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 from a physician or physician designee. A physician or physician designee who completes 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 state and federal privacy and security laws and regulations. The bill would provide immunitybegin delete for an authorized user who acts upon information obtained from the registry and acts in good faith.end deletebegin insert from criminal prosecution, civil liability, discipline for unprofessional conduct, and any other sanction for a health care provider who honors a patient’s request regarding resuscitative measures obtained from the registry, as specified.end insert
Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.
The people of the State of California do enact as follows:
This act shall be known, and may be cited, as the
2California POLST Registry Act.
Section 4788 is added to the Probate Code, to read:
(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 and their
10designees.
11(3) “Health care provider” has the meaning provided in Section
124621.
P3 1(4) “POLST form” means a Physician Orders for Life Sustaining
2Treatment form that fulfills the requirements of Section 4780.
3(5) “Registry” means the California POLST Registry established
4by the agency pursuant to this section.
5(b) The agency shall establish and operate a statewide registry
6system, to be known as the California POLST Registry, for the
7purpose of collecting a POLST form received from a physician or
8physician designee and disseminating the information in the form
9to an authorized user. The registry may be operated and maintained
10by a contractor of the agency. The agency shall adopt all rules
11necessary for the operation of the registry, which shall include,
12but not be limited to, the following:
13(1) The means by which an initial or subsequent POLST form
14may be submitted to, or withdrawn from, the registry, which shall
15include a method for electronic delivery of this information and
16the use of legally sufficient electronic signatures.
17(2) Appropriate and timely methods by which the information
18in the registry may be disseminated to an authorized user.
19(3) Procedures for verifying the identity of an authorized user.
20(4) Procedures to ensure the accuracy of, and to appropriately
21protect the confidentiality of, POLST forms submitted to the
22registry.
23(5) The requirement that a patient, or, when appropriate, his or
24her legally recognized health care decisionmaker, receive a
25confirmation or a receipt that the patient’s POLST form has been
26received by the registry.
27(6) The ability of the physician who signed the POLST form,
28or his or her designee, and of a patient, or, when appropriate, his
29or her legally recognized health care
decisionmaker, to review the
30information in the patient’s POLST form after it has been entered
31into the registry, and to confirm that it is accurate, prior to the
32information being available to an authorized user.
33(7) The ability of a patient, or, when appropriate, his or her
34legally recognized health care decisionmaker, to withdraw a
35POLST form from the registry.
36(c) The operation of the registry shall comply with state and
37federal privacy and security laws and regulations, including, but
38not limited to, compliance with the Confidentiality of Medical
39Information Act (Part 2.6 (commencing with Section 56) of
40Division 1 of the Civil Code) and the regulations promulgated
P4 1pursuant to thebegin insert
federalend insert Health Insurance Portability and
2Accountability Act of 1996begin insert (Public Law 104-191)end insert, found at Parts
3160 and 164 of Title 45 of the Code of Federal Regulations.
4(d) A physician or physician designee who completes a POLST
5form with a patient or his or her legally recognized health care
6decisionmaker shall include the POLST form in the patient’s
7official medical record. The physician or physician designee shall
8submit a copy of the POLST form to the registry unless the patient
9or the legally recognized health care decisionmaker chooses not
10to participate in the registry.
11(e) An authorized user acting upon information obtained from
12the registry is not subject to criminal prosecution, civil liability,
13discipline for unprofessional conduct, administrative sanction, or
14any other sanction, if the person acted in good faith and had no
15knowledge that the action or decision would be inconsistent with
16a health care decision that the individual signing the POLST form
17would have made on his or her own behalf, or on behalf of the
18patient, under the circumstances.
19(e) A health care provider who honors a patient’s request
20regarding resuscitative measures obtained from the registry shall
21not be subject to criminal prosecution, civil liability, discipline
22for unprofessional conduct, administrative sanction, or any other
23sanction as set forth in Section 4782 of the Probate Code.
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