Texas 2017 - 85th Regular

Texas House Bill HB243 Compare Versions

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

Old	New	Differences
1	1	85R673 LED-F
2	2	By: Howard H.B. No. 243
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to the immunization data included in and excluded from the
8	8	immunization registry.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Section 161.007, Health and Safety Code, is
11	11	amended by amending Subsections (a), (a-2), (b), (b-1), (c), (d),
12	12	and (e) and adding Subsections (e-1), (l), and (m) to read as
13	13	follows:
14	14	(a) The department, for the primary purpose of establishing
15	15	and maintaining a single repository of accurate, complete, and
16	16	current immunization records to be used in aiding, coordinating,
17	17	and promoting efficient and cost-effective communicable disease
18	18	prevention and control efforts, shall establish and maintain an
19	19	immunization registry. The executive commissioner by rule shall
20	20	develop guidelines to:
21	21	(1) protect the confidentiality of patients in
22	22	accordance with Section 159.002, Occupations Code;
23	23	(2) inform the individual or the individual's legally
24	24	authorized representative about the registry and that registry
25	25	information may be released under Section 161.00735;
26	26	(3) [require the written or electronic consent of the
27	27	individual or the individual's legally authorized representative
28	28	before any information relating to the individual is included in
29	29	the registry;
30	30	[(4)] permit the individual or the individual's
31	31	legally authorized representative to request that the individual's
32	32	information be removed from [withdraw consent for the individual to
33	33	be included in] the registry;
34	34	(4) provide opportunities for the individual or the
35	35	individual's legally authorized representative to request removal
36	36	at any time, including:
37	37	(A) at the time of the individual's birth if
38	38	attended by a health care provider who administers immunizations;
39	39	(B) each time the individual receives any
40	40	immunization administered by a health care provider in this state;
41	41	(C) through electronic submission of a request
42	42	for removal using a request for removal procedure available on the
43	43	department's Internet website;
44	44	(D) through submission to the department of a
45	45	written request for removal; and
46	46	(E) following a natural or man-made disaster;
47	47	[and]
48	48	(5) ensure that an individual or the individual's
49	49	legally authorized representative is not required to request
50	50	removal from the registry more than one time and that, after a
51	51	request for removal is made, the individual's immunization
52	52	information will not be included in the registry unless the
53	53	individual or the individual's legally authorized representative
54	54	submits to the department a written request for inclusion of the
55	55	individual's information in the registry; and
56	56	(6) include on each immunization record generated by
57	57	the registry the procedures for requesting removal from the
58	58	registry [determine the process by which consent is verified,
59	59	including affirmation by a health care provider, birth registrar,
60	60	regional health information exchange, or local immunization
61	61	registry that consent has been obtained].
62	62	(a-2) [The written or electronic consent required by
63	63	Subsection (a)(3) for an individual who is 18 years of age or older
64	64	is required to be obtained only one time and must be received from
65	65	the individual before the information may be released.] An
66	66	individual's legally authorized representative or the individual,
67	67	after the individual has attained 18 years of age, may submit a
68	68	request [consent] in writing or electronically for the individual's
69	69	information to be removed from [remain in] the registry. [The
70	70	consent of the representative or individual is valid until the
71	71	individual or the individual's legally authorized representative
72	72	withdraws consent in writing or electronically. The department
73	73	may not include in the registry the immunization information of an
74	74	individual who is 26 years of age or older until written or
75	75	electronic consent has been obtained as provided by this
76	76	subsection.] The department shall coordinate with the Texas
77	77	Education Agency to distribute materials described in Section
78	78	161.0095(a)(2) to students and parents through local school
79	79	districts.
80	80	(b) Except as provided by Section 161.0071, the
81	81	immunization registry must contain information on the immunization
82	82	history that is obtained by the department under:
83	83	(1) this section of each individual for whom
84	84	immunization information [consent] has been obtained, unless the
85	85	individual or the individual's legally authorized representative
86	86	has requested that the individual's information be removed from the
87	87	registry in accordance with guidelines adopted under Subsection
88	88	(a);
89	89	(2) Section 161.00705 of persons immunized to prepare
90	90	for or in response to a declared disaster, public health emergency,
91	91	terrorist attack, hostile military or paramilitary action, or
92	92	extraordinary law enforcement emergency;
93	93	(3) Section 161.00706 of first responders or their
94	94	immediate family members; and
95	95	(4) Section 161.00735 of persons evacuated or
96	96	relocated to this state because of a disaster.
97	97	(b-1) The department shall remove from the registry
98	98	information for any individual for whom [consent has been
99	99	withdrawn. The department may not retain individually identifiable
100	100	information about any individual:
101	101	[(1) for whom consent has been withdrawn;
102	102	[(2) for whom a consent for continued inclusion in the
103	103	registry following the end of the declared disaster, public health
104	104	emergency, terrorist attack, hostile military or paramilitary
105	105	action, or extraordinary law enforcement emergency has not been
106	106	received under Section 161.00705(f);
107	107	[(3) for whom a request to be removed from the registry
108	108	has been received under Section 161.00706(e);
109	109	[(4) for whom consent for continued inclusion in the
110	110	registry following the end of a disaster has not been received under
111	111	Section 161.00735(f); or
112	112	[(5) for whom] a request to remove information from
113	113	the registry has been received under this subchapter [Section
114	114	161.00735(g)].
115	115	(c) A payor that receives data elements from a health care
116	116	provider who administers an immunization to an individual younger
117	117	than 18 years of age shall provide the data elements to the
118	118	department. A payor is required to provide the department with only
119	119	the data elements the payor receives from a health care provider. A
120	120	payor that receives data elements from a health care provider who
121	121	administers an immunization to an individual 18 years of age or
122	122	older may provide the data elements to the department. The data
123	123	elements shall be submitted in a format prescribed by the
124	124	department. [The department shall verify consent before including
125	125	the reported information in the immunization registry. The
126	126	department may not retain individually identifiable information
127	127	about an individual for whom consent cannot be verified.]
128	128	(d) A health care provider who administers an immunization
129	129	to an individual younger than 18 years of age shall provide data
130	130	elements regarding an immunization to the department. A health
131	131	care provider who administers an immunization to an individual 18
132	132	years of age or older may submit data elements regarding an
133	133	immunization to the department. At the request and with the
134	134	authorization of the health care provider, the data elements may be
135	135	submitted through a health information exchange as defined by
136	136	Section 182.151. The data elements shall be submitted in a format
137	137	prescribed by the department. A health care provider who
138	138	administers an immunization to any individual and provides data
139	139	elements to the department shall notify the individual or the
140	140	individual's legally authorized representative:
141	141	(1) that the individual's immunization information
142	142	will be included in the registry unless removal from the registry is
143	143	requested in accordance with the guidelines adopted under
144	144	Subsection (a); and
145	145	(2) of the procedures for requesting removal from the
146	146	registry. [The department shall verify consent before including
147	147	the information in the immunization registry. The department may
148	148	not retain individually identifiable information about an
149	149	individual for whom consent cannot be verified.]
150	150	(e) The department shall:
151	151	(1) make available on the department's Internet
152	152	website a printable form that states an individual's immunization
153	153	information will be included in the registry unless removal from
154	154	the registry is requested and that details the procedures for
155	155	submitting an electronic or written request for removal from the
156	156	registry [provide notice to a health care provider that submits an
157	157	immunization history for an individual for whom consent cannot be
158	158	verified. The notice shall contain instructions for obtaining
159	159	consent] in accordance with guidelines adopted under Subsection
160	160	(a); and
161	161	(2) make the form described by Subdivision (1)
162	162	available for distribution to health care providers [and
163	163	resubmitting the immunization history to the department].
164	164	(e-1) A health care provider may use the printable form
165	165	described by Subsection (e) to provide the notification required
166	166	under Subsection (d).
167	167	(l) Registry information may not be used to exclude any
168	168	individual from the receipt of any service during a natural or
169	169	man-made disaster unless the service is withheld because of a
170	170	medical contraindication.
171	171	(m) The department may not sell registry information to any
172	172	public or private entity.
173	173	SECTION 2. Section 161.00705(f), Health and Safety Code, is
174	174	amended to read as follows:
175	175	(f) Unless an individual or the individual's legally
176	176	authorized representative [consents] in writing or electronically
177	177	requests that [to continued inclusion of] the individual's
178	178	information be removed from [in] the registry, the department shall
179	179	include [remove] the immunization records collected under this
180	180	section in [from] the registry [on expiration of the period
181	181	prescribed under Subsection (e)].
182	182	SECTION 3. Sections 161.0071(a) and (b), Health and Safety
183	183	Code, are amended to read as follows:
184	184	(a) The first time the department receives registry data for
185	185	an individual [for whom the department has received consent] to be
186	186	included in the registry, the department shall send notice to the
187	187	individual or the individual's legally authorized representative
188	188	disclosing:
189	189	(1) that providers and payors may be sending the
190	190	individual's immunization information to the department;
191	191	(2) the information that is included in the registry;
192	192	(3) the persons to whom the information may be
193	193	released under Sections 161.00735(b) and 161.008(d);
194	194	(4) the purpose and use of the registry;
195	195	(5) the procedure to exclude an individual from the
196	196	registry; and
197	197	(6) the procedure to report a violation if an
198	198	individual's information is included in the registry after
199	199	exclusion has been requested [or consent has been withdrawn].
200	200	(b) The [On discovering that consent to be included in the
201	201	registry has not been granted or has been withdrawn, the]
202	202	department shall exclude [the individual's immunization records]
203	203	from the registry and any other registry-related department record
204	204	that individually identifies the individual the immunization
205	205	record of any individual from whom a request for exclusion has been
206	206	received by the department.
207	207	SECTION 4. Section 161.0073, Health and Safety Code, is
208	208	amended by amending Subsection (a) and adding Subsections (e), (f),
209	209	(g), and (h) to read as follows:
210	210	(a) Except as provided by this section and Sections 161.007,
211	211	161.00705, 161.00706, [and] 161.00735, and 161.008, information
212	212	that individually identifies an individual that is received by the
213	213	department for the immunization registry is confidential and may be
214	214	used by the department for registry purposes only.
215	215	(e) The department may use registry information for
216	216	internal public health research on approval of the department's
217	217	institutional review board.
218	218	(f) The department may release registry information for
219	219	external public health research if:
220	220	(1) the individual or the individual's legally
221	221	authorized representative submits a written authorization to the
222	222	department for release of the individual's registry data;
223	223	(2) the department does not disclose individually
224	224	identifiable information; or
225	225	(3) the department's institutional review board
226	226	approves the release of individually identifiable information
227	227	subject to Subsection (g).
228	228	(g) The department's institutional review board may not
229	229	approve the release of individually identifiable information for a
230	230	research proposal unless the proposal includes a provision
231	231	requiring the proposal's researchers to obtain informed consent
232	232	from each individual or the individual's legally authorized
233	233	representative before the department releases the individual's
234	234	registry data to the researchers.
235	235	(h) The executive commissioner shall adopt rules to ensure
236	236	that the use or release of registry information under this
237	237	subchapter complies with all state and federal laws relating to the
238	238	privacy, protection, confidentiality, and transmission of health
239	239	information, including the Health Insurance Portability and
240	240	Accountability Act of 1996 (Pub. L. No. 104-191) and rules adopted
241	241	under that Act.
242	242	SECTION 5. Sections 161.00735(c) and (h), Health and Safety
243	243	Code, are amended to read as follows:
244	244	(c) The department may receive immunization information
245	245	from a health authority of another state or from a local health
246	246	authority in another state if the department determines that
247	247	residents of that state have evacuated or relocated to this state in
248	248	response to a disaster. The department shall include information
249	249	received under this subsection in the registry. [Notwithstanding
250	250	Section 161.007, the department is not required to obtain written
251	251	consent for the inclusion in the registry of information received
252	252	under this subsection.]
253	253	(h) The executive commissioner shall make every effort to
254	254	enter into a memorandum of agreement with each state to which
255	255	residents of this state are likely to evacuate in a disaster on:
256	256	(1) the release to and use by [of registry information
257	257	under this section to] the appropriate health authority or local
258	258	health authority of that state of registry information under this
259	259	section[, including the length of time the information may be
260	260	retained by that state]; and
261	261	(2) the receipt and use of information submitted by
262	262	the health authority or local health authority of that state for
263	263	inclusion in the registry under this section.
264	264	SECTION 6. Sections 161.008(c) and (e), Health and Safety
265	265	Code, are amended to read as follows:
266	266	(c) The department may obtain the data constituting an
267	267	immunization record for an individual from a public health
268	268	district, a local health department, the individual or the
269	269	individual's legally authorized representative, a physician to the
270	270	individual, a payor, or any health care provider licensed or
271	271	otherwise authorized to administer vaccines. [The department shall
272	272	verify consent before including the reported information in the
273	273	immunization registry. The department may not retain individually
274	274	identifiable information about an individual for whom consent
275	275	cannot be verified.]
276	276	(e) An individual or the individual's legally authorized
277	277	representative may obtain and on request to the department shall be
278	278	provided with all individually identifiable immunization registry
279	279	information concerning the individual and information on the
280	280	procedure for requesting removal from the registry.
281	281	SECTION 7. Section 161.0095(a), Health and Safety Code, is
282	282	amended to read as follows:
283	283	(a) The department shall develop:
284	284	(1) continuing education programs for health care
285	285	providers relating to immunizations and the vaccines for children
286	286	program operated by the department under authority of 42 U.S.C.
287	287	Section 1396s; and
288	288	(2) educational information, for health care
289	289	providers, health care clinics, hospitals, and any other health
290	290	care facility that provides health care to children 14 to 18 years
291	291	of age, relating to the immunization registry and the option for an
292	292	individual or the individual's legally authorized representative
293	293	to request removal [who is 18 years of age or older to consent to
294	294	submission and retention] of the individual's information from [in]
295	295	the immunization registry.
296	296	SECTION 8. Section 161.0107(c), Health and Safety Code, is
297	297	amended to read as follows:
298	298	(c) The executive commissioner by rule shall specify:
299	299	(1) the fields necessary to populate the immunization
300	300	registry[, including a field that indicates the patient's consent
301	301	to be listed in the immunization registry has been obtained]; and
302	302	(2) the data standards that must be used for
303	303	electronic submission of immunization information.
304	304	SECTION 9. The following provisions of the Health and
305	305	Safety Code are repealed:
306	306	(1) Sections 161.007(a-1), (a-3), (a-4), (a-5), and
307	307	(a-6);
308	308	(2) Sections 161.00705(e) and (h); and
309	309	(3) Sections 161.00735(e) and (f).
310	310	SECTION 10. (a) The changes in law made by this Act to
311	311	Subchapter A, Chapter 161, Health and Safety Code, apply to
312	312	immunization information received by the Department of State Health
313	313	Services before, on, or after January 1, 2019. An individual whose
314	314	immunization information was included immediately before January
315	315	1, 2019, in the immunization registry established under Subchapter
316	316	A, Chapter 161, Health and Safety Code, is subject to the changes in
317	317	law made by this Act to that subchapter, including the procedures
318	318	established by that subchapter as amended by this Act.
319	319	(b) The changes in law made by this Act do not authorize the
320	320	Department of State Health Services to include in the immunization
321	321	registry established under Subchapter A, Chapter 161, Health and
322	322	Safety Code, immunization information of an individual who is 18
323	323	years of age or older and whose immunization information was not
324	324	included in the registry on or before January 1, 2019, unless the
325	325	department receives immunization data from a health care provider
326	326	who:
327	327	(1) administers an immunization to the individual
328	328	after that date and elects to provide the individual's immunization
329	329	information to the department; and
330	330	(2) notifies the individual before submission of the
331	331	information to the department:
332	332	(A) that the health care provider is providing
333	333	the information to the department for inclusion in the registry;
334	334	(B) that the information will remain in the
335	335	registry until removal is requested by the individual or the
336	336	individual's legally authorized representative; and
337	337	(C) of the procedures for requesting removal from
338	338	the registry under Subchapter A, Chapter 161, Health and Safety
339	339	Code, as amended by this Act.
340	340	SECTION 11. (a) As soon as practicable after the effective
341	341	date of this section, the Department of State Health Services shall
342	342	conduct a public awareness campaign to educate health care
343	343	providers, parents, payors, schools, and the public about the
344	344	changes in law made by this Act.
345	345	(b) As soon as practicable after the effective date of this
346	346	section, the executive commissioner of the Health and Human
347	347	Services Commission shall adopt the rules required by Section
348	348	161.0073(h), Health and Safety Code, as added by this Act.
349	349	SECTION 12. (a) Except as provided by Subsection (b) of this
350	350	section, this Act takes effect January 1, 2019.
351	351	(b) Section 11 of this Act takes effect September 1, 2017.