§ 2168 — Statewide immunization information system

§ 2168. Statewide immunization information system. 1. The department\nis hereby directed to establish a statewide automated and electronic\nimmunization information system that will serve, and shall be\nadministered consistent with, the following public health purposes:\n (a) collect reports of immunizations and thus reduce the incidence of\nillness, disability and death due to vaccine preventable diseases and\ncollect results of blood lead analyses performed by physician office\nlaboratories to provide to the statewide registry of lead levels of\nchildren established pursuant to section thirteen hundred seventy-a of\nthis chapter;\n (b) establish the public health infrastructure necessary to obtain,\ncollect, preserve, and disclose information relating to vaccine\npreventable disease as it may promote the health and well-being of all\nchildren in this state;\n (c) make available to an individual, or parents, guardians, or other\nperson in a custodial relation to a child or, to local health districts,\nlocal social services districts responsible for the care and custody of\nchildren, health care providers and their designees, schools, WIC\nprograms, and third party payers the immunization status of children;\nand\n (d) appropriately protecting the confidentiality of individual\nidentifying information and the privacy of persons included in the\nstatewide immunization information system and their families.\n 2. For the purposes of this section:\n (a) The term "authorized user" shall mean any person or entity\nauthorized to provide information to or to receive information from the\nstatewide immunization information system and shall include health care\nproviders and their designees, as defined in paragraph (d) of this\nsubdivision, schools as defined in paragraph a of subdivision one of\nsection twenty-one hundred sixty-four of this title, colleges as defined\nin section two of the education law, professional and technical schools\nas referred to in the definition of higher education in section two of\nthe education law, children's overnight camps and summer day camps as\ndefined in section thirteen hundred ninety-two of this chapter, third\nparty payer as defined in paragraph (f) of this subdivision, local\nhealth districts as defined by paragraph (c) of subdivision one of\nsection two of this chapter, local social services districts and the\noffice of children and family services with regard to children in their\nlegal custody, WIC programs as defined in paragraph (g) of this\nsubdivision, registered professional nurses, and pharmacists authorized\nto administer immunizations pursuant to subdivision two of section\nsixty-eight hundred one of the education law. An authorized user may be\nlocated outside New York state. An entity other than a local health\ndistrict shall be an authorized user only with respect to a person\nseeking or receiving a health care service from the health care\nprovider, a person enrolled or seeking to be enrolled in the school, a\nperson insured by the third party payer, a person in the custody of the\nlocal social services district or the office of children and family\nservices, or a person seeking or receiving services through WIC\nprograms, as the case may be.\n (b) The term "statewide immunization information system" or "system"\nshall mean a statewide-computerized database maintained by the\ndepartment capable of collecting, storing, and disclosing the electronic\nand paper records of vaccinations received by persons under nineteen\nyears of age.\n (c) The term "citywide immunization registry" shall mean the\ncomputerized database maintained by the city of New York department of\nhealth and mental hygiene capable of collecting, storing, and disclosing\nthe electronic and paper records of vaccinations received by persons\nless than nineteen years of age. The term "citywide immunization\nregistry" shall not include the childhood blood lead registry\nestablished pursuant to the health code of the city of New York. For the\npurposes of this section the term New York city department of health and\nmental hygiene, shall mean such agency or any successor agency\nresponsible for the citywide immunization registry.\n (d) The term "health care provider" shall mean any person authorized\nby law to order an immunization or analysis of a blood sample for lead\nor any health care facility licensed under article twenty-eight of this\nchapter or any certified home health agency established under section\nthirty-six hundred six of this chapter; with respect to a person seeking\nor receiving a health care service from the health care provider.\n (e) For purposes of this section a school is a public health\nauthority, as defined in section 164.501 of part 45 of the federal code\nof rules, responsible for screening the immunization status of each\nchild pursuant to section twenty-one hundred sixty-four of this article.\n (f) The term "third party payer" shall mean health maintenance\norganizations certified under article forty-four of this chapter, health\nservice corporations licensed pursuant to article forty-three of the\ninsurance law, self-insured plans that pay for health care services,\nhealth insurance companies subject to article thirty-two of the\ninsurance law which offer preferred provider products, corporations\nsubject to article forty-three of the insurance law which offer\npreferred provider products, municipal cooperative health benefit plans\ncertified pursuant to article forty-seven of the insurance law which\noffer preferred provider products, and preferred provider organizations\nas defined in section three hundred fifty-two of the workers'\ncompensation law.\n (g) For purposes of this section the term "WIC program" shall mean a\nstate or local agency, as described pursuant to section 1786 of title 42\nof the United States Code.\n (h) The term "physician office laboratory" shall mean a laboratory\noperated by a health care provider pursuant to subdivision one of\nsection five hundred seventy-nine of this chapter that is certified by\nthe Centers for Medicare and Medicaid Services under regulations\nimplementing the federal Clinical Laboratory Improvement Amendments of\n1988 (CLIA).\n 3. (a) (i) Any health care provider who administers any vaccine to a\nperson less than nineteen years of age or, on or after September first,\ntwo thousand nine, conducts a blood lead analysis of a sample obtained\nfrom a person under eighteen years of age in accordance with paragraph\n(h) of subdivision two of this section; and immunizations received by a\nperson less than nineteen years of age in the past if not already\nreported, shall report all such immunizations and the results of any\nblood lead analysis to the department in a format prescribed by the\ncommissioner within fourteen days of administration of such\nimmunizations or of obtaining the results of any such blood lead\nanalysis. Health care providers administering immunizations to persons\nless than nineteen years of age in the city of New York shall report, in\na format prescribed by the city of New York commissioner of health and\nmental hygiene, all such immunizations to the citywide immunization\nregistry. Health care providers who conduct a blood lead analysis on a\nperson under eighteen years of age and who report the results of such\nanalysis to the city of New York commissioner of health and mental\nhygiene pursuant to New York city reporting requirements shall be exempt\nfrom this requirement for reporting blood lead analysis results to the\nstate commissioner of health; provided, however, blood lead analysis\ndata collected from physician office laboratories by the commissioner of\nhealth and mental hygiene of the city of New York pursuant to the health\ncode of the city of New York shall be provided to the department in a\nformat prescribed by the commissioner.\n (ii) A pharmacist who administers a vaccine pursuant to subdivision\ntwo of section sixty-eight hundred one of the education law, to a person\nless than nineteen years of age, shall report all such immunizations to\nthe department in a format prescribed by the commissioner within\nfourteen days of administration of such immunizations. Pharmacists\nadministering immunizations pursuant to subdivision two of section\nsixty-eight hundred one of the education law to persons less than\nnineteen years of age in the city of New York shall report, in a format\nprescribed by the city of New York commissioner of health and mental\nhygiene, all such immunizations to the citywide immunization registry.\n (b) (i) Any health care provider who administers any vaccine to a\nperson nineteen years of age or older, may report, with the consent of\nthe vaccinee, all such immunizations to the department in a format\nprescribed by the commissioner within fourteen days of administration of\nsuch immunizations. Health care providers administering immunizations to\npersons nineteen years of age or older in the city of New York may\nreport, with the consent of the vaccinee, in a format prescribed by the\ncity of New York commissioner of health and mental hygiene, all such\nimmunizations to the citywide immunization registry.\n (ii) A registered professional nurse, or a pharmacist who administers\na vaccine pursuant to subdivision two of section sixty-eight hundred one\nof the education law, to a person nineteen years of age or older, shall\nreport, with the consent of the vaccinee, all such immunizations to the\ndepartment in a format prescribed by the commissioner within fourteen\ndays of administration of such immunizations. Registered professional\nnurses or pharmacists administering immunizations pursuant to\nsubdivision two of section sixty-eight hundred one of the education law,\nto persons nineteen years of age or older in the city of New York shall\nreport, with the consent of the vaccinee, in a format prescribed by the\ncity of New York commissioner of health and mental hygiene, all such\nimmunizations to the citywide immunization registry.\n (c) The statewide immunization information system shall provide a\nmethod for health care providers to determine when the registrant is due\nor late for a recommended immunization and shall serve as a means for\nauthorized users to receive prompt and accurate information, as reported\nto the system, about the vaccines that the registrant has received.\n 4. (a) All information maintained by the department, or in the case of\nthe citywide immunization registry, the city of New York under the\nprovisions of this section shall be confidential except as necessary to\ncarry out the provisions of this section and shall not be released for\nany other purpose.\n (b) The department and for the city of New York the department of\nhealth and mental hygiene may also disclose or provide such information\nto an authorized user when (i) such person or agency provides sufficient\nidentifying information satisfactory to the department to identify such\nregistrant and (ii) such disclosure or provision of information is in\nthe best interests of the registrant or his or her family, or will\ncontribute to the protection of the public health.\n (c) Any data collected by the department may be included in the\nstatewide immunization information system and the statewide registry of\nlead levels of children if collection, storage and access of such data\nis otherwise authorized. Such data may be disclosed to the statewide\nimmunization information system only if provided for in statute or\nregulation, and shall be subject to any provisions in such statute or\nregulation limiting the use or redisclosure of the data. Nothing\ncontained in this paragraph shall permit inclusion of data in the\nstatewide immunization information system if that data could not\notherwise be accessed or disclosed in the absence of the system. For the\ncity of New York the commissioner of health and mental hygiene may\ninclude data collected in the citywide immunization registry as provided\nin this paragraph.\n (c-1) The department may require the collection of, maintenance and\naccess to newborn infant hearing screening data and results through the\nstatewide immunization information system in accordance with section\ntwenty-five hundred-g of this chapter.\n (d) A person, institution or agency to whom such immunization\ninformation is furnished or to whom, access to records or information\nhas been given, shall not divulge any part thereof so as to disclose the\nidentity of such person to whom such information or record relates,\nexcept insofar as such disclosure is necessary for the best interests of\nthe person or other persons, consistent with the purposes of this\nsection.\n 5. (a) All health care providers and their designees, except for\nproviders reporting to the citywide immunization registry, shall submit\nto the commissioner information about any vaccinee less than nineteen\nyears of age and about each vaccination given after January first, two\nthousand eight. The information provided to the system or the citywide\nimmunization registry shall include the national immunization program\ndata elements and other elements required by the commissioner. For the\ncity of New York the commissioner of health and mental hygiene may\nrequire additional elements with prior notice to the commissioner of any\nchanges.\n (b) In addition to the immunization administration information\nrequired by this section, the operation of any immunization registry\nestablished under chapter five hundred twenty-one of the laws of\nnineteen hundred ninety-four, section 11.07 of title twenty-four of\nvolume eight of the compilation of the rules of the city of New York and\nadministered by a local health district collecting information from\nhealth care providers about vaccinations previously administered to a\nvaccinee prior to the effective date of this section shall provide the\ncommissioner access to such information.\n (c) All health care providers shall provide the department or, as\nappropriate, the city of New York with additional or clarifying\ninformation upon request reasonably related to the purposes of this\nsection.\n (d) Notwithstanding the above, submission of incomplete information\nshall not prohibit entry of incomplete but viable data into the\nstatewide immunization information system.\n (e) The commissioner of the department of health and mental hygiene\nfor the city of New York shall implement the requirements of this\nsubdivision.\n (f) The immunization status of children exempt from immunizations\npursuant to subdivision eight of section twenty-one hundred sixty-four\nof this title shall be reported by the health care provider.\n 6. In the city of New York, the commissioner of the department of\nhealth and mental hygiene of the city of New York may maintain its\nexisting registry consistent with the requirements of this section and\nshall provide information to the commissioner and to authorized users.\n 7. Each parent or legal guardian of a newborn infant or a child newly\nenrolled in the statewide immunization information system shall receive\ninformation, developed by the department, describing the enrollment\nprocess and how to review and correct information and obtain a copy of\nthe child's immunization record. The city of New York will be\nresponsible for providing information about the processes for enrollment\nand access to the citywide immunization registry by a parent or legal\nguardian of a newborn infant or newly enrolled child residing in the\ncity of New York.\n 8. Access and use of identifiable registrant information shall be\nlimited to authorized users consistent with this subdivision and the\npurposes of this section. (a) The commissioner shall provide a method by\nwhich authorized users apply for access to the system. For the city of\nNew York, the commissioner of health and mental hygiene shall provide a\nmethod by which authorized users apply for access to the citywide\nimmunization registry.\n (b) (i) The commissioner may use the statewide immunization\ninformation system and the blood lead information in such system for\npurposes of outreach, quality improvement and accountability, including\nprofessional responsibility proceedings of the office of professional\nmedical conduct and the state education department, research,\nepidemiological studies and disease control, and to obtain blood lead\ntest results from physician office laboratories for the statewide\nregistry of lead levels of children established pursuant to subdivision\ntwo of section thirteen hundred seventy-a of this chapter; (ii) the\ncommissioner of health and mental hygiene for the city of New York may\nuse the immunization registry and the blood lead information in such\nsystem for purposes of outreach, quality improvement and accountability,\nresearch, epidemiological studies and disease control; (iii) local\nhealth departments shall have access to the immunization information\nsystem and the blood lead information in such system for purposes of\noutreach, quality improvement and accountability, epidemiological\nstudies and disease control within their county; and\n (c) health care providers and their designees, registered professional\nnurses, and pharmacists authorized to administer immunizations pursuant\nto subdivision two of section sixty-eight hundred one of the education\nlaw shall have access to the statewide immunization information system\nand the blood lead information in such system only for purposes of\nsubmission of information about vaccinations received by a specific\nregistrant, determination of the immunization status of a specific\nregistrant, determination of the blood lead testing status of a specific\nregistrant, submission of the results from a blood lead analysis of a\nsample obtained from a specific registrant in accordance with paragraph\n(h) of subdivision two of this section, review of practice coverage,\ngeneration of reminder notices, quality improvement and accountability,\nincluding professional responsibility proceedings of the office of\nprofessional medical conduct and the state education department, and\nprinting a copy of the immunization or lead testing record for the\nregistrant's medical record, for the registrant's parent or guardian, or\nother person in parental or custodial relation to a child, or for a\nregistrant upon reaching eighteen years of age.\n (d) The following authorized users shall have access to the statewide\nimmunization information system and the blood lead information in such\nsystem and the citywide immunization registry for the purposes stated in\nthis paragraph: (i) schools for the purpose of verifying immunization\nstatus for eligibility for admission, for the purpose of confirming a\nstudent has been screened for lead when enrolling in child care,\npre-school, pre-kindergarten or kindergarten, and for the provision of\nappropriate educational materials developed by the department pursuant\nto section thirteen hundred seventy-a of this chapter on the dangers of\nlead exposure, and the health risks associated with elevated blood lead\nlevels to the parents or legal guardians of the student with an elevated\nblood lead level, as such term is defined in subdivision six of section\nthirteen hundred seventy of this chapter, as well as information on\nprograms that may be available to the student and the parents or legal\nguardians of the student. For each school that has the technical ability\nto batch download sets of immunization records, the department shall\nmake available such sets of immunization records of only those children\nsubmitted by the school for which the school has obtained a certificate\nof immunization or for which the school has responsibility to verify the\nimmunization status for school attendance purposes under section\ntwenty-one hundred sixty-four of this article. Schools shall properly\nsafeguard such information for use only as authorized by this section;\n(ii) colleges for verifying immunization status for eligibility for\nadmission; (iii) professional and technical schools for verifying\nimmunization status for eligibility for admission; (iv) children's\novernight camps and summer day camps for verifying immunization status\nof children attending camp; (v) third party payer for performing quality\nassurance, accountability and outreach, relating to enrollees covered by\nthe third party payer; (vi) commissioners of local social services\ndistricts with regard to a child in his/her legal custody; (vii) the\ncommissioner of the office of children and family services with regard\nto children in their legal custody, and for quality assurance and\naccountability of commissioners of local social services districts, care\nand treatment of children in the custody of commissioners of local\nsocial services districts; and (viii) WIC programs for the purposes of\nverifying immunization and lead testing status for those seeking or\nreceiving services.\n (e) Institutes of higher education, medical research centers or other\ninstitutions engaged in epidemiological research or other public health\nresearch shall have access to de-identified registrant information in\nthe statewide immunization information system or the citywide\nimmunization registry for research purposes if approved by the\ncommissioner or the commissioner of the department of health and mental\nhygiene of the city of New York, as appropriate.\n 9. The commissioner may judge the legitimacy of any request for\nimmunization system information and may refuse access to the statewide\nimmunization information system based on the authenticity of the\nrequest, credibility of the authorized user or other reasons as provided\nfor in regulation. For the city of New York the commissioner of health\nand mental hygiene may judge the legitimacy of requests for access to\nthe citywide immunization registry and refuse access to the immunization\nregistry based on the authenticity of the request, credibility of the\nauthorized user or other reasons as provided for in regulation.\n 10. The person to whom any immunization record relates, or his or her\nparent, or guardian, or other person in parental or custodial relation\nto such person may request a copy of an immunization or lead testing\nrecord from the registrant's healthcare provider, the statewide\nimmunization information system or the citywide immunization registry\naccording to procedures established by the commissioner or, in the case\nof the citywide immunization registry, by the city of New York\ncommissioner of the department of health and mental hygiene.\n 11. The commissioner, or in the city of New York, the commissioner of\nthe department of health and mental hygiene, may provide registrant\nspecific immunization and lead test records to the federal centers for\ndisease control and prevention or its successor agency, to other state\nor city registries and registries maintained by the Indian Health\nService and tribal nations recognized by the state or the United States\npursuant to a written agreement requiring that the other registry\nconform to national standards for maintaining the integrity of the data\nand that the data will only be used for purposes consistent with the\nprovisions of this section and provided that disclosure of identifiable\nregistrant information shall be limited to the minimum amount necessary\nto accomplish the purposes consistent with the provisions of this\nsection as determined by the commissioner, or in the city of New York,\nthe commissioner of the department of health and mental hygiene.\n 11-a. The commissioner, or in the city of New York, the commissioner\nof the department of health and mental hygiene, may only share registry\ninformation maintained by the department, or in the case of the citywide\nimmunization registry, the city of New York under the provisions of this\nsection with the federal Centers for Disease Control and Prevention, or\nsuccessor agency, for public health purposes in summary, statistical,\naggregate, or other form such that no individual person can be\nidentified, except that either such commissioner may disclose\nidentifiable registrant information to the federal Centers for Disease\nControl and Prevention, or its successor agency, when the commissioner\nhas determined that the disclosure is in the best interests of the\nregistrant or will contribute to the protection of public health and\nthat the objective of the disclosure cannot be served by disclosure\nlimited to de-identified information, or the federal health officials\nhave committed in writing not to redisclose to or share registrant\ninformation with any other federal agency, including but not limited to\nthe department of homeland security, immigration and customs\nenforcement, customs and border protection, or any successor agency, or\nany law enforcement agency; provided that either such commissioner may\nforgo the written commitment if requiring written commitment would\nresult in the actual withholding of federal funds.\n 12. Information that would be provided upon the enrollment in the\nstatewide immunization information system of a child being vaccinated,\nfrom birth records of all infants born in New York state on or after\nJanuary first, two thousand four shall be entered into the statewide\nimmunization information system, except in the city of New York, where\nbirth record information shall be entered into the citywide immunization\nregistry.\n 13. The commissioner shall promulgate regulations as necessary to\neffectuate the provisions of this section. Such regulations shall\ninclude provision for orderly implementation and operation of the\nstatewide immunization information system, including the method by which\neach category of authorized user may access the system. Access standards\nshall include at a minimum a method for assigning and authenticating\neach user identification and password assigned.\n 14. No authorized user shall be subjected to civil or criminal\nliability, or be deemed to have engaged in unprofessional conduct for\nreporting to, receiving from, or disclosing information relating to the\nstatewide immunization information system when made reasonably and in\ngood faith and in accordance with the provisions of this section or any\nregulation adopted thereto.\n