BILL NUMBER: SB 19 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY AUGUST 31, 2015
AMENDED IN ASSEMBLY JULY 16, 2015
AMENDED IN SENATE JUNE 2, 2015
AMENDED IN SENATE MAY 5, 2015
AMENDED IN SENATE MARCH 25, 2015
INTRODUCED BY Senator Wolk
(Coauthors: Senators Hancock, Monning, and Vidak)
(Coauthors: Assembly Members Bonilla, Dababneh, and Eggman)
DECEMBER 1, 2014
An act to add and repeal Section 4788 to
of 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.
electronic registry pilot.
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
eRegistry Pilot Act. The bill would require the
California Health and Human Services Agency
Emergency Medical Services Authority to establish and
operate a statewide registry system, a pilot project,
in consultation with stakeholders, to operate an electronic registry
system on a pilot basis, to be known as the California POLST
Registry, eRegistry Pilot, for the
purpose of collecting POLST forms information
received from a physician or physician's designee. The
bill would require the authority to coordinate the POLST eRegistry
Pilot, which would be operated by health information exchange
networks, by an independent contractor, or by a combination thereof.
The bill would require the agency
authority to implement these provisions only after it
determines that sufficient nonstate funds have been received
are available for development of the
registry and POLST eRegistry Pilot, any related
startup costs. A costs, and an evaluation of
the POLST eRegistry Pilot. When the POLST eRegistry Pilot is operable
in the geographic area in which he or she operates or practices, a
physician or physician's designee who completes a
POLST form information would
be required to include the POLST form
information in the patient's medical
official electronic health record and would be required to
submit the form to the registry, a copy of
the form to, or to enter the information into, the POLST eRegistry
Pilot, 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.
POLST eRegistry Pilot. The bill would require the
agency authority to adopt
rules guidelines for, among other things, the
operation of the registry, POLST eRegistry
Pilot, including the means by which POLST forms
information would be submitted electronically,
revised, and revoked, the capability to check the POLST form
for accuracy prior to it being made available,
modified, or withdrawn, 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
information received by the registry.
POLST eRegistry Pilot. The bill would require that any
disclosure of POLST form information in the
registry POLST eRegistry Pilot 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, POLST eRegistry Pilot, as
specified. The bill would require an independent contractor
approved by the authority to conduct an evaluation of the POLST
eRegistry Pilot. The provisions of the bill would be operative until
January 1, 2020.
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 eRegistry Pilot
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.
(1) "Authority" means the Emergency Medical Services Authority.
(2) "Authorized user" means a person authorized by the
agency authority to submit information to, or to
receive information from, the POLST registry,
eRegistry Pilot, including health care providers and their
designees.
(3) "Health care provider" has the meaning provided in Section
4621. 4781.
(4) "POLST form" "POLST"
means a Physician Orders for Life Sustaining Treatment form
that fulfills the requirements
requirements, in any format, of Section 4780.
(5) "Registry" "POLST eRegistry Pilot"
means the California POLST Registry established by the
agency eRegistry Pilot Act established pursuant
to this section. section to make electronic,
in addition to other modes of submission and transmission, POLST
information available to authorized users.
(b) (1) The agency shall establish and operate a
statewide registry system, to be known as the California POLST
Registry, The authority shall establish a pilot
project, in consultation with stakeholders, to operate an electronic
registry system on a pilot basis, to be known as the California POLST
eRegistry Pilot, for the purpose of collecting a patient'
s POLST form information received
from a physician or physician's designee and disseminating the
information in the form to an authorized user.
(2) The agency authority shall
implement this section only after determining that sufficient
nonstate funds have been received are
available to allow for the development of the registry
and POLST eRegistry Pilot, any related startup
costs. costs, and an evaluation of the POLST
eRegistry Pilot.
(3) The registry may be operated and maintained by a contractor
of the agency. The agency
(3) The authority shall coordinate the POLST eRegistry Pilot,
which shall be operated by, and as a part of, the health information
exchange networks, or by an independent contractor, or by a
combination thereof. The POLST eRegistry Pilot may operate in a
single geographic area or multiple geographic areas and may test
various methods of making POLST information available electronically.
The design of the POLST eRegistry Pilot shall be sufficiently
robust, based on the success of the pilot, to inform the permanent,
statewide operation of a POLST eRegistry.
(4) The authority shall adopt
all rules guidelines necessary for the
operation of the registry, which POLST
eRegistry Pilot. In developing these guidelines, the authority shall
seek input from interested parties and hold at least one public
meeting. The adoption, amendment, or repeal of the guidelines
authorized by this paragraph is hereby exempted from the
Administrative Procedure Act (Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code).
The guidelines shall include, but not be limited to, the
following:
(A) The means by which an initial or subsequent
POLST form information may be
submitted to, or withdrawn from, the registry,
POLST eRe gistry Pilot, which shall include a
method for electronic delivery of this information and the use of
legally sufficient electronic signatures.
(B) Appropriate and timely methods by which the information in the
registry POLST eRegistry Pilot may be
disseminated to an authorized user.
(C) Procedures for verifying the identity of an authorized user.
(D) Procedures to ensure the accuracy of, and to appropriately
protect the confidentiality of, POLST forms
information submitted to the registry.
POLST eRegistry Pilot.
(E) The requirement that a patient, or, when appropriate, his or
her legally recognized health care decisionmaker, receive a
confirmation or a receipt that the patient's POLST form
information has been received by the
registry. POLST eRegistry Pilot.
(F) The ability of the physician who signed the POLST form, or his
or her designee, and of a patient, 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.
(G)
(F) The ability of a patient, or, when appropriate, his
or her legally recognized health care decisionmaker, to
withdraw a POLST form from the registry. with his or
her health care provider, to modify or withdraw POLST information on
the POLST eRegistry Pilot.
(6) (A) Prior to implementation of the POLST eRegistry Pilot, the
authority shall submit a detailed plan to the Legislature that
explains how the POLST eRegistry Pilot will operate.
(B) The plan to be submitted pursuant to subparagraph (A) shall be
submitted in compliance with Section 9795 of the Government Code.
(c) The operation of the registry POLST
eRegistry Pilot, for all users, 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
federal Health Insurance Portability and Accountability Act of 1996
(Public Law 104-191), found at Parts 160 and 164 of Title 45 of the
Code of Federal Regulations.
(d) A When the POLST eRegistry Pilot is
operable in the geographic area in which he or she practices or
operates, a physician or physician's designee who completes
a POLST form POLST information with a
patient or his or her legally recognized health care decisionmaker
shall include the POLST form information
in the patient's official medical record. The
physician or physician's designee electronic health
record and shall submit a copy of the POLST form to
the registry to, or enter the POLST information into,
the POLST eR egistry Pilot, unless the patient or
the legally recognized health care decisionmaker chooses not to
participate in the registry. POLST eRegistry
Pilot.
(e) When the POLST eRegistry Pilot is operable in the geographic
area in which they practice or operate, physicians, hospitals, and
health information exchange networks shall make electronic POLST
information available, for use during emergencies, through the POLST
eRegistry Pilot to health care providers that also practice or
operate in a geographic area where the POLST eRegistry Pilot is
operable, but that are outside of their health information exchange
networks.
(e)
(f) In accordance with Section 4782, a health care
provider who honors a patient's request regarding resuscitative
measures obtained from the registry POLST
eRegistry Pilot shall not be subject to criminal prosecution,
civil liability, discipline for unprofessional conduct,
administrative sanction, or any other sanction, if the health care
provider (1) believes in good faith that the action or decision is
consistent with this part, and (2) has no knowledge that the action
or decision would be inconsistent with a health care decision that
the individual signing the request would have made on his or her own
behalf under like circumstances.
(g) An independent contractor approved by the authority shall
perform an evaluation of the POLST eRegistry Pilot.
(h) This section shall remain in effect only until January 1,
2020, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2020, deletes or extends
that date.