88R2308 SRA-D
 
  By: Perry S.B. No. 2023
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to requirements for and prohibited uses of information
  contained in the immunization registry.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Sections 161.007(a) and (a-1), Health and Safety
  Code, are amended to read as follows:
         (a)  The department, for the primary purpose of establishing
  and maintaining a single repository of accurate, complete, and
  current immunization records to be used in aiding, coordinating,
  and promoting efficient and cost-effective communicable disease
  prevention and control efforts, shall establish and maintain an
  immunization registry. The executive commissioner by rule shall
  develop guidelines to:
               (1)  protect the confidentiality of patients in
  accordance with Section 159.002, Occupations Code;
               (2)  inform the individual or the individual's legally
  authorized representative about the registry and that registry
  information may be released under Section 161.00735;
               (3)  require the written or electronic consent of the
  individual or the individual's legally authorized representative
  before any information relating to the individual is included in
  the registry;
               (4)  permit the individual or the individual's legally
  authorized representative to withdraw consent for the individual to
  be included in the registry; [and]
               (5)  determine the process by which consent for the
  individual's information to be included in the registry is
  verified, including affirmation by a health care provider, birth
  registrar, regional health information exchange, or local
  immunization registry that consent has been obtained; and
               (6)  determine the process by which the immunization
  information of a first responder or immediate family member of a
  first responder may be accessed under Section 161.00708.
         (a-1)  The written or electronic consent required by
  Subsection (a)(3) for an individual [younger than 18 years of age]
  is required to be obtained only one time. The written or electronic
  consent of the individual, or, for a minor child, the individual's
  parent, managing conservator, or guardian must be submitted to the
  department [before the individual's 18th birthday]. After consent
  is submitted, the individual's immunization information may be
  included in the registry [until the individual becomes 26 years of
  age] unless the consent is withdrawn in writing or electronically[,
  or renewed after the individual's 18th birthday as provided by
  Subsection (a-2)]. A parent, managing conservator, or guardian of a
  minor may provide the consent by using an electronic signature on
  the minor's birth certificate.
         SECTION 2.  Section 161.00705, Health and Safety Code, is
  amended by amending Subsections (d) and (e) and adding Subsections
  (f-1), (f-2), (f-3), and (f-4) to read as follows:
         (d)  Sections 161.007, 161.0071, 161.0072, [and] 161.0074,
  and 161.008 apply to the data elements submitted to the department
  under this section, unless a provision in those sections conflicts
  with a requirement in this section.
         (e)  The [executive commissioner by rule shall determine the
  period during which the] information collected under this section
  must remain in the immunization registry until the seventh
  anniversary of the last day [following the end] of the disaster,
  public health emergency, terrorist attack, hostile military or
  paramilitary action, or extraordinary law enforcement emergency.
         (f-1)  The executive commissioner by rule shall develop
  guidelines and procedures for obtaining the consent required by
  Subsection (f) from an individual or the individual's legally
  authorized representative for continued inclusion in the registry
  of information collected under this section beyond the period
  prescribed by Subsection (e).
         (f-2)  The department shall make a reasonable effort to
  provide notice to an individual or an individual's legally
  authorized representative of the inclusion of the individual's
  immunization history in the registry under this section if the
  consent required under Subsection (f) has not been obtained before
  expiration of the period prescribed by Subsection (e). The
  reasonable effort shall include at least two attempts by the
  department to provide the notice required by this subsection by
  telephone or e-mail, or by regular mail to the last known address of
  the individual or the individual's legally authorized
  representative. The notice must inform the individual or the
  individual's legally authorized representative that the
  individual's immunization records collected under this section
  will be removed from the immunization registry on the expiration of
  the period prescribed under Subsection (e) unless the individual or
  the individual's legally authorized representative consents to
  continued inclusion as provided by Subsection (f).
         (f-3)  The department shall make a reasonable effort to
  obtain current contact information for written or electronic
  notices sent by the department under Subsection (f-2) that are
  returned due to incorrect address information.
         (f-4)  Consent for inclusion in the immunization registry
  obtained under Section 161.007(a-1) must meet the consent
  requirements of Subsection (f).
         SECTION 3.  Section 161.00708, Health and Safety Code, is
  amended to read as follows:
         Sec. 161.00708.  ACCESS TO FIRST RESPONDER AND IMMEDIATE
  FAMILY MEMBER IMMUNIZATION HISTORY. (a) The department shall
  establish a process to provide an employer of a first responder with
  direct access to the first responder's immunization information in
  the immunization registry for verification of the first responder's
  immunization history. The process must require:
               (1)  a first responder to provide electronic or written
  consent before the employer is granted direct access to the first
  responder's immunization information in the immunization registry;
  and
               (2)  affirmation by the employer that the first
  responder is a current employee of the employer.
         (b)  A first responder may withdraw consent provided under
  Subsection (a)(1) at any time.
         (c) [(b)]  The department may establish a process to provide
  a first responder or an immediate family member of a first responder
  with access to the individual's personal [first responder's]
  immunization information in the immunization registry.
         SECTION 4.  Subchapter A, Chapter 161, Health and Safety
  Code, is amended by adding Section 161.00709 to read as follows:
         Sec. 161.00709.  EXCLUSION REQUEST THROUGH SECURE INTERNET
  PORTAL. The department shall develop and maintain a secure
  Internet portal accessible through the department's Internet
  website through which an individual or the individual's legally
  authorized representative may request exclusion of the
  individual's immunization records from the registry in accordance
  with Section 161.0071(f).
         SECTION 5.  Section 161.0071, Health and Safety Code, is
  amended by adding Subsection (f) to read as follows:
         (f)  An individual or the individual's legally authorized
  representative may request exclusion of the individual's
  immunization records from the registry through a secure Internet
  portal accessed through the department's Internet website.
         SECTION 6.  Section 161.00735(e), Health and Safety Code, is
  amended to read as follows:
         (e)  The [executive commissioner by rule shall determine the
  period during which the] information collected under Subsection (c)
  must remain in the immunization registry until the seventh
  anniversary of the last day [following the end] of the disaster.
         SECTION 7.  Section 161.008, Health and Safety Code, is
  amended by amending Subsections (c) and (d) and adding Subsection
  (c-1) to read as follows:
         (c)  The department may obtain the data constituting an
  immunization record for an individual from a public health
  district, a local health department, the individual or the
  individual's legally authorized representative, a physician to the
  individual, a payor, or any health care provider licensed or
  otherwise authorized to administer vaccines.
         (c-1)  Except as provided by Section 161.00705, the [The]
  department shall verify consent before including the reported
  information in the immunization registry. The department may not
  retain individually identifiable information about an individual
  for whom consent cannot be verified.
         (d)  The department may release the data constituting an
  immunization record for the individual to:
               (1)  any entity that is described by Subsection (c);
               (2)  a school or child care facility in which the
  individual is enrolled;
               (3)  a state agency having legal custody of the
  individual; or
               (4)  an employer of a first responder, [or] a first
  responder, or an immediate family member of a first responder in
  accordance with Section 161.00708.
         SECTION 8.  Section 161.0107, Health and Safety Code, is
  amended by amending Subsection (c) and adding Subsection (e) to
  read as follows:
         (c)  The executive commissioner by rule shall specify:
               (1)  the fields necessary to populate the immunization
  registry, including a "yes" or "no" field that indicates the
  patient's consent to be listed in the immunization registry has
  been obtained; and
               (2)  the data standards that must be used for
  electronic submission of immunization information.
         (e)  The fields and data standards described by Subsection
  (c) relating to a patient's consent may not include demographic
  information of the patient.
         SECTION 9.  Sections 161.007(a-2), (a-3), (a-4), (a-5), and
  (a-6), Health and Safety Code, are repealed.
         SECTION 10.  As soon as practicable after the effective date
  of this Act, the Department of State Health Services shall develop
  the secure Internet portal required by Section 161.00709, Health
  and Safety Code, as added by this Act.
         SECTION 11.  This Act takes effect September 1, 2023.