BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                      



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          |SENATE RULES COMMITTEE            |                   SB 922|
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                                 THIRD READING


          Bill No:  SB 922
          Author:   Negrete McLeod (D)
          Amended:  3/22/11
          Vote:     21

           
           SENATE HEALTH COMMITTEE  :  7-0, 4/13/11
          AYES:  Hernandez, Strickland, Alquist, Anderson, De León, 
            DeSaulnier, Rubio
          NO VOTE RECORDED:  Blakeslee, Wolk

           SENATE APPROPRIATIONS COMMITTEE  :  Senate Rule 28.8


            SUBJECT  :    Immunizations:  disclosure of information:  
                      tuberculosis screening

           SOURCE  :     Health Officers Association of California


           DIGEST  :    This bill adds tuberculosis (TB) screening 
          results to the list of information that may be collected by 
          local health departments and the Department of Public 
          Health (DPH) for immunization information systems.

           ANALYSIS  :    

          Existing law:

          1. Authorizes local health officers to operate immunization 
             information systems in conjunction with the DPH 
             Immunization Branch.  Information systems may be 
             operated jointly among more than one health 
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             jurisdiction. Information contained within the systems 
             may be shared with other health officers operating the 
             systems.  

          2. Allows health care providers and other agencies to 
             disclose specified information from a patient's medical 
             record, or from a client's record, to local health 
             departments (LHD) operating county or regional 
             immunization systems and to DPH.  

          3. Allows LHDs and DPH to disclose this information to each 
             other and to health care providers providing medical 
             care for the patient, upon request. This information 
             includes:

             A.    The names of the patient and his/her parent or 
                guardian;

             B.    The patient or client's date of birth, birthplace, 
                and gender;

             C.    Types and dates of immunizations received by the 
                patient or client, including the manufacturers and 
                lot numbers of the immunizations, as well as any 
                adverse reactions to the immunizations received;

             D.    Other nonmedical information necessary to 
                establish identity; and

             E.    The current address and phone number of the 
                patient or client and the parents or guardians of the 
                patient or client.

          4. Requires, prior to disclosing patient or client 
             information to an immunization system, the disclosing 
             entity to inform the patient or client, or the parent or 
             guardian, that the information may be shared with 
             specified entities.  

          5. Allows a patient or a patient's parent or guardian to 
             refuse to allow records to be shared. 

          6. Permits the patient or client, or parent or guardian, to 
             examine the immunization record and correct errors.

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          7. Allows LHDs and DPH to disclose the information they 
             receive, with the exception of the current address and 
             phone number, to other specified entities upon request. 

          8. Provides that the information may only be used for 
             specified purposes including, but not limited to, 
             compiling immunization population data and protecting 
             the public health. 

          9. Requires health care providers, LHDs, DPH and other 
             specified entities to maintain the confidentiality of 
             this information. 

          10.Allows DPH to add any other disease to the list of 
             required vaccinations for school entry that is 
             consistent with the most current immunization 
             recommendations of the federal Centers for Disease 
             Control and Prevention and the American Academy of 
             Pediatrics. 

          This bill adds TB screening results to the list of 
          information that may be collected by LHDs and DPH for the 
          purpose of immunization information systems.

           Background
           
          California's statewide immunization system is called the 
          California Immunization Registry (CAIR).  CAIR consists of 
          10 regional immunization registries (mostly covering 
          multi-county regions).  Each registry provides a 
          computerized system designed to assist providers in 
          tracking patient immunization records by using web-based 
          registry software to enter immunization data on their 
          patients.  Regional registries work with the state to 
          maintain accurate, complete, and up-to-date immunization 
          histories of patients served by local providers, assist 
          with reminder notices for immunizations due or recall 
          notices for those overdue, and inform parents and guardians 
          about record-sharing and their right to opt out. 

          Relevant agencies, such as schools, child care centers, 
          service providers for the California Special Supplemental 
          Food Program for Women, Infants, and Children (WIC), health 

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          care plans, foster care agencies, and county welfare 
          departments may access the immunization data in CAIR to 
          verify a pupil or client's immunization status or assist in 
          providing medical care or services for a client.  CAIR may 
          also be used to provide the state with the data to assess 
          immunization coverage rates, identify pockets of need, and 
          analyze how best to ensure full immunization coverage.  

          Participation in CAIR is not mandatory for patients or 
          health care providers, but certain immunizations are 
          required for school entry, including Diphtheria, 
          Haemophilus influenzae type b, Measles, Mumps, Pertussis, 
          Poliomyelitis, Rubella, Tetanus, Hepatitis B, and 
          Varicella.  TB screening results are not currently mandated 
          for school entry, but TB is included on the list of 
          communicable diseases mandated to be reported by health 
          providers to their LHDs.

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes   
          Local:  No

           SUPPORT  :   (Verified  5/2/11)

          Health Officers Association of California (source)

           ARGUMENTS IN SUPPORT  :    The Health Officers Association of 
          California believes that not being able to collect TB 
          screening information in the immunization registry is an 
          inconvenience for parents and time-consuming for providers. 
           This bill fixes this by allowing the registry to record TB 
          screening results, which they believe will have the added 
          benefit of helping schools expedite student registration.


          CTW:kc  5/2/11   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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