Texas 2009 - 81st Regular

Texas House Bill HB2382 Compare Versions

The same version is selected twice. Please select two different versions to compare.

Version 1 (Old)

Version 2 (New)

Old	New	Differences
1	1	By: Kolkhorst H.B. No. 2382
2	2	Substitute the following for H.B. No. 2382:
3	3	By: Coleman C.S.H.B. No. 2382
4	4
5	5
6	6	A BILL TO BE ENTITLED
7	7	AN ACT
8	8	relating to information submitted to and maintained in the
9	9	immunization registry after an individual becomes an adult.
10	10	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
11	11	SECTION 1. Section 161.0001, Health and Safety Code, is
12	12	amended by adding Subdivisions (1-c) and (3) and amending
13	13	Subdivision (2) to read as follows:
14	14	(1-c) "Individual's legally authorized
15	15	representative" means:
16	16	(A) a parent, managing conservator, or guardian
17	17	of an individual, if the individual is a minor;
18	18	(B) a guardian of the individual, if the
19	19	individual has been adjudicated incompetent to manage the
20	20	individual's personal affairs; or
21	21	(C) an agent of the individual authorized under a
22	22	durable power of attorney for health care.
23	23	(2) "Payor" means an insurance company, a health
24	24	maintenance organization, or another organization that pays a
25	25	health care provider to provide health care benefits, including
26	26	providing immunizations [to a person younger than 18 years of age].
27	27	(3) "Electronically," as related to a communication
28	28	authorized under this chapter, means by e-mail, text message,
29	29	online communication, or another electronic method of
30	30	communication approved by the department.
31	31	SECTION 2. Section 161.007, Health and Safety Code, is
32	32	amended by amending Subsections (a), (a-1), (b), (b-1), (c), (d),
33	33	(e), (f), (j), and (k) and adding Subsections (a-2) and (a-3) to
34	34	read as follows:
35	35	(a) The department, for the primary purpose of establishing
36	36	and maintaining a single repository of accurate, complete, and
37	37	current immunization records to be used in aiding, coordinating,
38	38	and promoting efficient and cost-effective [childhood]
39	39	communicable disease prevention and control efforts, shall
40	40	establish and maintain an immunization registry. The executive
41	41	commissioner of the Health and Human Services Commission
42	42	[department] by rule shall develop guidelines to:
43	43	(1) protect the confidentiality of patients in
44	44	accordance with Section 159.002, Occupations Code;
45	45	(2) inform the individual or the individual's legally
46	46	authorized representative [a parent, managing conservator, or
47	47	guardian of each patient younger than 18 years of age] about the
48	48	registry;
49	49	(3) require the written or electronic consent of the
50	50	individual or the individual's legally authorized
51	51	representative [a parent, managing conservator, or guardian of a
52	52	patient younger than 18 years of age] before any information
53	53	relating to the individual [patient] is included in the registry;
54	54	(4) permit the individual or the individual's legally
55	55	authorized representative [a parent, managing conservator, or
56	56	guardian of a patient younger than 18 years of age] to withdraw
57	57	consent for the individual [patient] to be included in the
58	58	registry; and
59	59	(5) determine the process by which consent is
60	60	verified, including affirmation by a health care provider, birth
61	61	registrar, regional health information exchange, or local
62	62	immunization registry that consent has been obtained.
63	63	(a-1) The written or electronic consent required by
64	64	Subsection (a)(3) for an individual younger than 18 years of age is
65	65	required to be obtained only one time. The [written] consent is
66	66	valid until the individual [child] becomes 18 years of age unless
67	67	the consent is withdrawn in writing or electronically. A parent,
68	68	managing conservator, or guardian of a minor [child] may provide
69	69	the [written] consent by using an electronic signature on the
70	70	minor's [child's] birth certificate.
71	71	(a-2) An individual's legally authorized representative or
72	72	the individual, after the individual has attained 18 years of age,
73	73	may consent in writing or electronically for the individual's
74	74	information to remain in the registry after the individual's 18th
75	75	birthday and for the individual's subsequent immunizations to be
76	76	included in the registry. The written or electronic consent of the
77	77	minor's legally authorized representative as described by Section
78	78	161.0001(1-c)(A) must be submitted to the department before the
79	79	individual's 18th birthday. The written or electronic consent of
80	80	the individual or the individual's legally authorized
81	81	representative as described by Section 161.0001(1-c)(B) or (C) must
82	82	be submitted to the department not later than the individual's 19th
83	83	birthday. The consent of the representative or individual is valid
84	84	until the individual or the individual's legally authorized
85	85	representative withdraws consent in writing or electronically. The
86	86	department may not include in the registry the immunization
87	87	information of an individual who is 18 years of age or older until
88	88	written or electronic consent has been obtained as provided by this
89	89	subsection. The department shall coordinate with the Texas
90	90	Education Agency to distribute materials described in Section
91	91	161.0095(a)(2) to students and parents through local school
92	92	districts.
93	93	(a-3) The executive commissioner of the Health and Human
94	94	Services Commission by rule shall develop guidelines and procedures
95	95	for obtaining consent from an individual after the individual's
96	96	18th birthday, including procedures for retaining immunization
97	97	information in a separate database that is inaccessible by any
98	98	person other than the department during the one-year period during
99	99	which an 18-year-old may consent to inclusion in the registry under
100	100	Subsection (a-2).
101	101	(b) Except as provided by Section 161.0071, the [The]
102	102	immunization registry must contain information on the immunization
103	103	history that is obtained by the department under:
104	104	(1) this section of each individual [person who is
105	105	younger than 18 years of age and] for whom consent has been obtained
106	106	in accordance with guidelines adopted under Subsection (a) or
107	107	(a-3), as applicable;
108	108	(2) Section 161.00705 of persons immunized to prepare
109	109	for or in response to a declared disaster, public health emergency,
110	110	terrorist attack, hostile military or paramilitary action, or
111	111	extraordinary law enforcement emergency; and
112	112	(3) Section 161.00706 of first responders or their
113	113	immediate family members.
114	114	(b-1) The department shall remove from the registry
115	115	information for any individual [person] for whom consent has been
116	116	withdrawn. The department may not retain individually identifiable
117	117	information about any individual [person]:
118	118	(1) for whom consent has been withdrawn;
119	119	(2) for whom a consent for continued inclusion in the
120	120	registry following the end of the declared disaster, public health
121	121	emergency, terrorist attack, hostile military or paramilitary
122	122	action, or extraordinary law enforcement emergency has not been
123	123	received under Section 161.00705(f); or
124	124	(3) for whom a request to be removed from the registry
125	125	has been received under Section 161.00706(e).
126	126	(c) A payor that receives data elements from a health care
127	127	provider who administers an immunization to an individual [a
128	128	person] younger than 18 years of age shall provide the data elements
129	129	to the department. A payor is required to provide the department
130	130	with only the data elements the payor receives from a health care
131	131	provider. A payor that receives data elements from a health care
132	132	provider who administers an immunization to an individual 18 years
133	133	of age or older may provide the data elements to the department.
134	134	The data elements shall be submitted in a format prescribed by the
135	135	department. The department shall verify consent before including
136	136	the reported information in the immunization registry. The
137	137	department may not retain individually identifiable information
138	138	about an individual [a person] for whom consent cannot be verified.
139	139	(d) A health care provider who administers an immunization
140	140	to an individual [a person] younger than 18 years of age shall
141	141	provide data elements regarding an immunization to the department.
142	142	A health care provider who administers an immunization to an
143	143	individual 18 years of age or older may submit data elements
144	144	regarding an immunization to the department. The data elements
145	145	shall be submitted in a format prescribed by the department. The
146	146	department shall verify consent before including the information in
147	147	the immunization registry. The department may not retain
148	148	individually identifiable information about an individual [a
149	149	person] for whom consent cannot be verified.
150	150	(e) The department shall provide notice to a health care
151	151	provider that submits an immunization history for an individual [a
152	152	person] for whom consent cannot be verified. The notice shall
153	153	contain instructions for obtaining consent in accordance with
154	154	guidelines adopted under Subsections [Subsection] (a) and (a-3) and
155	155	resubmitting the immunization history to the department.
156	156	(f) The department and health care providers may use the
157	157	registry to provide notices by mail, telephone, personal contact,
158	158	or other means to an individual or the individual's legally
159	159	authorized representative [a parent, managing conservator, or
160	160	guardian] regarding an individual [his or her child or ward] who is
161	161	due or overdue for a particular type of immunization according to
162	162	the department's immunization schedule for children or another
163	163	analogous schedule recognized by the department for individuals 18
164	164	years of age or older. The department shall consult with health
165	165	care providers to determine the most efficient and cost-effective
166	166	manner of using the registry to provide those notices.
167	167	(j) Except as provided by Sections 161.00705, 161.00706,
168	168	and 161.008, information obtained by the department for the
169	169	immunization registry is confidential and may be disclosed only
170	170	with the written or electronic consent of the individual or the
171	171	individual's legally authorized representative [, if a child, the
172	172	child's parent, managing conservator, or guardian].
173	173	(k) The executive commissioner of the Health and Human
174	174	Services Commission [board] shall adopt rules to implement this
175	175	section.
176	176	SECTION 3. Section 161.00705(f), Health and Safety Code, is
177	177	amended to read as follows:
178	178	(f) Unless an individual or the individual's legally
179	179	authorized representative [, if a child, the child's parent,
180	180	managing conservator, or guardian] consents in writing or
181	181	electronically to continued inclusion of the [child's or other]
182	182	individual's information in the registry, the department shall
183	183	remove the immunization records collected under this section from
184	184	the registry on expiration of the period prescribed under
185	185	Subsection (e).
186	186	SECTION 4. Section 161.00706(e), Health and Safety Code, is
187	187	amended to read as follows:
188	188	(e) A person whose immunization records are included in the
189	189	immunization registry as authorized by this section may request in
190	190	writing or electronically that the department remove that
191	191	information from the registry. Not later than the 10th day after
192	192	receiving a request under this subsection, the department shall
193	193	remove the person's immunization records from the registry.
194	194	SECTION 5. Section 161.0071, Health and Safety Code, is
195	195	amended to read as follows:
196	196	Sec. 161.0071. NOTICE OF RECEIPT OF REGISTRY DATA;
197	197	EXCLUSION FROM REGISTRY. (a) The first time the department
198	198	receives registry data for an individual [a child] for whom the
199	199	department has received consent to be included in the registry,
200	200	[from a person other than the child's parent, managing conservator,
201	201	or guardian,] the department shall send [a written] notice to the
202	202	individual or the individual's legally authorized representative
203	203	[child's parent, managing conservator, or guardian] disclosing:
204	204	(1) that providers and payors may be sending the
205	205	individual's [child's] immunization information to the department;
206	206	(2) the information that is included in the registry;
207	207	(3) the persons to whom the information may be
208	208	released under Section 161.008(d);
209	209	(4) the purpose and use of the registry;
210	210	(5) the procedure to exclude an individual [a child]
211	211	from the registry; and
212	212	(6) the procedure to report a violation if an
213	213	individual's information [a parent, managing conservator, or
214	214	guardian discovers a child] is included in the registry after
215	215	exclusion has been requested or consent has been withdrawn.
216	216	(b) On discovering that consent to be included in the
217	217	registry has not been granted or has been withdrawn, the department
218	218	shall exclude the individual's [child's] immunization records from
219	219	the registry and any other registry-related department record that
220	220	individually identifies the individual [child].
221	221	(c) On receipt of a written or electronic request to exclude
222	222	an individual's [a child's] immunization records from the registry,
223	223	the department shall send to the individual or the individual's
224	224	legally authorized representative [a parent, managing conservator,
225	225	or guardian] who makes the request a written confirmation of
226	226	receipt of the request for exclusion and shall exclude the
227	227	individual's [child's] records from the registry.
228	228	(d) The department commits a violation if the department
229	229	fails to exclude an individual's [a child's] immunization
230	230	information from the registry as required by Subsection (b) or (c).
231	231	(e) The department shall accept a written or electronic
232	232	statement from an individual or the individual's legally authorized
233	233	representative [a parent, managing conservator, or guardian]
234	234	communicating to the department that an individual's information [a
235	235	child] should be excluded from the registry, including a statement
236	236	on a minor's [the child's] birth certificate, as a request for
237	237	exclusion under Subsection (c). [The written statement may include
238	238	the electronic signature on the child's birth certificate.]
239	239	SECTION 6. Section 161.0072, Health and Safety Code, is
240	240	amended to read as follows:
241	241	Sec. 161.0072. PROVIDING IMMUNIZATION INFORMATION TO
242	242	DEPARTMENT. (a) If the individual or the individual's legally
243	243	authorized representative [parent, managing conservator, or
244	244	guardian of a child] has reasonable concern that the individual's
245	245	[child's] health care provider is not submitting the immunization
246	246	history to the department [and the parent, managing conservator, or
247	247	guardian wants the child included in the registry], the individual
248	248	or the individual's legally authorized representative [parent,
249	249	managing conservator, or guardian] may provide the individual's
250	250	[child's] immunization history directly to the department to be
251	251	included in the immunization registry.
252	252	(b) The individual or the individual's legally authorized
253	253	representative [parent, managing conservator, or guardian of a
254	254	child] may send evidence of the individual's [child's] immunization
255	255	history to the department electronically, by facsimile
256	256	transmission, or by mail. The evidence may include a copy of:
257	257	(1) the individual's [child's] medical record
258	258	indicating the immunization history;
259	259	(2) an invoice from a health care provider for the
260	260	immunization; or
261	261	(3) documentation showing that a claim for the
262	262	immunization was paid by a payor.
263	263	(c) The board shall develop rules to ensure that the
264	264	immunization history submitted by an individual or the individual's
265	265	legally authorized representative [a parent, managing conservator,
266	266	or guardian] is medically verified immunization information.
267	267	SECTION 7. Sections 161.0073(a), (b), and (c), Health and
268	268	Safety Code, are amended to read as follows:
269	269	(a) Except as provided by Section 161.00705, information
270	270	that individually identifies an [a child or other] individual that
271	271	is received by the department for the immunization registry is
272	272	confidential and may be used by the department for registry
273	273	purposes only.
274	274	(b) Unless specifically authorized under this subchapter,
275	275	the department may not release registry information to any
276	276	individual or entity without the consent of the individual or the
277	277	individual's legally authorized representative [person or, if a
278	278	minor, the parent, managing conservator, or guardian of the child].
279	279	(c) A person required to report information to the
280	280	department for registry purposes or authorized to receive
281	281	information from the registry may not disclose the individually
282	282	identifiable information of an [a child or other] individual to any
283	283	other person without the written or electronic consent of the
284	284	individual or the individual's legally authorized representative
285	285	[, if a child, the parent, managing conservator, or guardian of the
286	286	child], except as provided by Chapter 159, Occupations Code, or
287	287	Section 602.053, Insurance Code.
288	288	SECTION 8. Sections 161.008(c), (d), (e), (g), and (h),
289	289	Health and Safety Code, are amended to read as follows:
290	290	(c) The department may obtain the data constituting an
291	291	immunization record for an individual [a child] from a public
292	292	health district, a local health department, the individual or the
293	293	individual's legally authorized representative [child's parent,
294	294	managing conservator, or guardian], a physician to the individual
295	295	[child], a payor, or any health care provider licensed or otherwise
296	296	authorized to administer vaccines. The department shall verify
297	297	consent before including the reported information in the
298	298	immunization registry. The department may not retain individually
299	299	identifiable information about an individual [a person] for whom
300	300	consent cannot be verified.
301	301	(d) The department may release the data constituting an
302	302	immunization record for the individual [child] to:
303	303	(1) any entity that is described by Subsection (c);
304	304	(2) [, to] a school or child care facility in which the
305	305	individual [child] is enrolled; or
306	306	(3) [, or to] a state agency having legal custody of
307	307	the individual [child].
308	308	(e) An individual or the individual's legally authorized
309	309	representative [A parent, managing conservator, or legal guardian]
310	310	may obtain and on request to the department shall be provided with
311	311	all individually identifiable immunization registry information
312	312	concerning the individual [his or her child or ward].
313	313	(g) The department may release nonidentifying summary
314	314	statistics related to the registry that do not individually
315	315	identify an individual [a child].
316	316	(h) The executive commissioner of the Health and Human
317	317	Services Commission [board] shall adopt rules to implement this
318	318	section.
319	319	SECTION 9. Section 161.009(a), Health and Safety Code, is
320	320	amended to read as follows:
321	321	(a) A person commits an offense if the person:
322	322	(1) negligently releases or discloses immunization
323	323	registry information in violation of Section 161.007, 161.0071,
324	324	161.0073, or 161.008;
325	325	(2) fails to exclude an individual's [a child's]
326	326	immunization information in violation of Section 161.0071;
327	327	(3) fails to remove a person's immunization
328	328	information in violation of Section 161.00705 or 161.00706; or
329	329	(4) negligently uses information in the immunization
330	330	registry to solicit new patients or clients or for other purposes
331	331	that are not associated with immunization or quality-of-care
332	332	purposes, unless authorized under this section.
333	333	SECTION 10. Section 161.0095, Health and Safety Code, is
334	334	amended to read as follows:
335	335	Sec. 161.0095. [PROVIDER] EDUCATION PROGRAMS AND
336	336	INFORMATION. (a) The department shall develop:
337	337	(1) continuing education programs for health care
338	338	providers relating to immunizations and the vaccines for children
339	339	program operated by the department under authority of 42 U.S.C.
340	340	Section 1396s; and
341	341	(2) educational information, for health care
342	342	providers, health care clinics, hospitals, and any other health
343	343	care facility that provides health care to children 14 to 18 years
344	344	of age, relating to the immunization registry and the option for an
345	345	individual who is 18 years of age or older to consent to submission
346	346	and retention of the individual's information in the immunization
347	347	registry[, as amended].
348	348	(b) The department shall establish a work group to assist
349	349	the department in developing the continuing education programs and
350	350	educational information [materials]. The work group shall include
351	351	physicians, nurses, department representatives, representatives of
352	352	managed care organizations that provide health care services under
353	353	Chapter 533, Government Code, representatives of health plan
354	354	providers that provide health care services under Chapter 62, and
355	355	members of the public.
356	356	SECTION 11. This Act takes effect September 1, 2009.