By: Klick, et al. (Senate Sponsor - Kolkhorst) H.B. No. 4272
(In the Senate - Received from the House May 10, 2021;
May 12, 2021, read first time and referred to Committee on Health &
Human Services; May 21, 2021, reported adversely, with favorable
Committee Substitute by the following vote: Yeas 8, Nays 0;
May 21, 2021, sent to printer.)
Click here to see the committee vote
COMMITTEE SUBSTITUTE FOR H.B. No. 4272 By: Seliger
A BILL TO BE ENTITLED
AN ACT
relating to requirements for and prohibited uses of 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 for seven years following
the end of the disaster, 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) The department shall make a reasonable effort to
provide notice to an individual or an individual's legally
authorized representative of the inclusion of the individual's
immunization history in the registry under this section if the
consent required under Subsection (f) has not been obtained before
expiration of the period prescribed by Subsection (e). 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 the 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) must 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. 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 accessible through
the department's Internet website through which an individual or
the individual's legally authorized representative may request
exclusion of the individual's immunization records from the
registry in accordance with Section 161.0071(f).
SECTION 5. 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 exclusion of the individual's
immunization records from the registry through a secure portal
accessed through the department's Internet website.
SECTION 6. 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 for seven years following
the end of the disaster.
SECTION 7. Section 161.008, Health and Safety Code, is
amended by amending Subsections (c) and (d) and adding Subsection
(c-1) 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.
(c-1) Except as provided by Section 161.00705, the [The]
department shall verify consent before including the reported
information in the immunization registry. 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 8. Subchapter A, Chapter 161, Health and Safety
Code, is amended by adding Section 161.0085 to read as follows:
Sec. 161.0085. COVID-19 VACCINE PASSPORTS AND VACCINATION
AS EMPLOYMENT CONDITION PROHIBITED. (a) In this section,
"COVID-19" means the 2019 novel coronavirus disease.
(b) A governmental entity in this state, using information
from the immunization registry authorized by Section 161.007, may
not issue a vaccine passport, vaccine pass, or other standardized
documentation to certify an individual's COVID-19 vaccination
status to a third party for a purpose other than health care or
otherwise publish or share any individual's COVID-19 immunization
record or similar health information for a purpose other than
health care.
(c) A business in this state, using information from the
immunization registry authorized by Section 161.007, may not
require a customer to provide any documentation certifying the
customer's COVID-19 vaccination or post-transmission recovery on
entry to, to gain access to, or to receive service from the
business. A business that fails to comply with this subsection is
not eligible to receive a grant or enter into a contract payable
with state funds.
(d) An employer in this state, using information from the
immunization registry authorized by Section 161.007, may not fail
or refuse to hire, discharge, or otherwise discriminate against an
individual with respect to compensation or the terms, conditions,
or privileges of employment because the individual does not provide
any documentation or other proof certifying the individual's
COVID-19 vaccination status.
(e) Notwithstanding any other law, each appropriate state
agency shall ensure that businesses and employers in this state
comply with Subsections (c) and (d), as applicable, and may require
compliance with those subsections as a condition for a license,
permit, or other state authorization necessary for conducting
business or employing individuals in this state.
(f) This section may not be construed to:
(1) restrict a business or employer from implementing
COVID-19 screening and infection control protocols in accordance
with state and federal law to protect public health; or
(2) interfere with an individual's right to access the
individual's personal health information under federal law.
SECTION 9. 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 described by Subsection
(c) may not include demographic information relating to the
patient.
SECTION 10. Sections 161.007(a-2), (a-3), (a-4), (a-5), and
(a-6), Health and Safety Code, are repealed.
SECTION 11. As soon as practicable after the effective date
of this Act, 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 12. This Act takes effect September 1, 2021.
* * * * *