TITLE 25. HEALTH SERVICES

PART 1. DEPARTMENT OF STATE HEALTH SERVICES

CHAPTER 97. COMMUNICABLE DISEASES

SUBCHAPTER B. IMMUNIZATION REQUIREMENTS IN TEXAS ELEMENTARY AND SECONDARY SCHOOLS AND INSTITUTIONS OF HIGHER EDUCATION

The executive commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), proposes an amendment to §97.62 concerning Exclusions from Compliance.

BACKGROUND AND PURPOSE

Section 97.62 provides that exclusions from compliance are allowable on an individual basis for medical contraindications, reasons of conscience, including a religious belief, and active duty with the armed forces of the United States. The rule outlines the steps of how an individual can claim any of these exclusions.

The purpose of the proposal is to comply with Health and Safety Code §161.0041, as amended by House Bill (H.B.) 1586, 89th Legislature, Regular Session, which requires DSHS to develop a blank affidavit form to be used by a person claiming an exemption from a required immunization and make the affidavit form available on the DSHS website. DSHS will post a blank affidavit form on the website for a person to download and submit to their child-care facility, school, or institution of higher education, including medical or veterinary school.

The current process requires individuals to request an affidavit form from DSHS, which DSHS must print on security-sealed paper and mail to the requesting individual.

Individuals will print these documents themselves (or request that DSHS send them a blank affidavit, which does not need to be printed on this special paper), and thus DSHS anticipates the volume of requests to decrease to the point we won't need contractors. Also anticipate envelopes, postage, and printing costs decrease.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §97.62 allows a person claiming exclusion for reasons of conscience, including a religious belief, from a required immunization to obtain an affidavit form by downloading it from the department's internet website or submitting the request to the department.

The proposal also removes the requirement for the submitted request to include full name and date of birth of child or student. Submitting a request (via online, fax, mail or hand-delivery) will only require a mailing address and number of affidavit forms requested. Those downloading the affidavit will not need to submit any information.

H.B. 1586's changes begin with the 2025-2026 school year.

FISCAL NOTE

Christy Havel-Burton, CFO, has determined that for each year of the first five years that the rule will be in effect, there will be an estimated reduction in cost to state government as a result of enforcing and administering the rule as proposed. Enforcing or administering the rule does not have foreseeable implications relating to costs or revenues of state or local government.

The effect on state government for each year of the first five years the proposed rule is in effect is an estimated reduction in cost of $177,746 in fiscal year (FY) 2026, $177,746 in FY 2027, $177,746 in FY 2028, $177,746 in FY 2029, and $177,746 in FY 2030.

GOVERNMENT GROWTH IMPACT STATEMENT

DSHS has determined that during the first five years that the rule will be in effect:

(1) the proposed rule will not create or eliminate a government program;

(2) implementation of the proposed rule will not affect the number of DSHS employee positions;

(3) implementation of the proposed rule will result in no assumed change in future legislative appropriations;

(4) the proposed rule will not affect fees paid to DSHS;

(5) the proposed rule will not create a new regulation;

(6) the proposed rule will not expand, limit, or repeal existing regulation;

(7) the proposed rule will not change the number of individuals subject to the rule; and

(8) DSHS has insufficient information to determine the proposed rule effect on the state's economy.

SMALL BUSINESS, MICRO-BUSINESS, AND RURAL COMMUNITY IMPACT ANALYSIS

Christy Havel-Burton has also determined that there will be no adverse economic effect on small businesses, micro-businesses, or rural communities because there is no involvement with small business, micro-business or rural community impact to satisfy the rule.

LOCAL EMPLOYMENT IMPACT

The proposed rule will not affect a local economy.

COSTS TO REGULATED PERSONS

Texas Government Code §2001.0045 does not apply to this rule because the rule is necessary to protect the health, safety, and welfare of the residents of Texas and to implement legislation that does not specifically state that Section 2001.0045 applies to the rule.

PUBLIC BENEFIT AND COSTS

Joshua Hutchison, Deputy Commissioner, Infectious Disease Prevention Division, has determined that for each year of the first five years the rule is in effect, the public benefit will be allowing individuals to download and print blank affidavit forms so they can submit to their child-care facility, school, or institution of higher education, including medical or veterinary school.

Christy Havel-Burton has also determined that for the first five years the rule is in effect, there are no anticipated economic costs to persons who are required to comply with the proposed rule because the rule would eliminate the need to hire contractors for the summer months between June-September. There would also be a reduction in cost due to reduced need for mailing supplies, to include: envelopes, postage and security paper.

TAKINGS IMPACT ASSESSMENT

DSHS has determined that the proposal does not restrict or limit an owner's right to the owner's property that would otherwise exist in the absence of government action and, therefore, does not constitute a taking under Texas Government Code §2007.043.

PUBLIC COMMENT

Written comments on the proposal may be submitted to Rules Coordination Office, P.O. Box 13247, Mail Code 4102, Austin, Texas 78711-3247, or street address 4601 West Guadalupe Street, Austin, Texas 78751; or emailed to HHSRulesCoordinationOffice@hhs.texas.gov.

To be considered, comments must be submitted no later than 14 days after the date of this issue of the Texas Register. Comments must be (1) postmarked or shipped before the last day of the comment period; (2) hand-delivered before 5:00 p.m. on the last working day of the comment period; or (3) emailed before midnight on the last day of the comment period. If the last day to submit comments falls on a holiday, comments must be postmarked, shipped, or emailed before midnight on the following business day to be accepted. When emailing comments, please indicate "Comments on Proposed Rule 25R041" in the subject line.

STATUTORY AUTHORITY

The amendment is authorized by Texas Health and Safety Code §161.004 and §161.0041, which authorize the executive commissioner to adopt rules necessary to administer statewide immunization of children and exceptions; and Texas Government Code §524.0151 and Texas Health and Safety Code §1001.075, which authorize the executive commissioner of HHSC to adopt rules for the operation and provision of health and human services by DSHS and for the administration of Texas Health and Safety Code Chapter 1001.

This amendment affects Texas Health and Safety Code §161.0041 and Chapter 1001, and Texas Government Code §524.0151.

§ 97.62. Exclusions from Compliance.

Exclusions from compliance are allowable on an individual basis for medical contraindications, reasons of conscience, including a religious belief, and active duty with the armed forces of the United States. Children and students seeking enrollment in schools, child-care facilities, or institutions of higher education, to include medical or veterinary school, [in these categories] must submit evidence for exclusion from compliance as specified in the Health and Safety Code[,] §161.004(d), Health and Safety Code[,] §161.0041, Education Code[,] Chapter 38, Education Code[,] Chapter 51, and the Human Resources Code[,] Chapter 42.

(1) To claim an exclusion for medical reasons, the child or student must present an exemption statement to the school or child-care facility, dated and signed by a physician (M.D. or D.O.), properly licensed and in good standing in any state in the United States who has examined the child or student. The statement must state that, in the physician's opinion, the vaccine required is medically contraindicated or poses a significant risk to the health and well-being of the child or student or any member of the child's or student's household. Unless it is written in the statement that a lifelong condition exists, the exemption statement is valid for only one year from the date signed by the physician.

(2) To claim an exclusion for reasons of conscience, including a religious belief, the child's parent, legal guardian, or a student 18 years of age or older must present to the school or child-care facility a completed, signed, and notarized affidavit on a form provided by the department stating that the child's parent, legal guardian, or the student declines vaccinations for reasons of conscience, including because of the person's religious beliefs. The affidavit will be valid for a two-year period from the date of notarization. A child or student, who has not received the required immunizations for reasons of conscience, including religious beliefs, may be excluded from school in times of emergency or epidemic declared by the commissioner of the department.

(A) A person claiming exclusion for reasons of conscience, including a religious belief, from a required immunization may only obtain the affidavit form from the department by:

(ii) submitting a request (via online, fax, mail, or hand-delivery) to the department.

(B) The request must include the following information:

(i) [(iii)] complete mailing address, including name, address, and telephone number; and

(ii) [(iv)] number of requested affidavit forms [(not to exceed 5)].

(C) [(B)] Requests for mailed affidavit forms must be submitted to the department through one of the following methods:

(i) written request through the United States Postal Service (or other commercial carrier) to the department at: DSHS Immunization Branch, Mail Code [code] 1946, P.O. Box 149347, Austin, Texas 78714-9347;

(ii) by fax [facsimile] to (512) 776-7544;

(iii) by hand-delivery to the department's physical address at 1100 West 49th Street, Austin, Texas 78756; or

(iv) via the department's Immunization program website (at www.ImmunizeTexas.com).

(D) [(C)] The department will mail the requested affidavit forms [form(s) (not to exceed five forms per child or student)] to the specified mailing address.

(E) [(D)] The department may [shall] not maintain a record of the personally identifiable information [names] of individuals who request an affidavit and must [shall] return the original documents (when applicable) with the requested affidavit forms.

(3) To claim an exclusion for armed forces, persons who can prove [that they are serving on] active duty service with the armed forces of the United States are exempted from the requirements in these sections.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on June 20, 2025.

TRD-202502086

Cynthia Hernandez

General Counsel

Department of State Health Services

Earliest possible date of adoption: August 3, 2025

For further information, please call: (512) 776-6319