By: Klick, Oliverson, Howard, Jetton, Guerra, H.B. No. 4272
et al.
A BILL TO BE ENTITLED
AN ACT
relating to requirements for information contained in the
immunization registry.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Sections 161.007(a) and (a-1), 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 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) require the written or electronic consent of the
individual or the individual's legally authorized representative
before any information relating to the individual is included in
the registry;
(4) permit the individual or the individual's legally
authorized representative to withdraw consent for the individual to
be included in the registry; [and]
(5) determine the process by which consent for the
individual's information to be included in the registry is
verified, including affirmation by a health care provider, birth
registrar, regional health information exchange, or local
immunization registry that consent has been obtained; and
(6) determine the process by which the immunization
information of a first responder or immediate family member of a
first responder may be accessed under Section 161.00708.
(a-1) The written or electronic consent required by
Subsection (a)(3) for an individual [younger than 18 years of age]
is required to be obtained only one time. The written or electronic
consent of the individual, or, for a minor child, the individual's
parent, managing conservator, or guardian must be submitted to the
department [before the individual's 18th birthday]. After consent
is submitted, the individual's immunization information may be
included in the registry [until the individual becomes 26 years of
age] unless the consent is withdrawn in writing or electronically[,
or renewed after the individual's 18th birthday as provided by
Subsection (a-2)]. A parent, managing conservator, or guardian of a
minor may provide the consent by using an electronic signature on
the minor's birth certificate.
SECTION 2. Section 161.00705, Health and Safety Code, is
amended by amending Subsections (d) and (e) and adding Subsections
(f-1), (f-2), (f-3), and (f-4) to read as follows:
(d) Sections 161.007, 161.0071, 161.0072, [and] 161.0074,
and 161.008 apply to the data elements submitted to the department
under this section, unless a provision in those sections conflicts
with a requirement in this section.
(e) The [executive commissioner by rule shall determine
the] period during which the information collected under this
section must remain in the immunization registry following the end
of the disaster is seven years[, public health emergency, terrorist
attack, hostile military or paramilitary action, or extraordinary
law enforcement emergency].
(f-1) The executive commissioner by rule shall develop
guidelines and procedures for obtaining the consent required by
Subsection (f) from an individual or the individual's legally
authorized representative for continued inclusion in the registry
of information collected under this section beyond the period
prescribed by Subsection (e).
(f-2) For an individual whose immunization history is
included in the registry under this section and for whom the consent
required under Subsection (f) for continued inclusion has not been
obtained from the individual or the individual's legally authorized
representative, prior to the expiration of the period prescribed by
Subsection (e), the department shall make a reasonable effort to
provide notice to the individual or the individual's legally
authorized representative. The reasonable effort shall include at
least two attempts by the department to provide the notice required
by this subsection by telephone or e-mail, or by regular mail to the
last known address of the individual or the individual's legally
authorized representative. The notice must inform the individual or
the individual's legally authorized representative that the
individual's immunization records collected under this section
will be removed from immunization registry on the expiration of the
period prescribed under Subsection (e) unless the individual or the
individual's legally authorized representative consents to
continued inclusion as provided by Subsection (f).
(f-3) The department shall make a reasonable effort to
obtain current contact information for written or electronic
notices sent by the department under Subsection (f-2) that are
returned due to incorrect address information.
(f-4) Consent for inclusion in the immunization registry
obtained under Section 161.007(a-1) shall meet the consent
requirements of Subsection (f).
SECTION 3. Section 161.00708, Health and Safety Code, is
amended to read as follows:
Sec. 161.00708. ACCESS TO FIRST RESPONDER AND IMMEDIATE
FAMILY MEMBER IMMUNIZATION HISTORY. (a) The department shall
establish a process to provide an employer of a first responder with
direct access to the first responder's immunization information in
the immunization registry for verification of the first responder's
immunization history. The process must require:
(1) a first responder to provide electronic or written
consent before the employer is granted direct access to the first
responder's immunization information in the immunization registry;
and
(2) affirmation by the employer that the first
responder is a current employee of the employer.
(b) A first responder may withdraw consent provided under
Subsection (a)(1) at any time.
(c) [(b)] The department may establish a process to provide
a first responder or an immediate family member of a first responder
with access to the individual's own [first responder's]
immunization information in the immunization registry.
SECTION 4. Section 161.0071, Health and Safety Code, is
amended by adding Subsection (f) to read as follows:
(f) An individual or the individual's legally authorized
representative may request to exclude the individual's
immunization records from the registry through a secure portal
accessed through the department's website.
SECTION 5. Section 161.00735(e), Health and Safety Code, is
amended to read as follows:
(e) The [executive commissioner by rule shall determine
the] period during which the information collected under Subsection
(c) must remain in the immunization registry following the end of
the disaster is seven years.
SECTION 6. Section 161.008, Health and Safety Code, is
amended by amending Subsections (c) and (d) 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. Except as provided by
Section 161.00705, the [The] department shall verify consent before
including the reported information in the immunization registry and
[. The department] may not retain individually identifiable
information about an individual for whom consent cannot be
verified.
(d) The department may release the data constituting an
immunization record for the individual to:
(1) any entity that is described by Subsection (c);
(2) a school or child care facility in which the
individual is enrolled;
(3) a state agency having legal custody of the
individual; or
(4) an employer of a first responder, [or] a first
responder, or an immediate family member of a first responder in
accordance with Section 161.00708.
SECTION 7. Section 161.0107, Health and Safety Code, is
amended by amending Subsection (c) and adding Subsection (e) to
read as follows:
(c) The executive commissioner by rule shall specify:
(1) the fields necessary to populate the immunization
registry, including a "yes" or "no" field that indicates the
patient's consent to be listed in the immunization registry has
been obtained; and
(2) the data standards that must be used for
electronic submission of immunization information.
(e) The fields and data standards specified in Subsection
(c) relating to a patient's consent to be included in the registry
shall not include demographic information relating to the patient.
SECTION 8. Subchapter A, Chapter 161, Health and Safety
Code, is amended by adding Section 161.00709 to read as follows:
Sec. 161.00709. CONSENT PORTAL. The department shall
develop and maintain a secure Internet portal through which an
individual or the individual's legally authorized representative
may request to exclude the individual's immunization records from
the registry in accordance with Section 161.0071(f).
SECTION 9. Sections 161.007(a-2), (a-3), (a-4), (a-5), and
(a-6), Health and Safety Code, are repealed.
SECTION 10. As soon as practicable after September 1, 2021,
the Department of State Health Services shall develop the Internet
portal required by Section 161.00709, Health and Safety Code, as
added by this Act.
SECTION 11. This Act takes effect September 1, 2021.