IML C.S.H.B. 3054 75(R)BILL ANALYSIS PUBLIC HEALTH C.S.H.B. 3054 By: Berlanga 4-17-97 Committee Report (Substituted) BACKGROUND With support from the legislature, the Texas Department of Health (TDH) in 1994 established an immunization tracking system (ImmTrac) for the purpose of monitoring immunization rates of children across the state. The tracking system also serves as an information depository for providers, who can tap into the system to determine whether a particular child's immunization record is up to date. This is especially important for children who do not have a primary provider, as these children run the risk of being "over- immunized." Currently, the tracking system contains only the data from public health clinics, Medicaid records, and others who provide it on a voluntary basis. Neither the state nor providers can obtain the complete picture of immunization rates as long as ImmTrac lacks data from the private sector. This lack of information is an obstacle to the state's goal of achieving and maintaining 90% immunization levels in two-year-olds. PURPOSE CSHB 3054 establishes a state-wide childhood immunization registry and requires certain health care and service providers possessing pertinent information to provide such information to the Department of Health. RULEMAKING AUTHORITY It is the committee's opinion that this bill expressly grants additional rulemaking authority to the Board of Health in SECTION 1 (Section 161.007(i), Health and Safety Code), and such rulemaking authority is referenced in SECTION 1 (Section 161.007(g), Health and Safety Code). SECTION BY SECTION ANALYSIS SECTION 1. Amends Subchapter A, Chapter 161, Health and Safety Code, by adding Sections 161.007, 161.008, and 161.009 as follows: Sec. 161.007. IMMUNIZATION REGISTRY; REPORTS TO DEPARTMENT. Subsection (a) Requires the Department of Health (department) to establish and maintain a childhood immunization registry for specified purposes. Subsection (b) Requires that the registry contain immunization information obtained by the department on persons under age 18. Subsection (c) Requires insurance companies, HMO's, and certain other organizations to provide immunization histories to the department. Subsection (d) Requires certain health care providers to submit immunization histories to the department unless the information is submitted to an entity covered under Subsection (c). This Subsection further requires that the report be in a format prescribed by the department. Subsection (e) Allows the department to use the registry to provide notices to parents, managing conservators, or guardians when a child is due or overdue for an immunization. This Subsection requires the department to consult with providers to determine the most cost-effective manner of providing notices. Subsection (f) Stipulates that nothing in this section diminishes a parent's, managing conservator's, or guardian's responsibility for having a child immunized properly. Subsection (g) Removes civil liability from a person, including a provider, who acts in good faith in compliance with this section and any rules adopted under this section. Subsection (h) Allows confidential information obtained by the department for the immunization registry to be disclosed only as provided by Section 161.008 or with written consent. Subsection (i) Requires the Board of Health to adopt rules implementing this section. Sec. 161.008. IMMUNIZATION RECORD. Subsection (a) Provides that an immunization record is part of the immunization registry. Subsection (b) Provides that an immunization record contains the person's name, date of birth, dates of immunization, types of immunization, and name and address of the provider. Subsection (c) Allows a parent, managing conservator, or guardian to obtain an exemption regarding the release of information under this section and to require the department to withhold the immunization record from the registry upon written notification. Allows the information to be exchanged between the department and certain specified entities if the department has not received an exemption request. Subsection (d) Allows a parent, managing conservator, or guardian to obtain, and requires the department to provide on request all registry information regarding the child. Sec. 161.009. PENALTIES FOR DISCLOSURE OF INFORMATION. Subsection (a) Stipulates that it is an offense to negligently release or disclose registry information in violation of Sections 161.007 and 161.008 or to negligently use the information to solicit new patients or clients or for purposes not associated with immunization. Subsection (b) Provides that an offense under this section is a Class A misdemeanor. SECTION 2. Requires the Department of Health to evaluate the immunization registry two years after implementation and to report to report to the legislature at specified times. SECTION 3. Effective date is September 1, 1997, except for Sections 161.007(c) and (d) which take effect January 1, 1999. SECTION 4. Emergency clause. COMPARISON OF ORIGINAL TO SUBSTITUTE SECTION 1. CSHB 3054 adds three Sections (161.007, 161.008, and 161.009) whereas the original combined all the language into Section 161.007. Subsection 161.007 (b) is added, rewording original Subsection 161.007 (d). Subsections 161.007 (c) and (d) are added, rewording pertinent parts of the original bill's Subsection 161.007 (b). Subsections 161.007 (e), (g), and (i) incorporate original Subsections 161.007 (c), (g), and (h), respectively. Subsection 161.007 (f) incorporates original Subsection 161.007 (f)(3). Subsection 161.007 (h) is added. These changes, including rewording and renumbering, are the result of Legislative Council drafting. The original bill was not drafted by the Legislative Council. Subsection 161.008 (a) is added, and Subsections 161.007 (b), (c), and (d) are added, incorporating language from original Subsections 161.007 (b) and (e). These changes are the result of Legislative Council drafting. CSHB 3054 adds language to Section 161.008 (c) to address concerns of parents wishing to exempt their children from the immunization registry. Section 161.009 incorporates original Subsection 161.007 (i), with rewording and renumbering based on Legislative Council drafting. SECTION 2. CSHB 3054 requires the Texas Department of Health to evaluate the registry and report to the legislature. This provision was not included in the original bill. SECTION 3. Effective dates are the same with conforming changes based on the redesignation of Subsections 161.007(c) and (d). SECTION 4. Emergency clause.