Amended in Senate March 25, 2015

Senate BillNo. 19


Introduced by Senator Wolk

(Coauthors: Senatorsbegin delete Monningend deletebegin insert Hancock, Monning,end insert and Vidak)

(Coauthors: Assembly Membersbegin delete Bonillaend deletebegin insert Bonilla, Dababneh,end insert 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 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 to establish and operate a statewide registry system, to be known as the California POLST Registry, for the purpose of collecting POLST forms received frombegin delete health care providers. Health care providersend deletebegin insert a physician or physician designee. A physician or physician designeeend insert whobegin delete completeend deletebegin insert completesend insert 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 applicablebegin insert state andend insert federal privacybegin insert and securityend insert lawsbegin insert and regulationsend insert. 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 carebegin delete providers.end deletebegin insert providers and
10their designeesend insert
begin insert.end insert

11(3) “Health care provider” has the meaning provided in Section
124621.

13(4) “POLST form” means a Physician Orders for Life Sustaining
14Treatment form that fulfills the requirements of Section 4780.

P3    1(5) “Registry” means the California POLST Registry established
2by the agency pursuant to this section.

3(b) The agency shall establish and operate a statewide registry
4system, to be known as the California POLST Registry, for the
5purpose of collecting a POLST form received from abegin delete health care
6providerend delete
begin insert physician or physician designeeend insert and disseminating the
7information in the form to an authorized user. The registry may
8be operated and maintained by a contractor of the agency. The
9agency shall adopt all rules necessary for the operation of the
10registry, which shall include, but not be limited to, the following:

11(1) The means by whichbegin delete aend deletebegin insert an initial or subsequentend insert POLST form
12may be submitted tobegin insert, or withdrawn from,end insert the registry,begin delete may be
13revised, and may be revoked,end delete
which shall include a method for
14electronic delivery of this information and the use of legally
15sufficient electronic signatures.

16(2) Appropriate and timely methods by which the information
17in the registry may be disseminated to an authorized user.

18(3) Procedures for verifying the identity of an authorized user.

19(4) Procedures to ensure the accuracy of, and to appropriately
20protect the confidentiality of, POLST forms submitted to the
21registry.

22(5) The requirement that a patient,begin delete orend deletebegin insert or, when appropriate,end insert his
23or her legally recognized health care decisionmaker, receive a
24confirmation or a receipt that the patient’s POLST form has been
25received by the registry.

26(6) The ability ofbegin insert the physician who signed the POLST form,
27or his or her designee, and ofend insert
a patient,begin delete orend deletebegin insert or, when appropriate,end insert
28 his or her legally recognized health care decisionmaker, to review
29the information in the patient’s POLST form after it has been
30entered into the registry, and to confirm that it is accurate, prior
31to the information being available to an authorized user.

32(7) The ability of a patient,begin delete orend deletebegin insert or, when appropriate,end insert his or her
33legally recognized health care decisionmaker, tobegin delete amend orend delete
34 withdraw a POLST form from the registry.

begin delete

35(c) The registry and the information it contains shall be the
36property of the state and any disclosure of information in a POLST
37form received by the registry shall be made in a manner consistent
38with the federal Health Insurance Portability and Accountability
39Act of 1996 (Public Law 104-191).

end delete
begin insert

P4    1(c) The operation of the registry shall comply with state and
2federal privacy and security laws and regulations, including, but
3not limited to, compliance with the Confidentiality of Medical
4Information Act (Part 2.6 (commencing with Section 56) of Division
51 of the Civil Code) and the regulations promulgated pursuant to
6the Health Insurance Portability and Accountability Act of 1996,
7found at parts 160 and 164 of Title 45 of the Code of Federal
8Regulations.

end insert

9(d) Abegin delete health care providerend deletebegin insert physician or physician designeeend insert who
10completes a POLST form with a patient or his or her legally
11recognized health care decisionmaker shall include the POLST
12form in the patient’s official medical record. Thebegin delete health care
13providerend delete
begin insert physician or physician designeeend insert shall submit a copy of
14the POLST form to the registry unless the patient or the legally
15recognized health care decisionmaker chooses not to participate
16in the registry.

17(e) An authorized user acting upon information obtained from
18the registry is not subject to criminal prosecution, civil liability,
19discipline for unprofessional conduct, administrative sanction, or
20any other sanction, if the person acted in good faith and had no
21knowledge that the action or decision would be inconsistent with
22a health care decision that the individual signing the POLST form
23would have made on his or her own behalf, or on behalf of the
24patient, under the circumstances.



O

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