BILL ANALYSIS

 

 

 

C.S.H.B. 2382

By: Kolkhorst

Public Health

Committee Report (Substituted)

 

 

 

BACKGROUND AND PURPOSE

 

Currently, parental consent is required for a child to be included in ImmTrac, the immunization registry. Records in ImmTrac are automatically deleted when a child turns 18 years of age. However, there are many instances after a person's 18th birthday when proof of immunization is required, such as admission into college, entry into the military, and study or travel abroad.

 

C.S.H.B. 2382 authorizes a person to maintain an immunization record in ImmTrac beyond the person's 18th birthday.

RULEMAKING AUTHORITY

 

It is the committee's opinion that rulemaking authority is expressly granted to the executive commissioner of the Health and Human Services Commission in SECTION 2 of this bill.

ANALYSIS

 

Section 531.0055, Government Code, as amended by Chapter 198 (H.B. 2292), Acts of the 78th Legislature, Regular Session, 2003, expressly grants to the executive commissioner of the Health and Human Services Commission all rulemaking authority for the operation of and provision of services by the health and human services agencies. Similarly, Sections 1.16-1.29, Chapter 198 (H.B. 2292), Acts of the 78th Legislature, Regular Session, 2003, provide for the transfer of a power, duty, function, program, or activity from a health and human services agency abolished by that act to the corresponding legacy agency. To the extent practicable, this bill analysis is written to reflect any transfer of rulemaking authority and to update references as necessary to an agency's authority with respect to a particular health and human services program.

 

C.S.H.B. 2382 amends the Health and Safety Code to expand the immunization registry to allow information regarding an individual 18 years of age or older to be submitted and maintained by the registry. The bill authorizes an individual's legally authorized representative or the individual, after the individual has attained 18 years of age, to consent in writing or electronically for the individual's information to remain in the registry after the individual's 18th birthday and for the individual's subsequent immunizations to be included in the registry. The bill requires the consent of the minor's legally authorized representative to be submitted to the Department of State Health Services (DSHS) before the individual's 18th birthday and consent of an individual or the individual's legally authorized representative to be submitted not later than the individual's 19th birthday. The bill provides that the consent is valid until the individual or representative withdraws consent in writing or electronically. The bill prohibits DSHS from including in the registry information of an individual who is 18 years of age or older until written or electronic consent has been obtained. The bill requires DSHS to coordinate with the Texas Education Agency to distribute educational materials regarding the immunization registry to students and parents through local school districts.  The bill requires the executive commissioner of the Health and Human Services Commission to develop guidelines and procedures by rule for obtaining consent from an individual after the individual's 18th birthday, including procedures for retaining immunization information in a separate database that is inaccessible by any person other than DSHS during the one-year period during which an 18-year-old may consent to continued inclusion in the registry.   

 

C.S.H.B. 2382 authorizes an insurance company, a health maintenance organization, or another organization that pays a health care provider to provide health care benefits that receives data elements from a  provider who administers an immunization to an individual 18 years of age or older to submit the data elements to DSHS. The bill authorizes a health care provider who administers an immunization to an individual 18 years of age or older to submit data elements regarding an immunization to DSHS. The bill makes conforming changes relating to an immunization schedule for individuals 18 years of age or older that is analogous to the immunization schedule for children for purposes of providing notice regarding an overdue or past due immunization, procedures for reporting a violation if an individual's information is included in the registry when consent has been withdrawn, excluding an individual from the registry on withdrawal of consent, and the definition of "payor."

 

C.S.H.B. 2382 adds to DSHS duties relating to immunization education and the development of educational information for health care providers, health care clinics, hospitals, and any other health care facility that provides health care to children 14 to 18 years of age relating to the immunization registry and the option for an individual who is 18 years of age or older to consent to submission and retention of the individual's information in the immunization registry. 

 

C.S.H.B. 2382 defines "individual's legally authorized representative" to mean a parent, managing conservator, or guardian of an individual, if the individual is a minor; a guardian of the individual, if the individual has been adjudicated incompetent to manage the individual's personal affairs; or an agent of the individual authorized under a durable power of attorney for health care. The bill defines "electronically," as related to a communication, to mean by electronic mail, text message, online communication, or other electronic method of communication approved by DSHS. The bill makes conforming changes.     

EFFECTIVE DATE

 

September 1, 2009.

COMPARISON OF ORIGINAL AND SUBSTITUTE

 

C.S.H.B. 2382 differs from the original by authorizing an individual or an individual's legally authorized representative to consent in writing or electronically for the individual's information to remain in the immunization registry after the individual has reached the age of 18 rather than requiring DSHS to notify an individual whose information is in the registry and the individual's legally authorized representative 30 days before the individual's 18th birthday about the option to consent to remain in the registry. The substitute differs from the original by making a conforming change relating to the requirement that consent of a minor's legally authorized representative be submitted before the individual's 18th birthday. The substitute adds a requirement not in the original requiring an individual or the individual's legally authorized representative to submit consent to remain in the immunization registry not later than the individual's 19th birthday. The substitute omits the 30-day time limit for an individual's submission of consent following the individual's 18th birthday. The substitute includes a prohibition not in the original prohibiting DSHS from including in the registry information relating to an individual who is 18 years of age or older until consent has been obtained. The substitute differs from the original by requiring DSHS to coordinate with the Texas Education Agency to distribute materials relating to the immunization registry through local school districts.

 

C.S.H.B. 2382 differs from the original by including a requirement requiring rules to be adopted by the executive commissioner regarding consent to include procedures for retaining immunization information from an individual after the individual's 18th birthday in a separate database that is inaccessible by any person other than DSHS, while the original did not set forth such a specification. The substitute adds a provision not included in the original relating to the development of educational information regarding the immunization registry. The substitute omits conforming changes made by the original relating to the 30-day consent period and includes conforming changes not made by the original relating to electronic consent. The substitute adds a definition of "electronically" not included in the original.