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A BILL TO BE ENTITLED
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AN ACT
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relating to the Texas Immunization and Screening Registry. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subtitle H, Title 2, Health and Safety Code, is |
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amended by adding Chapter 179 to read as follows: |
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CHAPTER 179. IMMUNIZATION AND SCREENING REGISTRY |
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SUBCHAPTER A. GENERAL PROVISIONS |
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Sec. 179.001. DEFINITIONS. In this chapter: |
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(1) "Department" means the Texas Department of State |
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Health Services. |
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(2) "Executive commissioner" means the executive |
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commissioner of the Health and Human Services Commission. |
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(3) "Payor" means an insurance company, a health |
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maintenance organization, or another organization that pays a |
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health care provider to provide health care benefits, including |
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providing immunizations or screening tests to a person younger than |
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18 years of age. |
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(4) "Screening test" means a rapid analytical |
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procedure to determine the need for further diagnostic evaluation. |
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SECTION 2. Sections 161.007, 161.0071, 161.0072, 161.0073, |
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161.0074, 161.0075, 161.0076, 161.008, 161.009, and 161.0105, |
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Health and Safety Code, are transferred to Chapter 179, Health and |
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Safety Code, as added by this Act, designated as Subchapter B, and |
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amended, and Subchapter B is amended by adding Sections 179.052, |
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179.053, 179.0601, and 179.063, to read as follows: |
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SUBCHAPTER B. IMMUNIZATION AND SCREENING REGISTRY |
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Sec. 179.051 [161.007]. IMMUNIZATION AND SCREENING |
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REGISTRY; REPORTS TO DEPARTMENT. (a) The department, for purposes |
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of establishing and maintaining a single repository of accurate, |
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complete, and current immunization and early childhood disease |
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screening records to be used in aiding, coordinating, and promoting |
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efficient and cost-effective childhood [communicable] disease |
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prevention and control efforts, shall establish and maintain a |
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childhood immunization and screening registry. The department by |
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rule shall develop guidelines to: |
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(1) protect the confidentiality of patients in |
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accordance with Section 159.002, Occupations Code; |
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(2) inform a parent, managing conservator, or guardian |
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of each patient about the registry; |
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(3) require the written consent of a parent, managing |
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conservator, or guardian of a patient before any information |
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relating to the patient is included in the registry; and |
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(4) permit a parent, managing conservator, or guardian |
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to withdraw consent for the patient to be included in the registry. |
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(a-1) The written consent required by Subsection (a)(3) is |
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required to be obtained only one time. The written consent is valid |
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until the child becomes 18 years of age unless the consent is |
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withdrawn in writing. A parent, managing conservator, or guardian |
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of a child may provide the written consent by using an electronic |
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signature on the child's birth certificate. |
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(b) The childhood immunization and screening registry must |
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contain information on the immunization and screening history that |
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is obtained by the department under this section of each person who |
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is younger than 18 years of age and for whom consent has been |
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obtained in accordance with guidelines adopted under Subsection |
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(a). The department shall remove from the registry information for |
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any person for whom consent has been withdrawn. The department may |
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not retain individually identifiable information about any person |
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for whom consent has been withdrawn. |
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(c) A payor that receives immunization or screening |
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information under Section 179.052 [data elements] from a health |
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care provider who administers an immunization to or performs a |
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screening test on a person younger than 18 years of age shall |
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provide the information [data elements] to the department. A payor |
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is required to provide the department with only the information |
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[data elements] the payor receives from a health care provider. The |
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information [data elements] shall be submitted in a format |
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prescribed by the department. The department shall verify consent |
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before including the reported information in the immunization and |
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screening registry. The department may not retain individually |
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identifiable information about a person for whom consent cannot be |
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verified. |
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(d) A health care provider who administers an immunization |
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to or performs a screening test on a person younger than 18 years of |
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age shall provide the information required by Section 179.052 [data
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elements regarding an immunization] to the department. The |
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information [data elements] shall be submitted in a format |
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prescribed by the department. The department shall verify consent |
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before including the information in the immunization and screening |
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registry. The department may not retain individually identifiable |
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information about a person for whom consent cannot be verified. |
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(e) The department shall provide notice to a health care |
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provider that submits [an] immunization and screening information |
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[history] for a person for whom consent cannot be verified. The |
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notice shall contain instructions for obtaining consent in |
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accordance with guidelines adopted under Subsection (a) and |
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resubmitting the immunization and screening information [history] |
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to the department. |
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(f) The department and health care providers may use the |
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registry to provide notices by mail, telephone, personal contact, |
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or other means to a parent, managing conservator, or guardian |
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regarding his or her child or ward who is due or overdue for a |
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particular type of immunization according to the department's |
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immunization schedule or who is due or overdue for a particular |
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screening test according to the department's screening schedule or |
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in the opinion of the child's health care provider. The department |
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shall consult with health care providers to determine the most |
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efficient and cost-effective manner of using the registry to |
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provide those notices. |
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(g) The department shall provide instruction and education |
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to providers about the immunization and screening registry provider |
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application and enrollment process. The department shall: |
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(1) initially target providers in the geographic |
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regions of the state with immunization or screening rates below the |
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state average for preschool children; and |
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(2) expedite the processing of provider applications. |
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(h) Nothing in this section diminishes a parent's, managing |
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conservator's, or guardian's responsibility for having a child |
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immunized or screened properly, subject to Section 161.004(d). |
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(i) A person, including a health care provider, a payor, or |
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an employee of the department who submits or obtains in good faith |
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immunization and screening information [data elements] to or from |
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the department in compliance with the provisions of this section |
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and any rules adopted under this section is not liable for any civil |
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damages. |
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(j) Except as provided by Section 179.0601 [161.008], |
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information obtained by the department for the immunization and |
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screening registry is confidential and may be disclosed only with |
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the written consent of the child's parent, managing conservator, or |
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guardian. |
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(k) The executive commissioner [board] shall adopt rules to |
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implement this section. |
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Sec. 179.052. REQUIRED INFORMATION. For the purposes of |
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the registry, the department shall collect: |
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(1) for a vaccine, all the information a health care |
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provider is required to record in a medical record under 42 U.S.C. |
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Section 300aa-25, including but not limited to: |
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(A) the date the vaccine was administered; |
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(B) the vaccine manufacturer and lot number of |
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the vaccine; |
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(C) the name, the address, and if appropriate, |
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the title of the health care provider administering the vaccine; |
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and |
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(D) any adverse or unexpected events for any |
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vaccine; and |
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(2) for a screening test, only: |
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(A) the date the test was performed; |
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(B) the results of the test; |
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(C) the name, the address, and if appropriate, |
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the title of the health care provider administering the test; and |
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(D) the name and address of the laboratory |
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performing the test. |
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Sec. 179.053. TYPES OF SCREENINGS INCLUDED. (a) The |
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department shall include the results from the following screening |
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tests in the immunization and screening registry: |
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(1) a screening test required under Chapter 33; |
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(2) a hearing screening test required by Chapter 47; |
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(3) an asthma screening test; |
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(4) a blood lead test under Section 88.0025; and |
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(5) a screening test for exposure to varicella. |
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(b) The department may add to or delete from the list under |
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Subsection (a) as it considers necessary. |
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Sec. 179.054 [161.0071]. NOTICE OF RECEIPT OF REGISTRY |
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INFORMATION [DATA]; EXCLUSION FROM REGISTRY. (a) The first time |
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the department receives registry information [data] for a child for |
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whom the department has received consent to be included in the |
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registry, from a person other than the child's parent, managing |
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conservator, or guardian, the department shall send a written |
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notice to the child's parent, managing conservator, or guardian |
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disclosing: |
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(1) that providers and payors may be sending the |
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child's immunization and screening information to the department; |
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(2) the information that is included in the registry; |
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(3) the persons to whom the information may be |
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released under Section 179.0601(a) [161.008(d)]; |
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(4) the purpose and use of the registry; |
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(5) the procedure to exclude a child from the |
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registry; and |
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(6) the procedure to report a violation if a parent, |
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managing conservator, or guardian discovers a child is included in |
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the registry after exclusion has been requested. |
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(b) On discovering that consent to be included in the |
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registry has not been granted, the department shall exclude the |
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child's immunization and screening records from the registry and |
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any other registry-related department record that individually |
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identifies the child. |
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(c) On receipt of a written request to exclude a child's |
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immunization and screening records from the registry, the |
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department shall send to a parent, managing conservator, or |
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guardian who makes the request a written confirmation of receipt of |
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the request for exclusion and shall exclude the child's records |
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from the registry. |
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(d) The department commits a violation if the department |
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fails to exclude a child's immunization and screening information |
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from the registry as required by Subsection (b) or (c). |
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(e) The department shall accept a written statement from a |
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parent, managing conservator, or guardian communicating to the |
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department that a child should be excluded from the registry, |
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including a statement on the child's birth certificate, as a |
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request for exclusion under Subsection (c). The written statement |
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may include the electronic signature on the child's birth |
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certificate. |
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Sec. 179.055 [161.0072]. PROVIDING IMMUNIZATION AND |
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SCREENING INFORMATION TO DEPARTMENT. (a) If the parent, managing |
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conservator, or guardian of a child has reasonable concern that the |
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child's health care provider is not submitting the immunization and |
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screening history to the department and the parent, managing |
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conservator, or guardian wants the child included in the registry, |
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the parent, managing conservator, or guardian may provide the |
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child's immunization and screening history directly to the |
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department to be included in the immunization and screening |
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registry. |
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(b) The parent, managing conservator, or guardian of a child |
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may send evidence of the child's immunization and screening history |
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to the department by facsimile transmission or by mail. The |
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evidence may include a copy of: |
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(1) the child's medical record indicating the |
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immunization history and screening reports; |
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(2) an invoice from a health care provider for the |
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immunization or screening; or |
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(3) documentation showing that a claim for the |
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immunization or screening was paid by a payor. |
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(c) The executive commissioner [board] shall develop rules |
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to ensure that the immunization and screening history submitted by |
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a parent, managing conservator, or guardian is medically verified |
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immunization and screening information. |
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Sec. 179.056 [161.0073]. REGISTRY CONFIDENTIALITY. (a) |
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The information that individually identifies a child received by |
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the department for the immunization and screening registry is |
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confidential and may be used by the department for registry |
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purposes only. |
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(b) Unless specifically authorized under this subchapter, |
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the department may not release registry information to any |
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individual or entity without the consent of the person or, if a |
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minor, the parent, managing conservator, or guardian of the child. |
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(c) A person required to report information to the |
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department for registry purposes or authorized to receive |
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information from the registry may not disclose the individually |
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identifiable information to any other person without written |
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consent of the parent, managing conservator, or guardian of the |
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child, except as provided by Chapter 159, Occupations Code, or |
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Section 602.053, Insurance Code. |
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(d) Registry information is not: |
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(1) subject to discovery, subpoena, or other means of |
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legal compulsion for release to any person or entity except as |
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provided by this subchapter; or |
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(2) admissible in any civil, administrative, or |
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criminal proceeding. |
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Sec. 179.057 [161.0074]. REPORT TO LEGISLATURE. (a) The |
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department shall report to the Legislative Budget Board, the |
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governor, the lieutenant governor, the speaker of the house of |
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representatives, and appropriate committees of the legislature not |
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later than September 30 of each even-numbered year. |
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(b) The department shall use the report required under |
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Subsection (a) to develop ways to increase immunization and |
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screening rates using state and federal resources. |
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(c) The report must: |
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(1) include the current immunization and screening |
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rates by geographic region of the state, where available; |
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(2) focus on the geographic regions of the state with |
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immunization and screening rates below the state average for |
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preschool children; |
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(3) describe the approaches identified to increase |
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immunization rates in underserved areas and the estimated cost for |
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each; |
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(4) identify changes to department procedures needed |
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to increase immunization and screening rates; |
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(5) identify the services provided under and |
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provisions of contracts entered into by the department to increase |
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immunization and screening rates in underserved areas; |
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(6) identify performance measures used in contracts |
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described by Subdivision (5); |
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(7) include the number and type of exemptions used in |
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the past year; |
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(8) include the number of complaints received by the |
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department related to the department's failure to comply with |
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requests for exclusion of individuals from the registry; |
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(9) identify all reported incidents of discrimination |
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for requesting exclusion from the registry or for using an |
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exemption for a required immunization; |
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(10) include department recommendations about the |
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best way to use, and communicate with, local registries in the |
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state; and |
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(11) include ways to increase provider participation |
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in the registry. |
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Sec. 179.058 [161.0075]. IMMUNITY FROM LIABILITY. Except as |
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provided by Section 179.061 [161.009], the following persons |
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subject to this subchapter that act in compliance with Sections |
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179.051, 179.054, 179.056, 179.057, 179.060 [161.007, 161.0071,
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161.0073, 161.0074], and 179.0601 [161.008] are not civilly or |
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criminally liable for furnishing the information required under |
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this subchapter: |
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(1) a payor; |
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(2) a health care provider who administers |
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immunizations or screening tests; and |
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(3) an employee of the department. |
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Sec. 179.059 [161.0076]. COMPLIANCE WITH FEDERAL LAW. If |
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the provisions of this subchapter [chapter] relating to the use or |
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disclosure of information in the registry are more stringent than |
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the Health Insurance Portability and Accountability Act and Privacy |
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Standards, as defined by Section 181.001, then the use or |
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disclosure of information in the registry is governed by this |
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subchapter [chapter]. |
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Sec. 179.060 [161.008]. IMMUNIZATION RECORD. (a) An |
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immunization record is part of the immunization registry. |
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(b) An immunization record contains the: |
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(1) name and date of birth of the person immunized; |
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(2) dates of immunization; |
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(3) types of immunization administered; and |
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(4) name and address of the health care provider |
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administering the immunization. |
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(c) The department may obtain the data constituting an |
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immunization record for a child from a public health district, a |
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local health department, the child's parent, managing conservator, |
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or guardian, a physician to the child, a payor, or any health care |
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provider licensed or otherwise authorized to administer vaccines. |
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The department shall verify consent before including the reported |
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information in the immunization and screening registry. The |
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department may not retain individually identifiable information |
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about a person for whom consent cannot be verified. |
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(d) The executive commissioner shall adopt rules to |
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implement this section. |
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Sec. 179.0601. RELEASE OF CERTAIN INFORMATION BY |
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DEPARTMENT. (a) [(d)] The department may release the information |
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[data] constituting an immunization record for the child to any |
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entity that is described by Section 179.060(c) and [Subsection
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(c),] to a school or child care facility in which the child is |
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enrolled, and may release that information and any information |
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described by Section 179.052(2) concerning a screening test [or] to |
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a state agency having legal custody of the child. |
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(b) [(e)] A parent, managing conservator, or legal guardian |
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may obtain and on request to the department shall be provided with |
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all individually identifiable immunization and screening registry |
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information concerning his or her child or ward. |
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(c) [(f)] A person, including a health care provider, a |
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payor, or an employee of the department, that submits in good faith |
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[an] immunization or screening information [history or data] to or |
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obtains in good faith [an] immunization and screening information |
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[history or data] from the department in compliance with the |
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provisions of Section 179.060 and this section and any rules |
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adopted under Section 179.060 and this section is not liable for any |
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civil damages. |
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(d) [(g)] The department may release nonidentifying summary |
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statistics related to the registry that do not individually |
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identify a child. |
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(e) [(h)] The executive commissioner [board] shall adopt |
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rules to implement this section. |
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Sec. 179.061 [161.009]. PENALTIES FOR DISCLOSURE OF |
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INFORMATION. (a) A person commits an offense if the person: |
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(1) negligently releases or discloses immunization |
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and screening registry information in violation of Section |
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179.051, 179.054, 179.056, 179.060, or 179.0601 [161.007,
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161.0071, 161.0073, or 161.008]; |
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(2) fails to exclude a child's immunization or |
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screening information in violation of Section 179.051 [161.0071]; |
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or |
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(3) negligently uses information in the immunization |
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and screening registry to solicit new patients or clients or for |
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other purposes that are not associated with immunization, |
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screening, or quality-of-care purposes, unless authorized under |
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this section. |
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(b) An offense under this section is a Class A misdemeanor. |
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Sec. 179.062 [161.0105]. LIMITATION ON LIABILITY. (a) A |
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health care provider who acts in compliance with Sections 179.051 |
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[161.007] and 179.060 [161.008] and any rules adopted under those |
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sections is not civilly or criminally liable for furnishing the |
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information required under those sections. This subsection does |
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not apply to criminal liability established under Section 179.061 |
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[161.009]. |
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(b) A person who administers a vaccination or performs a |
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screening test under a department program may be held liable only to |
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the extent the person would be liable if the person administered the |
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vaccination or performed the screening test outside the program. |
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The person is not liable for damages arising from the acts or |
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omissions of another person acting under the program or the |
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department. |
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(c) The immunity created by this section is in addition to |
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any immunity created by Sections 161.001 and 179.051(i) |
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[161.007(g)]. |
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Sec. 179.063. RULES. The executive commissioner shall |
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adopt rules necessary to carry out the registry. |
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SECTION 3. Section 161.0001(1), Health and Safety Code, is |
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repealed. |
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SECTION 4. This Act takes effect immediately if it receives |
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a vote of two-thirds of all the members elected to each house, as |
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provided by Section 39, Article III, Texas Constitution. If this |
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Act does not receive the vote necessary for immediate effect, this |
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Act takes effect September 1, 2007. |