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Texas Annotated Statutes
HEALTH AND SAFETY CODE
TITLE 2. HEALTH
SUBTITLE H. PUBLIC HEALTH PROVISIONS
CHAPTER 161. PUBLIC HEALTH PROVISIONS
SUBCHAPTER A. IMMUNIZATIONS
Date:
08/31/2009
Document:
§ 161.007. Immunization Registry; Reports to Department
(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 of the Health and Human Services Commission 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 is verified, including affirmation by a health care provider, birth registrar, regional health information exchange, or local immunization registry that consent has been obtained.
(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 The consent is valid until the individual becomes 18 years of age unless the consent is withdrawn in writing or electronically. A parent, managing conservator, or guardian of a minor may provide the consent by using an electronic signature on the minor's birth certificate.
(a-2) An individual's legally authorized representative or the individual, after the individual has attained 18 years of age, may consent in writing or electronically for the individual's information to remain in the registry after the individual's 18th birthday and for the individual's subsequent immunizations to be included in the registry. The written or electronic consent of the minor's legally authorized representative as described by Section 161.0001(1-c)(A) must be submitted to the department before the individual's 18th birthday. The written or electronic consent of the individual or the individual's legally authorized representative as described by Section 161.0001(1-c)(B) or (C) must be submitted to the department not later than the individual's 19th birthday. The consent of the representative or individual is valid until the individual or the individual's legally authorized representative withdraws consent in writing or electronically. The department may not include in the registry the immunization information of an individual who is 18 years of age or older until written or electronic consent has been obtained as provided by this subsection. The department shall coordinate with the Texas Education Agency to distribute materials described in Section 161.0095(a)(2) to students and parents through local school districts.
(a-3) The executive commissioner of the Health and Human Services Commission by rule shall develop guidelines and procedures for obtaining consent from an individual after the individual's 18th birthday, including procedures for retaining immunization information in a separate database that is inaccessible by any person other than the department during the one-year period during which an 18-year-old may consent to inclusion in the registry under Subsection (a-2).
(b) Except as provided by Section 161.0071, the immunization registry must contain information on the immunization history that is obtained by the department under:
(1) this section of each individual for whom consent has been obtained in accordance with guidelines adopted under Subsection (a) or (a-3), as applicable;
(2) Section 161.00705 of persons immunized to prepare for or in response to a declared disaster, public health emergency, terrorist attack, hostile military or paramilitary action, or extraordinary law enforcement emergency;
(3) Section 161.00706 of first responders or their immediate family members; and
(4) Section 161.00735 of persons evacuated or relocated to this state because of a disaster.
(b-1) The department shall remove from the registry information for any individual for whom consent has been withdrawn. The department may not retain individually identifiable information about any individual:
(1) for whom consent has been withdrawn;
(2) for whom a consent for continued inclusion in the registry following the end of the declared disaster, public health emergency, terrorist attack, hostile military or paramilitary action, or extraordinary law enforcement emergency has not been received under Section 161.00705(f);
(3) for whom a request to be removed from the registry has been received under Section 161.00706(e);
(4) for whom consent for continued inclusion in the registry following the end of a disaster has not been received under Section 161.00735(f); or
(5) for whom a request to remove information from the registry has been received under Section 161.00735(g).
(c) A payor that receives data elements from a health care provider who administers an immunization to an individual younger than 18 years of age shall provide the data elements to the department. A payor is required to provide the department with only the data elements the payor receives from a health care provider. A payor that receives data elements from a health care provider who administers an immunization to an individual 18 years of age or older may provide the data elements to the department. The data elements shall be submitted in a format prescribed by the department. 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) A health care provider who administers an immunization to an individual younger than 18 years of age shall provide data elements regarding an immunization to the department. A health care provider who administers an immunization to an individual 18 years of age or older may submit data elements regarding an immunization to the department. The data elements shall be submitted in a format prescribed by the department. The department shall verify consent before including the information in the immunization registry. The department may not retain individually identifiable information about an individual for whom consent cannot be verified.
(e) The department shall provide notice to a health care provider that submits an immunization history for an individual for whom consent cannot be verified. The notice shall contain instructions for obtaining consent in accordance with guidelines adopted under Subsections (a) and (a-3) and resubmitting the immunization history to the department.
(f) The department and health care providers may use the registry to provide notices by mail, telephone, personal contact, or other means to an individual or the individual's legally authorized representative regarding an individual who is due or overdue for a particular type of immunization according to the department's immunization schedule for children or another analogous schedule recognized by the department for individuals 18 years of age or older. The department shall consult with health care providers to determine the most efficient and cost-effective manner of using the registry to provide those notices.
(g) The department shall provide instruction and education to providers about the immunization registry provider application and enrollment process. The department shall:
(1) initially target providers in the geographic regions of the state with immunization rates below the state average for preschool children; and
(2) expedite the processing of provider applications.
(h) Nothing in this section diminishes a parent's, managing conservator's, or guardian's responsibility for having a child immunized properly, subject to Section 161.004(d).
(i) A person, including a health care provider, payor, or an employee of the department who submits or obtains in good faith immunization data elements to or from the department in compliance with the provisions of this section and any rules adopted under this section is not liable for any civil damages.
(j) Except as provided by Sections 161.00705, 161.00706, 161.00735(b), and 161.008, information obtained by the department for the immunization registry is confidential and may be disclosed only with the written or electronic consent of the individual or the individual's legally authorized representative.
(k) The executive commissioner of the Health and Human Services Commission shall adopt rules to implement this section.
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