
28applicant’s or licensee’s immunization history or refusal to
29submit to an immunization.
30Division II of the bill prohibits an insurer providing a
31group policy, contract, or plan for health insurance from
32using the immunization status of a person as a basis to
33reject; deny; limit; cancel; refuse to renew; increase the
34premiums for; limit the amount, extent, or kind of coverage
35available to; or otherwise adversely affect eligibility or
-10-1coverage for the group health policy, contract, or plan for
2health insurance. Division II also prohibits an insurer
3providing a group policy, contract, or plan for health
4insurance from using the immunization status of a person
5as a qualification or requirement for contracting with the
6person’s provider or as a basis for terminating a contract
7with the person’s provider. Division II of the bill prohibits
8an insurer providing a group policy, contract, or plan for
9health insurance from providing financial or other incentives
10to a participating provider based upon attaining a certain
11immunization administration rate or from imposing financial or
12other penalties on a participating provider who does not attain
13a certain immunization administration rate. Division II of the
14bill prohibits the immunization status of a person covered by a
15group policy, contract, or plan for health insurance from being
16used as a factor in the rating of a group policy, contract, or
17plan for health insurance in Iowa. An insurer issuing a group
18policy, contract, or plan for health insurance who violates
19any of these provisions of the bill is subject to the summary
20cease and desist order, cease and desist order, and penalty
21provisions pursuant to Code chapter 507B (insurance trade
22practices).
23DIVISION III. Division III of the bill relates to exemptions
24from immunizations and vaccinations.
25Division III includes as a new exemption from immunizations
26otherwise required for a person’s enrollment in any elementary
27or secondary school or licensed child care center, an exemption
28based on the submission of a signed affidavit by the applicant,
29or if the applicant is a minor, by the applicant’s parent
30or legal guardian, stating that the immunization conflicts
31with the conscientiously held beliefs of the applicant, or if
32the applicant is a minor, of the applicant’s parent or legal
33guardian. Existing provisions direct the department of public
34health, in consultation with the director of the department of
35education, to adopt rules to implement this provision.
-11- 1This division of the bill also amends the current provision
2relating to an exemption based on religious beliefs of the
3applicant, or if the applicant is a minor, the applicant’s
4parent or legal guardian.
5DIVISION IV. Division IV of the bill relates to unfair
6or discriminatory practices based on a person’s vaccine
7status. Division IV amends Code chapter 216 (civil rights
8commission) to provide that it is an unfair or discriminatory
9practice for any owner, lessee, sublessee, proprietor,
10manager, or superintendent of any public accommodation or
11any agent or employee thereof to do certain things based
12on the basis of a person’s vaccination or immunity status.
13These unfair or discriminatory practices include: providing
14any disposition, service, financial aid, or benefit to the
15person which is different, or is provided in a different
16manner, from that provided to other members of the general
17public; subjecting the person to segregation or separate
18treatment in any matter related to that person’s receipt of
19any disposition, service, financial aid, or benefit provided
20to other members of the general public; restricting the person
21in any way in the enjoyment of any advantage or privilege
22enjoyed by other persons receiving any disposition, service,
23financial aid, or benefit provided to other members of the
24general public; treating the person differently from other
25persons in determining whether that person satisfies any
26admission, enrollment, quota, eligibility, membership, or other
27requirement or condition which a person must meet in order to
28be provided any disposition, service, financial aid, function,
29or benefit available to other members of the general public;
30and denying the person an opportunity to participate in a
31program through the provision of service or otherwise afford
32that person an opportunity to do so which is different from
33that afforded to other members of the general public. The
34delineation of the actions under this division of the bill
35as unfair or discriminatory practices provides a basis under
-12-1Code chapter 216 for a person claiming to be aggrieved by the
2actions to file a complaint with the civil rights commission
3and to seek relief, judicial review, and enforcement.
4DIVISION V. Division V of the bill relates to prohibiting
5the connection of a person’s vaccination or immunity status
6to a state-issued driver’s license or state identification.
7Division V prohibits a driver’s license or a nonoperator’s
8identification card from including the vaccination or
9immunization status, immunity status, or test results relating
10to a communicable disease of the holder of any class of
11driver’s license or a nonoperator’s identification card.
12DIVISION VI. Division VI of the bill relates to the
13statewide immunization registry and the Iowa health information
14network (IHIN) and informed consent. Division VI requires
15the department of public health to require that a health care
16provider who administers vaccines and immunizations and is
17required to consult and review or report the administration
18of vaccines or immunizations to the statewide immunization
19registry or IHIN obtain written, informed consent from a
20patient, or if the patient is a minor, the patient’s parent or
21legal guardian, prior to reporting the administration of the
22vaccine or immunization to the statewide immunization registry
23or IHIN. The written, informed consent shall also provide
24the patient with the option of consenting to the sharing of
25the patient’s information with any entity with access to the
26information contained in the statewide immunization registry
27or IHIN. The health care provider shall submit a copy of the
28completed written, informed consent form to the statewide
29immunization registry or IHIN. A patient, or if the patient is
30a minor, the patient’s parent or legal guardian, may withdraw
31or amend the informed consent at any time. If informed consent
32is subsequently withdrawn, the patient’s information shall be
33deleted from the statewide immunization registry or IHIN.
34Additionally, only the information regarding the
35administration of vaccines or immunizations of a patient from
-13-1whom written, informed consent has been obtained shall be
2reported to and included in the statewide immunization registry
3or IHIN. No other information, report, or record relating
4to a person from whom written, informed consent has not been
5obtained shall be maintained by the department or included in
6the statewide immunization registry or IHIN.
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