Amended in Assembly May 23, 2014

Amended in Assembly May 6, 2014

Amended in Assembly April 8, 2014

Amended in Assembly March 20, 2014

California Legislature—2013–14 Regular Session

Assembly Bill No. 2452

Introduced by Assembly Member Pan

February 21, 2014

An act to amend Sections 4800, 4801, 4802, and 4806 of, and to add Sections 4801.5 and 4807 to, the Probate Code, relating to advance health care directives.

LEGISLATIVE COUNSEL’S DIGEST

AB 2452, as amended, Pan. Advance health care directive registry.

Existing law directs the Secretary of State to establish an Advance Health Care Directive Registry to receive and release specified information from a person who has executed a written advance health care directive. Existing law requires the Secretary of State to charge a fee to each registrant in an amount such that, when all fees charged to registrants are aggregated, the aggregated fees do not exceed the actual cost of establishing and maintaining the registry. Existing law provides that failure to register with the Secretary of State does not affect the validity of an advance health care directive.

This bill would require, commencing on January 1, 2016, the Secretary of State to establish and maintain access, as specified, to a secure portion of the Secretary of State’s Internet Web site that provides an electronic reproduction of an advance health care directive and other specified documents submitted to the registry system. The bill would require this access to include the ability to view the electronic reproduction on the Internet Web site, as well as download, print, and otherwise retrieve a copy of the electronic reproduction. The bill would, among other things, require the secretary to establish procedures to register, replace, and remove an advance health care directive, as specified. begin insert The bill would require that on or before January 1, 2020, the registry be fully supported by fees charged by the Secretary of State to each registrant. The bill would require the Secretary of State to develop and submit to the Legislature a financial sustainability plan, as specified, on or before January 1, 2018. 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:

SECTION 1.  

Section 4800 of the Probate Code is amended to
read:

4800.  

(a) (1) The Secretary of State shall establish a registry
system through which a person who has executed a written advance
health care directive may register in a central information center,
information regarding the advance directive, making that
information available upon request to any health care provider,
the public guardian, or the legal representative of the registrant.

(2) Commencing on January 1, 2016, the Secretary of State
shall establish and maintain access, as prescribed by this part, to
a secure portion of the Secretary of State’s Internet Web site that
provides an electronic reproduction of an advance health care
directive and other documents described in subdivision (c)
submitted to the registry system. This access shall include the
ability to view the electronic reproduction on the Internet Web
site, as well as download, print, and otherwise retrieve a copy of
the electronic reproduction.

(b) Commencing on January 1, 2016, the Secretary of State
shall establish a process to register an advance health care directive
and submit personal information and documents to the registry
either by electronic submission or submission of paper documents.
Commencing on January 1, 2016, the Secretary of State shall
establish a process to merge documents in the registry prior to
January 1, 2016, with the access system established in paragraph
(2) of subdivision (a). This process shall require a person who
registers an advance health care directive or other document
described in paragraph (2) to submit to the begin delete secretary end delete begin insert Secretary of
State end insert all of the following:

(1) An application in a form prescribed by the Secretary of State.

(2) A copy or electronic reproduction of any of the following:

(A) The registrant’s advance health care directive.

(B) A values statement, questionnaire, or other document that
supplements the advance health care directive.

(C) Durable power of attorney form.

(D) A physician orders for life-sustaining treatment (POLST)
form.

(E) The intended place of deposit or safekeeping of a written
advance health care directive and any other document described
in this paragraph.

(F) The name and telephone number of the agent and any
alternative agent.

(3) Any fee established by the Secretary of State pursuant to
subdivision (f).

(c) Information that may be received shall be limited to all of
the following regarding the registrant:

(1) Name.

(2) Social security number.

(3) Driver’s license number, or other state-issued individual
identifying number established by law, if any.

(4) Address.

(5) Date and place of birth.

(d) When the Secretary of State receives the items described in
subdivision (b) from a registrant, the secretary shall do all of the
following:

(1) Assign a registration number and password to access the
registry to the registrant.

(2) Issue the registrant an Advance Health Care Directive
Registry registration card indicating that an advance health care
directive, or information regarding an advance health care directive,
has been deposited with the registry. The information on the card
shall include, but not be limited to, the registrant’s name,
registration number, and password to access the registry. Costs
associated with issuance of the card shall be offset by the fee
charged by the Secretary of State to receive and register
information at the registry.

(3) Make or transfer an electronic reproduction of the advance
health care directive and other documents described in paragraph
(2) of subdivision (b) and post it to the registry.

(e) The Secretary of State, at the request of the registrant or his
or her legal representative, shall transmit the information received
regarding the written advance health care directive to the registry
system of another jurisdiction as identified by the registrant, or his
or her legal representative.

(f) The Secretary of State shall charge a fee to each registrant
in an amount such that, when all fees charged to registrants are
aggregated, the aggregated fees do not exceed the actual cost of
establishing and maintaining the registry. begin insert On or before January
1, 2020, the registry shall be fully supported by fees charged
pursuant to this subdivision. end insert

begin insert

(g) On or before January 1, 2018, the Secretary of State shall
develop and submit to the Legislature a financial sustainability
plan detailing all of the following:

end insert begin insert

(1) The amount of revenue generated by the fee charged
pursuant to subdivision (f).

end insert begin insert

(2) The estimated ongoing costs of maintaining the registry.

end insert begin insert

(3) The number of participants in the registry and the projected
participation in future years.

end insert begin insert

(4) A plan for ensuring that the revenue from fees charged
pursuant to subdivision (f) fully support the ongoing costs of
maintaining the registry.

end insert begin insert

(h) (1) The requirement for submitting a report imposed under
subdivision (g) is inoperative on January 1, 2022, pursuant to
Section 10231.5 of the Government Code.

end insert begin insert

(2) A report submitted pursuant to subdivision (g) shall be
submitted in compliance with Section 9795 of the Government
Code.

end insert

SEC. 2.  

Section 4801 of the Probate Code is amended to read:

4801.  

(a) Notwithstanding any other law, the Secretary of
State shall limit access to the registry, including a registrant’s
advance health care directive, personal information, and other
documents received, to when all of the following occur:

(1) The assigned registration number and password are provided.

(2) Access to the advance health care directive is required
pursuant to a lawful order of a court of competent jurisdiction,
requested by the registrant or the registrant’s legal representative,
requested by the public guardian, or requested by a provider of
health care to the registrant only for the purpose of providing health
care to the registrant.

(3) The Secretary of State determines that providing access to
the advance health care directive is in the best interest of the
registrant. However, a registrant or legal representative of the
registrant may access the advance health care directive of the
registrant for any purpose.

(b) The Secretary of State shall establish procedures to verify
the identities of health care providers, the public guardian, and
other authorized persons requesting information pursuant to Section
4800. No fee shall be charged to any health care provider, the
public guardian, or other authorized person requesting information
pursuant to Section 4800.

(c) A request for access pursuant to this part shall state the need
for the information.

(d) The Secretary of State shall respond by the close of business
on the next business day to a request for information made pursuant
to Section 4717 by the emergency department of a general acute
care hospital when the request is made by means other than through
the Secretary of State’s Internet Web site.

(e) Information that may be released upon request shall not
include the registrant’s social security number except when
necessary to verify the identity of the registrant.

SEC. 3.  

Section 4801.5 is added to the Probate Code, to read:

4801.5.  

The Secretary of State shall establish procedures for
all of the following:

(a) The registration of an advance health care directive or other
document described in Section 4800 that replaces an advance
health care directive or other document that is posted on the
registry.

(b) The removal from the registry of an advance health care
directive or other document described in Section 4800 that has
been revoked following the revocation of the advance health care
directive or other document or the death of the registrant.

(c) The issuance of a duplicate registration card or the provision
of other access to the registrant’s registration number and password
if a registration card issued pursuant to this section is lost, stolen,
destroyed, or otherwise unavailable.

SEC. 4.  

Section 4802 of the Probate Code is amended to read:

4802.  

The Secretary of State shall establish procedures to advise
each registrant of the following:

(a) A health care provider may not honor a written advance
health care directive until it receives a copy from the registrant or
accesses the advance health care directive from the registry.

(b) Each registrant must notify the registry upon revocation of
the advance health care directive.

(c) Each registrant must reregister upon execution of a
subsequent advance health care directive.

SEC. 5.  

Section 4806 of the Probate Code is amended to read:

4806.  

(a) The Secretary of State shall work with the State
Department of Public Health and the office of the Attorney General
to develop information about end-of-life care, advance health care
directives, and registration of the advance health care directives
at the registry established pursuant to subdivision (a) of Section
4800. This information shall be developed utilizing existing
information developed by the office of the Attorney General.

(b) Links to the information specified in subdivision (a) and to
the registry shall be available on the Internet Web sites of the
Secretary of State, the State Department of Public Health, the
Department of Motor Vehicles, the office of the Attorney General,
the Department of Managed Health Care, the Department of
Insurance, the Board of Registered Nursing, and the Medical Board
of California.

SEC. 6.  

Section 4807 is added to the Probate Code, to read:

4807.  

Commencing on January 1, 2016, the Secretary of State
shall, while establishing and maintaining electronic access to the
registry and to the extent practicable, consult with any entity
licensed pursuant to Division 2 (commencing with Section 1200)
of the Health and Safety Code, to integrate a process for retrieving
documents and information stored in the Advance Health Care
Directive Registry from a statewide health information exchange
system.