Texas 2009 - 81st Regular

Texas Senate Bill SB1251 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	81R4413 YDB-D
2	2	By: Zaffirini S.B. No. 1251
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to information submitted to, maintained in, and released
8	8	from the immunization registry.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Section 161.0001, Health and Safety Code, is
11	11	amended by adding Subdivision (1-c) and amending Subdivision (2) to
12	12	read as follows:
13	13	(1-c) "Individual's legally authorized
14	14	representative" means:
15	15	(A) a parent, managing conservator, or guardian
16	16	of an individual, if the individual is a minor;
17	17	(B) a guardian of the individual, if the
18	18	individual has been adjudicated incompetent to manage the
19	19	individual's personal affairs; or
20	20	(C) an agent of the individual authorized under a
21	21	durable power of attorney for health care.
22	22	(2) "Payor" means an insurance company, a health
23	23	maintenance organization, or another organization that pays a
24	24	health care provider to provide health care benefits, including
25	25	providing immunizations [to a person younger than 18 years of age].
26	26	SECTION 2. Sections 161.007(a), (a-1), (b), (b-1), (c),
27	27	(d), (e), (f), (j), and (k), Health and Safety Code, are amended to
28	28	read as follows:
29	29	(a) The department, for the primary purpose of establishing
30	30	and maintaining a single repository of accurate, complete, and
31	31	current immunization records to be used in aiding, coordinating,
32	32	and promoting efficient and cost-effective [childhood]
33	33	communicable disease prevention and control efforts, shall
34	34	establish and maintain an immunization registry. The executive
35	35	commissioner of the Health and Human Services Commission
36	36	[department] by rule shall develop guidelines to:
37	37	(1) protect the confidentiality of patients in
38	38	accordance with Section 159.002, Occupations Code;
39	39	(2) inform the individual or the individual's legally
40	40	authorized representative [a parent, managing conservator, or
41	41	guardian of each patient younger than 18 years of age] about the
42	42	registry and that registry information may be released under
43	43	Section 161.00705(g)(2) or (3) in the event of certain disasters,
44	44	emergencies, attacks, or actions;
45	45	(3) require the written consent of the individual or
46	46	the individual's legally authorized representative for the
47	47	individual's inclusion in the registry [a parent, managing
48	48	conservator, or guardian of a patient younger than 18 years of age]
49	49	before any information relating to the individual [patient] is
50	50	disclosed to any other user of [included in] the registry except as
51	51	otherwise provided by this subchapter;
52	52	(4) permit the individual or the individual's legally
53	53	authorized representative [a parent, managing conservator, or
54	54	guardian of a patient younger than 18 years of age] to withdraw
55	55	consent for the individual [patient] to be included in the
56	56	registry, except as provided by Section 161.00705(e); [and]
57	57	(5) determine the process by which consent is
58	58	verified, including affirmation by a health care provider, birth
59	59	registrar, regional health information exchange, or local
60	60	immunization registry that consent has been obtained; and
61	61	(6) allow the department to retain information in the
62	62	registry until a person's death.
63	63	(a-1) The written consent required by Subsection (a)(3) is
64	64	required to be obtained only one time. The written consent is valid
65	65	until the individual or the individual's legally authorized
66	66	representative withdraws [child becomes 18 years of age unless] the
67	67	consent [is withdrawn] in writing. A parent, managing conservator,
68	68	or guardian of a minor [child] may provide the written consent by
69	69	using an electronic signature on the minor's [child's] birth
70	70	certificate. The executive commissioner of the Health and Human
71	71	Services Commission by rule shall develop procedures for obtaining
72	72	consent from an individual who is 18 years of age or older.
73	73	(b) Except as provided by Section 161.0071, the [The]
74	74	immunization registry must contain information on the immunization
75	75	history that is obtained by the department under:
76	76	(1) this section of each individual [person who is
77	77	younger than 18 years of age and] for whom consent has been obtained
78	78	in accordance with guidelines adopted under Subsection (a);
79	79	(2) Section 161.00705 of persons immunized to prepare
80	80	for or in response to a declared disaster, public health emergency,
81	81	terrorist attack, hostile military or paramilitary action, or
82	82	extraordinary law enforcement emergency in this state or another
83	83	state; and
84	84	(3) Section 161.00706 of first responders or their
85	85	immediate family members.
86	86	(b-1) The department shall remove from the registry
87	87	information for any individual [person] for whom consent has been
88	88	withdrawn. The department may not retain individually identifiable
89	89	information about any individual [person]:
90	90	(1) for whom consent has been withdrawn;
91	91	(2) for whom a consent for continued inclusion in the
92	92	registry following the end of the declared disaster, public health
93	93	emergency, terrorist attack, hostile military or paramilitary
94	94	action, or extraordinary law enforcement emergency has not been
95	95	received under Section 161.00705(f); or
96	96	(3) for whom a request to be removed from the registry
97	97	has been received under Section 161.00706(e).
98	98	(c) A payor that receives data elements from a health care
99	99	provider who administers an immunization to an individual [a
100	100	person] younger than 18 years of age shall provide the data elements
101	101	to the department. A payor is required to provide the department
102	102	with only the data elements the payor receives from a health care
103	103	provider. A payor that receives data elements from a health care
104	104	provider who administers an immunization to an individual 18 years
105	105	of age or older may provide the data elements to the department.
106	106	The data elements shall be submitted in a format prescribed by the
107	107	department. Except as provided by this subchapter, the [The]
108	108	department shall verify consent before disclosing [including] the
109	109	reported information to other users of [in] the immunization
110	110	registry. The department may [not] retain individually
111	111	identifiable information about an individual obtained under this
112	112	subsection [a person] for whom consent cannot be verified. The
113	113	department may not disclose the information to other users of the
114	114	registry until consent is verified, except that the department may
115	115	disclose the information to public health officials or health
116	116	authorities during a disaster, emergency, attack, or action
117	117	described by Section 161.00705(a).
118	118	(d) A health care provider who administers an immunization
119	119	to an individual [a person] younger than 18 years of age shall
120	120	provide data elements regarding an immunization to the department.
121	121	A health care provider who administers an immunization to an
122	122	individual 18 years of age or older may submit data elements
123	123	regarding an immunization to the department. The data elements
124	124	shall be submitted in a format prescribed by the department. Except
125	125	as provided by this subchapter, the [The] department shall verify
126	126	consent before disclosing [including] the information to other
127	127	users of [in] the immunization registry. The department may [not]
128	128	retain individually identifiable information about an individual
129	129	obtained under this subsection [a person] for whom consent cannot
130	130	be verified. The department may not disclose the information to
131	131	other users of the registry until consent is verified, except that
132	132	the department may disclose the information to public health
133	133	officials or health authorities during a disaster, emergency,
134	134	attack, or action described by Section 161.00705(a).
135	135	(e) The department shall provide notice to a health care
136	136	provider that submits an immunization history for an individual [a
137	137	person] for whom consent cannot be verified. The notice shall
138	138	contain instructions for obtaining consent in accordance with
139	139	guidelines adopted under Subsection (a) and resubmitting the
140	140	immunization history to the department.
141	141	(f) The department and health care providers may use the
142	142	registry to provide notices by mail, telephone, personal contact,
143	143	or other means to an individual or the individual's legally
144	144	authorized representative [a parent, managing conservator, or
145	145	guardian] regarding an individual [his or her child or ward] who is
146	146	due or overdue for a particular type of immunization according to
147	147	the department's immunization schedule for minors or another
148	148	analogous schedule recognized by the department for individuals 18
149	149	years of age or older. The department shall consult with health
150	150	care providers to determine the most efficient and cost-effective
151	151	manner of using the registry to provide those notices.
152	152	(j) Except as provided by Sections 161.00705, 161.00706,
153	153	and 161.008, information obtained by the department for the
154	154	immunization registry is confidential and may be disclosed only
155	155	with the written consent of the individual or the individual's
156	156	legally authorized representative [, if a child, the child's
157	157	parent, managing conservator, or guardian].
158	158	(k) The executive commissioner of the Health and Human
159	159	Services Commission [board] shall adopt rules to implement this
160	160	section.
161	161	SECTION 3. Section 161.00705, Health and Safety Code, is
162	162	amended by amending Subsections (a), (c), (e), (f), and (g) and
163	163	adding Subsections (a-1) and (j) to read as follows:
164	164	(a) The department shall maintain a registry of persons who
165	165	receive an immunization, antiviral, and other medication
166	166	administered to prepare for a potential disaster, public health
167	167	emergency, terrorist attack, hostile military or paramilitary
168	168	action, or extraordinary law enforcement emergency in this state or
169	169	another state or in response to a declared disaster, public health
170	170	emergency, terrorist attack, hostile military or paramilitary
171	171	action, or extraordinary law enforcement emergency in this state or
172	172	in another state. A health care provider who administers an
173	173	immunization, antiviral, or other medication to a resident of this
174	174	state or to a resident of another state that has relocated or
175	175	evacuated to this state shall provide the data elements to the
176	176	department.
177	177	(a-1) The department may accept from a health authority in
178	178	another state or a local health authority in another state
179	179	immunization information for inclusion in the registry under this
180	180	section if the department determines that:
181	181	(1) residents of that state have evacuated or
182	182	relocated to this state in response to a declared disaster, public
183	183	health emergency, terrorist attack, hostile military or
184	184	paramilitary action, or extraordinary law enforcement emergency in
185	185	that state; or
186	186	(2) residents of this state have evacuated or
187	187	relocated to that state in response to a declared disaster, public
188	188	health emergency, terrorist attack, hostile military or
189	189	paramilitary action, or extraordinary law enforcement emergency in
190	190	this state.
191	191	(c) The department shall track adverse reactions to an
192	192	immunization, antiviral, and other medication administered to
193	193	prepare for a potential disaster, public health emergency,
194	194	terrorist attack, hostile military or paramilitary action, or
195	195	extraordinary law enforcement emergency in this state or another
196	196	state or in response to a declared disaster, public health
197	197	emergency, terrorist attack, hostile military or paramilitary
198	198	action, or extraordinary law enforcement emergency in this state or
199	199	another state. A health care provider who administers an
200	200	immunization, antiviral, or other medication to a resident of this
201	201	state or to a resident of another state that has relocated or
202	202	evacuated to this state may provide data related to adverse
203	203	reactions to the department.
204	204	(e) The executive commissioner of the Health and Human
205	205	Services Commission by rule shall determine the period during which
206	206	the information collected under this section must remain in the
207	207	immunization registry following the end of the disaster, public
208	208	health emergency, terrorist attack, hostile military or
209	209	paramilitary action, or extraordinary law enforcement emergency in
210	210	this state or another state.
211	211	(f) Unless an individual or, if a minor [child], the minor's
212	212	[child's] parent, managing conservator, or guardian consents in
213	213	writing to continued inclusion of the minor's [child's] or other
214	214	individual's information in the registry, the department shall
215	215	remove the immunization records collected under this section from
216	216	the registry on expiration of the period prescribed under
217	217	Subsection (e).
218	218	(g) The immunization information of a minor [child] or other
219	219	individual received by the department under this section, including
220	220	individually identifiable information, may be released only:
221	221	(1) on consent of the individual or, if a minor
222	222	[child], the minor's [child's] parent, managing conservator, or
223	223	guardian; [or]
224	224	(2) to a state agency or health care provider in this
225	225	state consistent with the purposes of this subchapter or the
226	226	purposes of aiding or coordinating communicable disease prevention
227	227	and control efforts during a declared disaster, public health
228	228	emergency, terrorist attack, hostile military or paramilitary
229	229	action, or extraordinary law enforcement emergency in this state or
230	230	another state; or
231	231	(3) to an appropriate health authority or local health
232	232	authority of another state to which residents of this state have
233	233	evacuated or relocated in response to a declared disaster, public
234	234	health emergency, terrorist attack, hostile military or
235	235	paramilitary action, or extraordinary law enforcement emergency
236	236	consistent with the purposes of this subchapter or the purposes of
237	237	aiding or coordinating communicable disease prevention and control
238	238	efforts during a declared disaster, public health emergency,
239	239	terrorist attack, hostile military or paramilitary action, or
240	240	extraordinary law enforcement emergency.
241	241	(j) The executive commissioner of the Health and Human
242	242	Services Commission may enter into a memorandum of agreement with
243	243	another state on:
244	244	(1) the release and use of registry information under
245	245	this section to the appropriate health authority or local health
246	246	authority of that state; or
247	247	(2) the receipt and use of information submitted by
248	248	the health authority or local health authority of that state for
249	249	inclusion in the registry under this section.
250	250	SECTION 4. Sections 161.00706(c) and (d), Health and Safety
251	251	Code, are amended to read as follows:
252	252	(c) The executive commissioner of the Health and Human
253	253	Services Commission shall:
254	254	(1) develop rules to ensure that immunization history
255	255	submitted under Subsection (a)(2) is medically verified
256	256	immunization information;
257	257	(2) develop guidelines for use by the department in
258	258	informing first responders about the registry and that registry
259	259	information may be released under Section 161.00705 in the event of
260	260	certain disasters, emergencies, attacks, or actions; and
261	261	(3) adopt rules necessary for the implementation of
262	262	this section.
263	263	(d) Except as provided by Section 161.00705, in the event of
264	264	certain disasters, emergencies, attacks, or actions, a [A] person's
265	265	immunization history or data received by the department under this
266	266	section may be released only:
267	267	(1) on consent of the person; or
268	268	(2) to any health care provider licensed or otherwise
269	269	authorized to administer vaccines.
270	270	SECTION 5. Section 161.0071, Health and Safety Code, is
271	271	amended to read as follows:
272	272	Sec. 161.0071. NOTICE OF RECEIPT OF REGISTRY DATA;
273	273	EXCLUSION FROM REGISTRY. (a) The first time the department
274	274	receives registry data for an individual [a child] for whom the
275	275	department has received consent to be included in the registry,
276	276	[from a person other than the child's parent, managing conservator,
277	277	or guardian,] the department shall send a written notice to the
278	278	individual or the individual's legally authorized representative
279	279	[child's parent, managing conservator, or guardian] disclosing:
280	280	(1) that providers and payors may be sending the
281	281	individual's [child's] immunization information to the department;
282	282	(2) the information that is included in the registry;
283	283	(3) the persons to whom the information may be
284	284	released under Section 161.00705(g)(2) or (3) and Section
285	285	161.008(d);
286	286	(4) the purpose and use of the registry;
287	287	(5) the procedure to exclude an individual [a child]
288	288	from the registry; and
289	289	(6) the procedure to report a violation if an
290	290	individual [a parent, managing conservator, or guardian discovers a
291	291	child] is included in the registry after exclusion has been
292	292	requested or consent has been withdrawn.
293	293	(b) On discovering that consent to be included in the
294	294	registry has not been granted or has been withdrawn, the department
295	295	shall exclude the individual's [child's] immunization records from
296	296	the registry and any other registry-related department record that
297	297	individually identifies the individual [child].
298	298	(c) On receipt of a written request to exclude an
299	299	individual's [a child's] immunization records from the registry,
300	300	the department shall send to the individual or the individual's
301	301	legally authorized representative [a parent, managing conservator,
302	302	or guardian] who makes the request a written confirmation of
303	303	receipt of the request for exclusion and shall exclude the
304	304	individual's [child's] records from the registry.
305	305	(d) The department commits a violation if the department
306	306	fails to exclude an individual's [a child's] immunization
307	307	information from the registry as required by Subsection (b) or (c).
308	308	(e) The department shall accept a written statement from an
309	309	individual or the individual's legally authorized representative
310	310	[a parent, managing conservator, or guardian] communicating to the
311	311	department that an individual's information [a child] should be
312	312	excluded from the registry, including a statement on a minor's [the
313	313	child's] birth certificate, as a request for exclusion under
314	314	Subsection (c). The written statement may include the electronic
315	315	signature on the minor's [child's] birth certificate.
316	316	SECTION 6. Section 161.0072, Health and Safety Code, is
317	317	amended to read as follows:
318	318	Sec. 161.0072. PROVIDING IMMUNIZATION INFORMATION TO
319	319	DEPARTMENT. (a) If the individual or the individual's legally
320	320	authorized representative [parent, managing conservator, or
321	321	guardian of a child] has reasonable concern that the individual's
322	322	[child's] health care provider is not submitting the immunization
323	323	history to the department [and the parent, managing conservator, or
324	324	guardian wants the child included in the registry], the individual
325	325	or the individual's legally authorized representative [parent,
326	326	managing conservator, or guardian] may provide the individual's
327	327	[child's] immunization history directly to the department to be
328	328	included in the immunization registry.
329	329	(b) The individual or the individual's legally authorized
330	330	representative [parent, managing conservator, or guardian of a
331	331	child] may send evidence of the individual's [child's] immunization
332	332	history to the department by facsimile transmission or by mail. The
333	333	evidence may include a copy of:
334	334	(1) the individual's [child's] medical record
335	335	indicating the immunization history;
336	336	(2) an invoice from a health care provider for the
337	337	immunization; or
338	338	(3) documentation showing that a claim for the
339	339	immunization was paid by a payor.
340	340	(c) The board shall develop rules to ensure that the
341	341	immunization history submitted by an individual or the individual's
342	342	legally authorized representative [a parent, managing conservator,
343	343	or guardian] is medically verified immunization information.
344	344	SECTION 7. Sections 161.0073(a), (b), and (c), Health and
345	345	Safety Code, are amended to read as follows:
346	346	(a) Except as provided by Section 161.00705, information
347	347	that individually identifies an [a child or other] individual that
348	348	is received by the department for the immunization registry is
349	349	confidential and may be used by the department for registry
350	350	purposes only.
351	351	(b) Unless specifically authorized under this subchapter,
352	352	the department may not release registry information to any
353	353	individual or entity without the consent of the individual or the
354	354	individual's legally authorized representative [person or, if a
355	355	minor, the parent, managing conservator, or guardian of the child].
356	356	(c) A person required to report information to the
357	357	department for registry purposes or authorized to receive
358	358	information from the registry may not disclose the individually
359	359	identifiable information of an [a child or other] individual to any
360	360	other person without written consent of the individual or the
361	361	individual's legally authorized representative [, if a child, the
362	362	parent, managing conservator, or guardian of the child], except as
363	363	provided by this subchapter, Chapter 159, Occupations Code, or
364	364	Section 602.053, Insurance Code.
365	365	SECTION 8. Sections 161.008(c), (d), (e), (g), and (h),
366	366	Health and Safety Code, are amended to read as follows:
367	367	(c) The department may obtain the data constituting an
368	368	immunization record for an individual [a child] from a public
369	369	health district, a local health department, the individual or the
370	370	individual's legally authorized representative [child's parent,
371	371	managing conservator, or guardian], a physician to the individual
372	372	[child], a payor, or any health care provider licensed or otherwise
373	373	authorized to administer vaccines. Except as provided by this
374	374	subchapter, the [The] department shall verify consent before
375	375	disclosing [including] the reported information in the
376	376	immunization registry. The department may [not] retain
377	377	individually identifiable information about an individual obtained
378	378	under this subsection [a person] for whom consent cannot be
379	379	verified. The department may not disclose the information to other
380	380	users of the registry until consent is verified, except that the
381	381	department may disclose the information to public health officials
382	382	or health authorities during a disaster, emergency, attack, or
383	383	action described by Section 161.00705 in accordance with that
384	384	section.
385	385	(d) The department may release the data constituting an
386	386	immunization record for the individual [child] to:
387	387	(1) any entity that is described by Subsection (c);
388	388	(2) [, to] a school or child care facility in which the
389	389	individual [child] is enrolled;
390	390	(3) [, or to] a state agency having legal custody of
391	391	the individual; or
392	392	(4) any entity as necessary to verify an immunization
393	393	required for:
394	394	(A) admittance in a professional school,
395	395	college, or university;
396	396	(B) certification in a health care profession;
397	397	(C) enlistment in the United States armed forces;
398	398	or
399	399	(D) any other purpose at the request of the
400	400	individual [child].
401	401	(e) An individual or the individual's legally authorized
402	402	representative [A parent, managing conservator, or legal guardian]
403	403	may obtain and on request to the department shall be provided with
404	404	all individually identifiable immunization registry information
405	405	concerning the individual [his or her child or ward].
406	406	(g) The department may release nonidentifying summary
407	407	statistics related to the registry that do not individually
408	408	identify an individual [a child].
409	409	(h) The executive commissioner of the Health and Human
410	410	Services Commission [board] shall adopt rules to implement this
411	411	section.
412	412	SECTION 9. Section 161.009(a), Health and Safety Code, is
413	413	amended to read as follows:
414	414	(a) A person commits an offense if the person:
415	415	(1) negligently releases or discloses immunization
416	416	registry information in violation of Section 161.007, 161.0071,
417	417	161.0073, or 161.008;
418	418	(2) fails to exclude an individual's [a child's]
419	419	immunization information in violation of Section 161.0071;
420	420	(3) fails to remove a person's immunization
421	421	information in violation of Section 161.00705 or 161.00706; or
422	422	(4) negligently uses information in the immunization
423	423	registry to solicit new patients or clients or for other purposes
424	424	that are not associated with immunization or quality-of-care
425	425	purposes, unless authorized under this section.
426	426	SECTION 10. This Act takes effect September 1, 2009.