BILL NUMBER: SB 19	AMENDED
	BILL TEXT

	AMENDED IN SENATE  MARCH 25, 2015

INTRODUCED BY   Senator Wolk
   (Coauthors: Senators  Monning   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  health care providers. Health care providers
  a physician or physician designee. A physician or
physician designee  who  complete  complet
  es  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 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:

  SECTION 1.  This act shall be known, and may be cited, as the
California POLST Registry Act.
  SEC. 2.  Section 4788 is added to the Probate Code, to read:
   4788.  (a)  For purposes of this section:
   (1) "Agency" means the California Health and Human Services
Agency.
   (2) "Authorized user" means a person authorized by the agency to
submit information to, or to receive information from, the POLST
registry, including health care  providers.  
providers and their designees   . 
   (3) "Health care provider" has the meaning provided in Section
4621.
   (4) "POLST form" means a Physician Orders for Life Sustaining
Treatment form that fulfills the requirements of Section 4780.
   (5) "Registry" means the California POLST Registry established by
the agency pursuant to this section.
   (b) The agency shall establish and operate a statewide registry
system, to be known as the California POLST Registry, for the purpose
of collecting a POLST form received from a  health care
provider   physician or physician designee  and
disseminating the information in the form to an authorized user. The
registry may be operated and maintained by a contractor of the
agency. The agency shall adopt all rules necessary for the operation
of the registry, which shall include, but not be limited to, the
following:
   (1) The means by which  a   an initial or
subsequent  POLST form may be submitted to  , or withdrawn
from,  the registry,  may be revised, and may be
revoked,  which shall include a method for electronic
delivery of this information and the use of legally sufficient
electronic signatures.
   (2) Appropriate and timely methods by which the information in the
registry may be disseminated to an authorized user.
   (3) Procedures for verifying the identity of an authorized user.
   (4) Procedures to ensure the accuracy of, and to appropriately
protect the confidentiality of, POLST forms submitted to the
registry.
   (5) The requirement that a patient,  or   or,
when appropriate,  his or her legally recognized health care
decisionmaker, receive a confirmation or a receipt that the patient's
POLST form has been received by the registry.
   (6) The ability of  the physician who signed the POLST form,
or his or her designee, and of  a patient,  or 
 or, when   appropriate,  his or her legally
recognized health care decisionmaker, to review the information in
the patient's POLST form after it has been entered into the registry,
and to confirm that it is accurate, prior to the information being
available to an authorized user.
   (7) The ability of a patient,  or   or, when
appropriate,  his or her legally recognized health care
decisionmaker, to  amend or  withdraw a POLST form
from the registry. 
   (c) The registry and the information it contains shall be the
property of the state and any disclosure of information in a POLST
form received by the registry shall be made in a manner consistent
with the federal Health Insurance Portability and Accountability Act
of 1996 (Public Law 104-191).  
   (c) The operation of the registry shall comply with state and
federal privacy and security laws and regulations, including, but not
limited to, compliance with the Confidentiality of Medical
Information Act (Part 2.6 (commencing with Section 56) of Division 1
of the Civil Code) and the regulations promulgated pursuant to the
Health Insurance Portability and Accountability Act of 1996, found at
parts 160 and 164 of Title 45 of the Code of Federal Regulations.

   (d) A  health care provider   physician or
physician designee  who completes a POLST form with a patient or
his or her legally recognized health care decisionmaker shall
include the POLST form in the patient's official medical record. The
 health care provider   physician or physician
designee  shall submit a copy of the POLST form to the registry
unless the patient or the legally recognized health care
decisionmaker chooses not to participate in the registry.
   (e) An authorized user acting upon information obtained from the
registry is not subject to criminal prosecution, civil liability,
discipline for unprofessional conduct, administrative sanction, or
any other sanction, if the person acted in good faith and had no
knowledge that the action or decision would be inconsistent with a
health care decision that the individual signing the POLST form would
have made on his or her own behalf, or on behalf of the patient,
under the circumstances.