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.