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’s designee. The bill would require the agency to implement these provisions only after it determines that sufficient nonstate
begin delete findsend delete have been received for development of the registry and any related startup costs. A physician or physician’s 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
would define “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:
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
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
3(3) “Health care provider” has the meaning provided in Section
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) (1) 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 or physician’s designee and disseminating the
13information in the form to an authorized user.
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
18 (3) The registry may be operated and maintained by a
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:
22(A) The means by which an initial or subsequent POLST form
23may be submitted to, or withdrawn from, the registry, which shall
24include a method for electronic delivery of this information and
25the use of legally sufficient electronic signatures.
26(B) Appropriate and timely methods by which the information
27in the registry may be disseminated to an authorized user.
28(C) Procedures for verifying the identity of an authorized user.
29(D) Procedures to ensure the accuracy of, and to appropriately
30protect the confidentiality of, POLST forms submitted to the
32(E) The requirement that a patient, or, when appropriate, his or
33her legally recognized health care decisionmaker, receive a
34confirmation or a receipt that the patient’s POLST form has been
35received by the registry.
36(F) The ability of the physician who signed the POLST form,
37or his or her designee, and of a patient, or, when appropriate, his
38or her legally recognized health care decisionmaker, to review the
39information in the patient’s POLST form after it has been entered
P4 1into the registry, and to confirm that it is accurate, prior to the
2information being available to an authorized user.
3(G) The ability of a patient, or, when appropriate, his or her
4legally recognized health care decisionmaker, to withdraw a
5POLST form from the registry.
6(c) The operation of the registry shall comply with state and
7federal privacy and security laws and regulations, including, but
8not limited to, compliance with the Confidentiality of Medical
9Information Act (Part 2.6 (commencing with Section 56) of
10Division 1 of the Civil Code) and the regulations promulgated
11pursuant to the federal Health Insurance Portability and
12Accountability Act of 1996 (Public Law 104-191), found at Parts
13160 and 164 of Title 45 of the Code of Federal Regulations.
14(d) A physician or physician’s designee who completes a POLST
15form with a patient or his or her legally recognized health care
16decisionmaker shall include the POLST form in the patient’s
17official medical record. The physician or physician’s designee
18shall submit a copy of the POLST form to the registry unless the
19patient or the legally recognized health care decisionmaker chooses
20not to participate in the registry.
begin deleteA end deletehealth care provider
22who honors a patient’s request regarding resuscitative measures
23obtained from the registry shall not be subject to criminal
24prosecution, civil liability, discipline for unprofessional conduct,
25administrative sanction, or any other
begin delete sanction as set forth in Section
264782 of the Probate Code.end delete