SRC- TAG, VRA S.B. 39 78(R) BILL ANALYSIS
Senate Research Center S.B. 39
78R1037 MCK-DBy: Zaffirini
Health and Human Services
2/27/2003
As Filed
DIGEST AND PURPOSE
In 1994, the Texas Department of Health (TDH) established an immunization
tracking system to monitor immunization rates for children across Texas.
Additionally, this system serves as an information depository for
providers who are then able to determine if a child's immunization record
is up to date. For children who do not consistently see the same health
care provider, the system serves to protect them from "over immunization."
However, the current system lacks data from the private sector, and thus
does not present an accurate report of the immunization rates in Texas.
As proposed, S.B. 39 would modify the state's current immunization
tracking system, ImmTrac, to increase collection data. The primary goal is
to increase the reporting to ImmTrac by changing the registry from an
opt-in to an opt-out system.
RULEMAKING AUTHORITY
Rulemaking authority previously granted to the Texas Department of Health
is modified in SECTION 1 (Section 161.007, Health and Safety Code) of
this bill.
Rulemaking authority is expressly granted to the Texas Board of Health in
SECTION 5 and is modified in SECTION 1 (Section 161.007, Health and
Safety Code) of this bill.
SECTION BY SECTION ANALYSIS
SECTION 1. Amends Section 161.007, Health and Safety Code, as follows:
(a) Requires the Texas Department of Health (TDH) by rule to develop
certain guidelines to:
protect the confidentiality of registrants in accordance with state and
federal law, rather than patients in accordance with Section 159.002
(Confidential Communications), Occupations Code;
inform a parent, managing conservator, or guardian of each registrant,
rather than each patient, about the registry; and
permit the written consent of a parent, managing conservator, or guardian
of a registrant to choose in writing to have the registrant excluded from
the registry, rather than require the written consent of such persons
before any information relating to the patient is included in the
registry.
Makes conforming changes.
(b) Requires the childhood immunization registry to contain information
on the immunization history that is obtained by TDH under this section of
each person who is younger than 18 years of age, except as provided by
Section 161.0071. Deletes existing language regarding consent to
guidelines in accordance with guidelines adopted under Subsection (a).
Deletes existing language regarding TDH removing registry information.
(c) Requires the report to contain the elements prescribed by TDH.
Authorizes the report to be submitted in writing or by electronic means.
Deletes existing language exempting certain entities from providing an
immunization history.
(d) Requires the report to contain the elements, rather than be in a
format, prescribed by the department. Authorizes the report to be
submitted in writing or by electronic means and deletes language
authorizing submission by voice. Deletes language exempting a health
care provider from providing certain immunization histories to TDH. Makes
a nonsubstantive change.
(e) Requires the notice to contain instructions for the parent, managing
conservator, or guardian to request that future notices not be sent and to
remove the child's immunization record from the registry and any other
registry-related record that individually identifies the child. Requires
the notice to describe the procedures to report a violation if a child is
included in the registry after the submission of a written request for
exclusion.
(f) Provides that nothing in this subchapter diminishes a parent's,
managing conservator's, or guardian's
responsibility for having a child immunized properly,
subject to Section 161.004(d).
(g) Provides that a person, including a health care provider or an
insurance company, a health maintenance organization, or another
organization that pays or reimburses a claim for immunization, and
submits or obtains in good faith an immunization history or data to or
from TDH in compliance with both the provision of this subchapter and any
rules adopted in this subchapter is not liable for any civil damages.
Makes conforming changes.
(h) Deletes language regarding the confidentiality and the disclosure of
the information obtained by TDH. Requires the board to adopt rules to
implement this subchapter, rather than this section. Reletters Subsection
(i) as Subsection (h).
SECTION 2. Amends Chapter 161A, Health and Safety Code, by adding
Sections 161.0071, 161.0072, 161.0073, and 161.0074, as follows:
Sec. 161.0071. NOTICE OF RECEIPT OF REGISTRY DATA; EXCLUSION
FROM REGISTRY. (a) Requires TDH to send a written notification to a
child's parent, managing conservator, or guarding disclosing certain
information, the first time it receives registry data for the child.
(b) Requires TDH to delete the child's immunization records from the
registry and any other registry-related TDH record that individually
identifies the child by the 30th day after the date the TDH receives from
the parent, managing conservator, or guardian of the child a written
request that the child be excluded from registry. Requires the TDH to
maintain only those records related to the child necessary to ensure that
the child continues to be excluded from the registry and prohibits release
of the identity of a child excluded from the registry.
(c) Requires for TDH to send a written confirmation of receipt of the
request for exclusion and the exclusion of child's record from the
registry to a parent, managing conservator, or guardian who makes a
written a request under Subsection (b).
(d) Provides that TDH commits a violation if it fails to exclude a child
from the registry within the period required by Subsection (b).
(e) Requires TDH to accept a written statement from a parent, managing
conservator, or guardian communicating the exclusion of the child from the
registry, including a statement on the child's birth certificate, as a
request for exclusion under Subsection (b).
Sec. 161.0072. REGISTRY CONFIDENTIALITY. (a) Provides that the
information that individually identifies a child received by TDH for the
immunization registry is confidential and may only be used for TDH's
registry purposes.
(b) Prohibits TDH from releasing registry information to any individual
or entitity without the consent of the person, or if a minor, the parent,
managing conservator, or guardian of the child, unless specifically
authorized by this subchapter.
(c) Provides that a person required to report information to TDH for
registry purposes or authorized to receive information from registry
may not disclose the individually identifiable information to any other
person without the written consent from the parent, managing conservator,
or guardian of the child, except as provided by Chapter 159 (
Physician-Patient Communication), Occupations Code.
(d) Provides that registry information is not subject to
discovery, subpoena, or other means of legal compulsion for release to any
person or entity except as provided by this subchapter or admissible in
any civil, administrative, or criminal proceeding.
Sec. 161.0073. REPORT TO LEGISLATURE. Requires TDH to report to certain
officials by September 30 of each even-numbered year. Require TDH to use
the report required under Subsection (a) to develop ways to increase
immunization rates using state and federal resources. Requires the report
to include certain information.
Sec. 161.0074. IMMUNITY FROM LIABILITY. Provides that an insurance
company, HMO, or other organization that pays or reimburses a claim for
immunization, a healthcare provider who administers immunizations, and an
employee of TDH who acts in compliance with Section 161.007, 161.0071,
161.0072, 161.0073 and 161.008 is not civilly or criminally liable for
furnishing the information required under this subchapter, except as
provided by Section 161.009 ( Penalties for Disclosure of Information).
SECTION 3. Amends Section 161.008, Health and Safety Code, by amending
Subsections (c)-(d) and by adding Subsections (e)-(g), as follows:
(c) Authorizes TDH to obtain data constituting an immunization record for
the child from a public health district, local health department, an
insurance company, HMO, or any other organization that pays or reimburses
a claim for immunization, or any health care provider licensed or
otherwise authorized to administer vaccines. Makes a nonsubstantive
change.
(d) Requires the TDH, if it has not received a written request to exclude
the child from the registry within the 30th day after the date notice was
sent by the department to the child's parent, managing conservator, or
guarding under Section 161.007 to enter the child into the registry and
release the data constituting an immunization record for a child to any
entity in this state that is described by Subsection (c) and is providing
immunization services to the child or is paying or reimbursing a claim for
immunization for the child, to a school or child care facility in which a
child is enrolled, or to a state agency responsible for the health care
child.
(e) Reletters existing Subsection (d).
(f) Authorizes TDH to release nonidentifying summary statistics related
to the registry that do not individually identify a child.
(g) Prohibits TDH from releasing individually identifiable information
under Subsection (d) (2) to an entity outside of this state.
SECTION 4. Amends Section 161.009(a), Health and Safety Code, to make
conforming changes.
SECTION 5. Requires the Texas Board of Health, as soon as practicable or
by August 1, 2004, to adopt rules necessary to implement the procedure for
excluding children from the immunization registry required by this Act;
and make available for use a form for requesting exclusion from the
immunization registry required under Section 161.0071, Health and Safety
Code, as added by this Act. Prohibits the report required under Section
161.007(c), Health and Safety Code, as amended by this Act and the data
obtained or released under Section 161.008, Health and Safety Code, as
amended by this Act, from being accepted or released by the department
until TDH has adopted rules and prescribed forms required by this Act.
SECTION 6. Effective date: upon passage or September 1, 2003.