Section 2168. Statewide immunization information system

1. The department
  is hereby directed to establish a  statewide  automated  and  electronic
  immunization   information   system   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 and
  collect results of blood lead analyses  performed  by  physician  office
  laboratories  to  provide  to  the  statewide registry of lead levels of
  children established pursuant to section thirteen hundred  seventy-a  of
  this chapter;
    (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,  WIC
  programs,  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
  statewide immunization information system 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
  statewide immunization information system 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, third party payer
  as defined in paragraph (f) of this subdivision, local health  districts
  as  defined  by  paragraph (c) of subdivision one of section two of this
  chapter, local social services districts and the office of children  and
  family  services with regard to children in their legal custody, and WIC
  programs as defined in paragraph (g) of this subdivision. 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 third party payer, a person in the custody of  the
  local  social  services  district  or  the office of children and family
  services,  or  a  person  seeking  or  receiving  services  through  WIC
  programs, as the case may be.
    (b)  The  term "statewide immunization information system" or "system"
  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
  less  than  nineteen  years  of  age.  The  term  "citywide immunization
  registry"  shall  not  include  the  childhood   blood   lead   registry
  established pursuant to the health code of the city of New York. 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 an immunization or analysis of a blood sample for lead
  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.
    (f) The  term  "third  party  payer"  shall  mean  health  maintenance
  organizations certified under article forty-four of this chapter, health
  service  corporations  licensed  pursuant  to article forty-three of the
  insurance law, self-insured plans that pay  for  health  care  services,
  health   insurance  companies  subject  to  article  thirty-two  of  the
  insurance law which  offer  preferred  provider  products,  corporations
  subject  to  article  forty-three  of  the  insurance  law  which  offer
  preferred provider products, municipal cooperative health benefit  plans
  certified  pursuant  to  article  forty-seven of the insurance law which
  offer preferred provider products, and preferred provider  organizations
  as   defined   in  section  three  hundred  fifty-two  of  the  workers'
  compensation law.
    (g) For purposes of this section the term "WIC program" shall  mean  a
  state or local agency, as described pursuant to section 1786 of title 42
  of the United States Code.
    (h)  The  term  "physician  office laboratory" shall mean a laboratory
  operated by a health  care  provider  pursuant  to  subdivision  one  of
  section  five  hundred seventy-nine of this chapter that is certified by
  the  Centers  for  Medicare  and  Medicaid  Services  under  regulations
  implementing  the  federal Clinical Laboratory Improvement Amendments of
  1988 (CLIA).
    3. (a) Any health care provider  who  administers  any  vaccine  to  a
  person  less than nineteen years of age or, on or after September first,
  two thousand nine, conducts a blood lead analysis of a  sample  obtained
  from  a  person under eighteen years of age in accordance with paragraph
  (h) of subdivision two of this section; and immunizations received by  a
  person  less  than  nineteen  years  of  age  in the past if not already
  reported, shall report all such immunizations and  the  results  of  any
  blood  lead  analysis  to  the  department in a format prescribed by the
  commissioner  within   fourteen   days   of   administration   of   such
  immunizations  or  of  obtaining  the  results  of  any  such blood lead
  analysis. Health care providers administering immunizations  to  persons
  less than 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 system information regarding immunizations
  administered to individuals nineteen years of  age  or  older  with  the
  express  written  consent  of  the  vaccine.  Health  care providers who
  conduct a blood lead analysis on a person under eighteen  years  of  age
  and  who  report  the  results  of such analysis to the city of New York
  commissioner of health and mental hygiene  pursuant  to  New  York  city
  reporting  requirements  shall  be  exempt  from  this  requirement  for
  reporting blood lead analysis  results  to  the  state  commissioner  of
  health;  provided,  however,  blood  lead  analysis  data collected from
  physician office laboratories by the commissioner of health  and  mental
  hygiene  of the city of New York pursuant to the health code of the city

  of New York shall be provided to the department in a  format  prescribed
  by the commissioner.
    (b)  The  statewide  immunization  information  system 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 system, 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
  statewide immunization information system and the statewide registry  of
  lead  levels  of children if collection, storage and access of such data
  is otherwise authorized. Such data may be  disclosed  to  the  statewide
  immunization  information  system  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
  statewide  immunization  information  system  if  that  data  could  not
  otherwise be accessed or disclosed in the absence of the system. For the
  city of New York the commissioner  of  health  and  mental  hygiene  may
  include data collected in the citywide immunization registry as provided
  in this paragraph.
    (d)  A  person,  institution  or  agency  to  whom  such  immunization
  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 less than nineteen
  years of age and about each vaccination given after January  first,  two
  thousand  eight.  The information provided to the system 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  11.07  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
  statewide immunization information system.
    (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 of this  section  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 statewide immunization information system shall  receive
  information,  developed  by  the  department,  describing the 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 system. 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  citywide
  immunization registry.
    (b)   (i)   The   commissioner  may  use  the  statewide  immunization
  information system and the blood lead information  in  such  system  for
  purposes  of outreach, quality improvement and accountability, research,
  epidemiological studies and disease control, and to  obtain  blood  lead
  test  results  from  physician  office  laboratories  for  the statewide
  registry of lead levels of children established pursuant to  subdivision
  two  of  section  thirteen  hundred  seventy-a of this chapter; (ii) the
  commissioner of health and mental hygiene for the city of New  York  may
  use  the  immunization  registry  and the blood lead information in such
  system for purposes of outreach, quality improvement and accountability,
  research, epidemiological  studies  and  disease  control;  (iii)  local
  health  departments  shall  have  access to the immunization information
  system and the blood lead information in such  system  for  purposes  of
  outreach,   quality   improvement  and  accountability,  epidemiological
  studies and disease control within their county; and
    (c) health care providers and their designees shall have access to the
  statewide immunization information system and the blood lead information
  in such system only for purposes  of  submission  of  information  about
  vaccinations  received  by  a  specific registrant, determination of the
  immunization status of a specific registrant, determination of the blood
  lead testing status of a specific registrant, submission of the  results
  from  a  blood  lead  analysis  of  a  sample  obtained  from a specific
  registrant in accordance with paragraph (h) of subdivision two  of  this
  section,  review  of  practice coverage, generation of reminder notices,

  quality improvement and  accountability  and  printing  a  copy  of  the
  immunization or lead testing 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  statewide
  immunization  information  system and the blood lead information in such
  system and the citywide immunization registry for the purposes stated in
  this paragraph:  (i)  schools  for  verifying  immunization  status  for
  eligibility for admission; (ii) third party payer for performing quality
  assurance, accountability and outreach, relating to enrollees covered by
  the  third  party  payer;  (iii)  commissioners of local social services
  districts with regard to a child in  his/her  legal  custody;  (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; and (v) WIC  programs  for  the  purposes  of
  verifying  immunization  and  lead  testing  status for those seeking or
  receiving services.
    9. The commissioner may  judge  the  legitimacy  of  any  request  for
  immunization  system  information and may refuse access to the statewide
  immunization  information  system  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  or  lead  testing
  record   from   the  registrant's  healthcare  provider,  the  statewide
  immunization information system 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, or in the city of New York, the commissioner of
  the department of health and  mental  hygiene,  may  provide  registrant
  specific  immunization  records  to other state registries pursuant to a
  written agreement requiring that the out-of-state  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
  statewide immunization information system 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  statewide
  immunization  information  system, 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
  statewide immunization information system, including the method by which
  each category of authorized user may access the system. 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
  statewide  immunization  information  system when made reasonably and in
  good  faith and in accordance with the provisions of this section or any
  regulation adopted thereto.