Maryland Code § HG-18-109

Section HG-18-109
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(a) (1) In this section the following words have the meanings indicated.
(2) "Authorized user" means:
(i) A child care facility;
(ii) A health care provider;
(iii) A health insurer;
(iv) A health maintenance organization;
(v) An institution of higher learning;
(vi) A local health department;
(vii) A long-term care facility;
(viii) A managed care organization;
(ix) A nonprofit health service plan;
(x) A patient;
(xi) A school;
(xii) A school-based health center;
(xiii) In the case of a minor child, a parent or guardian; and
(xiv) Any other user designated by the Secretary.
(3) "Health care provider" means a licensed health care practitioner
authorized under the Health Occupations Article to administer vaccines in the State.
(4) "ImmuNet" means a computerized information and reminder
system to:

(i) Improve the timely and appropriate delivery of
immunizations;
(ii) Provide a coordinated network for reminder notices when
immunizations are due;
(iii) Provide and collect information to be shared by authorized
users; and
(iv) Provide a quality indicator for the insurers' health care
provider practices and public health purposes.
(5) "Immunization" means the process by which an individual
becomes protected against a disease including, as the result of having a disease,
receiving a vaccination, or receiving preformed antibodies.
(6) "Refusal to permit" means the right of an individual or the parent
or guardian of a minor to prevent disclosure to authorized users of individual
identifiable information that was reported to ImmuNet.
(7) "Vaccination" means the administration of a killed or weakened
infectious organism to prevent disease caused by that organism.
(8) "Vaccine" means a substance that:
(i) May be administered by injection, mouth, or aerosol; and
(ii) Produces immunity that protects the body from a disease.
(b) There is an ImmuNet program in the Department.
(c) Subject to subsection (d) of this section, an authorized user may use the
information in ImmuNet for the following purposes:
(1) To provide coordinated immunization services, including sending
reminder notices to individuals who need immunizations;
(2) To obtain an individual immunization history;
(3) To identify geographic areas or population groups that are
underimmunized;
(4) To compile aggregate data and distribute statistical reports on
the status of immunizations in geographic areas and population groups;

(5) To assist in the management of State and local immunization
programs;
(6) To monitor the safety of vaccines;
(7) To assess compliance with immunization requirements by
monitoring admissions to schools, institutions of higher learning, and child care
facilities; and
(8) For any other purpose that the Secretary deems necessary to
prevent the spread of communicable diseases.
(d) (1) An individual, or the parent or guardian of a minor child who has
received a vaccination, may refuse to permit disclosure of confidential information
collected by ImmuNet, to an authorized user.
(2) If the individual or the parent or guardian of a minor child does
not want the release of the individual's or child's confidential information, the
individual or the parent or guardian of a minor child shall complete a "refusal to
permit" form, provided by the Department, to be returned to the Department.
(3) The Secretary shall make available "refusal to permit" forms to
each health care provider who gives vaccinations.
(4) The Department shall:
(i) Develop brochures about ImmuNet that:
1. Describe the benefits of ImmuNet for authorized
users;
2. Describe privacy protections in ImmuNet;
3. Notify an individual of the right to refuse to permit
disclosure to an authorized user;
4. Notify an individual that the individual may correct
any inaccurate information;
5. Provide a list of addresses where an individual may
obtain a form to request the correction or removal of inaccurate information from
ImmuNet;

6. Explain the right of an individual who has received
a vaccination to have the individual's personal information kept confidential;
7. Describe the kind of information collected and
retained by ImmuNet about an individual who receives a vaccination;
8. Describe who has access to the information in
ImmuNet; and
9. Describe how the information is used by ImmuNet;
and
(ii) Make the brochure available to each health care provider
who administers vaccines.
(5) Prior to administering vaccines to a newborn child, each birth
hospital or birthing center shall distribute the form and the brochure described in
paragraphs (2) and (4) of this subsection to the parent of a newborn child.
(6) A health care provider who administers a vaccine, or the agent of
the health care provider, shall:
(i) Provide the individual with a copy of the form and the
brochure described in paragraphs (2) and (4) of this subsection;
(ii) Notify the individual or the parent or guardian of a minor
of the right to refuse to disclose to ImmuNet; and
(iii) Report to ImmuNet all vaccines administered.
(e) Subject to the provisions of subsection (d) of this section, information for
ImmuNet may be obtained from:
(1) Any records owned or controlled by the Department, including
Medicaid records, clinic records, and vital records;
(2) Any authorized user; and
(3) Any other source of information authorized by the Secretary for
use.
(f) Authorized users may not use the information in ImmuNet:

(1) To release or disclose information in ImmuNet that an individual
has refused to disclose;
(2) To solicit new patients or clients; or
(3) For any other purpose unless authorized by the Secretary.
(g) (1) A local health department may operate a local immunization
system.
(2) A local health department operating a local immunization system
shall be subject to the provisions of subsections (c) through (f) of this section.
(3) A local health department is required to submit information
maintained in a local immunization system to ImmuNet in accordance with
regulations adopted by the Secretary.
(h) An authorized user who in good faith discloses or does not disclose
information to ImmuNet is not liable in any cause of action arising from the disclosure
or nondisclosure of that information.
(i) An authorized user, including an officer or employee of a governmental
unit, who knowingly and willfully violates subsection (f) of this section is guilty of a
misdemeanor and on conviction is subject to a fine not exceeding $1,000 for the first
offense and not exceeding $5,000 for each subsequent offense.
(j) If the confidentiality of records of Maryland citizens is protected, the
Secretary may enter into collaborative agreements with other states for the purpose
of sharing information about immunizations.
(k) The Secretary shall adopt regulations to implement this section,
including regulations specifying:
(1) The type and kind of information to be collected;
(2) Procedures for protecting the confidentiality of information in
ImmuNet;
(3) The permissible use of information compiled by ImmuNet; and
(4) Standards for maintaining security and reliability of collected
information in the system.

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