Testimony: House Bill 574
House Public Health Committee
Presented by Jason Terk, MD
April 13, 2011
Hello, my name is Dr. Jason Terk. I am a senior consultant pediatrician with the Cook Children’s Health Care System practicing in Keller. I am pleased to represent The Immunization Partnership, which provides advocacy and education for immunization issues as well as the Texas Pediatric Society, the Texas Medical Association, and the Texas Academy of Family Physicians, which collectively represent more than 48,000 physicians across Texas.
Thank you for the opportunity to provide a physician's perspective regarding the consent process for ImmTrac. I stand fully in support of HB 574 because it will help me perform the mission of protecting children from dangerous vaccine-preventable diseases. Almost as important in these fiscally challenging times, this bill will save money for the state of Texas. Many children receive shots in multiple venues of care and the registry is an indispensible tool in our efforts to prevent devastating diseases. As an example, homeless children often are over-immunized because their records are not readily available, and once compiled into one location, it is not unusual to find that some of these children have been fully immunized 4 times over. Obviously this is a waste of precious health care dollars and resources and we as health care providers only want to give the vaccines that are needed.
A robust, well-populated registry is an essential component for ensuring that children stay healthy; it is also critical for protecting the public’s health in Texas. However, in my experience, the current process of consent for inclusion in ImmTrac is burdensome and inhibits the provider’s ability to access complete immunization histories for the children we serve. At the point of care, we must gather and document consent for the vast majority of children who want to be in the registry. In my busy active practice, this process is time-consuming and occupies staff resources that are needed for patient care. Frankly, it is such a difficult task that many providers simply do not obtain consent at all, which means that the child’s record is not available to other providers who may see that child in the future. Moving to an opt-out system of consent will mean that providers can advise families that their information will be entered into ImmTrac unless they specifically opt-out of the system. This means that we would only have to process and document a small subset of the population which declines to consent—between 5 and 10% of the patients, as opposed to the opt-in system where we must gather and document consent on 90 to 95% of the children we serve. The lifting of the administrative burdens under an opt-out system would free up staff time for more appropriate patient-care activities, and would ensure that we more efficiently document immunizations to support the public health infrastructure in Texas. In light of crippling budget cuts and the cuts to Medicaid provider payment rates, we physicians who serve Medicaid enrollees are squeezed to the breaking point. Offering relief to providers would be a double win;we would serve our patients in a more effective manner and we would save valuable resources that can be better spent on taking care of children.
Thank you for the opportunity to share my testimony today. I would be happy to answer any questions that you have now, or that come up during the course of the subsequent testimony.
82nd Texas Legislature Testimonies