Texas 2019 - 86th Regular

Texas Senate Bill SB1427 Compare Versions

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

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1	1	By: Zaffirini S.B. No. 1427
2	2
3	3
4	4	A BILL TO BE ENTITLED
5	5	AN ACT
6	6	relating to the immunization data included in and excluded from the
7	7	immunization registry.
8	8	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
9	9	SECTION 1. Section 161.007, Health and Safety Code, is
10	10	amended by amending Subsections (a), (a-2), (b), (b-1), (c), (d),
11	11	and (e) and adding Subsections (e-1), (l), and (m) to read as
12	12	follows:
13	13	(a) The department, for the primary purpose of establishing
14	14	and maintaining a single repository of accurate, complete, and
15	15	current immunization records to be used in aiding, coordinating,
16	16	and promoting efficient and cost-effective communicable disease
17	17	prevention and control efforts, shall establish and maintain an
18	18	immunization registry. The executive commissioner by rule shall
19	19	develop guidelines to:
20	20	(1) protect the confidentiality of patients in
21	21	accordance with Section 159.002, Occupations Code;
22	22	(2) inform the individual or the individual's legally
23	23	authorized representative about the registry and that registry
24	24	information may be released under Section 161.00735;
25	25	(3) [require the written or electronic consent of the
26	26	individual or the individual's legally authorized representative
27	27	before any information relating to the individual is included in
28	28	the registry;
29	29	[(4)] permit the individual or the individual's
30	30	legally authorized representative to request that the individual's
31	31	information be excluded from [withdraw consent for the individual
32	32	to be included in] the registry;
33	33	(4) provide opportunities for the individual or the
34	34	individual's legally authorized representative to request
35	35	exclusion at any time, including:
36	36	(A) at the time of the individual's birth if
37	37	attended by a health care provider who administers immunizations;
38	38	(B) each time the individual receives any
39	39	immunization administered by a health care provider in this state;
40	40	(C) through electronic submission of a request
41	41	for exclusion using a request for exclusion procedure available on
42	42	the department's Internet website;
43	43	(D) through submission to the department of a
44	44	written request for exclusion; and
45	45	(E) following a natural or man-made disaster;
46	46	[and]
47	47	(5) ensure that an individual or the individual's
48	48	legally authorized representative is not required to request
49	49	exclusion from the registry more than one time and that, after a
50	50	request for exclusion is made, the individual's immunization
51	51	information will not be included in the registry unless the
52	52	individual or the individual's legally authorized representative
53	53	submits to the department a written request for inclusion of the
54	54	individual's information in the registry; and
55	55	(6) include on each immunization record generated by
56	56	the registry the procedures for requesting exclusion from the
57	57	registry [determine the process by which consent is verified,
58	58	including affirmation by a health care provider, birth registrar,
59	59	regional health information exchange, or local immunization
60	60	registry that consent has been obtained].
61	61	(a-2) [The written or electronic consent required by
62	62	Subsection (a)(3) for an individual who is 18 years of age or older
63	63	is required to be obtained only one time and must be received from
64	64	the individual before the information may be released.] An
65	65	individual's legally authorized representative or the individual,
66	66	after the individual has attained 18 years of age, may submit a
67	67	request [consent] in writing or electronically for the individual's
68	68	information to be excluded from [remain in] the registry. [The
69	69	consent of the representative or individual is valid until the
70	70	individual or the individual's legally authorized representative
71	71	withdraws consent in writing or electronically. The department may
72	72	not include in the registry the immunization information of an
73	73	individual who is 26 years of age or older until written or
74	74	electronic consent has been obtained as provided by this
75	75	subsection.] The department shall coordinate with the Texas
76	76	Education Agency to distribute materials described in Section
77	77	161.0095(a)(2) to students and parents through local school
78	78	districts.
79	79	(b) Except as provided by Section 161.0071, the
80	80	immunization registry must contain information on the immunization
81	81	history that is obtained by the department under:
82	82	(1) this section of each individual for whom
83	83	immunization information [consent] has been obtained, unless the
84	84	individual or the individual's legally authorized representative
85	85	has requested that the individual's information be excluded from
86	86	the registry in accordance with guidelines adopted under Subsection
87	87	(a);
88	88	(2) Section 161.00705 of persons immunized to prepare
89	89	for or in response to a declared disaster, public health emergency,
90	90	terrorist attack, hostile military or paramilitary action, or
91	91	extraordinary law enforcement emergency;
92	92	(3) Section 161.00706 of first responders or their
93	93	immediate family members; and
94	94	(4) Section 161.00735 of persons evacuated or
95	95	relocated to this state because of a disaster.
96	96	(b-1) The department shall exclude [remove] from the
97	97	registry information for any individual for whom [consent has been
98	98	withdrawn. The department may not retain individually identifiable
99	99	information about any individual:
100	100	[(1) for whom consent has been withdrawn;
101	101	[(2) for whom a consent for continued inclusion in the
102	102	registry following the end of the declared disaster, public health
103	103	emergency, terrorist attack, hostile military or paramilitary
104	104	action, or extraordinary law enforcement emergency has not been
105	105	received under Section 161.00705(f);
106	106	[(3) for whom a request to be removed from the registry
107	107	has been received under Section 161.00706(e);
108	108	[(4) for whom consent for continued inclusion in the
109	109	registry following the end of a disaster has not been received under
110	110	Section 161.00735(f); or
111	111	[(5) for whom] a request to exclude [remove]
112	112	information from the registry has been received under this
113	113	subchapter [Section 161.00735(g)].
114	114	(c) A payor that receives data elements from a health care
115	115	provider who administers an immunization to an individual younger
116	116	than 18 years of age shall provide the data elements to the
117	117	department. A payor is required to provide the department with only
118	118	the data elements the payor receives from a health care provider. A
119	119	payor that receives data elements from a health care provider who
120	120	administers an immunization to an individual 18 years of age or
121	121	older may provide the data elements to the department. The data
122	122	elements shall be submitted in a format prescribed by the
123	123	department. [The department shall verify consent before including
124	124	the reported information in the immunization registry. The
125	125	department may not retain individually identifiable information
126	126	about an individual for whom consent cannot be verified.]
127	127	(d) A health care provider who administers an immunization
128	128	to an individual younger than 18 years of age shall provide data
129	129	elements regarding an immunization to the department. A health
130	130	care provider who administers an immunization to an individual 18
131	131	years of age or older may submit data elements regarding an
132	132	immunization to the department. At the request and with the
133	133	authorization of the health care provider, the data elements may be
134	134	submitted through a health information exchange as defined by
135	135	Section 182.151. The data elements shall be submitted in a format
136	136	prescribed by the department. A health care provider who
137	137	administers an immunization to any individual and provides data
138	138	elements to the department shall notify the individual or the
139	139	individual's legally authorized representative of:
140	140	(1) the inclusion in the registry of the individual's
141	141	immunization information unless exclusion from the registry is
142	142	requested in accordance with the guidelines adopted under
143	143	Subsection (a); and
144	144	(2) the procedures for requesting exclusion from the
145	145	registry. [The department shall verify consent before including
146	146	the information in the immunization registry. The department may
147	147	not retain individually identifiable information about an
148	148	individual for whom consent cannot be verified.]
149	149	(e) The department shall:
150	150	(1) make available on the department's Internet
151	151	website a printable form that states an individual's immunization
152	152	information will be included in the registry unless exclusion from
153	153	the registry is requested and that details the procedures for
154	154	submitting an electronic or written request for exclusion from the
155	155	registry [provide notice to a health care provider that submits an
156	156	immunization history for an individual for whom consent cannot be
157	157	verified. The notice shall contain instructions for obtaining
158	158	consent] in accordance with guidelines adopted under Subsection
159	159	(a); and
160	160	(2) make the form described by Subdivision (1)
161	161	available for distribution to health care providers [and
162	162	resubmitting the immunization history to the department].
163	163	(e-1) A health care provider may use the printable form
164	164	described by Subsection (e) to provide the notification required
165	165	under Subsection (d).
166	166	(l) Registry information may not be used to exclude any
167	167	individual from the receipt of any service during a natural or
168	168	man-made disaster unless the service is withheld because of a
169	169	medical contraindication.
170	170	(m) The department may not sell registry information to any
171	171	public or private entity.
172	172	SECTION 2. Section 161.00705(f), Health and Safety Code, is
173	173	amended to read as follows:
174	174	(f) Unless an individual or the individual's legally
175	175	authorized representative [consents] in writing or electronically
176	176	requests that [to continued inclusion of] the individual's
177	177	information be excluded from [in] the registry, the department
178	178	shall include [remove] the immunization records collected under
179	179	this section in [from] the registry [on expiration of the period
180	180	prescribed under Subsection (e)].
181	181	SECTION 3. Sections 161.00706(e) and (f), Health and Safety
182	182	Code, are amended to read as follows:
183	183	(e) A person whose immunization records are included in the
184	184	immunization registry as authorized by this section may request in
185	185	writing or electronically that the department exclude [remove] that
186	186	information from the registry. Not later than the 10th day after
187	187	receiving a request under this subsection, the department shall
188	188	exclude [remove] the person's immunization records from the
189	189	registry.
190	190	(f) The report required under Section 161.0074 must also
191	191	include the number of complaints received by the department related
192	192	to the department's failure to comply with requests for exclusion
193	193	[removal] of information from the registry under Subsection (e).
194	194	SECTION 4. Sections 161.0071(a) and (b), Health and Safety
195	195	Code, are amended to read as follows:
196	196	(a) The first time the department receives registry data for
197	197	an individual [for whom the department has received consent] to be
198	198	included in the registry, the department shall send notice to the
199	199	individual or the individual's legally authorized representative
200	200	disclosing:
201	201	(1) that providers and payors may be sending the
202	202	individual's immunization information to the department;
203	203	(2) the information that is included in the registry;
204	204	(3) the persons to whom the information may be
205	205	released under Sections 161.00735(b) and 161.008(d);
206	206	(4) the purpose and use of the registry;
207	207	(5) the procedure to request exclusion of an
208	208	individual's information [exclude an individual] from the
209	209	registry; and
210	210	(6) the procedure to report a violation if an
211	211	individual's information is included in the registry after
212	212	exclusion has been requested [or consent has been withdrawn].
213	213	(b) The [On discovering that consent to be included in the
214	214	registry has not been granted or has been withdrawn, the]
215	215	department shall exclude [the individual's immunization records]
216	216	from the registry and any other registry-related department record
217	217	that individually identifies the individual the immunization
218	218	record of any individual from whom a request for exclusion has been
219	219	received by the department.
220	220	SECTION 5. Section 161.0073, Health and Safety Code, is
221	221	amended by amending Subsection (a) and adding Subsections (e), (f),
222	222	(g), and (h) to read as follows:
223	223	(a) Except as provided by this section and Sections 161.007,
224	224	161.00705, 161.00706, [and] 161.00735, and 161.008, information
225	225	that individually identifies an individual that is received by the
226	226	department for the immunization registry is confidential and may be
227	227	used by the department for registry purposes only.
228	228	(e) The department may use registry information for
229	229	internal public health research on approval of the department's
230	230	institutional review board.
231	231	(f) The department may release registry information for
232	232	external public health research if:
233	233	(1) the individual or the individual's legally
234	234	authorized representative submits a written authorization to the
235	235	department for release of the individual's registry data;
236	236	(2) the department does not disclose individually
237	237	identifiable information; or
238	238	(3) the department's institutional review board
239	239	approves the release of individually identifiable information
240	240	subject to Subsection (g).
241	241	(g) The department's institutional review board may not
242	242	approve the release of individually identifiable information for a
243	243	research proposal unless the proposal includes a provision
244	244	requiring the proposal's researchers to obtain informed consent
245	245	from each individual or the individual's legally authorized
246	246	representative before the department releases the individual's
247	247	registry data to the researchers.
248	248	(h) The executive commissioner shall adopt rules to ensure
249	249	that the use or release of registry information under this
250	250	subchapter complies with all state and federal laws relating to the
251	251	privacy, protection, confidentiality, and transmission of health
252	252	information, including the Health Insurance Portability and
253	253	Accountability Act of 1996 (Pub. L. No. 104-191) and rules adopted
254	254	under that Act.
255	255	SECTION 6. Sections 161.00735(c), (g), and (h), Health and
256	256	Safety Code, are amended to read as follows:
257	257	(c) The department may receive immunization information
258	258	from a health authority of another state or from a local health
259	259	authority in another state if the department determines that
260	260	residents of that state have evacuated or relocated to this state in
261	261	response to a disaster. The department shall include information
262	262	received under this subsection in the registry. [Notwithstanding
263	263	Section 161.007, the department is not required to obtain written
264	264	consent for the inclusion in the registry of information received
265	265	under this subsection.]
266	266	(g) If an individual or, if a child, the child's parent,
267	267	managing conservator, or guardian requests in writing that the
268	268	individual's or child's information obtained under Subsection (c)
269	269	be excluded [removed] from the registry, the department shall
270	270	exclude [remove] that information from the registry.
271	271	(h) The executive commissioner shall make every effort to
272	272	enter into a memorandum of agreement with each state to which
273	273	residents of this state are likely to evacuate in a disaster on:
274	274	(1) the release to and use by [of registry information
275	275	under this section to] the appropriate health authority or local
276	276	health authority of that state of registry information under this
277	277	section[, including the length of time the information may be
278	278	retained by that state]; and
279	279	(2) the receipt and use of information submitted by
280	280	the health authority or local health authority of that state for
281	281	inclusion in the registry under this section.
282	282	SECTION 7. Sections 161.008(c) and (e), Health and Safety
283	283	Code, are amended to read as follows:
284	284	(c) The department may obtain the data constituting an
285	285	immunization record for an individual from a public health
286	286	district, a local health department, the individual or the
287	287	individual's legally authorized representative, a physician to the
288	288	individual, a payor, or any health care provider licensed or
289	289	otherwise authorized to administer vaccines. [The department shall
290	290	verify consent before including the reported information in the
291	291	immunization registry. The department may not retain individually
292	292	identifiable information about an individual for whom consent
293	293	cannot be verified.]
294	294	(e) An individual or the individual's legally authorized
295	295	representative may obtain and on request to the department shall be
296	296	provided with all individually identifiable immunization registry
297	297	information concerning the individual and information on the
298	298	procedure for requesting exclusion from the registry.
299	299	SECTION 8. Section 161.009(a), Health and Safety Code, is
300	300	amended to read as follows:
301	301	(a) A person commits an offense if the person:
302	302	(1) negligently releases or discloses immunization
303	303	registry information in violation of Section 161.007, 161.0071,
304	304	161.0073, or 161.008;
305	305	(2) fails to exclude an individual's immunization
306	306	information in violation of Section 161.0071;
307	307	(3) fails to exclude [remove] a person's immunization
308	308	information in violation of Section 161.00705, 161.00706, or
309	309	161.00735; or
310	310	(4) negligently uses information in the immunization
311	311	registry to solicit new patients or clients or for other purposes
312	312	that are not associated with immunization or quality-of-care
313	313	purposes, unless authorized under this section.
314	314	SECTION 9. Section 161.0095(a), Health and Safety Code, is
315	315	amended to read as follows:
316	316	(a) The department shall develop:
317	317	(1) continuing education programs for health care
318	318	providers relating to immunizations and the vaccines for children
319	319	program operated by the department under authority of 42 U.S.C.
320	320	Section 1396s; and
321	321	(2) educational information, for health care
322	322	providers, health care clinics, hospitals, and any other health
323	323	care facility that provides health care to children 14 to 18 years
324	324	of age, relating to the immunization registry and the option for an
325	325	individual or the individual's legally authorized representative
326	326	to request exclusion [who is 18 years of age or older to consent to
327	327	submission and retention] of the individual's information from [in]
328	328	the immunization registry.
329	329	SECTION 10. Section 161.0107(c), Health and Safety Code, is
330	330	amended to read as follows:
331	331	(c) The executive commissioner by rule shall specify:
332	332	(1) the fields necessary to populate the immunization
333	333	registry[, including a field that indicates the patient's consent
334	334	to be listed in the immunization registry has been obtained]; and
335	335	(2) the data standards that must be used for
336	336	electronic submission of immunization information.
337	337	SECTION 11. The following provisions of the Health and
338	338	Safety Code are repealed:
339	339	(1) Sections 161.007(a-1), (a-3), (a-4), (a-5), and
340	340	(a-6);
341	341	(2) Sections 161.00705(e) and (h); and
342	342	(3) Sections 161.00735(e) and (f).
343	343	SECTION 12. (a) The changes in law made by this Act to
344	344	Subchapter A, Chapter 161, Health and Safety Code, apply to
345	345	immunization information received by the Department of State Health
346	346	Services before, on, or after January 1, 2021. An individual whose
347	347	immunization information was included immediately before January
348	348	1, 2021, in the immunization registry established under Subchapter
349	349	A, Chapter 161, Health and Safety Code, is subject to the changes in
350	350	law made by this Act to that subchapter, including the procedures
351	351	established by that subchapter as amended by this Act.
352	352	(b) The changes in law made by this Act do not authorize the
353	353	Department of State Health Services to include in the immunization
354	354	registry established under Subchapter A, Chapter 161, Health and
355	355	Safety Code, immunization information of an individual who is 18
356	356	years of age or older and whose immunization information was not
357	357	included in the registry on or before January 1, 2021, unless the
358	358	department receives immunization data from a health care provider
359	359	who:
360	360	(1) administers an immunization to the individual
361	361	after that date and elects to provide the individual's immunization
362	362	information to the department; and
363	363	(2) notifies the individual before submission of the
364	364	information to the department:
365	365	(A) that the health care provider is providing
366	366	the information to the department for inclusion in the registry;
367	367	(B) that the information will remain in the
368	368	registry until exclusion is requested by the individual or the
369	369	individual's legally authorized representative; and
370	370	(C) of the procedures for requesting exclusion
371	371	from the registry under Subchapter A, Chapter 161, Health and
372	372	Safety Code, as amended by this Act.
373	373	(c) The changes in law made by this Act apply only to an
374	374	offense committed on or after the effective date of this Act. An
375	375	offense committed before the effective date of this Act is governed
376	376	by the law in effect on the date the offense was committed, and the
377	377	former law is continued in effect for that purpose. For purposes of
378	378	this section, an offense was committed before the effective date of
379	379	this Act if any element of the offense occurred before that date.
380	380	SECTION 13. (a) As soon as practicable after the effective
381	381	date of this section, the Department of State Health Services shall
382	382	conduct a public awareness campaign to educate health care
383	383	providers, parents, payors, schools, and the public about the
384	384	changes in law made by this Act.
385	385	(b) As soon as practicable after the effective date of this
386	386	section, the executive commissioner of the Health and Human
387	387	Services Commission shall adopt the rules required by Section
388	388	161.0073(h), Health and Safety Code, as added by this Act.
389	389	SECTION 14. (a) Except as provided by Subsection (b) of this
390	390	section, this Act takes effect January 1, 2021.
391	391	(b) Section 13 of this Act takes effect September 1, 2019.