Amended in Senate March 27, 2014

Senate Bill No. 1357

Introduced by Senator Wolk

February 21, 2014

An act to begin delete amend Section 4780 of the Probate Code, relating to health care decisions. end delete begin insert add Section 4788 to the Probate Code, relating to resuscitative measures. end insert

LEGISLATIVE COUNSEL’S DIGEST

SB 1357, as amended, Wolk. begin delete Resuscitative measures. end delete begin insert Physician Orders for Life Sustaining Treatment form: state-wide registry. end insert

Existing law defines a request regarding resuscitative measures as a written document, signed by an individual with capacity, or a legally recognized health care decisionmaker, and the individual’s physician, directing a health care provider regarding resuscitative measures. begin insert Existing law defines a Physician Orders for Life Sustaining Treatment form, which is commonly referred to as a POLST form and provides that a request regarding resuscitative measures includes a POLST form. Existing law requires that a POLST form and the medical intervention and procedures offered by the form be explained by a health care provider. end insert Existing law distinguishes a request regarding resuscitative measures from an advance health care directive.

This bill would begin delete make nonsubstantive changes in these provisions end delete begin insert enact the California POLST Registry Act. The bill would require the State Department of Public Health to establish and operate a state wide registry system, to be known as the California POLST Registry, for the purpose of collecting POLST forms received from individuals electing to submit the forms and disseminating the information in the forms to authorized users, including health care providers. The bill would require the department to adopt rules for the operation of the registry, which would include the means by which POLST forms would be submitted, revised, and revoked, appropriate and timely methods for dissemination of POLST form information, and procedures for verifying the identity of users and maintaining the confidentiality of POLST forms. The bill would require that any disclosure of POLST form information in the registry be made in accordance with applicable federal privacy laws. The bill would authorize the department to charge an appropriate fee to registrants using the registry and would provide immunity for people who submit information to, and use information in, the registry and act in good faith end insert .

Vote: majority. Appropriation: no. Fiscal committee:  begin delete no end delete begin insert yes end insert . State-mandated local program: no.

The people of the State of California do enact as follows:

begin insert

begin insert SECTION 1. end insert   

end insert

begin insert This act shall be known, and may be cited, as the
California POLST Registry Act. end insert

begin insert

begin insert SEC. 2. end insert   

end insert

begin insert Section 4788 is added to the end insert begin insert Probate Code end insert begin insert , to read: end insert

begin insert

begin insert 4788. end insert   

(a) For purposes of this section:

(1) “Authorized user” means a person authorized by the
department to submit information to, or to receive information
from, the POLST registry, including health care providers.

(2) “Department” means the State Department of Public Health.

(3) “POLST form” means a Physician Orders for Life Sustaining
Treatment form that fulfills the requirements of Section 4780.

(4) “Registrant” means an individual who elects to submit a
POLST form to the registry.

(5) “Registry” means the California POLST Registry established
by the department pursuant to this section.

(b) The department shall establish and operate a statewide
registry system, to be known as the California POLST Registry,
for the purpose of collecting a POLST form received from a
registrant and disseminating the information in the form to an
authorized user. The department shall adopt all rules and
regulations necessary for the operation of the registry, which shall
include, but not be limited to, the following:

(1) The means by which a POLST form may be submitted to the
registry, may be revised, and may be revoked.

(2) Appropriate and timely methods by which the information
in the registry may be disseminated to an authorized user.

(3) Procedures for verifying the identity of an authorized user.

(4) Procedures to ensure the accuracy of and to appropriately
protect the confidentiality of POLST forms submitted to the
registry.

(c) The registry and the information it contains shall be the
property of the state and any disclosure of information in POLST
forms received by the registry shall be made in a manner consistent
with the federal Health Insurance Portability and Accountability
Act of 1996 (Public Law 104-191).

(d) The department may charge an appropriate and reasonable
fee to a registrant in an amount that, when the fees charged to
registrants are aggregated, does not exceed the actual cost of
establishing and maintaining the registry.

(e) A registrant reporting information to the registry or an
authorized user acting upon information obtained from the registry
is not subject to criminal prosecution, civil liability, discipline for
unprofessional conduct, administrative sanction, or any other
sanction if the person acted in good faith and had no knowledge
that the action or decision would be inconsistent with a health
care decision that the individual signing the request would have
made on his or her own behalf under like circumstances.

end insert

begin delete

SECTION 1.  

Section 4780 of the Probate Code is amended to
read:

4780.  

(a) As used in this part:

(1) “Request regarding resuscitative measures” means a written
document, signed by an individual with capacity, or a legally
recognized health care decisionmaker, and the individual’s
physician, that directs a health care provider regarding resuscitative
measures. A request regarding resuscitative measures is not an
advance health care directive.

(2) “Request regarding resuscitative measures” includes one,
or both of, the following:

(A) A prehospital “do not resuscitate” form as developed by
the Emergency Medical Services Authority or other substantially
similar form.

(B) A Physician Orders for Life Sustaining Treatment form, as
approved by the Emergency Medical Services Authority.

(3) “Physician Orders for Life Sustaining Treatment form”
means a request regarding resuscitative measures that directs a
health care provider regarding resuscitative and life-sustaining
measures.

(b) A legally recognized health care decisionmaker may execute
the Physician Orders for Life Sustaining Treatment form only if
the individual lacks capacity, or the individual has designated that
the decisionmaker’s authority is effective pursuant to Section 4682.

(c) The Physician Orders for Life Sustaining Treatment form
and medical intervention and procedures offered by the form shall
be explained by a health care provider, as defined in Section 4621.
The form shall be completed by a health care provider based on
patient preferences and medical indications, and signed by a
physician and the patient or his or her legally recognized health
care decisionmaker. The health care provider, during the process
of completing the Physician Orders for Life Sustaining Treatment
form, should inform the patient about the difference between an
advance health care directive and the Physician Orders for Life
Sustaining Treatment form.

(d) An individual having capacity may revoke a Physician
Orders for Life Sustaining Treatment form at any time and in any
manner that communicates an intent to revoke, consistent with
Section 4695.

(e) A request regarding resuscitative measures may also be
evidenced by a medallion engraved with the words “do not
resuscitate” or the letters “DNR,” a patient identification number,
and a 24-hour toll-free telephone number, issued by a person
pursuant to an agreement with the Emergency Medical Services
Authority.

end delete