HBA-MPM, NRS H.B. 1702 77(R) BILL ANALYSIS Office of House Bill AnalysisH.B. 1702 By: Green Public Health 5/3/2001 Introduced BACKGROUND AND PURPOSE In 1997, the Texas Department of Health (department) established an immunization registry tracking system called Immtrac for the purpose of monitoring immunization rates for children in Texas. This tracking system also serves as an information depository for providers, who are then able to determine if a child's immunization record is current. For children who do not regularly see the same care provider, Immtrac serves to protect them from duplicate immunizations. However, the current system lacks data from the private sector, and therefore does not provide an adequate picture of immunization rates in Texas. House Bill 1702 establishes the Texas immunization advisory committee to assist the department and the Texas Board of Health in the development of procedures, guidelines, and policies related to immunizations and requires a report on the immunization history of a person younger than 18 years to be in a format prescribed by the department. The bill changes Immtrac from an opt-in to an opt-out system and adds an exemption from immunization for reasons of conscience. RULEMAKING AUTHORITY It is the opinion of the Office of House Bill Analysis that rulemaking authority is expressly delegated to the Texas Board of Health in SECTION 5 (Section 161.007, Health and Safety Code) and SECTION 14 of this bill. ANALYSIS House Bill 1702 amends the Health and Safety Code to establish the Texas immunization advisory committee (committee) to assist the Texas Board of Health (board) and the Texas Department of Health (department) in the development of procedures, guidelines, and policies related to immunizations. The bill sets forth the composition and duties of the committee (Secs 110.002, 110.003, and 110.004). The bill provides that a person who administers a vaccination or immunization is not liable for the failure to immunize a child because the child's parent, guardian, or managing conservator (parent) does not consent to the vaccination or immunization of that child for reasons of conscience or religious belief (Secs. 161.001). The bill provides that a child is exempt from an immunization required by the state if the child's parent states that the immunization is being declined for reasons of conscience or religious belief (Sec. 161.004). The bill requires the department to develop and provide an exemption form to a person subject to exclusion from a school or facility because the person declines a required immunization for reasons of conscience or because of religious belief. The bill sets forth the contents of the form and requires the department to provide the exemption form on request by mail, facsimile, or electronic mail, or through the department's Internet website in a printable format (Sec. 161.0045). The bill permits a parent to choose to have the patient excluded from the department's childhood immunization registry (registry) rather than requiring the written consent of the parent to include the patient in the registry. The bill requires a report from an organization that pays or reimburses a claim for an immunization on the immunization history of a person younger than 18 years to be in a format prescribed by the department, which may include submission in writing, by electronic format, or by voice. The bill requires the department to consult with such organizations and health care providers to determine the most efficient and cost-effective manner of reporting immunization histories. The bill provides that the notice to parents regarding a due or overdue immunization must contain instructions for the parent to request that future notices not be sent and to remove the child's immunization record from the registry and all department files. The notice must describe the procedure to report a violation if a child is included in the registry after requesting exclusion. The bill requires the board to adopt rules to implement immunization provisions (Sec. 161.007). H.B. 1702 requires the department to send a written notification to the child's parent disclosing certain information relating to the registry the first time the department receives data for a child. The bill requires the department to destroy all of a child's immunization records in the possession of the department and delete the child's immunization records from the registry and any other registry-related department record that individually identifies the child not later than the 30th day after the date the department receives from the parent of the child a written request that the child be excluded from the registry. The department commits a violation if the department fails to exclude a child from the registry within 30 days of receiving the written request. The bill requires the department to accept any written indication from a parent communicating to the department that a child should be excluded from the registry, including a statement on the child's birth certificate, as a request for exclusion from the registry (Sec. 161.0071). The bill provides that information that individually identifies a child received by the department for the immunization registry is confidential and is authorized for use by the department for registry purposes only. The bill prohibits the department from releasing registry information to any individual or entity without the consent of the person or if the person is a minor the person's parent. The bill prohibits a person required to report information to the department for registry purposes from disclosing individually identifiable information of a child to any other person without written consent of a parent except to a physician providing medical treatment to the child. The bill provides that registry information cannot be brought before a court of law (Sec. 161.0072). The bill authorizes the department to obtain and release data constituting an immunization record for a child to certain health care related organizations without requiring consent of a child's parent (Sec. 161.008). The bill requires the department to report to the Legislative Budget Board and the governor ways increase immunization rates using state and federal resources (Sec. 161.0075). H.B. 1702 amends the Education Code to set forth provisions for the exemption from immunization requirements for admission to elementary or secondary schools or an institution of higher education due to the possibility of an injury being inflicted or for reasons of conscience or religious beliefs (Secs. 38.001 and 51.933). The bill requires each public school to keep a record of personal or religious exemption from immunization for each student admitted to a school. The bill requires each school to submit a report annually to the department stating the number and type of exemptions on file for children who are attending a school and exercising the exemption option (Sec. 38.002). The bill amends the Human Resources Code to authorize a child care facility to refuse admission to a child who has not received the required immunization unless exemptions are made from immunization for admission due to the possibility of an injury being inflicted on a child or for reasons of conscience or for religious beliefs in the form of an immunization exemption form signed by the child's parent (Sec. 42.043). The bill requires the board of health to appoint members of the Texas immunization advisory committee not later than September 1, 2001. The bill requires the board to adopt rules necessary to implement procedures for excluding children from the immunization registry and to make available the immunization exemption form as soon as practicable but no later than August 1, 2002. The bill prohibits the report on immunization histories and the immunization record data from being accepted or released by the department until the department has adopted rules and prescribed the immunization exemption form (SECTION 14). EFFECTIVE DATE On passage, or if the Act does not receive the necessary vote, the Act takes effect September 1, 2001.