SB 1545 mandates that fire departments offer an annual occupational medical examination to all firefighters employed by the department at no cost to the firefighter. The bill specifies that the examination must include various health screenings such as blood and urine tests, pulmonary function tests, electrocardiograms, infectious disease screenings, cancer screenings, and chest x-rays every five years. The Texas Commission on Fire Protection is tasked with adopting rules to establish minimum standards for the medical examinations based on National Fire Protection Association guidelines. Fire departments may submit alternative medical examination plans that meet specified criteria. Compliance with the bill’s provisions is required by February 1, 2027.