Texas 2025 - 89th Regular

Texas House Bill HB772 Compare Versions

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

Old	New	Differences
1	1	89R337 SRA-F
2	2	By: Howard H.B. No. 772
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7	7	A BILL TO BE ENTITLED
8	8	AN ACT
9	9	relating to the immunization data included in and excluded from the
10	10	immunization registry.
11	11	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
12	12	SECTION 1. Section 161.007, Health and Safety Code, is
13	13	amended by amending Subsections (a), (a-2), (b), (b-1), (c), (d),
14	14	and (e) and adding Subsections (e-1), (l), and (m) to read as
15	15	follows:
16	16	(a) The department, for the primary purpose of establishing
17	17	and maintaining a single repository of accurate, complete, and
18	18	current immunization records to be used in aiding, coordinating,
19	19	and promoting efficient and cost-effective communicable disease
20	20	prevention and control efforts, shall establish and maintain an
21	21	immunization registry. The executive commissioner by rule shall
22	22	develop guidelines to:
23	23	(1) protect the confidentiality of patients in
24	24	accordance with Section 159.002, Occupations Code;
25	25	(2) inform the individual or the individual's legally
26	26	authorized representative about the registry and that registry
27	27	information may be released under Section 161.00735;
28	28	(3) [require the written or electronic consent of the
29	29	individual or the individual's legally authorized representative
30	30	before any information relating to the individual is included in
31	31	the registry;
32	32	[(4)] permit the individual or the individual's
33	33	legally authorized representative to request exclusion of the
34	34	individual's information from [withdraw consent for the individual
35	35	to be included in] the registry;
36	36	(4) provide opportunities for the individual or the
37	37	individual's legally authorized representative to request
38	38	exclusion from the registry at any time, including:
39	39	(A) at the time of the individual's birth if
40	40	attended by a health care provider who administers immunizations;
41	41	(B) each time a health care provider in this
42	42	state administers any immunization to the individual;
43	43	(C) through electronic submission of a request
44	44	for exclusion using a procedure available on the department's
45	45	Internet website;
46	46	(D) through submission to the department of a
47	47	written request for exclusion; and
48	48	(E) following a natural or man-made disaster;
49	49	[and]
50	50	(5) ensure the individual or the individual's legally
51	51	authorized representative is not required to request exclusion from
52	52	the registry more than one time and, following the department's
53	53	receipt of the request for exclusion, the individual's immunization
54	54	information is not included in the registry unless the individual
55	55	or the individual's legally authorized representative subsequently
56	56	submits to the department a written request for inclusion in the
57	57	registry; and
58	58	(6) include on each immunization record the registry
59	59	generates the procedure for requesting exclusion from the registry
60	60	[determine the process by which consent is verified, including
61	61	affirmation by a health care provider, birth registrar, regional
62	62	health information exchange, or local immunization registry that
63	63	consent has been obtained].
64	64	(a-2) [The written or electronic consent required by
65	65	Subsection (a)(3) for an individual who is 18 years of age or older
66	66	is required to be obtained only one time and must be received from
67	67	the individual before the information may be released.] An
68	68	individual's legally authorized representative or the individual,
69	69	after the individual has attained 18 years of age, may submit a
70	70	request [consent] in writing or electronically for exclusion of the
71	71	individual's information from [to remain in] the registry. [The
72	72	consent of the representative or individual is valid until the
73	73	individual or the individual's legally authorized representative
74	74	withdraws consent in writing or electronically. The department may
75	75	not include in the registry the immunization information of an
76	76	individual who is 26 years of age or older until written or
77	77	electronic consent has been obtained as provided by this
78	78	subsection.] The department shall coordinate with the Texas
79	79	Education Agency to distribute materials described in Section
80	80	161.0095(a)(2) to students and parents through local school
81	81	districts.
82	82	(b) Except as provided by Section 161.0071, the
83	83	immunization registry must contain information on the immunization
84	84	history that is obtained by the department under:
85	85	(1) this section of each individual for whom
86	86	immunization information [consent] has been obtained, unless the
87	87	individual or the individual's legally authorized representative
88	88	requested exclusion of the individual's information from the
89	89	registry in accordance with guidelines adopted under Subsection
90	90	(a);
91	91	(2) Section 161.00705 of individuals [persons]
92	92	immunized to prepare for or in response to a declared disaster,
93	93	public health emergency, terrorist attack, hostile military or
94	94	paramilitary action, or extraordinary law enforcement emergency;
95	95	(3) Section 161.00706 of first responders or their
96	96	immediate family members; and
97	97	(4) Section 161.00735 of individuals [persons]
98	98	evacuated or relocated to this state because of a disaster.
99	99	(b-1) The department shall exclude [remove] from the
100	100	registry information for any individual for whom [consent has been
101	101	withdrawn. The department may not retain individually identifiable
102	102	information about any individual:
103	103	[(1) for whom consent has been withdrawn;
104	104	[(2) for whom a consent for continued inclusion in the
105	105	registry following the end of the declared disaster, public health
106	106	emergency, terrorist attack, hostile military or paramilitary
107	107	action, or extraordinary law enforcement emergency has not been
108	108	received under Section 161.00705(f);
109	109	[(3) for whom a request to be removed from the registry
110	110	has been received under Section 161.00706(e);
111	111	[(4) for whom consent for continued inclusion in the
112	112	registry following the end of a disaster has not been received under
113	113	Section 161.00735(f); or
114	114	[(5) for whom] a request to exclude [remove]
115	115	information from the registry has been received under this
116	116	subchapter [Section 161.00735(g)].
117	117	(c) A payor that receives data elements from a health care
118	118	provider who administers an immunization to an individual younger
119	119	than 18 years of age shall provide the data elements to the
120	120	department. A payor is required to provide the department with only
121	121	the data elements the payor receives from a health care provider. A
122	122	payor that receives data elements from a health care provider who
123	123	administers an immunization to an individual 18 years of age or
124	124	older may provide the data elements to the department. The data
125	125	elements shall be submitted in a format prescribed by the
126	126	department. [The department shall verify consent before including
127	127	the reported information in the immunization registry. The
128	128	department may not retain individually identifiable information
129	129	about an individual for whom consent cannot be verified.]
130	130	(d) A health care provider who administers an immunization
131	131	to an individual younger than 18 years of age shall provide data
132	132	elements regarding an immunization to the department. A health
133	133	care provider who administers an immunization to an individual 18
134	134	years of age or older may submit data elements regarding an
135	135	immunization to the department. At the request and with the
136	136	authorization of the health care provider, the data elements may be
137	137	submitted through a health information exchange as defined by
138	138	Section 182.151. The data elements shall be submitted in a format
139	139	prescribed by the department. A health care provider who
140	140	administers an immunization to any individual and provides data
141	141	elements to the department shall notify the individual or the
142	142	individual's legally authorized representative of:
143	143	(1) the inclusion in the registry of the individual's
144	144	immunization information unless exclusion from the registry is
145	145	requested in accordance with the guidelines adopted under
146	146	Subsection (a); and
147	147	(2) the procedure for requesting exclusion from the
148	148	registry [The department shall verify consent before including the
149	149	information in the immunization registry. The department may not
150	150	retain individually identifiable information about an individual
151	151	for whom consent cannot be verified].
152	152	(e) The department shall:
153	153	(1) post on the department's Internet website a
154	154	printable form that:
155	155	(A) states an individual's immunization
156	156	information will be included in the registry unless exclusion from
157	157	the registry is requested; and
158	158	(B) details the procedure for submitting an
159	159	electronic or written request for exclusion from the registry
160	160	[provide notice to a health care provider that submits an
161	161	immunization history for an individual for whom consent cannot be
162	162	verified. The notice shall contain instructions for obtaining
163	163	consent] in accordance with guidelines adopted under Subsection
164	164	(a); and
165	165	(2) make the form described by Subdivision (1)
166	166	available for distribution to health care providers [and
167	167	resubmitting the immunization history to the department].
168	168	(e-1) A health care provider may use the printable form
169	169	described by Subsection (e) to provide the notification required
170	170	under Subsection (d).
171	171	(l) Registry information may not be used to exclude any
172	172	individual from the receipt of any service during a natural or
173	173	man-made disaster unless the service is withheld because of a
174	174	medical contraindication.
175	175	(m) The department may not sell registry information to any
176	176	public or private entity.
177	177	SECTION 2. Section 161.00705(f), Health and Safety Code, is
178	178	amended to read as follows:
179	179	(f) Unless an individual or the individual's legally
180	180	authorized representative [consents] in writing or electronically
181	181	requests exclusion [to continued inclusion] of the individual's
182	182	information from [in] the registry, the department shall include
183	183	[remove] the immunization records collected under this section in
184	184	[from] the registry [on expiration of the period prescribed under
185	185	Subsection (e)].
186	186	SECTION 3. Sections 161.00706(e) and (f), Health and Safety
187	187	Code, are amended to read as follows:
188	188	(e) A person whose immunization records are included in the
189	189	immunization registry as authorized by this section may request in
190	190	writing or electronically that the department exclude [remove] that
191	191	information from the registry. Not later than the 10th day after
192	192	receiving a request under this subsection, the department shall
193	193	exclude [remove] the person's immunization records from the
194	194	registry.
195	195	(f) The report required under Section 161.0074 must also
196	196	include the number of complaints received by the department related
197	197	to the department's failure to comply with requests for exclusion
198	198	[removal] of information from the registry under Subsection (e).
199	199	SECTION 4. Sections 161.0071(a) and (b), Health and Safety
200	200	Code, are amended to read as follows:
201	201	(a) The first time the department receives registry data for
202	202	an individual [for whom the department has received consent] to be
203	203	included in the registry, the department shall send notice to the
204	204	individual or the individual's legally authorized representative
205	205	disclosing:
206	206	(1) that providers and payors may be sending the
207	207	individual's immunization information to the department;
208	208	(2) the information that is included in the registry;
209	209	(3) the persons to whom the information may be
210	210	released under Sections 161.00735(b) and 161.008(d);
211	211	(4) the purpose and use of the registry;
212	212	(5) the procedure to request exclusion of an
213	213	individual's information [exclude an individual] from the
214	214	registry; and
215	215	(6) the procedure to report a violation if an
216	216	individual's information is included in the registry after
217	217	exclusion has been requested [or consent has been withdrawn].
218	218	(b) The [On discovering that consent to be included in the
219	219	registry has not been granted or has been withdrawn, the]
220	220	department shall exclude [the individual's immunization records]
221	221	from the registry and any other registry-related department record
222	222	that individually identifies the individual the immunization
223	223	record of any individual from whom the department receives a
224	224	request for exclusion.
225	225	SECTION 5. Section 161.0073, Health and Safety Code, is
226	226	amended by amending Subsection (a) and adding Subsections (e), (f),
227	227	(g), and (h) to read as follows:
228	228	(a) Except as provided by this section and Sections 161.007,
229	229	161.00705, 161.00706, [and] 161.00735, and 161.008, information
230	230	that individually identifies an individual that is received by the
231	231	department for the immunization registry is confidential and may be
232	232	used by the department for registry purposes only.
233	233	(e) The department may use registry information for
234	234	internal public health research on approval of the department's
235	235	institutional review board.
236	236	(f) The department may release registry information for
237	237	external public health research if:
238	238	(1) the individual or the individual's legally
239	239	authorized representative submits to the department a written
240	240	authorization for release of the individual's registry data;
241	241	(2) the department does not disclose individually
242	242	identifiable information; or
243	243	(3) subject to Subsection (g), the department's
244	244	institutional review board approves the release of individually
245	245	identifiable information.
246	246	(g) The department's institutional review board may not
247	247	approve the release of individually identifiable information for a
248	248	research proposal unless the proposal includes a provision
249	249	requiring the proposal's researchers to obtain informed consent
250	250	from each individual or the individual's legally authorized
251	251	representative before the department releases the individual's
252	252	registry data to the researchers.
253	253	(h) The executive commissioner shall adopt rules to ensure
254	254	the use or release of registry information under this subchapter
255	255	complies with all state and federal laws relating to the privacy,
256	256	protection, confidentiality, and transmission of health
257	257	information, including the Health Insurance Portability and
258	258	Accountability Act of 1996 (Pub. L. No. 104-191) and rules adopted
259	259	under that Act.
260	260	SECTION 6. Sections 161.00735(c), (g), and (h), Health and
261	261	Safety Code, are amended to read as follows:
262	262	(c) The department may receive immunization information
263	263	from a health authority of another state or from a local health
264	264	authority in another state if the department determines that
265	265	residents of that state have evacuated or relocated to this state in
266	266	response to a disaster. The department shall include information
267	267	received under this subsection in the registry. [Notwithstanding
268	268	Section 161.007, the department is not required to obtain written
269	269	consent for the inclusion in the registry of information received
270	270	under this subsection.]
271	271	(g) If an individual or, if a child, the child's parent,
272	272	managing conservator, or guardian requests in writing that the
273	273	individual's or child's information obtained under Subsection (c)
274	274	be excluded [removed] from the registry, the department shall
275	275	exclude [remove] that information from the registry.
276	276	(h) The executive commissioner shall make every effort to
277	277	enter into a memorandum of agreement with each state to which
278	278	residents of this state are likely to evacuate in a disaster on:
279	279	(1) the release to and use by [of registry information
280	280	under this section to] the appropriate health authority or local
281	281	health authority of that state of registry information under this
282	282	section[, including the length of time the information may be
283	283	retained by that state]; and
284	284	(2) the receipt and use of information submitted by
285	285	the health authority or local health authority of that state for
286	286	inclusion in the registry under this section.
287	287	SECTION 7. Sections 161.008(c) and (e), Health and Safety
288	288	Code, are amended to read as follows:
289	289	(c) The department may obtain the data constituting an
290	290	immunization record for an individual from a public health
291	291	district, a local health department, the individual or the
292	292	individual's legally authorized representative, a physician to the
293	293	individual, a payor, or any health care provider licensed or
294	294	otherwise authorized to administer vaccines. [The department shall
295	295	verify consent before including the reported information in the
296	296	immunization registry. The department may not retain individually
297	297	identifiable information about an individual for whom consent
298	298	cannot be verified.]
299	299	(e) An individual or the individual's legally authorized
300	300	representative may obtain and on request to the department shall be
301	301	provided with all individually identifiable immunization registry
302	302	information concerning the individual and information on the
303	303	procedure for requesting exclusion from the registry.
304	304	SECTION 8. Section 161.009(a), Health and Safety Code, is
305	305	amended to read as follows:
306	306	(a) A person commits an offense if the person:
307	307	(1) negligently releases or discloses immunization
308	308	registry information in violation of Section 161.007, 161.0071,
309	309	161.0073, or 161.008;
310	310	(2) fails to exclude an individual's immunization
311	311	information in violation of Section 161.0071;
312	312	(3) fails to exclude an individual's [remove a
313	313	person's] immunization information in violation of Section
314	314	161.00705, 161.00706, or 161.00735; or
315	315	(4) negligently uses information in the immunization
316	316	registry to solicit new patients or clients or for other purposes
317	317	that are not associated with immunization or quality-of-care
318	318	purposes, unless authorized under this section.
319	319	SECTION 9. Section 161.0095(a), Health and Safety Code, is
320	320	amended to read as follows:
321	321	(a) The department shall develop:
322	322	(1) continuing education programs for health care
323	323	providers relating to immunizations and the vaccines for children
324	324	program operated by the department under authority of 42 U.S.C.
325	325	Section 1396s; and
326	326	(2) educational information, for health care
327	327	providers, health care clinics, hospitals, and any other health
328	328	care facility that provides health care to children 14 to 18 years
329	329	of age, relating to the immunization registry and the option for an
330	330	individual or the individual's legally authorized representative
331	331	to request exclusion [who is 18 years of age or older to consent to
332	332	submission and retention] of the individual's information from [in]
333	333	the immunization registry.
334	334	SECTION 10. Section 161.0107(c), Health and Safety Code, is
335	335	amended to read as follows:
336	336	(c) The executive commissioner by rule shall specify:
337	337	(1) the fields necessary to populate the immunization
338	338	registry[, including a field that indicates the patient's consent
339	339	to be listed in the immunization registry has been obtained]; and
340	340	(2) the data standards that must be used for
341	341	electronic submission of immunization information.
342	342	SECTION 11. The following provisions of the Health and
343	343	Safety Code are repealed:
344	344	(1) Sections 161.007(a-1), (a-3), (a-4), (a-5), and
345	345	(a-6);
346	346	(2) Sections 161.00705(e) and (h); and
347	347	(3) Sections 161.00735(e) and (f).
348	348	SECTION 12. (a) The changes in law made by this Act to
349	349	Subchapter A, Chapter 161, Health and Safety Code, apply to
350	350	immunization information received by the Department of State Health
351	351	Services before, on, or after January 1, 2027. An individual whose
352	352	immunization information was included immediately before January
353	353	1, 2027, in the immunization registry established under Subchapter
354	354	A, Chapter 161, Health and Safety Code, is subject to the changes in
355	355	law made by this Act to that subchapter, including the procedures
356	356	established by that subchapter as amended by this Act.
357	357	(b) The changes in law made by this Act do not authorize the
358	358	Department of State Health Services to include in the immunization
359	359	registry established under Subchapter A, Chapter 161, Health and
360	360	Safety Code, immunization information of an individual who is 18
361	361	years of age or older and whose immunization information was not
362	362	included in the registry on or before January 1, 2027, unless the
363	363	department receives immunization data from a health care provider
364	364	who:
365	365	(1) administers an immunization to the individual
366	366	after that date and elects to provide the individual's immunization
367	367	information to the department; and
368	368	(2) notifies the individual before submission of the
369	369	information to the department:
370	370	(A) that the health care provider is providing
371	371	the information to the department for inclusion in the registry;
372	372	(B) that the information will remain in the
373	373	registry until exclusion is requested by the individual or the
374	374	individual's legally authorized representative; and
375	375	(C) of the procedures for requesting exclusion
376	376	from the registry under Subchapter A, Chapter 161, Health and
377	377	Safety Code, as amended by this Act.
378	378	(c) The changes in law made by this Act apply only to an
379	379	offense committed on or after the effective date of this Act. An
380	380	offense committed before the effective date of this Act is governed
381	381	by the law in effect on the date the offense was committed, and the
382	382	former law is continued in effect for that purpose. For purposes of
383	383	this subsection, an offense was committed before the effective date
384	384	of this Act if any element of the offense occurred before that date.
385	385	SECTION 13. (a) As soon as practicable after the effective
386	386	date of this section, the Department of State Health Services shall
387	387	conduct a public awareness campaign to educate health care
388	388	providers, parents, payors, schools, and the public about the
389	389	changes in law made by this Act.
390	390	(b) As soon as practicable after the effective date of this
391	391	section, the executive commissioner of the Health and Human
392	392	Services Commission shall adopt the rules required by Section
393	393	161.0073(h), Health and Safety Code, as added by this Act.
394	394	SECTION 14. (a) Except as provided by Subsection (b) of this
395	395	section, this Act takes effect January 1, 2027.
396	396	(b) Section 13 of this Act takes effect September 1, 2025.