BILL NUMBER: SB 1357	AMENDED
	BILL TEXT

	AMENDED IN SENATE  MAY 6, 2014
	AMENDED IN SENATE  APRIL 21, 2014
	AMENDED IN SENATE  MARCH 27, 2014

INTRODUCED BY   Senator Wolk

                        FEBRUARY 21, 2014

   An act to add Section 4788 to the Probate Code, relating to
resuscitative measures.


	LEGISLATIVE COUNSEL'S DIGEST


   SB 1357, as amended, Wolk. Physician Orders for Life Sustaining
Treatment form: statewide registry.
   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. 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. Existing law distinguishes a request regarding
resuscitative measures from an advance health care directive.
   This bill would enact the California POLST Registry Act. The bill
would require the California Health and Human Services Agency  ,
on or before January 1, 2016,  to establish and operate a
statewide registry system, to be known as the California POLST
Registry, for the purpose of collecting POLST forms received from
health care providers, who would be required to submit the forms to
the registry unless a patient or his or her health care decisionmaker
chooses not to participate. The bill would require the agency to
disseminate the information in the forms to authorized users,
including health care providers. The bill would require the agency 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 provide immunity for people who use information in the
registry and act in good faith.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  This act shall be known, and may be cited, as the
California POLST Registry Act.
  SEC. 2.  Section 4788 is added to the Probate Code, to read:
   4788.  (a) For purposes of this section:
   (1) "Agency" means the California Health and Human Services
Agency.
   (2) "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.
   (3) "Health care provider" has the meaning provided in Section
4621.
   (4) "POLST form" means a Physician Orders for Life Sustaining
Treatment form that fulfills the requirements of Section 4780.
   (5) "Registry" means the California POLST Registry established by
the agency pursuant to this section.
   (b)  The   On or before January 1, 2016, the
 agency 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 health care provider and
disseminating the information in the form to an authorized user. The
registry may be operated and maintained by a contractor of the
agency. The agency shall adopt all rules 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 and which shall include
a method for electronic delivery of this information and the use of
legally sufficient electronic signatures.
   (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. 
   (5) The requirement that a patient or his or her legally
recognized health care decisionmaker receive a confirmation or a
receipt that the patient's POLST has been received by the registry.
 
   (6) The ability of a patient or his or her legally recognized
decisionmaker to review the information in the patient's POLST form
after it has been entered into the registry and confirm that it is
accurate prior to the information being available to authorized
users.  
   (7) The ability of a patient or his or her legally recognized
health care decisionmaker to amend or withdraw a POLST form from 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) A health care provider who completes a POLST with a patient or
his or her legally recognized health care decisionmaker shall 
include the POLST form in the patient's official medical record and
 submit a copy of the POLST to the registry unless the patient
or the decisionmaker chooses not to participate in the registry.
   (e) 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.