82R1298 YDB-F

By: Zaffirini S.B. No. 56

A BILL TO BE ENTITLED

AN ACT

relating to the inclusion and exclusion of certain information as part of the immunization registry.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Sections 161.007(a), (b), (b-1), (c), (d), (e), and (f), Health and Safety Code, are amended to read as follows:

(a) The department, for the primary purpose 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 communicable disease prevention and control efforts, shall establish and maintain an immunization registry. The executive commissioner of the Health and Human Services Commission by rule shall develop guidelines to:

(1) protect the confidentiality of patients in accordance with Section 159.002, Occupations Code;

(2) inform the individual or the individual's legally authorized representative about the registry and that registry information may be released under Section 161.00735;

(3) for an individual younger than 18 years of age, permit [require the written or electronic consent of the individual or] the individual's legally authorized representative to have the individual excluded from [before any information relating to the individual is included in] the registry; and

(4) for an individual 18 years of age or older:

(A) require the consent of the individual or the individual's legally authorized representative for continued inclusion in the registry;

(B) permit the individual or the individual's legally authorized representative to withdraw consent for the individual to be included in the registry; and

(C) [(5)] determine the process by which consent is verified before the inclusion of any individually identifiable information in the registry[, including affirmation by a health care provider, birth registrar, regional health information exchange, or local immunization registry that consent has been obtained].

(b) Except as provided by Section 161.0071, the immunization registry must contain information on the immunization history that is obtained by the department under:

(1) this section of each individual:

(A) younger than 18 years of age for whom exclusion from the registry has not been requested; and

(B) 18 years of age or older for whom consent to remain in the registry has been obtained in accordance with guidelines adopted under Subsection [(a) or] (a-3)[, as applicable];

(2) Section 161.00705 of persons immunized to prepare for or in response to a declared disaster, public health emergency, terrorist attack, hostile military or paramilitary action, or extraordinary law enforcement emergency;

(3) Section 161.00706 of first responders or their immediate family members; and

(4) Section 161.00735 of persons evacuated or relocated to this state because of a disaster.

(b-1) [The department shall remove from the registry information for any individual for whom consent has been withdrawn.] The department may not retain and must remove from the registry individually identifiable information about any individual:

(1) younger than 18 years of age for whom a request to be excluded from the registry has been received under this section;

(2) 18 years of age or older for whom consent to remain in the registry has not been received, has been withdrawn, or cannot be verified;

(3) [(2)] for whom a consent for continued inclusion in the registry following the end of the declared disaster, public health emergency, terrorist attack, hostile military or paramilitary action, or extraordinary law enforcement emergency has not been received under Section 161.00705(f);

(4) [(3)] for whom a request to be removed from the registry has been received under Section 161.00706(e);

(5) [(4)] for whom consent for continued inclusion in the registry following the end of a disaster has not been received under Section 161.00735(f); or

(6) [(5)] for whom a request to remove information from the registry has been received under Section 161.00735(g).

(c) A payor that receives data elements from a health care provider who administers an immunization to an individual younger than 18 years of age shall provide the data elements to the department. A payor is required to provide the department with only the data elements the payor receives from a health care provider. A payor that receives data elements from a health care provider who administers an immunization to an individual 18 years of age or older may provide the data elements to the department. The data elements shall be submitted in a format prescribed by the department. The department shall verify consent to remain in the registry for an individual 18 years of age or older before including the reported information in the immunization registry. [The department may not retain individually identifiable information about an individual for whom consent cannot be verified.]

(d) A health care provider who administers an immunization to an individual younger than 18 years of age shall provide data elements regarding an immunization to the department. A health care provider who administers an immunization to an individual 18 years of age or older may submit data elements regarding an immunization to the department. The data elements shall be submitted in a format prescribed by the department. [The department shall verify consent before including the information in the immunization registry. The department may not retain individually identifiable information about an individual for whom consent cannot be verified.]

(e) The department shall provide notice to a health care provider that submits an immunization history for an individual 18 years of age or older for whom consent cannot be verified. The notice shall contain instructions for the individual to [obtaining] consent in accordance with guidelines adopted under Subsections (a) and (a-3) and for the health care provider to resubmit [resubmitting] the immunization history to the department.

(f) The department and health care providers may use the registry to provide notices by mail, telephone, personal contact, or other means to an individual or the individual's legally authorized representative regarding an individual who is due or overdue for a particular type of immunization according to the department's immunization schedule for children or another analogous schedule recognized by the department for individuals 18 years of age or older. The notice must contain instructions for the legally authorized representative of an individual younger than 18 years of age to request that future notices not be sent and to remove the individual's immunization record from the registry and any registry-related records. The notice must describe the procedure to report a violation if the individual's immunization record is included in the registry after requesting 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.

SECTION 2. Sections 161.0071(a) and (b), Health and Safety Code, are amended to read as follows:

(a) The first time the department receives registry data for an individual who is younger than 18 years of age or for whom the department has received consent to remain [be included] in the registry, the department shall send notice to the individual or the individual's legally authorized representative disclosing:

(1) that providers and payors may be sending the individual's immunization information to the department, but the department may not keep the information if the individual's legally authorized representative chooses to exclude the individual from the registry or, for an individual 18 years of age or older, the individual or the individual's legally authorized representative withdraws consent to remain in the registry;

(2) the information that is included in the registry;

(3) the persons to whom the information may be released under Sections 161.00735(b) and 161.008(d);

(4) the purpose and use of the registry;

(5) the procedure to exclude an individual from the registry; and

(6) the procedure to report a violation if an individual's information is included in the registry after exclusion has been requested [or consent has been withdrawn].

(b) On receipt of a written or electronic request to exclude an individual's immunization records from or on discovering that consent for an individual 18 years of age or older to remain [be included] in the registry has not been granted or has been withdrawn, the department shall exclude the individual's immunization records from the registry and any other registry-related department record that individually identifies the individual.

SECTION 3. Section 161.008(c), Health and Safety Code, is amended to read as follows:

(c) The department may obtain the data constituting an immunization record for an individual from a public health district, a local health department, the individual or the individual's legally authorized representative, a physician to the individual, a payor, or any health care provider licensed or otherwise authorized to administer vaccines. The department shall verify consent to remain in the registry for an individual 18 years of age or older before including the reported information in the immunization registry. [The department may not retain individually identifiable information about an individual for whom consent cannot be verified.]

SECTION 4. Section 161.0107(c), Health and Safety Code, is amended to read as follows:

(c) The executive commissioner of the Health and Human Services Commission by rule shall specify:

(1) the fields necessary to populate the immunization registry, including a field that indicates the patient's consent to remain [be listed] in the immunization registry for an individual 18 years of age or older [has been obtained]; and

(2) the data standards that must be used for electronic submission of immunization information.

SECTION 5. Section 161.007(a-1), Health and Safety Code, is repealed.

SECTION 6. This Act takes effect September 1, 2011.