Current through Register Vol. 48, 12, December 27, 2024
A. Purpose and Scope.
The purpose of this regulation is to provide rules, implementing
Section
44-29-40
of the S.C. Code of Laws, 1976, as amended, regarding the South Carolina
Immunization Registry requirements for reporting immunizations occurring in
South Carolina, implementation and operation of the registry, data elements to
be collected, content of electronic forms and reports, and the procedures for
disclosure of confidential registry information. This regulation will apply to
all healthcare providers who give immunizations in South Carolina. Nothing in
this regulation shall be construed to affect statutory or common law principles
governing the liabilities of health care providers for acts or omissions of
their employees, agents, or contractors. Nothing in this regulation shall be
construed to conflict with any state law or regulation governing immunizations
or to alter, add to, or eliminate any requirement of state law or regulation
regarding the administration of immunizations or to regulate the practice of
any of the health care professions.
B. Definitions.
1. AUTHORIZED USER means an employee of an
immunization provider who has been identified during the registration process
as a user of the registry.
2.
DEPARTMENT means the Department of Health and Environmental Control.
3. IMMUNIZATION PROVIDER means an individual
health care provider licensed, certified, registered, or otherwise authorized
by law to provide immunizations, and an organization, facility, or other entity
that provides immunizations through such individual providers.
4. PATIENT means an individual who receives
an immunization or other health care services.
5. REGISTRY means the data system for the
collection, storage, and dissemination of information on immunizations
administered in South Carolina established by the Department pursuant to
Section
44-29-40.
C. Registration and Reporting
Requirements.
1. Immunization providers shall
register with the Department for access to the Registry.
a. All immunization providers shall register
with the Department before administering any immunizations for which reporting
is required under the implementation schedule in this regulation. This section
governs only the registration requirement and is not intended to prohibit or
restrict the administration of immunizations by any person authorized by law to
do so.
b. Authorized users shall
complete training under schedules established by the Department in a format
determined by the Department. The Department will contact registered users to
schedule and provide the training and other needed activities in order to use
the registry. Immunization providers will not be responsible for completing the
reporting requirements of this regulation until necessary training and set up
have been completed by the Department.
c. An immunization provider that is a
facility or business entity administering vaccines through employees, agents,
or contractors may register in its own name, and the employees, agents, and
contractors of such facilities or business entities need not register
individually. An immunization provider that is a business entity with multiple
locations may register once as a single provider for more than one location.
Individual immunization providers who practice in a group or with a facility or
business entity may register individually or in the name of the group or
facility or business entity.
2. Each immunization provider shall identify
one or more employees who will be authorized users of the registry on behalf of
the immunization provider.
a. All authorized
users shall maintain the confidentiality of their individual access codes and
passwords for the immunization registry and shall not share or exchange such
codes with any other person, regardless of whether or not that other person is
an authorized user.
b. Each
immunization provider and authorized user shall be individually responsible for
complying with this regulation and the user agreement. The immunization
provider shall be responsible, according to existing principles of agency law,
for its authorized users' access to the registry and uses and disclosures of
registry information, and compliance with this regulation and the user
agreement.
c. Immunization
providers and authorized users shall enter into and comply with user agreements
specifying terms of use and confidentiality and other obligations. A breach of
a user agreement is a violation of this regulation.
3. The immunization provider shall notify the
Department within fifteen (15) business days after an authorized user is
terminated or leaves employment for any reason. The immunization provider shall
not be liable for applicable statutory penalties for its authorized users'
post-employment violations of this regulation, if the immunization provider has
notified the Department that the authorized user is no longer employed. This
regulation shall not be construed to affect the immunization provider's
liability to any third party for acts or omissions of its employee or other
authorized user.
4. Immunization
providers shall report all immunizations administered to the registry within
ten (10) business days of administration. Immunizations shall be reported in a
standard electronic format specified by the Department via the internet at a
website specified by the Department, or via the South Carolina Health
Information Exchange or other method specified by the Department. An
immunization provider that is a facility or business entity administering
vaccines through employees, agents, or contractors shall report immunizations
administered by its employees, agents, and contractors.
5. For each immunization administered,
immunization providers shall report, at a minimum, the date of immunization;
specific type of vaccine given; first and last name, gender, and date of birth
of the person receiving the vaccine; and name of the registered immunization
provider. The Department may require reporting of other data as needed to
comply with federal requirements.
6. In the event of a state or federal
declared disaster, state of emergency, or public health emergency, at the
Department's discretion, immunization providers shall report to the Department
information regarding administration or dispensing of certain drugs,
medications, chemicals, vaccines, or biological products used in response to
the declared disaster, state of emergency, or public health
emergency.
7. Immunization
providers in other states who administer immunizations in South Carolina must
comply with the requirements of this regulation. Immunization providers who
administer immunizations in other states to South Carolina residents are not
required to register with or report immunizations administered out of state to
the registry, but may register and report voluntarily. Out-of-state
immunization providers who register voluntarily are subject to and must comply
with the provisions of this regulation governing permitted uses and disclosures
of registry information and compliance and enforcement as fully as if located
in and administering immunizations in South Carolina.
8. Immunization providers who do not
administer vaccines may register with the Department for access to the
registry. Immunization providers who register under this paragraph and their
authorized users are subject to and will comply with all provisions of this
regulation applicable to immunization providers and authorized users and may
access and use registry information under Section D.
D. Permitted Uses and Disclosures of
Immunization Registry Information.
1.
Information in the immunization registry is confidential and shall be made
available only to registered immunization providers through their authorized
users. Immunizations providers who have registered for access to the registry
may obtain information from the registry pertaining only to their own
patients.
2. Immunization providers
may use registry information for the following purposes:
a. To provide care and treatment to their
patients;
b. To determine
appropriate and needed immunizations for their patients;
c. To generate reports to review their
practice's coverage;
d. To generate
reminder and recall notices;
e. To
review their practice's immunizations for quality improvement
purposes;
f. To print a patient's
immunization record;
g. To print a
South Carolina Certificate of Immunization for a patient for school and daycare
attendance; and for
h. Other uses
specifically authorized by the Department.
3. Immunization providers and authorized
users may not disclose identifying information obtained from the registry
except as allowed or required by applicable law.
4. The Department may use registry
information for public health purposes, including, but not limited to, the
following:
a. To determine appropriate and
needed immunizations for patients;
b. To print a patient's immunization record
at the request or with permission of an immunization provider;
c. To print a copy of an immunization record
or a South Carolina Certificate of Immunization for a patient and at the
written request of the patient, or a parent or legal guardian of the patient if
the patient is under eighteen (18) years of age;
d. To allow a patient, or a parent or legal
guardian of the patient if the patient is under eighteen (18) years of age, to
obtain a copy of the patient's immunization record through a Department
authorized electronic Patient Portal;
e. To investigate vaccine fraud;
f. To prevent, investigate, and control
outbreaks of vaccine preventable communicable diseases;
g. To conduct epidemiological
studies;
h. To provide data that
does not identify an individual either directly or indirectly for research and
only if the researcher submits a research protocol describing, at a minimum:
the intended use of the data, the methodology of the research project; why
access to the information is necessary, and approval by an official
Institutional Review Board;
i. To
assure the quality of the data entered into the registry;
j. To review the quality of the immunization
practices of immunization providers;
k. To publish aggregate data that does not
identify an individual either directly or indirectly;
l. When deemed necessary by the Director in
the event of a disaster, state of emergency, or public health
emergency;
m. To perform repairs,
maintenance, and updates of the Immunization registry;
n. To provide information needed by law
enforcement officers and agencies in the investigation or prosecution of a
crime;
o. To implement this
regulation, including compliance assistance and enforcement activities;
and
p. To provide immunization
records to the Revenue and Fiscal Affairs Office so that it may provide these
records to health plans of members and enrollees of the health plan who
received immunizations during the time in which they were enrolled in the
health plan. Each immunization record may only be used by health plans for
public health and Healthcare Effectiveness Data and Information Set (HEDIS)
purposes. Health plans shall enter into a data sharing agreement with the
Department and the Revenue and Fiscal Affairs Office prior to receiving
immunization records.
5.
Uses and disclosures by immunization providers or authorized users of registry
information not authorized by this section are prohibited. Nothing in this
regulation authorizes an immunization provider or authorized user to make any
use or disclosure of registry information that is otherwise prohibited by
law.
E. Compliance and
Enforcement.
1. Immunization providers shall
make immunization records available within a reasonable time to authorized
representatives of the Department for inspection upon request.
2. For a violation of this regulation, the
Department may:
a. Require an immunization
provider or an authorized user to attend registry training;
b. Suspend or revoke access to the registry;
or
c. Assess civil penalties as
authorized by Section
44-1-150,
S.C. Code of Laws, 1976, as amended.
3. A Department decision under Section E.2
may be appealed by an immunization provider or authorized user, pursuant to
applicable law, including S.C. Code Title 44, Chapter 1 and Title 1, Chapter
23.
F. Exceptions to
Regulation.
1. The Department may grant a
waiver to a requirement of this regulation, in its discretion when an
immunization provider demonstrates to the Department's satisfaction that
compliance would cause substantial hardship, that the waiver would protect and
promote the health and safety of patients, and that the requirement is not
specifically mandated by statute.
2. A delay in reporting caused by an act of
God, war, strike, riot, or other catastrophe as to which negligence or
willfulness on the part of the immunization provider was not the proximate
cause will not be considered a violation of this regulation, as long as the
immunization provider reports as required at the earliest practicable time
after the event or catastrophe.
G. Severability.
If a court of competent jurisdiction rules any part of this
regulation invalid or otherwise unenforceable, the remaining portions of this
regulation shall remain in effect as if the invalid portions were not
originally a part of this regulation.