BILL NUMBER: SB 19	INTRODUCED
	BILL TEXT


INTRODUCED BY   Senator Wolk
   (Coauthors: Senators Monning and Vidak)
   (Coauthors: Assembly Members Bonilla 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 introduced, 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 who
complete 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 federal privacy laws. 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.
   (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 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 POLST form may be submitted to 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 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 a patient, or 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 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).
   (d) A health care provider 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 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.