Bill Text: CA AB2139 | 2013-2014 | Regular Session | Chaptered
Bill Title: End-of-life care: patient notification.
Spectrum: Moderate Partisan Bill (Democrat 6-1)
Status: (Passed) 2014-09-25 - Chaptered by Secretary of State - Chapter 568, Statutes of 2014. [AB2139 Detail]
Download: California-2013-AB2139-Chaptered.html
BILL NUMBER: AB 2139 CHAPTERED
BILL TEXT
CHAPTER 568
FILED WITH SECRETARY OF STATE SEPTEMBER 25, 2014
APPROVED BY GOVERNOR SEPTEMBER 25, 2014
PASSED THE SENATE AUGUST 21, 2014
PASSED THE ASSEMBLY AUGUST 25, 2014
AMENDED IN SENATE AUGUST 18, 2014
AMENDED IN ASSEMBLY MAY 13, 2014
AMENDED IN ASSEMBLY APRIL 2, 2014
INTRODUCED BY Assembly Member Eggman
(Principal coauthor: Senator Leno)
(Coauthors: Assembly Members Ammiano, Olsen, and Wieckowski)
(Coauthors: Senators Monning and Wolk)
FEBRUARY 20, 2014
An act to amend Sections 442.5 and 442.7 of the Health and Safety
Code, relating to terminal illness.
LEGISLATIVE COUNSEL'S DIGEST
AB 2139, Eggman. End-of-life care: patient notification.
Under existing law, the State Department of Public Health licenses
and regulates health facilities, including hospice facilities, and
the provision of hospice services. Existing law establishes the
Medical Practice Act, which provides for the regulation and licensure
of physicians and surgeons by the Medical Board of California.
When a health care provider, as defined, makes a diagnosis that a
patient has a terminal illness, existing law requires the health care
provider to provide the patient, upon the patient's request, with
comprehensive information and counseling regarding legal end-of-life
options, as specified, and provide for the referral or transfer of a
patient, as provided, if the patient's health care provider does not
wish to comply with the patient's request for information on
end-of-life options.
This bill would apply these provisions to another person
authorized to make health care decisions, as defined, for a patient
with a terminal illness diagnosis. The bill would additionally
require the health care provider to notify, except as specified, the
patient or, when applicable, the other person authorized to make
health care decisions, when the health care provider makes a
diagnosis that a patient has a terminal illness, of the patient's and
the other authorized person's right to comprehensive information and
counseling regarding legal end-of-life care options.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 442.5 of the Health and Safety Code is amended
to read:
442.5. (a) When a health care provider makes a diagnosis that a
patient has a terminal illness, the health care provider shall do
both of the following:
(1) Notify the patient of his or her right, or when applicable,
the right of another person authorized to make health care decisions
for the patient, to comprehensive information and counseling
regarding legal end-of-life options. This notification may be
provided at the time of diagnosis or at a subsequent visit in which
the provider discusses treatment options with the patient or the
other authorized person.
(2) Upon the request of the patient or another person authorized
to make health care decisions for the patient, provide the patient or
other authorized person with comprehensive information and
counseling regarding legal end-of-life care options pursuant to this
section. When a terminally ill patient is in a health facility, as
defined in Section 1250, the health care provider, or medical
director of the health facility if the patient's health care provider
is not available, may refer the patient or other authorized person
to a hospice provider or private or public agencies and
community-based organizations that specialize in end-of-life care
case management and consultation to receive comprehensive information
and counseling regarding legal end-of-life care options.
(b) If a patient or another person authorized to make health care
decisions for the patient, requests information and counseling
pursuant to paragraph (2) of subdivision (a), the comprehensive
information shall include, but not be limited to, the following:
(1) Hospice care at home or in a health care setting.
(2) A prognosis with and without the continuation of
disease-targeted treatment.
(3) The patient's right to refusal of or withdrawal from
life-sustaining treatment.
(4) The patient's right to continue to pursue disease-targeted
treatment, with or without concurrent palliative care.
(5) The patient's right to comprehensive pain and symptom
management at the end of life, including, but not limited to,
adequate pain medication, treatment of nausea, palliative
chemotherapy, relief of shortness of breath and fatigue, and other
clinical treatments useful when a patient is actively dying.
(6) The patient's right to give individual health care instruction
pursuant to Section 4670 of the Probate Code, which provides the
means by which a patient may provide written health care instruction,
such as an advance health care directive, and the patient's right to
appoint a legally recognized health care decisionmaker.
(c) The information described in subdivision (b) may, but is not
required to, be in writing. Health care providers may utilize
information from organizations specializing in end-of-life care that
provide information on factsheets and Internet Web sites to convey
the information described in subdivision (b).
(d) Counseling may include, but is not limited to, discussions
about the outcomes for the patient and his or her family, based on
the interest of the patient. Information and counseling, as described
in subdivision (b), may occur over a series of meetings with the
health care provider or others who may be providing the information
and counseling based on the patient's needs.
(e) The information and counseling sessions may include a
discussion of treatment options in a culturally sensitive manner that
the patient and his or her family, or, when applicable, another
person authorized to make health care decisions for the patient, can
easily understand. If the patient or other authorized person requests
information on the costs of treatment options, including the
availability of insurance and eligibility of the patient for
coverage, the patient or other authorized person shall be referred to
the appropriate entity for that information.
(f) The notification made pursuant to paragraph (1) of subdivision
(a) shall not be required if the patient or other person authorized
to make health care decisions, as defined in Section 4617 of the
Probate Code, for the patient has already received the notification.
(g) For purposes of this section, "health care decisions" has the
meaning set fourth in Section 4617 of the Probate Code.
(h) This section shall not be construed to interfere with the
clinical judgment of a health care provider in recommending the
course of treatment.
SEC. 2. Section 442.7 of the Health and Safety Code is amended to
read:
442.7. If a health care provider does not wish to comply with his
or her patient's request or, when applicable, the request of another
person authorized to make health care decisions, as defined in
Section 4617 of the Probate Code, for the patient for information on
end-of-life options, the health care provider shall do both of the
following:
(a) Refer or transfer a patient to another health care provider
that shall provide the requested information.
(b) Provide the patient or other person authorized to make health
care decisions for the patient with information on procedures to
transfer to another health care provider that shall provide the
requested information.
