Public Health Law Section 2168 - Statewide Immunization Registry

    §  2168.  Statewide immunization registry. 1. The department is hereby
  directed to establish a statewide automated and electronic  immunization
  registry that will serve, and shall be administered consistent with, the
  following public health purposes:
    (a)  collect reports of immunizations and thus reduce the incidence of
  illness, disability and death due to vaccine preventable diseases;
    (b) establish the public health infrastructure  necessary  to  obtain,
  collect,   preserve,	 and  disclose  information  relating  to  vaccine
  preventable disease as it may promote the health and well-being  of  all
  children in this state;
    (c)  make  available to an individual, or parents, guardians, or other
  person in a custodial relation to a child or, to local health districts,
  local social services districts responsible for the care and custody  of
  children,  health care providers and their designees, schools, and third
  party payers the immunization status of children; and
    (d)  appropriately  protecting  the  confidentiality   of	individual
  identifying  information  and  the  privacy  of  persons included in the
  registry and their families.
    2. For the purposes of this section:
    (a) The term  "authorized  user"  shall  mean  any  person  or  entity
  authorized  to provide information to or to receive information from the
  immunization registry and shall include health care providers and  their
  designees,  as  defined in paragraph (d) of this subdivision, schools as
  defined in paragraph a of subdivision one of section twenty-one  hundred
  sixty-four  of  this  title,  health maintenance organizations certified
  under article forty-four of this chapter or article forty-three  of  the
  insurance  law,  local  health  districts as defined by paragraph (c) of
  subdivision one of  section  two  of  this  chapter,  and  local  social
  services  districts  and the office of children and family services with
  regard to children in their legal custody. An  authorized  user  may  be
  located  outside  New  York  state.  An entity other than a local health
  district shall be an authorized user  only  with  respect  to  a  person
  seeking  or  receiving  a  health  care  service  from  the  health care
  provider, a person enrolled or seeking to be enrolled in the  school,  a
  person  insured  by  the health maintenance organization, or a person in
  the custody of the local social  services  district  or  the  office  of
  children and family services, as the case may be.
    (b)	   The	  term	  "immunization    registry"	shall	 mean	 a
  statewide-computerized database maintained by the department capable  of
  collecting,  storing, and disclosing the electronic and paper records of
  vaccinations received by persons under nineteen years of age.
    (c)  The  term  "citywide  immunization  registry"  shall	mean   the
  computerized  database  maintained by the city of New York department of
  health and mental hygiene capable of collecting, storing, and disclosing
  the electronic and paper records of  vaccinations  received  by  persons
  under  nineteen  years of age. For the purposes of this section the term
  New York city department of health and mental hygiene  shall  mean  such
  agency or any successor agency responsible for the citywide immunization
  registry.
    (d)  The  term "health care provider" shall mean any person authorized
  by law to order  or  administer  an  immunization  or  any  health  care
  facility  licensed  under  article  twenty-eight  of this chapter or any
  certified  home  health  agency  established  under  section  thirty-six
  hundred  six  of  this  chapter;  with  respect  to  a person seeking or
  receiving a health care service from the health care provider.
    (e) For  purposes  of  this  section  a  school  is  a  public  health
  authority,  as defined in section 164.501 of part 45 of the federal code
  of rules, responsible for screening  the  immunization  status  of  each
  child pursuant to section twenty-one hundred sixty-four of this article.
    3.  (a)  Any  health  care  provider  who administers any vaccine to a
  person under nineteen years of age;  and  immunizations  received  by  a
  person  under nineteen years of age in the past if not already reported,
  shall report all such  immunizations  to  the  department  in  a  format
  prescribed  by  the commissioner within fourteen days of administration.
  Health care  providers  administering  immunizations  to  persons  under
  nineteen  years of age in the city of New York shall report, in a format
  prescribed by the city of New York commissioner  of  health  and  mental
  hygiene,  all  such immunizations to the citywide immunization registry.
  The commissioner, and for the city  of  New  York  the  commissioner  of
  health  and  mental  hygiene,  shall  have  the discretion to accept for
  inclusion  in	  the	registry   information	 regarding   immunizations
  administered  to  individuals  nineteen  years  of age or older with the
  express written consent of the vaccine.
    (b) The immunization registry shall provide a method for  health  care
  providers  to  determine  when  the  registrant  is  due  or  late for a
  recommended immunization and shall serve as a means for authorized users
  to receive prompt and accurate information, as reported to the registry,
  about the vaccines that the registrant has received.
    4. (a) All information maintained by the department, or in the case of
  the citywide immunization registry, the  city  of  New  York  under  the
  provisions  of this section shall be confidential except as necessary to
  carry out the provisions of this section and shall not be  released  for
  any other purpose.
    (b)  The  department  and  for  the city of New York the department of
  health and mental hygiene may also disclose or provide such  information
  to an authorized user when (i) such person or agency provides sufficient
  identifying  information satisfactory to the department to identify such
  registrant and (ii) such disclosure or provision of  information  is  in
  the  best  interests  of  the  registrant  or his or her family, or will
  contribute to the protection of the public health.
    (c) Any data collected by  the  department  may  be  included  in  the
  immunization  registry if collection, storage and access of such data is
  otherwise authorized. Such data may be  disclosed  to  the  immunization
  registry  only  if  provided for in statute and regulation, and shall be
  subject to any provisions in such statute or regulation limiting the use
  or redisclosure of the data. Nothing contained in this  paragraph  shall
  permit inclusion of data in the immunization registry if that data could
  not  otherwise  be accessed or disclosed in the absence of the registry.
  For the city of New York the commissioner of health and  mental  hygiene
  may  include data collected in the citywide registry as provided in this
  paragraph.
    (d) A person, institution or agency to whom such immunization registry
  information is furnished or to whom, access to  records  or  information
  has been given, shall not divulge any part thereof so as to disclose the
  identity  of  such  person  to  whom such information or record relates,
  except insofar as such disclosure is necessary for the best interests of
  the person or other  persons,  consistent  with  the  purposes  of  this
  section.
    5.  (a)  All  health  care  providers  and their designees, except for
  providers reporting to the citywide immunization registry, shall  submit
  to  the commissioner information about any vaccinee under nineteen years
  of age and  about  each  vaccination  given  after  January  first,  two
  thousand eight. The information provided to the registry or the citywide
  immunization  registry  shall  include the national immunization program
  data elements and other elements required by the commissioner.  For  the
  city  of  New  York  the  commissioner  of health and mental hygiene may
  require additional elements with prior notice to the commissioner of any
  changes.
    (b)	  In  addition  to  the  immunization  administration  information
  required by this section, the operation  of  any  immunization  registry
  established  under  chapter  five  hundred  twenty-one  of  the  laws of
  nineteen hundred ninety-four, section  11.04  of  title  twenty-four  of
  volume eight of the compilation of the rules of the city of New York and
  administered  by  a  local  health  district collecting information from
  health care providers about vaccinations previously  administered  to  a
  vaccinee  prior  to the effective date of this section shall provide the
  commissioner access to such information.
    (c) All health care providers shall  provide  the  department  or,  as
  appropriate,  the  city  of  New  York  with  additional  or  clarifying
  information upon request reasonably related  to  the  purposes  of  this
  section.
    (d)  Notwithstanding  the  above, submission of incomplete information
  shall not prohibit entry of incomplete but viable data into the registry
  database.
    (e) The commissioner of the department of health  and  mental  hygiene
  for  the  city  of  New  York  shall  implement the requirements of this
  subdivision.
    (f) The immunization status  of  children  exempt  from  immunizations
  pursuant  to  subdivision eight and a parent claiming exemption pursuant
  to subdivision nine of section twenty-one  hundred  sixty-four  of  this
  title shall be reported by the health care provider.
    6.  In  the  city  of  New York, the commissioner of the department of
  health and mental hygiene of the city  of  New  York  may  maintain  its
  existing  registry  consistent with the requirements of this section and
  shall provide information to the commissioner and to authorized users.
    7. Each parent or legal guardian of a newborn infant or a child  newly
  enrolled  in  the  registry  shall receive information, developed by the
  department, describing the registry enrollment process and how to review
  and correct information and obtain a copy of  the  child's  immunization
  record.  The  city  of  New  York  will  be  responsible  for  providing
  information about  the  processes  for  enrollment  and  access  to  the
  citywide  immunization  registry  by  a  parent  or  legal guardian of a
  newborn infant or newly enrolled child residing in the city of New York.
    8. Access and use of  identifiable  registrant  information  shall  be
  limited  to  authorized  users  consistent with this subdivision and the
  purposes of this section. (a) The commissioner shall provide a method by
  which authorized users apply for access to the registry. For the city of
  New York, the commissioner of health and mental hygiene shall provide  a
  method by which authorized users apply for access to the registry.
    (b)  (i)  The  commissioner  may  use  the  immunization  registry for
  purposes of outreach, quality improvement  and  vaccine  accountability,
  research,   epidemiological	studies  and  disease  control;  (ii)  the
  commissioner of health and mental hygiene for the city of New  York  may
  use	the  immunization  registry  for  purposes  of  outreach,  quality
  improvement  and  vaccine  accountability,   research,   epidemiological
  studies  and  disease control; (iii) local health departments shall have
  access to the immunization registry for purposes  of  outreach,  quality
  improvement  and  vaccine  accountability,  epidemiological  studies and
  disease control within their county; and
    (c) health care providers and their designees shall have access to the
  immunization registry only for purposes  of  submission  of  information
  about  vaccinations  received by a specific registrant, determination of
  the immunization status of a specific  registrant,  review  of  practice
  coverage,  generation  of  reminder  notices,  quality  improvement  and
  vaccine accountability and printing a copy of  the  immunization  record
  for  the  registrant's  medical  record,  for the registrant's parent or
  guardian,  or other person in parental or custodial relation to a child,
  or for a registrant upon reaching eighteen years of age.
    (d)  The  following  authorized  users  shall  have  access	  to   the
  immunization  registry  and  the  citywide immunization registry for the
  purposes stated in this paragraph: (i) schools for verifying eligibility
  for admission; (ii)  health  maintenance  organizations  for  performing
  quality  assurance,  accountability  and outreach, relating to enrollees
  covered by the health maintenance organization; (iii)  commissioners  of
  local  social services districts with regard to a child in his/her legal
  custody; and (iv) the commissioner of the office of children and  family
  services with regard to children in their legal custody, and for quality
  assurance  and  accountability of commissioners of local social services
  districts,  care  and  treatment  of  children   in	the   custody	of
  commissioners of local social services districts.
    9.  The  commissioner  may  judge  the  legitimacy  of any request for
  immunization  registry  information  and  may  refuse  access	  to   the
  immunization	 registry  based  on  the  authenticity  of  the  request,
  credibility of the authorized user or other reasons as provided  for  in
  regulation.  For  the  city  of  New York the commissioner of health and
  mental hygiene may judge the legitimacy of requests for  access  to  the
  citywide  immunization  registry  and  refuse access to the immunization
  registry based on the authenticity of the request,  credibility  of  the
  authorized user or other reasons as provided for in regulation.
    10.  The person to whom any immunization record relates, or his or her
  parent, or guardian, or other person in parental or  custodial  relation
  to  such  person  may  request a copy of an immunization record from the
  registrant's healthcare  provider,  the  immunization  registry  or  the
  citywide  immunization  registry  according to procedures established by
  the commissioner or, in the case of the citywide immunization  registry,
  by  the  city  of  New York commissioner of the department of health and
  mental hygiene.
    11. The commissioner  may  provide  registrant  specific  immunization
  records  to  other  state  registries  pursuant  to  a written agreement
  requiring that the foreign registry conform to  national  standards  for
  maintaining  the integrity of the data and will not be used for purposes
  inconsistent with the provisions of this section.
    12. Information that would be provided  upon  the  enrollment  in  the
  registry  of a child being vaccinated, from birth records of all infants
  born in New York state on or after  January  first,  two  thousand  four
  shall  be  entered into the immunization registry, except in the city of
  New York, where birth record  information  shall  be  entered  into  the
  citywide immunization registry.
    13.  The  commissioner  shall  promulgate  regulations as necessary to
  effectuate the  provisions  of  this  section.  Such  regulations  shall
  include  provision  for  orderly  implementation  and  operation  of the
  registry, including the method by which each category of authorized user
  may access the registry. Access standards shall include at a  minimum  a
  method  for  assigning  and  authenticating each user identification and
  password assigned.
    14. No authorized  user  shall  be  subjected  to  civil  or  criminal
  liability,  or  be  deemed to have engaged in unprofessional conduct for
  reporting to, receiving from, or disclosing information relating to  the
  registry  when  made reasonably and in good faith and in accordance with
  the provisions of this section or any regulation adopted thereto.