78R6865 MCK-F
By: Coleman H.B. No. 1556
A BILL TO BE ENTITLED
AN ACT
relating to the immunization registry.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 161.007, Health and Safety Code, is
amended to read as follows:
Sec. 161.007. IMMUNIZATION REGISTRY; REPORTS TO
DEPARTMENT. (a) The department, for purposes of establishing and
maintaining a single repository of accurate, complete, and current
immunization records to be used in aiding, coordinating, and
promoting efficient and cost-effective childhood communicable
disease prevention and control efforts, shall establish and
maintain a childhood immunization registry. The department by rule
shall develop guidelines to:
(1) protect the confidentiality of patients in
accordance with Section 159.002, Occupations Code;
(2) inform a parent, managing conservator, or guardian
of each patient about the registry; and
(3) permit [require the written consent of] a parent,
managing conservator, or guardian of a patient to choose to have the
patient excluded from [before any information relating to the
patient is included in] the registry[; and
[(4) permit a parent, managing conservator, or
guardian to withdraw consent for the patient to be included in the
registry].
(b) Except as provided by Section 161.0071, the [The]
childhood immunization registry must contain information on the
immunization history that is obtained by the department under this
section of each person who is younger than 18 years of age [and for
whom consent has been obtained in accordance with guidelines
adopted under Subsection (a). The department shall remove from the
registry information for any person for whom consent has been
withdrawn].
(c) An insurance company, a health maintenance
organization, or another organization that pays or reimburses a
claim for an immunization of a person younger than 18 years of age
shall provide an immunization history to the department. The
report shall be in a format prescribed by the department, which may
include submission in writing, by electronic format, or by voice.
An insurance company, health maintenance organization, or other
organization is not required to provide an immunization history to
the department under this subsection for a person excluded from the
registry. The department shall consult with entities required to
report under this section to determine the most efficient and
cost-effective manner of reporting immunization histories [for
whom consent has not been obtained in accordance with guidelines
adopted under Subsection (a) or for whom consent has been
withdrawn].
(d) A health care provider, including an emergency medical
services provider, who administers an immunization to a person
younger than 18 years of age shall provide an immunization history
to the department unless the immunization history is submitted to
an insurance company, a health maintenance organization, or another
organization that pays or reimburses a claim for an immunization to
a person younger than 18 years of age. The report shall be in a
format prescribed by the department, which may include submission
in writing, by electronic means, or by voice. A health care
provider, including an emergency medical services provider, is not
required to provide an immunization history to the department under
this subsection for a person excluded from the registry. The
department shall consult with health care providers, including
emergency medical services providers, to determine the most
efficient and cost-effective manner of reporting immunization
histories [for whom consent has not been obtained in accordance
with guidelines adopted under Subsection (a) or for whom consent
has been withdrawn].
(e) The department may use the registry to provide notices
by mail, telephone, personal contact, or other means to a parent,
managing conservator, or guardian regarding his or her child or
ward who is due or overdue for a particular type of immunization
according to the department's immunization schedule. The notice
must 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 records. The notice must describe the procedure to
report a violation if a child is included in the registry after
requesting exclusion. The department shall consult with health
care providers, including emergency medical services providers, to
determine the most efficient and cost-effective manner of using the
registry to provide those notices.
(f) Nothing in this subchapter [section] diminishes a
parent's, managing conservator's, or guardian's responsibility for
having a child immunized properly, subject to Section 161.004(d).
(g) A person, including a health care provider, an emergency
medical services provider, a health maintenance organization, or an
insurance company, who submits or obtains in good faith an
immunization history or data to or from the department in
compliance with the provisions of this subchapter [section] and any
rules adopted under this subchapter [section] is not liable for any
civil damages.
(h) [Information obtained by the department for the
immunization registry is confidential and may be disclosed only
with the written consent of the child's parent, managing
conservator, or guardian.
[(i)] The board shall adopt rules to implement this
subchapter [section].
SECTION 2. Subchapter A, Chapter 161, Health and Safety
Code, is amended by adding Section 161.0071 to read as follows:
Sec. 161.0071. NOTICE OF RECEIPT OF REGISTRY DATA;
EXCLUSION FROM REGISTRY. (a) The first time the department
receives registry data for a child, the department shall send a
written notification to the child's parent, managing conservator,
or guardian disclosing:
(1) that providers and insurers may be sending the
child's immunization information to the department, but the
department may not keep the information if the parent, managing
conservator, or guardian chooses to exclude the child from the
registry;
(2) the information that is included in the registry;
(3) the persons to whom the information may be
released under Section 161.008(d);
(4) the purpose and use of the registry;
(5) the procedure to exclude a child from the
registry; and
(6) the procedure to report a violation if a parent,
managing conservator, or guardian discovers a child is included in
the registry after exclusion has been requested.
(b) The department shall delete the child's immunization
records from the registry and any other registry-related department
record that individually identifies the child, not later than the
30th day after the date the department receives from the parent,
managing conservator, or guardian of the child a written request
that the child be excluded from the registry. The department shall
maintain only those records related to the child necessary to
ensure that the child continues to be excluded from the registry.
(c) The department shall send to a parent, managing
conservator, or guardian who makes a written request under
Subsection (b) a written confirmation of receipt of the request for
exclusion and the exclusion of the child's records from the
registry.
(d) The department commits a violation if the department
fails to exclude a child from the registry within the period
required by Subsection (b).
(e) A parent, managing conservator, or guardian may request
that the birth certificate of a child be excluded from the registry.
(f) The department shall accept any written indication from
a parent, managing conservator, or guardian communicating to the
department that a child should be excluded from the registry,
including a statement on the child's birth certificate, as a
request for exclusion under Subsection (b).
SECTION 3. Subchapter A, Chapter 161, Health and Safety
Code, is amended by adding Section 161.0072 to read as follows:
Sec. 161.0072. REGISTRY CONFIDENTIALITY. (a) The
information that individually identifies a child received by the
department for the immunization registry is confidential and may be
used by the department for registry purposes only.
(b) Unless specifically authorized under this subchapter,
the department may not release registry information to any
individual or entity without the consent of the person, or if a
minor, the parent, managing conservator, or guardian of the child.
(c) A person required to report information to the
department for registry purposes or authorized to receive
information from the registry may not disclose the individually
identifiable information to any other person without written
consent of the parent, managing conservator, or guardian of the
child, except as provided by Chapter 159, Occupations Code.
(d) Registry information is not:
(1) subject to discovery, subpoena, or other means of
legal compulsion for release to any person or entity except as
provided by this subchapter; or
(2) admissible in any civil, administrative, or
criminal proceeding.
SECTION 4. Subchapter A, Chapter 161, Health and Safety
Code, is amended by adding Section 161.0075 to read as follows:
Sec. 161.0075. REPORT TO LEGISLATURE. (a) The department
shall report to the Legislative Budget Board, the governor, the
lieutenant governor, the speaker of the house of representatives,
and appropriate committees of the legislature not later than
December 1 of each even-numbered year.
(b) The department shall use the report required under
Subsection (a) to develop ways to increase immunization rates using
state and federal resources.
(c) The report must:
(1) include the current immunization rates by
geographic region of the state, where available;
(2) focus on the geographic regions of the state with
immunization rates below the state average for preschool children;
(3) describe the approaches identified to increase
immunization rates in underserved areas and the estimated cost for
each;
(4) identify changes to department procedures needed
to increase immunization rates;
(5) identify the services provided under and
provisions of contracts entered into by the department to increase
immunization rates in underserved areas;
(6) identify performance measures used in contracts
described by Subdivision (5);
(7) include the number of complaints received by the
department related to the department's failure to comply with
requests for exclusion of individuals from the registry; and
(8) identify all reported incidents of discrimination
for requesting exclusion from the registry.
SECTION 5. Section 161.008, Health and Safety Code, is
amended by amending Subsections (c) and (d) and adding Subsections
(e)-(h) to read as follows:
(c) The department[, only with the consent of a child's
parent, managing conservator, or guardian,] may[:
[(1)] obtain the data constituting an immunization
record for the child from a public health district, a local health
department, an insurance company, a health maintenance
organization, or any other organization that pays or reimburses a
claim for immunization, or any physician, health care professional,
emergency medical services provider, or health care facility
personnel licensed or otherwise authorized to administer vaccines.
(d) After the 30th day after the date notice was sent by the
department to the child's parent, managing conservator, or guardian
under Section 161.0071, the department, if the department has not
received a written request to exclude the child from the registry,
may:
(1) enter the child into the registry; and [or a
physician to the child; or]
(2) release the data constituting an immunization
record for the child to any entity in this state that is described
by Subsection (c) and is providing immunization services to the
child or to [a public health district, a local health department, a
physician to the child, or] a school or child care facility in which
the child is enrolled.
(e) [(d)] A parent, managing conservator, or legal guardian
may obtain and on request to the department shall be provided with
all individually identifiable immunization registry information
concerning his or her child or ward.
(f) The department may release nonidentifying summary
statistics related to the registry that do not individually
identify a child.
(g) The department may develop a secure Internet-based
system by which a school or child care facility may verify a child's
immunization record for immunizations required by Sections 38.001
and 51.933, Education Code.
(h) The department may share with other state health
departments information relating to the registry that does not
individually identify any child.
SECTION 6. 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, may not be accepted or released by the Texas
Department of Health until the department has adopted rules and
prescribed the forms required by this Act.
SECTION 7. This Act takes effect immediately if it receives
a vote of two-thirds of all the members elected to each house, as
provided by Section 39, Article III, Texas Constitution. If this
Act does not receive the vote necessary for immediate effect, this
Act takes effect September 1, 2003.