Senate BillNo. 19


Introduced by Senator Wolk

(Coauthors: Senators Monning and Vidak)

(Coauthors: Assembly Members Bonilla and Eggman)

December 1, 2014


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

LEGISLATIVE COUNSEL’S DIGEST

SB 19, as introduced, 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 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. Health care providers who complete a POLST form would be required to include the POLST form in the patient’s medical record and would be required to submit the form to the registry, unless a patient or his or her health care decisionmaker chooses not to participate in the registry. The bill would require the agency to disseminate the information in the POLST form to an authorized user. The bill defines “authorized user” to include a health care provider. The bill would require the agency to adopt rules for, among other things, the operation of the registry, including the means by which POLST forms would be submitted electronically, revised, and revoked, the capability to check the POLST form for accuracy prior to it being made available, the appropriate and timely methods for dissemination of POLST form information, the procedures for verifying the identity of an authorized user, and rules for maintaining the confidentiality of a POLST form received by the registry. 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 an authorized user who acts upon information obtained from the registry and acts 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:

P2    1

SECTION 1.  

This act shall be known, and may be cited, as the
2California POLST Registry Act.

3

SEC. 2.  

Section 4788 is added to the Probate Code, to read:

4

4788.  

(a)    For purposes of this section:

5(1) “Agency” means the California Health and Human Services
6Agency.

7(2) “Authorized user” means a person authorized by the agency
8to submit information to, or to receive information from, the
9POLST registry, including health care providers.

10(3) “Health care provider” has the meaning provided in Section
114621.

12(4) “POLST form” means a Physician Orders for Life Sustaining
13Treatment form that fulfills the requirements of Section 4780.

14(5) “Registry” means the California POLST Registry established
15by the agency pursuant to this section.

16(b) The agency shall establish and operate a statewide registry
17system, to be known as the California POLST Registry, for the
18purpose of collecting a POLST form received from a health care
19provider and disseminating the information in the form to an
20authorized user. The registry may be operated and maintained by
P3    1a contractor of the agency. The agency shall adopt all rules
2necessary for the operation of the registry, which shall include,
3but not be limited to, the following:

4(1) The means by which a POLST form may be submitted to
5the registry, may be revised, and may be revoked, which shall
6include a method for electronic delivery of this information and
7the use of legally sufficient electronic signatures.

8(2) Appropriate and timely methods by which the information
9in the registry may be disseminated to an authorized user.

10(3) Procedures for verifying the identity of an authorized user.

11(4) Procedures to ensure the accuracy of, and to appropriately
12protect the confidentiality of, POLST forms submitted to the
13registry.

14(5) The requirement that a patient, or his or her legally
15recognized health care decisionmaker, receive a confirmation or
16a receipt that the patient’s POLST form has been received by the
17registry.

18(6) The ability of a patient, or his or her legally recognized
19health care decisionmaker, to review the information in the
20patient’s POLST form after it has been entered into the registry,
21and to confirm that it is accurate, prior to the information being
22available to an authorized user.

23(7) The ability of a patient, or his or her legally recognized
24health care decisionmaker, to amend or withdraw a POLST form
25from the registry.

26(c) The registry and the information it contains shall be the
27property of the state and any disclosure of information in a POLST
28form received by the registry shall be made in a manner consistent
29with the federal Health Insurance Portability and Accountability
30Act of 1996 (Public Law 104-191).

31(d) A health care provider who completes a POLST form with
32a patient or his or her legally recognized health care decisionmaker
33shall include the POLST form in the patient’s official medical
34record. The health care provider shall submit a copy of the POLST
35form to the registry unless the patient or the legally recognized
36health care decisionmaker chooses not to participate in the registry.

37(e) An authorized user acting upon information obtained from
38the registry is not subject to criminal prosecution, civil liability,
39discipline for unprofessional conduct, administrative sanction, or
40any other sanction, if the person acted in good faith and had no
P4    1knowledge that the action or decision would be inconsistent with
2a health care decision that the individual signing the POLST form
3would have made on his or her own behalf, or on behalf of the
4patient, under the circumstances.



O

    99