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By: Zaffirini S.B. No. 39
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 registrants in
accordance with state and federal law [patients in accordance with
Section 159.002, Occupations Code];
(2) inform a parent, managing conservator, or guardian
of each registrant [patient] about the registry; and
(3) permit [require] the written consent of a parent,
managing conservator, or guardian of a registrant to choose in
writing to have the registrant excluded from [patient 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withdrawn].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 contain the elements prescribed by the department.
The report may be submitted in writing or by electronic means [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 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 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 contain the elements [be in a format] prescribed by
the department. The report may be submitted[, which may include
submission] in writing or[,] by electronic means[, or by voice]. [A
health care provider is not required to provide an immunization
history to the department under this subsection for a person 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 record that individually identifies the child.
The notice must describe the procedure to report a violation if a
child is included in the registry after the submission of a written
request for exclusion. The department shall consult with health
care 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 or an
insurance company, a health maintenance organization, or another
organization that pays or reimburses a claim for immunization, 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 Sections 161.0071, 161.0072, 161.0073,
and 161.0074 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 and
may not release the identity of a child 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) The department shall accept a written statement 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).
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.
Sec. 161.0073. 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
September 30 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 and type of exemptions used in
the past year;
(8) 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
(9) identify all reported incidents of discrimination
for requesting exclusion from the registry or for using an
exemption for a required immunization.
Sec. 161.0074. IMMUNITY FROM LIABILITY. Except as provided
by Section 161.009, the following persons subject to this
subchapter that act in compliance with Sections 161.007, 161.0071,
161.0072, 161.0073, and 161.008 are not civilly or criminally
liable for furnishing the information required under this
subchapter:
(1) an insurance company, a health maintenance
organization, or another organization that pays or reimburses a
claim for immunization;
(2) a health care provider who administers
immunizations; and
(3) an employee of the department.
SECTION 3. Section 161.008, Health and Safety Code, is
amended by amending Subsections (c) and (d) and adding Subsections
(e)-(g) 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 health care provider 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,
shall:
(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 is paying or reimbursing a claim for an immunization for
the child, 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, or to a state agency responsible for
the health care of the child.
(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 not release individually
identifiable information under Subsection (d)(2) to an entity
outside of this state.
SECTION 4. Section 161.009(a), Health and Safety Code, is
amended to read as follows:
(a) A person commits an offense if the person:
(1) negligently releases or discloses immunization
registry information in violation of Section 161.007, 161.0071,
161.0072, or 161.008; or
(2) negligently uses the information in the
immunization registry to solicit new patients or clients or for
other purposes that are not associated with immunization purposes,
unless authorized under this section.
SECTION 5. (a) As soon as practicable, but not later than
August 1, 2004, the Texas Board of Health shall:
(1) adopt rules necessary to implement the procedure
for excluding children from the immunization registry required by
this Act; and
(2) 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.
(b) 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 6. 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.