Texas 2013 - 83rd Regular

Texas House Bill HB772 Compare Versions

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1	1	83R20242 YDB-F
2	2	By: Howard, Zerwas, Callegari H.B. No. 772
3	3	Substitute the following for H.B. No. 772:
4	4	By: Collier C.S.H.B. No. 772
5	5
6	6
7	7	A BILL TO BE ENTITLED
8	8	AN ACT
9	9	relating to the immunization data included in and excluded from the
10	10	immunization registry.
11	11	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
12	12	SECTION 1. Section 161.007, Health and Safety Code, is
13	13	amended by amending Subsections (a), (a-2), (b), (b-1), (c), (d),
14	14	and (e) and adding Subsections (e-1), (l), and (m) to read as
15	15	follows:
16	16	(a) The department, for the primary purpose of establishing
17	17	and maintaining a single repository of accurate, complete, and
18	18	current immunization records to be used in aiding, coordinating,
19	19	and promoting efficient and cost-effective communicable disease
20	20	prevention and control efforts, shall establish and maintain an
21	21	immunization registry. The executive commissioner of the Health
22	22	and Human Services Commission by rule shall develop guidelines to:
23	23	(1) protect the confidentiality of patients in
24	24	accordance with Section 159.002, Occupations Code;
25	25	(2) inform the individual or the individual's legally
26	26	authorized representative about the registry and that registry
27	27	information may be released under Section 161.00735;
28	28	(3) [require the written or electronic consent of the
29	29	individual or the individual's legally authorized representative
30	30	before any information relating to the individual is included in
31	31	the registry;
32	32	[(4)] permit the individual or the individual's
33	33	legally authorized representative to request that the individual's
34	34	information be removed from [withdraw consent for the individual to
35	35	be included in] the registry;
36	36	(4) provide opportunities for the individual or the
37	37	individual's legally authorized representative to request removal:
38	38	(A) at the time of the individual's birth if
39	39	attended by a health care provider who administers immunizations;
40	40	(B) at the time the individual receives any
41	41	immunization administered by a health care provider in this state;
42	42	(C) through electronic submission of a request
43	43	for removal using a request for removal procedure available on the
44	44	department's Internet website;
45	45	(D) through submission to the department of a
46	46	written request for removal; and
47	47	(E) following a natural or man-made disaster; and
48	48	(5) include on each immunization record generated by
49	49	the registry the procedures for requesting removal from the
50	50	registry [determine the process by which consent is verified,
51	51	including affirmation by a health care provider, birth registrar,
52	52	regional health information exchange, or local immunization
53	53	registry that consent has been obtained].
54	54	(a-2) An individual's legally authorized representative or
55	55	the individual, after the individual has attained 18 years of age,
56	56	may submit a request [consent] in writing or electronically for the
57	57	individual's information to be removed from [remain in] the
58	58	registry [after the individual's 18th birthday and for the
59	59	individual's subsequent immunizations to be included in the
60	60	registry. The written or electronic consent of the minor's legally
61	61	authorized representative as described by Section 161.0001(1-c)(A)
62	62	must be submitted to the department before the individual's 18th
63	63	birthday. The written or electronic consent of the individual or
64	64	the individual's legally authorized representative as described by
65	65	Section 161.0001(1-c)(B) or (C) must be submitted to the department
66	66	not later than the individual's 19th birthday. The consent of the
67	67	representative or individual is valid until the individual or the
68	68	individual's legally authorized representative withdraws consent
69	69	in writing or electronically. The department may not include in the
70	70	registry the immunization information of an individual who is 18
71	71	years of age or older until written or electronic consent has been
72	72	obtained as provided by this subsection]. The department shall
73	73	coordinate with the Texas Education Agency to distribute materials
74	74	described in Section 161.0095(a)(2) to students and parents through
75	75	local school districts.
76	76	(b) Except as provided by Section 161.0071, the
77	77	immunization registry must contain information on the immunization
78	78	history that is obtained by the department under:
79	79	(1) this section of each individual for whom
80	80	immunization information [consent] has been obtained, unless the
81	81	individual or the individual's legally authorized representative
82	82	has requested that the individual's information be removed from the
83	83	registry in accordance with guidelines adopted under Subsection (a)
84	84	[or (a-3), as applicable];
85	85	(2) Section 161.00705 of persons immunized to prepare
86	86	for or in response to a declared disaster, public health emergency,
87	87	terrorist attack, hostile military or paramilitary action, or
88	88	extraordinary law enforcement emergency;
89	89	(3) Section 161.00706 of first responders or their
90	90	immediate family members; and
91	91	(4) Section 161.00735 of persons evacuated or
92	92	relocated to this state because of a disaster.
93	93	(b-1) The department shall remove from the registry
94	94	information for any individual for whom [consent has been
95	95	withdrawn. The department may not retain individually identifiable
96	96	information about any individual:
97	97	[(1) for whom consent has been withdrawn;
98	98	[(2) for whom a consent for continued inclusion in the
99	99	registry following the end of the declared disaster, public health
100	100	emergency, terrorist attack, hostile military or paramilitary
101	101	action, or extraordinary law enforcement emergency has not been
102	102	received under Section 161.00705(f);
103	103	[(3) for whom a request to be removed from the registry
104	104	has been received under Section 161.00706(e);
105	105	[(4) for whom consent for continued inclusion in the
106	106	registry following the end of a disaster has not been received under
107	107	Section 161.00735(f); or
108	108	[(5) for whom] a request to remove information from
109	109	the registry has been received under this subchapter [Section
110	110	161.00735(g)].
111	111	(c) A payor that receives data elements from a health care
112	112	provider who administers an immunization to an individual younger
113	113	than 18 years of age shall provide the data elements to the
114	114	department. A payor is required to provide the department with only
115	115	the data elements the payor receives from a health care provider. A
116	116	payor that receives data elements from a health care provider who
117	117	administers an immunization to an individual 18 years of age or
118	118	older may provide the data elements to the department. The data
119	119	elements shall be submitted in a format prescribed by the
120	120	department. [The department shall verify consent before including
121	121	the reported information in the immunization registry. The
122	122	department may not retain individually identifiable information
123	123	about an individual for whom consent cannot be verified.]
124	124	(d) A health care provider who administers an immunization
125	125	to an individual younger than 18 years of age shall provide data
126	126	elements regarding an immunization to the department. A health
127	127	care provider who administers an immunization to an individual 18
128	128	years of age or older may submit data elements regarding an
129	129	immunization to the department. The data elements shall be
130	130	submitted in a format prescribed by the department. A health care
131	131	provider who administers an immunization to any individual and
132	132	provides data elements to the department shall notify the
133	133	individual or the individual's legally authorized representative:
134	134	(1) that the individual's immunization information
135	135	will be included in the registry unless removal from the registry is
136	136	requested in accordance with the guidelines adopted under
137	137	Subsection (a); and
138	138	(2) of the procedures for requesting removal from the
139	139	registry. [The department shall verify consent before including the
140	140	information in the immunization registry. The department may not
141	141	retain individually identifiable information about an individual
142	142	for whom consent cannot be verified.]
143	143	(e) The department shall:
144	144	(1) make available on the department's Internet
145	145	website a printable form that states an individual's immunization
146	146	information will be included in the registry unless removal from
147	147	the registry is requested and that details the procedures for
148	148	submitting an electronic or written request for removal from the
149	149	registry [provide notice to a health care provider that submits an
150	150	immunization history for an individual for whom consent cannot be
151	151	verified. The notice shall contain instructions for obtaining
152	152	consent] in accordance with guidelines adopted under Subsection
153	153	[Subsections] (a); and
154	154	(2) make the form described by Subdivision (1)
155	155	available for distribution to health care providers [and (a-3) and
156	156	resubmitting the immunization history to the department].
157	157	(e-1) A health care provider may use the printable form
158	158	described by Subsection (e) to provide the notification required
159	159	under Subsection (d).
160	160	(l) Registry information may not be used to exclude any
161	161	individual from the receipt of any service during a natural or
162	162	man-made disaster unless the service is withheld because of a
163	163	medical contraindication.
164	164	(m) The department may not sell registry information to any
165	165	public or private entity.
166	166	SECTION 2. Section 161.00705(f), Health and Safety Code, is
167	167	amended to read as follows:
168	168	(f) Unless an individual or the individual's legally
169	169	authorized representative [consents] in writing or electronically
170	170	requests that [to continued inclusion of] the individual's
171	171	information be removed from [in] the registry, the department shall
172	172	include [remove] the immunization records collected under this
173	173	section in [from] the registry [on expiration of the period
174	174	prescribed under Subsection (e)].
175	175	SECTION 3. Sections 161.0071(a) and (b), Health and Safety
176	176	Code, are amended to read as follows:
177	177	(a) The first time the department receives registry data for
178	178	an individual [for whom the department has received consent] to be
179	179	included in the registry, the department shall send notice to the
180	180	individual or the individual's legally authorized representative
181	181	disclosing:
182	182	(1) that providers and payors may be sending the
183	183	individual's immunization information to the department;
184	184	(2) the information that is included in the registry;
185	185	(3) the persons to whom the information may be
186	186	released under Sections 161.00735(b) and 161.008(d);
187	187	(4) the purpose and use of the registry;
188	188	(5) the procedure to exclude an individual from the
189	189	registry; and
190	190	(6) the procedure to report a violation if an
191	191	individual's information is included in the registry after
192	192	exclusion has been requested [or consent has been withdrawn].
193	193	(b) The [On discovering that consent to be included in the
194	194	registry has not been granted or has been withdrawn, the]
195	195	department shall exclude [the individual's immunization records]
196	196	from the registry and any other registry-related department record
197	197	that individually identifies the individual the immunization
198	198	record of any individual from whom a request for exclusion has been
199	199	received by the department.
200	200	SECTION 4. Section 161.0073, Health and Safety Code, is
201	201	amended by amending Subsection (a) and adding Subsections (e), (f),
202	202	and (g) to read as follows:
203	203	(a) Except as provided by this section and Sections 161.007,
204	204	161.00705, 161.00706, [and] 161.00735, and 161.008, information
205	205	that individually identifies an individual that is received by the
206	206	department for the immunization registry is confidential and may be
207	207	used by the department for registry purposes only.
208	208	(e) The department may use registry information for
209	209	internal public health research on approval of the department's
210	210	institutional review board.
211	211	(f) The department may release registry information for
212	212	external public health research if:
213	213	(1) the individual or the individual's legally
214	214	authorized representative submits a written authorization to the
215	215	department for release of the individual's registry data;
216	216	(2) the department does not disclose individually
217	217	identifiable information; or
218	218	(3) the department's institutional review board
219	219	approves the release of individually identifiable information
220	220	subject to Subsection (g).
221	221	(g) The department's institutional review board may not
222	222	approve the release of individually identifiable information for a
223	223	research proposal unless the proposal includes a provision
224	224	requiring the proposal's researchers to obtain informed consent
225	225	from each individual or the individual's legally authorized
226	226	representative before the department releases the individual's
227	227	registry data to the researchers.
228	228	SECTION 5. Sections 161.00735(c) and (h), Health and Safety
229	229	Code, are amended to read as follows:
230	230	(c) The department may receive immunization information
231	231	from a health authority of another state or from a local health
232	232	authority in another state if the department determines that
233	233	residents of that state have evacuated or relocated to this state in
234	234	response to a disaster. The department shall include information
235	235	received under this subsection in the registry. [Notwithstanding
236	236	Section 161.007, the department is not required to obtain written
237	237	consent for the inclusion in the registry of information received
238	238	under this subsection.]
239	239	(h) The executive commissioner of the Health and Human
240	240	Services Commission shall make every effort to enter into a
241	241	memorandum of agreement with each state to which residents of this
242	242	state are likely to evacuate in a disaster on:
243	243	(1) the release to and use by [of registry information
244	244	under this section to] the appropriate health authority or local
245	245	health authority of that state of registry information under this
246	246	section[, including the length of time the information may be
247	247	retained by that state]; and
248	248	(2) the receipt and use of information submitted by
249	249	the health authority or local health authority of that state for
250	250	inclusion in the registry under this section.
251	251	SECTION 6. Sections 161.008(c) and (e), Health and Safety
252	252	Code, are amended to read as follows:
253	253	(c) The department may obtain the data constituting an
254	254	immunization record for an individual from a public health
255	255	district, a local health department, the individual or the
256	256	individual's legally authorized representative, a physician to the
257	257	individual, a payor, or any health care provider licensed or
258	258	otherwise authorized to administer vaccines. [The department shall
259	259	verify consent before including the reported information in the
260	260	immunization registry. The department may not retain individually
261	261	identifiable information about an individual for whom consent
262	262	cannot be verified.]
263	263	(e) An individual or the individual's legally authorized
264	264	representative may obtain and on request to the department shall be
265	265	provided with all individually identifiable immunization registry
266	266	information concerning the individual and information on the
267	267	procedure for requesting removal from the registry.
268	268	SECTION 7. Section 161.0095(a), Health and Safety Code, is
269	269	amended to read as follows:
270	270	(a) The department shall develop:
271	271	(1) continuing education programs for health care
272	272	providers relating to immunizations and the vaccines for children
273	273	program operated by the department under authority of 42 U.S.C.
274	274	Section 1396s; and
275	275	(2) educational information, for health care
276	276	providers, health care clinics, hospitals, and any other health
277	277	care facility that provides health care to children 14 to 18 years
278	278	of age, relating to the immunization registry and the option for an
279	279	individual or the individual's legally authorized representative
280	280	to request removal [who is 18 years of age or older to consent to
281	281	submission and retention] of the individual's information from [in]
282	282	the immunization registry.
283	283	SECTION 8. Section 161.0107(c), Health and Safety Code, is
284	284	amended to read as follows:
285	285	(c) The executive commissioner of the Health and Human
286	286	Services Commission by rule shall specify:
287	287	(1) the fields necessary to populate the immunization
288	288	registry[, including a field that indicates the patient's consent
289	289	to be listed in the immunization registry has been obtained]; and
290	290	(2) the data standards that must be used for
291	291	electronic submission of immunization information.
292	292	SECTION 9. The following provisions of the Health and
293	293	Safety Code are repealed:
294	294	(1) Sections 161.007(a-1) and (a-3);
295	295	(2) Sections 161.00705(e) and (h); and
296	296	(3) Sections 161.00735(e) and (f).
297	297	SECTION 10. The changes in law made by this Act to
298	298	Subchapter A, Chapter 161, Health and Safety Code, apply to
299	299	immunization information received by the Department of State Health
300	300	Services before, on, or after January 1, 2015. An individual whose
301	301	immunization information was included immediately before January
302	302	1, 2015, in the immunization registry established under Subchapter
303	303	A, Chapter 161, Health and Safety Code, is subject to the changes in
304	304	law made by this Act to that subchapter, including the procedures
305	305	established by that subchapter as amended by this Act.
306	306	SECTION 11. As soon as practicable after the effective date
307	307	of this Act, the Department of State Health Services shall conduct a
308	308	public awareness campaign to educate health care providers,
309	309	parents, payors, schools, and the public about the changes in law
310	310	made by this Act.
311	311	SECTION 12. (a) Except as provided by Subsection (b) of this
312	312	section, this Act takes effect January 1, 2015.
313	313	(b) Section 11 of this Act takes effect September 1, 2013.