AMENDED IN ASSEMBLY MAY 2, 2022
AMENDED IN ASSEMBLY MARCH 24, 2022
california legislature—2021–22 regular session
ASSEMBLY BILL No. 1797
Introduced by Assembly Member Akilah Weber
(Principal coauthor: Senator Pan)
(Coauthors: Assembly Members Low and Wicks)
(Coauthors: Senators Newman and Wiener)
February 7, 2022
An act to amend amend, repeal, and add Section 120440 of the Health and Safety Code, relating to immunization registry.
legislative counsel’s digest
AB 1797, as amended, Akilah Weber. Immunization registry.
Existing law authorizes local health officers and the State Department of Public health to operate immunization information systems. Existing law, e xcept as pro vided, authorizes health care pro viders and other agencies, including, among others, schools, childcare facilities, family childcare homes, and county human services agencies, to disclose specified immunization information with local health departments and the State Department of Public Health, and authorizes local health departments and the department to disclose that same information to each other and to health care pro viders, schools, childcare f acilities, family childcare homes, and county human services agencies, among others, as specified. Existing la w specifies the immunization, patient, or client information that may be disclosed, which includes, among other things, patient or client demographic information, immunization
97 data, adverse reactions to the immunization, or other information needed to identify the patient or client or to comply with other laws.
This bill w ould instead require health care pro viders and other agencies, including schools, childcare facilities, family childcare homes, and county human services agencies to disclose the specified immunization information, and would add the patient’s or client’s race or ethnicity to the list of information that shall or may be disclosed. By imposing new duties on schools and county human services agencies, the bill would impose a state-mandated local program.
Existing law requires schools, childcare f acilities, family childcare homes, and county human services agencies to maintain the confidentiality of the specified immunization information and to only use the information for specified purposes, including to carry out their responsibilities re garding required immunization for attendance or participation benefits, or both.
This bill would would, until January 1, 2026, additionally authorize schools, childcare facilities, family childcare homes, and county human services agencies to use the specified immunization information, in the event of a for the CO VID-19 public health emer gency, to perform immunization status assessments of pupils, adults, and clients to ensure health and safety.
The California Constitution requires the state to reimb urse local agencies and school districts for certain costs mandated by the state.
Statutory provisions establish procedures for making that reimbursement.
This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.
Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: yes.
The people of the State of California do enact as follows:
line 1 SECTION 1. Section 120440 of the Health and Safety Code line 2 is amended to read:
line 3 120440. (a) For the purposes of this chapter , the follo wing line 4 definitions shall apply:
line 5 (1) “Health care provider” means any person licensed pursuant line 6 to Division 2 (commencing with Section 500) of the Business and 97 — 2 — AB 1797
line 1 Professions Code or a clinic or health facility licensed pursuant to line 2 Division 2 (commencing with Section 1200).
line 3 (2) “Schools, childcare facilities, and family childcare homes” line 4 means those institutions referred to in subdi vision (b) of Section line 5 120335, regardless of whether they directly provide immunizations line 6 to patients or clients.
line 7 (3) “WIC service pro vider” means an y public or pri vate line 8 nonprofit agenc y contracting with the department to pro vide line 9 services under the California Special Supplemental Food Program line 10 for Women, Infants, and Children, as pro vided for in Article 2 line 11 (commencing with Section 123275) of Chapter 1 of P art 2 of line 12 Division 106.
line 13 (4) “Health care plan” means a health care service plan as line 14 defined in subdivision (f) of Section 1345, a go vernment-funded line 15 program the purpose of which is paying the costs of health care, line 16 or an insurer as described in Sections 10123.5 and 10123.55 of line 17 the Insurance Code, regardless of whether the plan directly provides line 18 immunizations to patients or clients.
line 19 (5) “County human services agenc y” means a county welf are line 20 agency administering the California Work Opportunity and line 21 Responsibility to Kids (CalWORKs) program, pursuant to Chapter line 22 2 (commencing with Section 11200.5) of P art 3 of Division 9 of line 23 the Welfare and Institutions Code.
line 24 (6) “Foster care agenc y” means an y of the county and state line 25 social services agencies providing foster care services in California. line 26 (7) “Tuberculosis screening” means an appro ved intradermal line 27 tuberculin test or an y other test for tuberculosis infection that is line 28 recommended by the federal Centers for Disease Control and line 29 Prevention and licensed by the federal F ood and Drug line 30 Administration.
line 31 (b) (1) Local health officers may operate immunization line 32 information systems pursuant to their authority under Section line 33 120175, in conjunction with the Immunization Branch of the State line 34 Department of Public Health. Local health officers and the State line 35 Department of Public Health may operate these systems in either line 36 or both of the following manners:
line 37 (A) Separately within their individual jurisdictions. line 38 (B) Jointly among more than one jurisdiction.
line 39 (2) This subdivision does not preclude local health officers from line 40 sharing the information set forth in paragraphs (1) to (12), 97 AB 1797 — 3 —
line 1 inclusive, of subdi vision (c) with other health officers jointly line 2 operating the system.
line 3 (c) Notwithstanding Sections 49075 and 49076 of the Education line 4 Code, Chapter 5 (commencing with Section 10850) of P art 2 of line 5 Division 9 of the Welfare and Institutions Code, or an y other line 6 provision of law, unless a refusal to permit recordsharing is made line 7 pursuant to subdi vision (e), health care pro viders, and other line 8 agencies, including, but not limited to, schools, childcare facilities, line 9 service providers for the California Special Supplemental F ood line 10 Program for Women, Inf ants, and Children (WIC), health care line 11 plans, foster care agencies, and county human services agencies, line 12 shall disclose the information set forth in paragraphs (1) to (12), line 13 inclusive, from the patient’s medical record, or the client’s record, line 14 to local health departments operating countywide or re gional line 15 immunization information and reminder systems and the State line 16 Department of Public Health. Local health departments and the line 17 State Department of Public Health may disclose the information line 18 set forth in paragraphs (1) to (12), inclusi ve, to each other and, line 19 upon a request for information pertaining to a specific person, to line 20 health care providers taking care of the patient and to the Medical line 21 Board of California and the Osteopathic Medical Board of line 22 California. Local health departments and the State Department of line 23 Public Health may disclose the information in paragraphs (1) to line 24 (7), inclusive, and paragraphs (9) to (12), inclusi ve, to schools, line 25 childcare facilities, county human services agencies, and f amily line 26 childcare homes to which the person is being admitted or in line 27 attendance, foster care agencies in assessing and providing medical line 28 care for children in foster care, and WIC service pro viders line 29 providing services to the person, health care plans arranging for line 30 immunization services for the patient, and county human services line 31 agencies assessing immunization histories of dependents of line 32 CalWORKs participants, upon request for information pertaining line 33 to a specific person. Determination of benefits based upon line 34 immunization of a dependent CalWORKs participant shall be made line 35 pursuant to Section 11265.8 of the Welfare and Institutions Code. line 36 The following information shall be subject to this subdivision:
line 37 (1) The name of the patient or client and names of the parents line 38 or guardians of the patient or client.
line 39 (2) Date of birth of the patient or client.
97 — 4 — AB 1797
line 1 (3) Types and dates of immunizations recei ved by the patient line 2 or client.
line 3 (4) Manufacturer and lot number for each immunization line 4 received.
line 5 (5) Adverse reaction to immunizations received. line 6 (6) Other nonmedical information necessary to establish the line 7 patient’s or client’s unique identity and record. line 8 (7) Results of tuberculosis screening.
line 9 (8) Current address and telephone number of the patient or client line 10 and the parents or guardians of the patient or client. line 11 (9) Patient’s or client’s gender.
line 12 (10) Patient’s or client’s place of birth.
line 13 (11) Patient’s or client’s race or ethnicity.
line 14 (12) Patient’s or client’ s information needed to comply with line 15 Chapter 1 (commencing with Section 120325), b ut e xcluding line 16 Section 120380.
line 17 (d) (1) Health care providers, local health departments, and the line 18 State Department of Public Health shall maintain the confidentiality line 19 of information listed in subdivision (c) in the same manner as other line 20 medical record information with patient identification that the y line 21 possess. These providers, departments, and contracting agencies line 22 are subject to civil action and criminal penalties for the wrongful line 23 disclosure of the information listed in subdivision (c), in accordance line 24 with e xisting la w. They shall use the information listed in line 25 subdivision (c) only for the following purposes:
line 26 (A) To provide immunization services to the patient or client, line 27 including issuing reminder notifications to patients or clients or line 28 their parents or guardians when immunizations are due. line 29 (B) To pro vide or f acilitate pro vision of third-party payer line 30 payments for immunizations.
line 31 (C) To compile and disseminate statistical information of line 32 immunization status on groups of patients or clients or populations line 33 in California, without identifying information for these patients or line 34 clients included in these groups or populations. line 35 (D) In the case of health care pro viders only, as authorized by line 36 Part 2.6 (commencing with Section 56) of Division 1 of the Civil line 37 Code.
line 38 (2) Schools, childcare facilities, family childcare homes, WIC line 39 service pro viders, foster care agencies, county human services line 40 agencies, and health care plans shall maintain the confidentiality 97 AB 1797 — 5 —
line 1 of information listed in subdivision (c) in the same manner as other line 2 client, patient, and pupil information that the y possess. These line 3 institutions and providers are subject to civil action and criminal line 4 penalties for the wrongful disclosure of the information listed in line 5 subdivision (c), in accordance with e xisting law. They shall use line 6 the information listed in subdi vision (c) only for those purposes line 7 provided in subparagraphs (A) to (D), inclusive, of paragraph (1) line 8 and as follows:
line 9 (A) In the case of schools, childcare facilities, family childcare line 10 homes, and county human services agencies, to carry out their line 11 responsibilities regarding required immunization for attendance line 12 or participation benefits, or both, as described in Chapter 1 line 13 (commencing with Section 120325), and in Section 11265.8 of line 14 the Welfare and Institutions Code.
line 15 (B) In the case of WIC service pro viders, to perform line 16 immunization status assessments of clients and to refer those clients line 17 found to be due or o verdue for immunizations to health care line 18 providers.
line 19 (C) In the case of health care plans, to f acilitate payments to line 20 health care pro viders, to assess the immunization status of their line 21 clients, and to tabulate statistical information on the immunization line 22 status of groups of patients, without including patient-identifying line 23 information in these tabulations.
line 24 (D) In the case of foster care agencies, to perform immunization line 25 status assessments of foster children and to assist those foster line 26 children found to be due or overdue for immunization in obtaining line 27 immunizations from health care providers.
line 28 (E) (i) In the case of schools, childcare f acilities, f amily line 29 childcare homes, and county human services agencies, in the event line 30 of a for the CO VID-19 public health emer gency, to perform line 31 immunization status assessments of pupils, adults, and clients to line 32 ensure health and safety.
line 33 (ii) In the case of schools, this subparagraph only applies if the line 34 school’s governing board or body has adopted a policy mandating line 35 COVID-19 immunization for sc hool attendance and the sc hool line 36 limits the use of the data to verifying immunization status for this line 37 purpose.
line 38 (e) A patient or a patient’ s parent or guardian may refuse to line 39 permit recordsharing. The health care pro vider administering line 40 immunization and any other agency possessing any patient or client 97 — 6 — AB 1797
line 1 information listed in subdivision (c), if planning to provide patient line 2 or client information to an immunization system, as described in line 3 subdivision (b), shall inform the patient or client, or the parent or line 4 guardian of the patient or client, of the following:
line 5 (1) The information listed in subdi vision (c) shall be shared line 6 with local health departments and the State Department of Public line 7 Health. The health care provider or other agency shall provide the line 8 name and address of the State Department of Public Health or of line 9 the immunization registry with which the provider or other agency line 10 will share the information.
line 11 (2) Any of the information shared with local health departments line 12 and the State Department of Public Health shall be treated as line 13 confidential medical information and shall be used only to share line 14 with each other , and, upon request, with health care pro viders, line 15 schools, childcare facilities, family childcare homes, WIC service line 16 providers, county human services agencies, foster care agencies, line 17 and health care plans. These providers, agencies, and institutions line 18 shall, in turn, treat the shared information as confidential, and shall line 19 use it only as described in subdivision (d).
line 20 (3) The patient or client, or parent or guardian of the patient or line 21 client, has the right to e xamine an y immunization-related line 22 information or tuberculosis screening results shared pursuant to line 23 this section and to correct any errors in it.
line 24 (4) The patient or client, or the parent or guardian of the patient line 25 or client, may refuse to allow this information to be shared pursuant line 26 to this section or to recei ve immunization reminder notifications line 27 at any time, or both. After refusal, the patient’s or client’s physician line 28 may maintain access to this information for the purposes of patient line 29 care or protecting the public health. After refusal, the local health line 30 department and the State Department of Public Health may line 31 maintain access to this information for the purpose of protecting line 32 the public health pursuant to Sections 100325, 120140, and 120175, line 33 as well as Sections 2500 to 2643.20, inclusi ve, of Title 17 of the line 34 California Code of Regulations.
line 35 (f) (1) The health care provider administering the immunization line 36 or tuberculosis screening and an y other agenc y possessing an y line 37 patient or client information listed in subdivision (c), may inform line 38 the patient or client, or the parent or guardian of the patient or line 39 client, by ordinary mail, of the information in paragraphs (1) to line 40 (4), inclusi ve, of subdi vision (e). The mailing shall include a 97 AB 1797 — 7 —
line 1 reasonable means for refusal, such as a return form or contact line 2 telephone number.
line 3 (2) The information in paragraphs (1) to (4), inclusi ve, of line 4 subdivision (e) may also be presented to the parent or guardian of line 5 the patient or client during an y hospitalization of the patient or line 6 client.
line 7 (g) If the patient or client, or parent or guardian of the patient line 8 or client, refuses to allo w the information to be shared, pursuant line 9 to paragraph (4) of subdi vision (e), the health care pro vider or line 10 other agenc y may not share this information in the manner line 11 described in subdivision (c), except as provided in subparagraph line 12 (D) of paragraph (1) of subdivision (d).
line 13 (h) (1) Upon request of the patient or client, or the parent or line 14 guardian of the patient or client, in writing or by other means line 15 acceptable to the recipient, a local health department or the State line 16 Department of Public Health that has received information about line 17 a person pursuant to subdivision (c) shall do all of the following:
line 18 (A) Provide the name and address of other persons or agencies line 19 with whom the recipient has shared the information. line 20 (B) Stop sharing the information in its possession after the date line 21 of the receipt of the request.
line 22 (2) After refusal, the patient’s or client’s physician may maintain line 23 access to this information for the purposes of patient care or line 24 protecting the public health. After refusal, the local health line 25 department and the State Department of Public Health may line 26 maintain access to this information for the purpose of protecting line 27 the public health pursuant to Sections 100325, 120140, and 120175, line 28 as well as Sections 2500 to 2643.20, inclusi ve, of Title 17 of the line 29 California Code of Regulations.
line 30 (i) Upon notification, in writing or by other means acceptable line 31 to the recipient, of an error in the information, a local health line 32 department or the State Department of Public Health that has line 33 information about a person pursuant to subdivision (c) shall correct line 34 the error. If the recipient is aware of a disagreement about whether line 35 an error exists, information to that effect may be included. line 36 (j) (1) Any party authorized to mak e medical decisions for a line 37 patient or client, including, but not limited to, those authorized by line 38 Section 6922, 6926, or 6927 of, Part 1.5 (commencing with Section line 39 6550), Chapter 2 (commencing with Section 6910) of P art 4, or line 40 Chapter 1 (commencing with Section 7000) of Part 6, of Division 97 — 8 — AB 1797
line 1 11 of, the Family Code, Section 1530.6 of the Health and Safety line 2 Code, or Sections 727 and 1755.3 of, and Article 6 (commencing line 3 with Section 300) of Chapter 2 of P art 1 of Di vision 2 of, the line 4 Welfare and Institutions Code, may permit sharing of the patient’s line 5 or client’ s record with an y of the immunization information line 6 systems authorized by this section.
line 7 (2) For a patient or client who is a dependent of a juvenile court, line 8 the court or a person or agency designated by the court may permit line 9 this recordsharing.
line 10 (3) For a patient or client recei ving foster care, a person or line 11 persons licensed to provide residential foster care, or having legal line 12 custody, may permit this recordsharing.
line 13 (k) For purposes of supporting immunization information line 14 systems, the State Department of Public Health shall assist the line 15 Immunization Branch of the State Department of Public Health in line 16 both of the following:
line 17 (1) Providing department records containing information about line 18 publicly funded immunizations.
line 19 (2) Supporting ef forts for the reporting of publicly funded line 20 immunizations into immunization information systems by health line 21 care providers and health care plans.
line 22 (l) Subject to any other provisions of state and federal la w or line 23 regulation that limit the disclosure of health information and protect line 24 the privacy and confidentiality of personal information, local health line 25 departments and the State Department of Public Health may share line 26 the information listed in subdivision (c) with a state, local health line 27 departments, health care pro viders, immunization information line 28 systems, or any representative of an entity designated by federal line 29 or state la w or re gulation to recei ve this information. The State line 30 Department of Public Health may enter into written agreements line 31 to e xchange confidential immunization information with other line 32 states for the purposes of patient care, protecting the public health, line 33 entrance into school, childcare and other institutions requiring line 34 immunization prior to entry, and the other purposes described in line 35 subdivision (d). The written agreement shall provide that the state line 36 that receives confidential immunization information must maintain line 37 its confidentiality and may only use it for purposes of patient care, line 38 protecting the public health, entrance into school, childcare and line 39 other institutions requiring immunization prior to entry , and the line 40 other purposes described in subdivision (d). Information shall not 97 AB 1797 — 9 —
line 1 be shared pursuant to this subdivision if a patient or client, or parent line 2 or guardian of a patient or client, refuses to allo w the sharing of line 3 immunization information pursuant to subdivision (e). line 4 (m) This section shall r emain in ef fect only until J anuary 1, line 5 2026, and as of that date is repealed.
line 6 SEC. 2. Section 120440 is added to the Health and Safety Code, line 7 to read:
line 8 120440. (a) For the purposes of this c hapter, the following line 9 definitions shall apply:
line 10 (1) “Health care provider” means any person licensed pursuant line 11 to Division 2 (commencing with Section 500) of the Business and line 12 Professions Code or a clinic or health facility licensed pur suant line 13 to Division 2 (commencing with Section 1200).
line 14 (2) “Schools, childcare facilities, and family childcare homes” line 15 means those institutions referred to in subdivision (b) of Section line 16 120335, regardless of whether they directly provide immunizations line 17 to patients or clients.
line 18 (3) “WIC service pr ovider” means any public or private line 19 nonprofit a gency contr acting with the department to pr ovide line 20 services under the California Special Supplemental Food Program line 21 for Women, Infants, and Childr en, as pr ovided for in Article 2 line 22 (commencing with Section 123275) of Chapter 1 of P art 2 of line 23 Division 106.
line 24 (4) “Health care plan” means a health car e service plan as line 25 defined in subdivision (f) of Section 1345, a go vernment-funded line 26 program the purpose of which is paying the costs of health car e, line 27 or an insurer as described in Sections 10123.5 and 10123.55 of line 28 the Insur ance Code , r egardless of whether the plan dir ectly line 29 provides immunizations to patients or clients.
line 30 (5) “County human services agency” means a county welfar e line 31 agency administering the California Work Opportunity and line 32 Responsibility to Kids (CalWORKs) program, pursuant to Chapter line 33 2 (commencing with Section 11200.5) of P art 3 of Division 9 of line 34 the Welfare and Institutions Code.
line 35 (6) “Foster care agency” means any of the county and state line 36 social services a gencies pr oviding foster car e services in line 37 California.
line 38 (7) “Tuberculosis screening” means an approved intradermal line 39 tuberculin test or any other test for tuber culosis infection that is line 40 recommended by the feder al Center s for Disease Contr ol and 97 — 10 — AB 1797
line 1 Prevention and licensed by the feder al F ood and Drug line 2 Administration.
line 3 (b) (1) Local health officer s may oper ate immunization line 4 information systems pur suant to their authority under Section line 5 120175, in conjunction with the Immunization Branch of the State line 6 Department of Public Health. Local health officers and the State line 7 Department of Public Health may operate these systems in either line 8 or both of the following manners:
line 9 (A) Separately within their individual jurisdictions. line 10 (B) Jointly among more than one jurisdiction.
line 11 (2) This subdivision does not preclude local health officers from line 12 sharing the information set forth in par agraphs (1) to (12), line 13 inclusive, of subdivision (c) with other health officer s jointly line 14 operating the system.
line 15 (c) Notwithstanding Sections 49075 and 49076 of the Education line 16 Code, Chapter 5 (commencing with Section 10850) of P art 2 of line 17 Division 9 of the Welfare and Institutions Code , or any other line 18 provision of law, unless a refusal to permit recordsharing is made line 19 pursuant to subdivision (e), health car e pr oviders, and other line 20 agencies, including, but not limited to, schools, childcare facilities, line 21 service providers for the California Special Supplemental F ood line 22 Program for Women, Infants, and Childr en (WIC), health car e line 23 plans, foster care agencies, and county human services agencies, line 24 shall disclose the information set forth in paragraphs (1) to (12), line 25 inclusive, from the patient’s medical record, or the client’s record, line 26 to local health departments oper ating countywide or r egional line 27 immunization information and r eminder systems and the State line 28 Department of Public Health. Local health departments and the line 29 State Department of Public Health may disclose the information line 30 set forth in par agraphs (1) to (12), inclusive , to each other and, line 31 upon a request for information pertaining to a specific person, to line 32 health care providers taking care of the patient and to the Medical line 33 Board of California and the Osteopathic Medical Boar d of line 34 California. Local health departments and the State Department line 35 of Public Health may disclose the information in par agraphs (1) line 36 to (7), inclusive, and paragraphs (9) to (12), inclusive, to schools, line 37 childcare facilities, county human services a gencies, and family line 38 childcare homes to whic h the per son is being admitted or in line 39 attendance, foster car e a gencies in assessing and pr oviding line 40 medical care for children in foster care, and WIC service providers 97 AB 1797 — 11 —
line 1 providing services to the person, health care plans arranging for line 2 immunization services for the patient, and county human services line 3 agencies assessing immunization histories of dependents of line 4 CalWORKs participants, upon request for information pertaining line 5 to a specific per son. Determination of benefits based upon line 6 immunization of a dependent CalWORKs participant shall be made line 7 pursuant to Section 11265.8 of the Welfare and Institutions Code. line 8 The following information shall be subject to this subdivision:
line 9 (1) The name of the patient or client and names of the par ents line 10 or guardians of the patient or client.
line 11 (2) Date of birth of the patient or client.
line 12 (3) Types and dates of immunizations r eceived by the patient line 13 or client.
line 14 (4) Manufacturer and lot number for eac h immunization line 15 received.
line 16 (5) Adverse reaction to immunizations received. line 17 (6) Other nonmedical information necessary to establish the line 18 patient’s or client’s unique identity and record. line 19 (7) Results of tuberculosis screening.
line 20 (8) Current address and telephone number of the patient or line 21 client and the parents or guardians of the patient or client. line 22 (9) Patient’s or client’s gender.
line 23 (10) Patient’s or client’s place of birth.
line 24 (11) Patient’s or client’s race or ethnicity.
line 25 (12) Patient’s or client’ s information needed to comply with line 26 Chapter 1 (commencing with Section 120325), b ut e xcluding line 27 Section 120380.
line 28 (d) (1) Health care providers, local health departments, and line 29 the State Department of Public Health shall maintain the line 30 confidentiality of information listed in subdivision (c) in the same line 31 manner as other medical r ecord information with patient line 32 identification that they possess. These providers, departments, and line 33 contracting a gencies ar e subject to civil action and criminal line 34 penalties for the wrongful disclosure of the information listed in line 35 subdivision (c), in accor dance with e xisting law. They shall use line 36 the information listed in subdivision (c) only for the following line 37 purposes:
line 38 (A) To provide immunization services to the patient or client, line 39 including issuing reminder notifications to patients or clients or line 40 their parents or guardians when immunizations are due. 97 — 12 — AB 1797
line 1 (B) To pr ovide or facilitate pr ovision of thir d-party payer line 2 payments for immunizations.
line 3 (C) To compile and disseminate statistical information of line 4 immunization status on groups of patients or clients or populations line 5 in California, without identifying information for these patients line 6 or clients included in these groups or populations. line 7 (D) In the case of health care providers only, as authorized by line 8 Part 2.6 (commencing with Section 56) of Division 1 of the Civil line 9 Code.
line 10 (2) Schools, childcare facilities, family c hildcare homes, WIC line 11 service providers, foster car e a gencies, county human services line 12 agencies, and health care plans shall maintain the confidentiality line 13 of information listed in subdivision (c) in the same manner as other line 14 client, patient, and pupil information that the y possess. These line 15 institutions and providers are subject to civil action and criminal line 16 penalties for the wrongful disclosure of the information listed in line 17 subdivision (c), in accor dance with e xisting law. They shall use line 18 the information listed in subdivision (c) only for those purposes line 19 provided in subparagraphs (A) to (D), inclusive, of paragraph (1) line 20 and as follows:
line 21 (A) In the case of schools, childcare facilities, family childcare line 22 homes, and county human services a gencies, to carry out their line 23 responsibilities regarding required immunization for attendance line 24 or participation benefits, or both, as described in Chapter 1 line 25 (commencing with Section 120325), and in Section 11265.8 of the line 26 Welfare and Institutions Code.
line 27 (B) In the case of WIC service pr oviders, to perform line 28 immunization status assessments of clients and to refer those clients line 29 found to be due or o verdue for immunizations to health car e line 30 providers.
line 31 (C) In the case of health car e plans, to facilitate payments to line 32 health care providers, to assess the immunization status of their line 33 clients, and to tabulate statistical information on the immunization line 34 status of groups of patients, without including patient-identifying line 35 information in these tabulations.
line 36 (D) In the case of foster care agencies, to perform immunization line 37 status assessments of foster c hildren and to assist those foster line 38 children found to be due or overdue for immunization in obtaining line 39 immunizations from health care providers.
97 AB 1797 — 13 —
line 1 (e) A patient or a patient’ s parent or guar dian may r efuse to line 2 permit r ecordsharing. The health car e pr ovider administering line 3 immunization and any other a gency possessing any patient or line 4 client information listed in subdivision (c), if planning to provide line 5 patient or client information to an immunization system, as line 6 described in subdivision (b), shall inform the patient or client, or line 7 the parent or guardian of the patient or client, of the following:
line 8 (1) The information listed in subdivision (c) shall be shar ed line 9 with local health departments and the State Department of Public line 10 Health. The health car e provider or other a gency shall pr ovide line 11 the name and addr ess of the State Department of Public Health line 12 or of the immunization r egistry with which the provider or other line 13 agency will share the information.
line 14 (2) Any of the information shared with local health departments line 15 and the State Department of Public Health shall be tr eated as line 16 confidential medical information and shall be used only to shar e line 17 with each other, and, upon r equest, with health car e providers, line 18 schools, childcare facilities, family childcare homes, WIC service line 19 providers, county human services agencies, foster care agencies, line 20 and health care plans. These providers, agencies, and institutions line 21 shall, in turn, tr eat the shar ed information as confidential, and line 22 shall use it only as described in subdivision (d). line 23 (3) The patient or client, or par ent or guardian of the patient line 24 or client, has the right to e xamine any immunization-r elated line 25 information or tuberculosis screening results shared pursuant to line 26 this section and to correct any errors in it.
line 27 (4) The patient or client, or the parent or guardian of the patient line 28 or client, may r efuse to allow this information to be shar ed line 29 pursuant to this section or to r eceive immunization r eminder line 30 notifications at any time , or both. After refusal, the patient’ s or line 31 client’s physician may maintain access to this information for the line 32 purposes of patient car e or pr otecting the public health. After line 33 refusal, the local health department and the State Department of line 34 Public Health may maintain access to this information for the line 35 purpose of pr otecting the public health pur suant to Sections line 36 100325, 120140, and 120175, as well as Sections 2500 to 2643.20, line 37 inclusive, of Title 17 of the California Code of Regulations. line 38 (f) (1) The health care provider administering the immunization line 39 or tuberculosis screening and any other a gency possessing any line 40 patient or client information listed in subdivision (c), may inform 97 — 14 — AB 1797
line 1 the patient or client, or the par ent or guardian of the patient or line 2 client, by ordinary mail, of the information in par agraphs (1) to line 3 (4), inclusive , of subdivision (e). The mailing shall include a line 4 reasonable means for r efusal, such as a r eturn form or contact line 5 telephone number.
line 6 (2) The information in par agraphs (1) to (4), inclusive , of line 7 subdivision (e) may also be pr esented to the par ent or guardian line 8 of the patient or client during any hospitalization of the patient or line 9 client.
line 10 (g) If the patient or client, or parent or guardian of the patient line 11 or client, refuses to allow the information to be shared, pursuant line 12 to paragraph (4) of subdivision (e), the health car e provider or line 13 other a gency may not shar e this information in the manner line 14 described in subdivision (c), except as provided in subparagraph line 15 (D) of paragraph (1) of subdivision (d).
line 16 (h) (1) Upon request of the patient or client, or the par ent or line 17 guardian of the patient or client, in writing or by other means line 18 acceptable to the recipient, a local health department or the State line 19 Department of Public Health that has received information about line 20 a person pursuant to subdivision (c) shall do all of the following:
line 21 (A) Provide the name and address of other persons or agencies line 22 with whom the recipient has shared the information. line 23 (B) Stop sharing the information in its possession after the date line 24 of the receipt of the request.
line 25 (2) After refusal, the patient’s or client’s physician may maintain line 26 access to this information for the purposes of patient car e or line 27 protecting the public health. After r efusal, the local health line 28 department and the State Department of Public Health may line 29 maintain access to this information for the purpose of pr otecting line 30 the public health pur suant to Sections 100325, 120140, and line 31 120175, as well as Sections 2500 to 2643.20, inclusive, of Title 17 line 32 of the California Code of Regulations.
line 33 (i) Upon notification, in writing or by other means acceptable line 34 to the r ecipient, of an err or in the information, a local health line 35 department or the State Department of Public Health that has line 36 information about a per son pur suant to subdivision (c) shall line 37 correct the error. If the recipient is aware of a disagreement about line 38 whether an error exists, information to that effect may be included. line 39 (j) (1) Any party authorized to mak e medical decisions for a line 40 patient or client, including, but not limited to, those authorized by 97 AB 1797 — 15 —
line 1 Section 6922, 6926, or 6927 of, Part 1.5 (commencing with Section line 2 6550), Chapter 2 (commencing with Section 6910) of P art 4, or line 3 Chapter 1 (commencing with Section 7000) of Part 6, of Division line 4 11 of, the Family Code, Section 1530.6 of the Health and Safety line 5 Code, or Sections 727 and 1755.3 of, and Article 6 (commencing line 6 with Section 300) of Chapter 2 of P art 1 of Division 2 of , the line 7 Welfare and Institutions Code, may permit sharing of the patient’s line 8 or client’s record with any of the immunization information systems line 9 authorized by this section.
line 10 (2) For a patient or client who is a dependent of a juvenile court, line 11 the court or a person or agency designated by the court may permit line 12 this recordsharing.
line 13 (3) For a patient or client r eceiving foster car e, a per son or line 14 persons licensed to provide residential foster care, or having legal line 15 custody, may permit this recordsharing.
line 16 (k) For purposes of supporting immunization information line 17 systems, the State Department of Public Health shall assist the line 18 Immunization Branch of the State Department of Public Health in line 19 both of the following:
line 20 (1) Providing department records containing information about line 21 publicly funded immunizations.
line 22 (2) Supporting ef forts for the r eporting of publicly funded line 23 immunizations into immunization information systems by health line 24 care providers and health care plans.
line 25 (l) Subject to any other pr ovisions of state and feder al law or line 26 regulation that limit the disclosur e of health information and line 27 protect the privacy and confidentiality of per sonal information, line 28 local health departments and the State Department of Public line 29 Health may share the information listed in subdivision (c) with a line 30 state, local health departments, health car e pr oviders, line 31 immunization information systems, or any r epresentative of an line 32 entity designated by federal or state law or r egulation to receive line 33 this information. The State Department of Public Health may enter line 34 into written a greements to e xchange confidential immunization line 35 information with other states for the purposes of patient car e, line 36 protecting the public health, entr ance into school, childcare and line 37 other institutions requiring immunization prior to entry , and the line 38 other purposes described in subdivision (d). The written agreement line 39 shall provide that the state that receives confidential immunization line 40 information must maintain its confidentiality and may only use it 97 — 16 — AB 1797
line 1 for purposes of patient care, protecting the public health, entrance line 2 into school, childcare and other institutions requiring immunization line 3 prior to entry , and the other purposes described in subdivision line 4 (d). Information shall not be shar ed pursuant to this subdivision line 5 if a patient or client, or parent or guardian of a patient or client, line 6 refuses to allow the sharing of immunization information pursuant line 7 to subdivision (e).
line 8 (m) This section shall become operative on January 1, 2026. line 9 SEC. 2.
line 10 SEC. 3. If the Commission on State Mandates determines that line 11 this act contains costs mandated by the state, reimb ursement to line 12 local agencies and school districts for those costs shall be made line 13 pursuant to Part 7 (commencing with Section 17500) of Division line 14 4 of Title 2 of the Government Code.
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97 AB 1797 — 17 —