83R666 YDB-F
 
  By: Zaffirini S.B. No. 40
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to the immunization data included in and excluded from the
  immunization registry.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Sections 161.007(a), (a-2), (b), (b-1), (c), and
  (d), 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; and
               (3)  [require the written or electronic consent of the
  individual or the individual's legally authorized representative
  before any information relating to the individual is included in
  the registry;
               [(4)]  permit the individual or the individual's
  legally authorized representative to request that the individual's
  information be removed from [withdraw consent for the individual to
  be included in] the registry[; and
               [(5)     determine the process by which consent is
  verified, including affirmation by a health care provider, birth
  registrar, regional health information exchange, or local
  immunization registry that consent has been obtained].
         (a-2)  An individual's legally authorized representative or
  the individual, after the individual has attained 18 years of age,
  may submit a request [consent] in writing or electronically for the
  individual's information to be removed from [remain in] the
  registry [after the individual's 18th birthday and for the
  individual's subsequent immunizations to be included in the
  registry.   The written or electronic consent of the minor's legally
  authorized representative as described by Section 161.0001(1-c)(A)
  must be submitted to the department before the individual's 18th
  birthday.   The written or electronic consent of the individual or
  the individual's legally authorized representative as described by
  Section 161.0001(1-c)(B) or (C) must be submitted to the department
  not later than the individual's 19th birthday.   The consent of the
  representative or individual is valid until the individual or the
  individual's legally authorized representative withdraws consent
  in writing or electronically.   The department may not include in the
  registry the immunization information of an individual who is 18
  years of age or older until written or electronic consent has been
  obtained as provided by this subsection].  The department shall
  coordinate with the Texas Education Agency to distribute materials
  described in Section 161.0095(a)(2) to students and parents through
  local school districts.
         (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 for whom
  immunization information [consent] has been obtained, unless the
  individual or the individual's legally authorized representative
  has requested that the individual's information be removed from the
  registry 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 individually identifiable
  information about any individual:
               [(1)  for whom consent has been withdrawn;
               [(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);
               [(3)     for whom a request to be removed from the registry
  has been received under Section 161.00706(e);
               [(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
               [(5)  for whom] a request to remove information from
  the registry has been received under this subchapter [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 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.]
         SECTION 2.  Section 161.00705(f), Health and Safety Code, is
  amended to read as follows:
         (f)  Unless an individual or the individual's legally
  authorized representative [consents] in writing or electronically
  requests that [to continued inclusion of] the individual's
  information be removed from [in] the registry, the department shall
  include [remove] the immunization records collected under this
  section in [from] the registry [on expiration of the period
  prescribed under Subsection (e)].
         SECTION 3.  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 [for whom the department has received consent] to 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;
               (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)  The [On discovering that consent to 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 the immunization
  record of any individual from whom a request for exclusion has been
  received by the department.
         SECTION 4.  Sections 161.00735(c) and (h), Health and Safety
  Code, are amended to read as follows:
         (c)  The department may receive immunization information
  from a health authority of another state or from a local health
  authority in another state if the department determines that
  residents of that state have evacuated or relocated to this state in
  response to a disaster.  The department shall include information
  received under this subsection in the registry.  [Notwithstanding
  Section 161.007, the department is not required to obtain written
  consent for the inclusion in the registry of information received
  under this subsection.]
         (h)  The executive commissioner of the Health and Human
  Services Commission shall make every effort to enter into a
  memorandum of agreement with each state to which residents of this
  state are likely to evacuate in a disaster on:
               (1)  the release to and use by [of registry information
  under this section to] the appropriate health authority or local
  health authority of that state of registry information under this
  section[, including the length of time the information may be
  retained by that state]; and
               (2)  the receipt and use of information submitted by
  the health authority or local health authority of that state for
  inclusion in the registry under this section.
         SECTION 5.  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 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 6.  Section 161.0095(a), Health and Safety Code, is
  amended to read as follows:
         (a)  The department shall develop:
               (1)  continuing education programs for health care
  providers relating to immunizations and the vaccines for children
  program operated by the department under authority of 42 U.S.C.
  Section 1396s; and
               (2)  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 or the individual's legally authorized representative
  to request removal [who is 18 years of age or older to consent to
  submission and retention] of the individual's information from [in]
  the immunization registry.
         SECTION 7.  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 be listed in the immunization registry has been obtained]; and
               (2)  the data standards that must be used for
  electronic submission of immunization information.
         SECTION 8.  The following provisions of the Health and
  Safety Code are repealed:
               (1)  Sections 161.007(a-1), (a-3), and (e);
               (2)  Sections 161.00705(e) and (h); and
               (3)  Sections 161.00735(e) and (f).
         SECTION 9.  The changes in law made by this Act to Subchapter
  A, Chapter 161, Health and Safety Code, apply only to immunization
  information received by the Department of State Health Services on
  or after the effective date of this Act. The information received
  by the department before the effective date of this Act is covered
  by the law in effect immediately before that date, and that law is
  continued in effect for that purpose.
         SECTION 10.  This Act takes effect September 1, 2013.