By Coleman H.B. No. 2160
Line and page numbers may not match official copy.
Bill not drafted by TLC or Senate E&E.
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the immunization registry.
1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-4 SECTION 1. Section 161.007, Health and Safety Code, is
1-5 amended to read as follows:
1-6 Sec. 161.007. Immunization Registry; Reports to Department.
1-7 (a) The department, for purposes of establishing and maintaining a
1-8 single repository of accurate, complete, and current immunization
1-9 records to be used in aiding, coordinating, and promoting efficient
1-10 and cost-effective childhood communicable disease prevention and
1-11 control efforts, shall establish and maintain a childhood
1-12 immunization registry. The department by rule shall develop
1-13 guidelines to:
1-14 (1) protect the confidentiality of patients in
1-15 accordance with Chapter 159, Occupations Code [Section 5.08,
1-16 Medical Practice Act (Article 4495b, Vernon's Texas Civil
1-17 Statutes)];
1-18 (2) inform a parent, managing conservator, or guardian
1-19 of each patient about the registry; and
1-20 (3) permit [require the written consent of] a parent,
1-21 managing conservator, or guardian of a patient to choose to have
1-22 the patient excluded from [before any information relating to the
2-1 patient is included in] the registry[; and]
2-2 [(4) permit a parent, managing conservator, or
2-3 guardian to withdraw consent for the patient to be included in the
2-4 registry].
2-5 (b) Except as provided by Section 161.0071, the [The]
2-6 childhood immunization registry must contain information on the
2-7 immunization history that is obtained by the department under this
2-8 section of each person who is younger than 18 years of age [and for
2-9 whom consent has been obtained in accordance with guidelines
2-10 adopted under Subsection (a). The department shall remove from the
2-11 registry information for any person for whom consent has been
2-12 withdrawn].
2-13 (c) An insurance company, a health maintenance organization,
2-14 or another organization that pays or reimburses a claim for an
2-15 immunization of a person younger than 18 years of age shall provide
2-16 an immunization history to the department. The report shall be in
2-17 a format prescribed by the department, which may include submission
2-18 in writing, by electronic format, or by voice. An insurance
2-19 company, health maintenance organization, or other organization is
2-20 not required to provide an immunization history to the department
2-21 under this subsection for a person excluded from the registry. The
2-22 department shall consult with entities required to report under
2-23 this section to determine the most efficient and cost-effective
2-24 manner of reporting immunization histories [for whom consent has
2-25 not been obtained in accordance with guidelines adopted under
2-26 Subsection (a) or for whom consent has been withdrawn].
3-1 (d) A health care provider, including an emergency medical
3-2 service provider, who administers an immunization to a person
3-3 younger than 18 years of age shall provide an immunization history
3-4 to the department unless the immunization history is submitted to
3-5 an insurance company, a health maintenance organization, or another
3-6 organization that pays or reimburses a claim for an immunization to
3-7 a person younger than 18 years of age. The report shall be in a
3-8 format prescribed by the department, which may include submission
3-9 in writing, by electronic means, or by voice. A health care
3-10 provider, including an emergency medical service provider is not
3-11 required to provide an immunization history to the department under
3-12 this subsection for a person excluded from the registry. The
3-13 department shall consult with health care providers, including
3-14 emergency medical service providers, to determine the most
3-15 efficient and cost-effective manner of reporting immunization
3-16 histories [for whom consent has not been obtained in accordance
3-17 with guidelines adopted under Subsection (a) or for whom consent
3-18 has been withdrawn].
3-19 (e) The department may use the registry to provide notices
3-20 by mail, telephone, personal contact, or other means to a parent,
3-21 managing conservator, or guardian regarding his or her child or
3-22 ward who is due or overdue for a particular type of immunization
3-23 according to the department's immunization schedule. The notice
3-24 must contain instructions for the parent, managing conservator, or
3-25 guardian to request that future notices not be sent and to remove
3-26 the child's immunization record from the registry and any other
4-1 registry related records. The notice must describe the procedure
4-2 to report a violation if a child is included in the registry after
4-3 requesting exclusion. The department shall consult with health
4-4 care providers, including emergency medical service providers, to
4-5 determine the most efficient and cost-effective manner of using the
4-6 registry to provide those notices.
4-7 (f) Nothing in this subchapter [section] diminishes a
4-8 parent's, managing conservator's, or guardian's responsibility for
4-9 having a child immunized properly, subject to Section 161.004(d).
4-10 (g) A person, including a health care provider, an emergency
4-11 medical service provider, health maintenance organization, or an
4-12 insurance company, who submits or obtains in good faith an
4-13 immunization history or data to or from the department in
4-14 compliance with the provisions of this subchapter [section] and any
4-15 rules adopted under this subchapter [section] is not liable for any
4-16 civil damages.
4-17 (h) [Information obtained by the department for the
4-18 immunization registry is confidential and may be disclosed only
4-19 with the written consent of the child's parent, managing
4-20 conservator, or guardian.]
4-21 [(i)] The board shall adopt rules to implement this
4-22 subchapter [section].
4-23 SECTION 2. Subchapter A, Chapter 161, Health and Safety
4-24 Code, is amended by adding Section 161.0071 to read as follows:
4-25 Sec. 161.0071. NOTICE OF RECEIPT OF REGISTRY DATA; EXCLUSION
4-26 FROM REGISTRY. (a) The first time the department receives data
5-1 for a child, the department shall send a written notification to
5-2 the child's parent, managing conservator, or guardian disclosing:
5-3 (1) that providers and insurers may be sending the
5-4 child's immunization information to the department, but the
5-5 department may not keep the information if the parent, managing
5-6 conservator, or guardian chooses to exclude the child from the
5-7 registry;
5-8 (2) the information that is included in the registry;
5-9 (3) the persons to whom the information may be
5-10 released under Section 161.008(d);
5-11 (4) the purpose and use of the registry;
5-12 (5) the procedure to exclude a child from the
5-13 registry; and
5-14 (6) the procedure to report a violation if a parent,
5-15 managing conservator, or guardian discovers a child is included in
5-16 the registry after exclusion has been requested.
5-17 (b) The department shall delete the child's immunization
5-18 records from the registry and any other registry-related department
5-19 record that individually identifies the child, not later than the
5-20 30th day after the date the department receives from the parent,
5-21 managing conservator, or guardian of the child a written request
5-22 that the child be excluded from the registry. The department shall
5-23 maintain only those records related to the child necessary to
5-24 ensure that the child continues to be excluded from the registry.
5-25 (c) The department shall send to a parent, managing
5-26 conservator, or guardian who makes a written request under
6-1 Subsection (b) a written confirmation of receipt of the request for
6-2 exclusion and the exclusion of the child's records from the
6-3 registry.
6-4 (d) The department commits a violation if the department
6-5 fails to exclude a child from the registry within the period
6-6 required by Subsection (b).
6-7 (e) A parent, managing conservator, or guardian may request
6-8 that the birth certificate of a child be excluded from the
6-9 registry.
6-10 (f) The department shall accept any written indication from
6-11 a parent, managing conservator, or guardian communicating to the
6-12 department that a child should be excluded from the registry,
6-13 including a statement on the child's birth certificate, as a
6-14 request for exclusion under Subsection (b).
6-15 SECTION 3. Subchapter A, Chapter 161, Health and Safety
6-16 Code, is amended by adding Section 161.0072 to read as follows:
6-17 Sec. 161.0072. REGISTRY CONFIDENTIALITY. (a) The
6-18 information that individually identifies a child received by the
6-19 department for the immunization registry is confidential and may be
6-20 used by the department for registry purposes only.
6-21 (b) Unless specifically authorized under this subchapter,
6-22 the department may not release registry information to any
6-23 individual or entity without the consent of the person, or if a
6-24 minor, the parent, managing conservator, or guardian of the child.
6-25 (c) A person required to report information to the
6-26 department for registry purposes or authorized to receive
7-1 information from the registry, may not disclose the individually
7-2 identifiable information to any other person without written
7-3 consent of the parent, managing conservator, or guardian of the
7-4 child, except as provided by Chapter 159, Occupations Code.
7-5 (d) Registry information is not:
7-6 (1) subject to discovery, subpoena, or other means of
7-7 legal compulsion for release to any person or entity except as
7-8 provided by this subchapter; or
7-9 (2) admissible in any civil, administrative, or
7-10 criminal proceeding.
7-11 SECTION 4. Subchapter A, Chapter 161, Health and Safety
7-12 Code, is amended by adding Section 161.0075 to read as follows:
7-13 Sec. 161.0075. REPORT TO LEGISLATURE. (a) The department
7-14 shall report to the Legislative Budget Board, the governor, the
7-15 lieutenant governor, the speaker of the house and the appropriate
7-16 health committees of the house and senate not later than December 1
7-17 of each even-numbered year.
7-18 (b) The department shall use the report required under
7-19 Subsection (a) to develop ways to increase immunization rates using
7-20 state and federal resources.
7-21 (c) The report must:
7-22 (1) include the current immunization rates by
7-23 geographic region of the state, where available;
7-24 (2) focus on the geographic regions of the state with
7-25 immunization rates below the state average for preschool children;
7-26 (3) describe the approaches identified to increase
8-1 immunization rates in underserved areas and the estimated cost for
8-2 each;
8-3 (4) identify changes to department procedures needed
8-4 to increase immunization rates;
8-5 (5) identify the services provided under and
8-6 provisions of contracts entered into by the department to increase
8-7 immunization rates in underserved areas;
8-8 (6) identify performance measures used in contracts
8-9 described by Subdivision (5);
8-10 (7) include the number of complaints received by the
8-11 department related to the department's failure to comply with
8-12 requests for exclusion of individuals from the registry; and
8-13 (8) identify all reported incidents of discrimination
8-14 for requesting exclusion from the registry.
8-15 SECTION 5. Section 161.008, Health and Safety Code, is
8-16 amended by amending Subsections (c) and (d) and adding Subsections
8-17 (e), [and] (f), (g) and (h) to read as follows:
8-18 (c) The department[, only with the consent of a child's
8-19 parent, managing conservator, or guardian,] may[:]
8-20 [(1)] obtain the data constituting an immunization
8-21 record for the child from a public health district, a local health
8-22 department, an insurance company, a health maintenance organization
8-23 or any other organization that pays or reimburses a claim for
8-24 immunization, or any physician, health care professional, emergency
8-25 medical service provider or health care facility personnel licensed
8-26 or otherwise authorized to administer vaccines.
9-1 (d) After the 30th day after the date notice was sent by the
9-2 department to the child's parent, managing conservator, or guardian
9-3 under Section 161.0071, the department, if the department has not
9-4 received a written request to exclude the child from the registry,
9-5 may:
9-6 (1) enter the child into the registry; and [or a
9-7 physician to the child; or]
9-8 (2) release the data constituting an immunization
9-9 record for the child to any entity in this state that is described
9-10 by Subsection (c) and is providing immunization services to the
9-11 child or to [a public health district, a local health department, a
9-12 physician to the child, or] a school or child care facility in
9-13 which the child is enrolled.
9-14 (e) [(d)] A parent, managing conservator, or legal guardian
9-15 may obtain and on request to the department shall be provided with
9-16 all individually identifiable immunization registry information
9-17 concerning his or her child or ward.
9-18 (f) The department may release nonidentifying summary
9-19 statistics related to the registry that do not individually
9-20 identify a child.
9-21 (g) The department may develop a secure internet-based
9-22 system by which a school or child-care facility may verify a
9-23 child's immunization record for immunizations required by sections
9-24 38.001 and 51.933, Education Code.
9-25 (h) The department may share with other state health
9-26 departments information relating to the registry that does not
10-1 individually identify any child.
10-2 SECTION 6. (c) The report required under Section
10-3 161.007(c), Health and Safety Code, as amended by this Act, and the
10-4 data obtained or released under Section 161.008, Health and Safety
10-5 Code, as amended by this Act, may not be accepted or released by
10-6 the Texas Department of Health until the department has adopted
10-7 rules and prescribed the forms required by this Act.
10-8 SECTION 7. This Act takes effect immediately if it receives
10-9 a vote of two-thirds of all the members elected to each house, as
10-10 provided by Section 39, Article III, Texas Constitution. If this
10-11 Act does not receive the vote necessary for immediate effect, this
10-12 Act takes effect September 1, 2001.