Amended in Senate June 2, 2015

Amended in Senate May 5, 2015

Amended in Senate March 25, 2015

Senate BillNo. 19


Introduced by Senator Wolk

(Coauthors: Senators Hancock, Monning, and Vidak)

(Coauthors: Assembly Members Bonilla, Dababneh, 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 from a physician orbegin delete physicianend deletebegin insert physician’send insert designee.begin insert The bill would require the agency to implement these provisions only after it determines that sufficient nonstate finds have been received for development of the registry and any related startup costs.end insert A physician orbegin delete physicianend deletebegin insert physician’send insert 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 billbegin delete definesend deletebegin insert would defineend insert “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 immunity 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.

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
P3    1POLST registry, including health care providers and their
2designees.

3(3) “Health care provider” has the meaning provided in Section
44621.

5(4) “POLST form” means a Physician Orders for Life Sustaining
6Treatment form that fulfills the requirements of Section 4780.

7(5) “Registry” means the California POLST Registry established
8by the agency pursuant to this section.

9(b) begin insert(1)end insertbegin insertend insert The agency shall establish and operate a statewide
10registry system, to be known as the California POLST Registry,
11for the purpose of collecting a POLST form received from a
12physician orbegin delete physicianend deletebegin insert physician’send insert designee and disseminating the
13information in the form to an authorized user.begin delete Theend delete

begin insert

14(2) The agency shall implement this section only after
15determining that sufficient nonstate funds have been received to
16allow for the development of the registry and any related startup
17costs.

end insert

18begin insert (3)end insertbegin insertend insertbegin insertTheend insert registry may be operated and maintained by a contractor
19of the agency. The agency shall adopt all rules necessary for the
20operation of the registry, which shall include, but not be limited
21to, the following:

begin delete

22(1)

end delete

23begin insert(A)end insert The means by which an initial or subsequent POLST form
24may be submitted to, or withdrawn from, the registry, which shall
25include a method for electronic delivery of this information and
26the use of legally sufficient electronic signatures.

begin delete

27(2)

end delete

28begin insert(B)end insert Appropriate and timely methods by which the information
29in the registry may be disseminated to an authorized user.

begin delete

30(3)

end delete

31begin insert(C)end insert Procedures for verifying the identity of an authorized user.

begin delete

32(4)

end delete

33begin insert(D)end insert Procedures to ensure the accuracy of, and to appropriately
34protect the confidentiality of, POLST forms submitted to the
35registry.

begin delete

36(5)

end delete

37begin insert(E)end insert The requirement that a patient, or, when appropriate, his or
38her legally recognized health care decisionmaker, receive a
39confirmation or a receipt that the patient’s POLST form has been
40received by the registry.

begin delete

P4    1(6)

end delete

2begin insert(F)end insert The ability of the physician who signed the POLST form,
3or his or her designee, and of a patient, or, when appropriate, his
4or her legally recognized health care decisionmaker, to review the
5information in the patient’s POLST form after it has been entered
6into the registry, and to confirm that it is accurate, prior to the
7information being available to an authorized user.

begin delete

8(7)

end delete

9begin insert(G)end insert The ability of a patient, or, when appropriate, his or her
10legally recognized health care decisionmaker, to withdraw a
11POLST form from the registry.

12(c) The operation of the registry shall comply with state and
13federal privacy and security laws and regulations, including, but
14not limited to, compliance with the Confidentiality of Medical
15Information Act (Part 2.6 (commencing with Section 56) of
16Division 1 of the Civil Code) and the regulations promulgated
17pursuant to the federal Health Insurance Portability and
18Accountability Act of 1996 (Public Law 104-191), found at Parts
19160 and 164 of Title 45 of the Code of Federal Regulations.

20(d) A physician orbegin delete physicianend deletebegin insert physician’send insert designee who
21completes a POLST form with a patient or his or her legally
22recognized health care decisionmaker shall include the POLST
23form in the patient’s official medical record. The physician or
24begin delete physicianend deletebegin insert physician’send insert designee shall submit a copy of the POLST
25form to the registry unless the patient or the legally recognized
26health care decisionmaker chooses not to participate in the registry.

27(e) A health care provider who honors a patient’s request
28regarding resuscitative measures obtained from the registry shall
29not be subject to criminal prosecution, civil liability, discipline for
30unprofessional conduct, administrative sanction, or any other
31sanction as set forth in Section 4782 of the Probate Code.



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