FORT LAUDERDALE, Fla. (AP) — Hillsborough and Miami-Dade counties became the third and fourth school districts in Florida to adopt stricter mask mandates Wednesday, a day after school boards in Broward and Alachua counties faced threats of severe penalties for defying Gov. Ron DeSantis’ administration.

The Hillsborough County school board, which oversees the state’s third-largest district with more than 206,000 students in the Tampa area, voted 5-2 to adopt a 30-day mask mandate with a medical opt-out for students, teachers and staff. Most school districts have adopted optional mask policies or given options to parents to easily opt out of requirements. The new policy takes effect Thursday.

Hillsborough school board attorney Jim Porter acknowledged the move could lead to conflict with DeSantis and state education officials who argue such mandates are illegal and subject to punishment.

“There is a risk they will find us in non-compliance,” Porter said at a nearly five-hour meeting.

The main sponsor, board member Nadia Combs, said the virus outbreak poses “an immediate danger” to the system and steps must be taken to contain it or the district might face a complete shutdown. Within days of students returning to class, infections forced thousands of students into isolation, having tested positive for COVID-19, or into quarantine because of close contact with a positive case.

“I am not on the board for political partisanship,” Combs said. “We have to keep our schools open. That is my goal.”

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One member who voted against the mask mandate, Melissa Snively, said there will be “repercussions” from the state that could include funding cuts, although President Joe Biden has vowed the federal government would make up any losses for districts that impose mask mandates.

“We’re going to go down this road and get our hands slapped,” Snively said. “I have no interest today in breaking the law.”

Also Wednesday, the Miami-Dade school board passed a similar mandate with a medical exemption by a 7-1 vote. In Miami-Dade, Florida’s largest school district with 334,000 students, a task force of medical experts recommended students be required to wear masks when they return to classrooms next week. Superintendent Alberto Carvalho agreed and pushed for the new rule at Wednesday’s meeting.

DeSantis said at a Wednesday news conference near Fort Lauderdale that Broward, Miami-Dade and other districts that impose mask mandates are violating a law passed by the Legislature and signed by him that states it is up to parents to make health decisions.

Last month, DeSantis held a news conference with parents who opposed mask mandates in schools and issued an executive order to “protect parents’ right to make decisions regarding masking of their children.” DeSantis’ order also tasked the education commissioner to find ways to make districts comply, including withholding state funds.

The districts were changing their policies following a recommendation by the U.S. Centers for Disease Control and Prevention that all teachers, staff, students and visitors at schools wear masks.

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“Forcing young kids to wear masks all day, these kindergartners, having the government to force them, that’s not defying me, that is defying the state of Florida’s laws,” DeSantis said. “This is not something we are making up. This is what the state law says.”

In Broward County, the state’s second-largest district with 261,000 students, two teachers and an assistant teacher died from COVID-19 last week. In Miami, a 13-year-old student and four district employees have died from the virus in recent weeks, Carvalho said.

Hospitalizations have risen this week in the state after slowing down over the weekend. Hospitals are reporting 16,721 patients with COVID-19, compared to Tuesday’s tally of 16,521, according to the U.S. Department of Health and Human Services. About 55% — more than 3,600 patients — of intensive care unit patients have COVID-19.

Many hospitals statewide expect critical staffing shortages starting next week.

“There can be no question that many Florida hospitals are stretched to their absolute limits,” said Mary Mayhew, president of the Florida Hospital Association.

Florida’s Board of Education voted unanimously Tuesday for the Department of Education to further investigate Broward and Alachua school districts to impose possible sanctions and report to the state Legislature, which could take additional action for violating rules such as not allowing opt-out for parents who don’t want their children wearing masks.

Despite this pressure, the Alachua County School Board, which serves nearly 30,000 students in the Gainesville area, voted Tuesday night to extend its mask mandate for another two months, WJXT reported. Alachua’s mandate requires a doctor’s note, violating the governor’s executive order to let students opt out without requiring any medical recommendations, referrals, or permissions, the station reported.

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Associated Press writers Curt Anderson in Tampa, Florida, Kelli Kennedy, Terry Spencer in Fort Lauderdale, Florida, and Mike Schneider in Orlando, Florida, contributed to this report.

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Follow AP’s coverage of the pandemic at https://apnews.com/hub/coronavirus-pandemic.