By Hupp                                               H.B. No. 2722
         76R4509 CMR-D                           
                                A BILL TO BE ENTITLED
 1-1                                   AN ACT
 1-2     relating to a registry and reporting requirements concerning
 1-3     immunizations.
 1-4           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
 1-5           SECTION 1.  Section 161.007, Health and Safety Code, is
 1-6     amended to read as follows:
 1-7           Sec. 161.007.  IMMUNIZATION REGISTRY;  REPORTS TO DEPARTMENT.
 1-8     (a)  The department, for purposes of establishing and maintaining a
 1-9     single repository of accurate, complete, and current immunization
1-10     records to be used in aiding, coordinating, and promoting efficient
1-11     and cost-effective childhood communicable disease prevention and
1-12     control efforts, shall establish and maintain a childhood
1-13     immunization registry.  The department by rule shall develop
1-14     guidelines to:
1-15                 (1)  protect the confidentiality of patients in
1-16     accordance with Section 5.08, Medical Practice Act (Article 4495b,
1-17     Vernon's Texas Civil Statutes);
1-18                 (2)  inform a parent, managing conservator, or guardian
1-19     of each patient about the registry;
1-20                 (3)  require the written consent of a parent, managing
1-21     conservator, or guardian of a patient before any information
1-22     relating to the patient is released to the department or included
1-23     in the registry; and
1-24                 (4)  permit a parent, managing conservator, or guardian
 2-1     to withdraw consent for the patient to be included in the registry.
 2-2           (b)  The form of the written consent used under Subsection
 2-3     (a)(3) must be established by the guidelines established under
 2-4     Subsection (a).  The consent form must fully disclose:
 2-5                 (1)  all information that may be included in the
 2-6     registry;
 2-7                 (2)  the persons to whom the information may be
 2-8     released under Section 161.008(c)(2); and
 2-9                 (3)  the purpose and use of the registry.
2-10           (c)  The childhood immunization registry must contain
2-11     information on the immunization history that is obtained by the
2-12     department under this section of each person who is younger than 18
2-13     years of age and for whom consent has been obtained in accordance
2-14     with guidelines adopted under Subsection (a).  The department shall
2-15     remove from the registry information for any person for whom
2-16     consent has been withdrawn.
2-17           (d) [(c)]  An insurance company, a health maintenance
2-18     organization, or another organization that pays or reimburses a
2-19     claim for an immunization of a person younger than 18 years of age
2-20     shall provide an immunization history to the department.  An
2-21     insurance company, health maintenance organization, or other
2-22     organization may not [is not required to] provide an immunization
2-23     history to the department under this subsection for a person unless
2-24     [for whom] consent has [not] been obtained for the person in
2-25     accordance with guidelines adopted under Subsection (a) [or for
2-26     whom consent has been withdrawn].
2-27           (e) [(d)]  A health care provider who administers an
 3-1     immunization to a person younger than 18 years of age shall provide
 3-2     an immunization history to the department unless the immunization
 3-3     history is submitted to an insurance company, a health maintenance
 3-4     organization, or another organization that pays or reimburses a
 3-5     claim for an immunization to a person younger than 18 years of age.
 3-6     The report shall be in a format prescribed by the department, which
 3-7     may include submission in writing, by electronic means, or by
 3-8     voice.  A health care provider may not [is not required to] provide
 3-9     an immunization history to the department under this subsection for
3-10     a person unless [for whom] consent has [not] been obtained for the
3-11     person in accordance with guidelines adopted under Subsection (a)
3-12     [or for whom consent has been withdrawn].
3-13           (f) [(e)]  The department may use the registry to provide not
3-14     more than three notices by mail, telephone, or personal contact [,
3-15     or other means] to a parent, managing conservator, or guardian
3-16     regarding his or her child or ward who is due or overdue for a
3-17     particular type of immunization according to the department's
3-18     immunization schedule.  The department shall consult with health
3-19     care providers to determine the most efficient and cost-effective
3-20     manner of using the registry to provide those notices.
3-21           (g) [(f)]  Nothing in this section diminishes a parent's,
3-22     managing conservator's, or guardian's responsibility for having a
3-23     child immunized properly, subject to Section 161.004(d).
3-24           (h) [(g)]  A person, including a health care provider, who
3-25     submits or obtains in good faith an immunization history or data to
3-26     or from the department in compliance with the provisions of this
3-27     section and any rules adopted under this section is not liable for
 4-1     any civil damages.
 4-2           (i) [(h)]  Information obtained by the department for the
 4-3     immunization registry is confidential and may be disclosed only
 4-4     with the written consent of the child's parent, managing
 4-5     conservator, or guardian.
 4-6           (j) [(i)]  The board shall adopt rules to implement this
 4-7     section.
 4-8           SECTION 2.  Section 161.008, Health and Safety Code, is
 4-9     amended by amending Subsection (c) and adding Subsection (e) to
4-10     read as follows:
4-11           (c)  The department, only with the consent of a child's
4-12     parent, managing conservator, or guardian, may:
4-13                 (1)  obtain the data constituting an immunization
4-14     record for the child from a public health district, a local health
4-15     department, or a physician to the child; or
4-16                 (2)  release the data constituting an immunization
4-17     record for the child in this state and only to a public health
4-18     district or [,] a local health department in this state, a
4-19     physician to the child in this state, or a school or child care
4-20     facility in this state in which the child is enrolled.
4-21           (e)  The department may not obtain the data constituting an
4-22     immunization record from a person other than a person described by
4-23     Subsection (c)(1).  This subsection does not affect the
4-24     department's ability to obtain an immunization history under
4-25     Section 161.007.
4-26           SECTION 3.  Section 161.009(a), Health and Safety Code, is
4-27     amended to read as follows:
 5-1           (a)  A person commits an offense if the person:
 5-2                 (1)  negligently releases or discloses immunization
 5-3     registry information in violation of Section 161.007 or 161.008; or
 5-4                 (2)  negligently uses the information in the
 5-5     immunization registry to solicit new patients or clients or for any
 5-6     other purposes that are not associated with immunization purposes,
 5-7     including the denial of insurance or other benefits based on the
 5-8     person's immunization history, unless authorized under this
 5-9     section.
5-10           SECTION 4.  The Texas Board of Health shall adopt a consent
5-11     form as required by Section 161.007, Health and Safety Code, as
5-12     amended by this Act, not later than December 15, 1999.
5-13           SECTION 5.  The change in law made by this Act applies only
5-14     to a report of an immunization history made to the Texas Department
5-15     of Health, and to release of data constituting an immunization
5-16     record by the department, on or after January 1, 2000. A report
5-17     made or data released before that date is governed by the law as it
5-18     existed immediately before the effective date of this Act, and the
5-19     former law is continued in effect for that purpose.
5-20           SECTION 6.  This Act takes effect September 1, 1999.
5-21           SECTION 7.  The importance of this legislation and the
5-22     crowded condition of the calendars in both houses create an
5-23     emergency and an imperative public necessity that the
5-24     constitutional rule requiring bills to be read on three several
5-25     days in each house be suspended, and this rule is hereby suspended.