Amend CSHB 1921 as follows:                                                  

(1)  On page 4, line 2, strike "may" and substitute "shall".
	(2)  On page 4, between lines 15 and 16, insert the following 
and reletter the subsequent subsections of amended Section 161.007, 
Health and Safety Code, accordingly:
	(g)  The department shall provide instruction and education 
to providers about the immunization registry provider application 
and enrollment process.  The department shall:
		(1)  initially target providers in the geographic 
regions of the state with immunization rates below the state 
average for preschool children; and
		(2)  expedite the processing of provider applications.                 
	(3)  On page 5, strike lines 24-27.                                            
	(4)  On page 6, strike lines 1-10 and substitute the 
following:              
	(b)  On discovering that consent to be included in the 
registry has not been granted, the department shall exclude the 
child's immunization records from the registry and any other 
registry-related department record that individually identifies 
the child.
	(c)  On receipt of a written request to exclude a child's 
immunization  records from the registry, the department shall send 
to a parent, managing conservator, or guardian who makes the 
request a written confirmation of receipt of the request for 
exclusion and shall exclude the child's records from the registry.
	(d)  The department commits a violation if the department 
fails to exclude a child's immunization information from the 
registry as required by Subsection (b) or (c).
	(5)  On page 6, line 15, strike "(b)" and substitute "(c)".      
	(6)  On page 7, between lines 7 and 8, insert the following:                   
	(c)  The board shall develop rules to ensure that the 
immunization history submitted by a parent, managing conservator, 
or guardian is medically verified immunization information.
	(7)  On page 9, line 2, strike "and".                                   
	(8)  On page 9, line 5, between "immunization" and the 
period, insert the following:

;                                                                      
		(10)  include department recommendations about the 
best way to use, and communicate with, local registries in the 
state; and
		(11)  include ways to increase provider participation 
in the registry
	(9)  On page 10, line 15, between "department" and "that", 
insert a comma.
	(10)  On page 10, line 19, strike the comma.                                   
	(11)  On page 10, line 27, and page 11, line 1, strike 
"individually identifiable".
	(12)  On page 11, line 2, between the semicolon and "or", 
insert the following:
		(2)  fails to exclude a child's immunization 
information in violation of Section 161.0071;
	(13)  On page 11, line 3, strike "(2)" and substitute "(3) 
[(2)]".
	(14)  On page 11, line 3, strike "individually 
identifiable".         
	(15)  On page 11, strike lines 8-15 and substitute the 
following:            
	SECTION 6.  (a)  As soon as practicable, but not later than 
January 1, 2005, the Texas Board of Health shall adopt rules and 
forms necessary to implement this Act.
	(16)  On page 11, line 27, and page 12, line 1, strike 
"September 1, 2004" and substitute "January 1, 2005".