Texas 2021 - 87th Regular

Texas House Bill HB325 Compare Versions

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

Old	New	Differences
1	1	87R2338 SRA-F
2	2	By: Howard H.B. No. 325
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 excluded from [withdraw consent for the individual
33	33	to be included in] the registry;
34	34	(4) provide opportunities for the individual or the
35	35	individual's legally authorized representative to request
36	36	exclusion from the registry 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 exclusion using a request for exclusion procedure available on
43	43	the department's Internet website;
44	44	(D) through submission to the department of a
45	45	written request for exclusion; 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	exclusion from the registry more than one time and that, after a
51	51	request for exclusion 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 in the
55	55	registry; and
56	56	(6) include on each immunization record generated by
57	57	the registry the procedures for requesting exclusion 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 excluded 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 may
73	73	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 the individual's information to be excluded 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 exclude [remove] from the
98	98	registry 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 exclude [remove]
113	113	information from the registry has been received under this
114	114	subchapter [Section 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 of:
141	141	(1) the inclusion in the registry of the individual's
142	142	immunization information unless exclusion from the registry is
143	143	requested in accordance with the guidelines adopted under
144	144	Subsection (a); and
145	145	(2) the procedures for requesting exclusion 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:
153	153	(A) states an individual's immunization
154	154	information will be included in the registry unless exclusion from
155	155	the registry is requested; and
156	156	(B) details the procedures for submitting an
157	157	electronic or written request for exclusion from the registry
158	158	[provide notice to a health care provider that submits an
159	159	immunization history for an individual for whom consent cannot be
160	160	verified. The notice shall contain instructions for obtaining
161	161	consent] in accordance with guidelines adopted under Subsection
162	162	(a); and
163	163	(2) make the form described by Subdivision (1)
164	164	available for distribution to health care providers [and
165	165	resubmitting the immunization history to the department].
166	166	(e-1) A health care provider may use the printable form
167	167	described by Subsection (e) to provide the notification required
168	168	under Subsection (d).
169	169	(l) Registry information may not be used to exclude any
170	170	individual from the receipt of any service during a natural or
171	171	man-made disaster unless the service is withheld because of a
172	172	medical contraindication.
173	173	(m) The department may not sell registry information to any
174	174	public or private entity.
175	175	SECTION 2. Section 161.00705(f), Health and Safety Code, is
176	176	amended to read as follows:
177	177	(f) Unless an individual or the individual's legally
178	178	authorized representative [consents] in writing or electronically
179	179	requests that [to continued inclusion of] the individual's
180	180	information be excluded from [in] the registry, the department
181	181	shall include [remove] the immunization records collected under
182	182	this section in [from] the registry [on expiration of the period
183	183	prescribed under Subsection (e)].
184	184	SECTION 3. Sections 161.00706(e) and (f), Health and Safety
185	185	Code, are amended to read as follows:
186	186	(e) A person whose immunization records are included in the
187	187	immunization registry as authorized by this section may request in
188	188	writing or electronically that the department exclude [remove] that
189	189	information from the registry. Not later than the 10th day after
190	190	receiving a request under this subsection, the department shall
191	191	exclude [remove] the person's immunization records from the
192	192	registry.
193	193	(f) The report required under Section 161.0074 must also
194	194	include the number of complaints received by the department related
195	195	to the department's failure to comply with requests for exclusion
196	196	[removal] of information from the registry under Subsection (e).
197	197	SECTION 4. Sections 161.0071(a) and (b), Health and Safety
198	198	Code, are amended to read as follows:
199	199	(a) The first time the department receives registry data for
200	200	an individual [for whom the department has received consent] to be
201	201	included in the registry, the department shall send notice to the
202	202	individual or the individual's legally authorized representative
203	203	disclosing:
204	204	(1) that providers and payors may be sending the
205	205	individual's immunization information to the department;
206	206	(2) the information that is included in the registry;
207	207	(3) the persons to whom the information may be
208	208	released under Sections 161.00735(b) and 161.008(d);
209	209	(4) the purpose and use of the registry;
210	210	(5) the procedure to request exclusion of an
211	211	individual's information [exclude an individual] from the
212	212	registry; and
213	213	(6) the procedure to report a violation if an
214	214	individual's information is included in the registry after
215	215	exclusion has been requested [or consent has been withdrawn].
216	216	(b) The [On discovering that consent to be included in the
217	217	registry has not been granted or has been withdrawn, the]
218	218	department shall exclude [the individual's immunization records]
219	219	from the registry and any other registry-related department record
220	220	that individually identifies the individual the immunization
221	221	record of any individual from whom a request for exclusion has been
222	222	received by the department.
223	223	SECTION 5. Section 161.0073, Health and Safety Code, is
224	224	amended by amending Subsection (a) and adding Subsections (e), (f),
225	225	(g), and (h) to read as follows:
226	226	(a) Except as provided by this section and Sections 161.007,
227	227	161.00705, 161.00706, [and] 161.00735, and 161.008, information
228	228	that individually identifies an individual that is received by the
229	229	department for the immunization registry is confidential and may be
230	230	used by the department for registry purposes only.
231	231	(e) The department may use registry information for
232	232	internal public health research on approval of the department's
233	233	institutional review board.
234	234	(f) The department may release registry information for
235	235	external public health research if:
236	236	(1) the individual or the individual's legally
237	237	authorized representative submits a written authorization to the
238	238	department for release of the individual's registry data;
239	239	(2) the department does not disclose individually
240	240	identifiable information; or
241	241	(3) subject to Subsection (g), the department's
242	242	institutional review board approves the release of individually
243	243	identifiable information.
244	244	(g) The department's institutional review board may not
245	245	approve the release of individually identifiable information for a
246	246	research proposal unless the proposal includes a provision
247	247	requiring the proposal's researchers to obtain informed consent
248	248	from each individual or the individual's legally authorized
249	249	representative before the department releases the individual's
250	250	registry data to the researchers.
251	251	(h) The executive commissioner shall adopt rules to ensure
252	252	that the use or release of registry information under this
253	253	subchapter complies with all state and federal laws relating to the
254	254	privacy, protection, confidentiality, and transmission of health
255	255	information, including the Health Insurance Portability and
256	256	Accountability Act of 1996 (Pub. L. No. 104-191) and rules adopted
257	257	under that Act.
258	258	SECTION 6. Sections 161.00735(c), (g), and (h), Health and
259	259	Safety Code, are amended to read as follows:
260	260	(c) The department may receive immunization information
261	261	from a health authority of another state or from a local health
262	262	authority in another state if the department determines that
263	263	residents of that state have evacuated or relocated to this state in
264	264	response to a disaster. The department shall include information
265	265	received under this subsection in the registry. [Notwithstanding
266	266	Section 161.007, the department is not required to obtain written
267	267	consent for the inclusion in the registry of information received
268	268	under this subsection.]
269	269	(g) If an individual or, if a child, the child's parent,
270	270	managing conservator, or guardian requests in writing that the
271	271	individual's or child's information obtained under Subsection (c)
272	272	be excluded [removed] from the registry, the department shall
273	273	exclude [remove] that information from the registry.
274	274	(h) The executive commissioner shall make every effort to
275	275	enter into a memorandum of agreement with each state to which
276	276	residents of this state are likely to evacuate in a disaster on:
277	277	(1) the release to and use by [of registry information
278	278	under this section to] the appropriate health authority or local
279	279	health authority of that state of registry information under this
280	280	section[, including the length of time the information may be
281	281	retained by that state]; and
282	282	(2) the receipt and use of information submitted by
283	283	the health authority or local health authority of that state for
284	284	inclusion in the registry under this section.
285	285	SECTION 7. Sections 161.008(c) and (e), Health and Safety
286	286	Code, are amended to read as follows:
287	287	(c) The department may obtain the data constituting an
288	288	immunization record for an individual from a public health
289	289	district, a local health department, the individual or the
290	290	individual's legally authorized representative, a physician to the
291	291	individual, a payor, or any health care provider licensed or
292	292	otherwise authorized to administer vaccines. [The department shall
293	293	verify consent before including the reported information in the
294	294	immunization registry. The department may not retain individually
295	295	identifiable information about an individual for whom consent
296	296	cannot be verified.]
297	297	(e) An individual or the individual's legally authorized
298	298	representative may obtain and on request to the department shall be
299	299	provided with all individually identifiable immunization registry
300	300	information concerning the individual and information on the
301	301	procedure for requesting exclusion from the registry.
302	302	SECTION 8. Section 161.009(a), Health and Safety Code, is
303	303	amended to read as follows:
304	304	(a) A person commits an offense if the person:
305	305	(1) negligently releases or discloses immunization
306	306	registry information in violation of Section 161.007, 161.0071,
307	307	161.0073, or 161.008;
308	308	(2) fails to exclude an individual's immunization
309	309	information in violation of Section 161.0071;
310	310	(3) fails to exclude [remove] a person's immunization
311	311	information in violation of Section 161.00705, 161.00706, or
312	312	161.00735; or
313	313	(4) negligently uses information in the immunization
314	314	registry to solicit new patients or clients or for other purposes
315	315	that are not associated with immunization or quality-of-care
316	316	purposes, unless authorized under this section.
317	317	SECTION 9. Section 161.0095(a), Health and Safety Code, is
318	318	amended to read as follows:
319	319	(a) The department shall develop:
320	320	(1) continuing education programs for health care
321	321	providers relating to immunizations and the vaccines for children
322	322	program operated by the department under authority of 42 U.S.C.
323	323	Section 1396s; and
324	324	(2) educational information, for health care
325	325	providers, health care clinics, hospitals, and any other health
326	326	care facility that provides health care to children 14 to 18 years
327	327	of age, relating to the immunization registry and the option for an
328	328	individual or the individual's legally authorized representative
329	329	to request exclusion [who is 18 years of age or older to consent to
330	330	submission and retention] of the individual's information from [in]
331	331	the immunization registry.
332	332	SECTION 10. Section 161.0107(c), Health and Safety Code, is
333	333	amended to read as follows:
334	334	(c) The executive commissioner by rule shall specify:
335	335	(1) the fields necessary to populate the immunization
336	336	registry[, including a field that indicates the patient's consent
337	337	to be listed in the immunization registry has been obtained]; and
338	338	(2) the data standards that must be used for
339	339	electronic submission of immunization information.
340	340	SECTION 11. The following provisions of the Health and
341	341	Safety Code are repealed:
342	342	(1) Sections 161.007(a-1), (a-3), (a-4), (a-5), and
343	343	(a-6);
344	344	(2) Sections 161.00705(e) and (h); and
345	345	(3) Sections 161.00735(e) and (f).
346	346	SECTION 12. (a) The changes in law made by this Act to
347	347	Subchapter A, Chapter 161, Health and Safety Code, apply to
348	348	immunization information received by the Department of State Health
349	349	Services before, on, or after January 1, 2023. An individual whose
350	350	immunization information was included immediately before January
351	351	1, 2023, in the immunization registry established under Subchapter
352	352	A, Chapter 161, Health and Safety Code, is subject to the changes in
353	353	law made by this Act to that subchapter, including the procedures
354	354	established by that subchapter as amended by this Act.
355	355	(b) The changes in law made by this Act do not authorize the
356	356	Department of State Health Services to include in the immunization
357	357	registry established under Subchapter A, Chapter 161, Health and
358	358	Safety Code, immunization information of an individual who is 18
359	359	years of age or older and whose immunization information was not
360	360	included in the registry on or before January 1, 2023, unless the
361	361	department receives immunization data from a health care provider
362	362	who:
363	363	(1) administers an immunization to the individual
364	364	after that date and elects to provide the individual's immunization
365	365	information to the department; and
366	366	(2) notifies the individual before submission of the
367	367	information to the department:
368	368	(A) that the health care provider is providing
369	369	the information to the department for inclusion in the registry;
370	370	(B) that the information will remain in the
371	371	registry until exclusion is requested by the individual or the
372	372	individual's legally authorized representative; and
373	373	(C) of the procedures for requesting exclusion
374	374	from the registry under Subchapter A, Chapter 161, Health and
375	375	Safety Code, as amended by this Act.
376	376	(c) The changes in law made by this Act apply only to an
377	377	offense committed on or after the effective date of this Act. An
378	378	offense committed before the effective date of this Act is governed
379	379	by the law in effect on the date the offense was committed, and the
380	380	former law is continued in effect for that purpose. For purposes of
381	381	this section, an offense was committed before the effective date of
382	382	this Act if any element of the offense occurred before that date.
383	383	SECTION 13. (a) As soon as practicable after the effective
384	384	date of this section, the Department of State Health Services shall
385	385	conduct a public awareness campaign to educate health care
386	386	providers, parents, payors, schools, and the public about the
387	387	changes in law made by this Act.
388	388	(b) As soon as practicable after the effective date of this
389	389	section, the executive commissioner of the Health and Human
390	390	Services Commission shall adopt the rules required by Section
391	391	161.0073(h), Health and Safety Code, as added by this Act.
392	392	SECTION 14. (a) Except as provided by Subsection (b) of this
393	393	section, this Act takes effect January 1, 2023.
394	394	(b) Section 13 of this Act takes effect September 1, 2021.