Bill Text: CA SB1357 | 2013-2014 | Regular Session | Amended

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Physician Orders for Life Sustaining Treatment form: statewide registry.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced - Dead) 2014-05-23 - Held in committee and under submission. [SB1357 Detail]

Download: California-2013-SB1357-Amended.html

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BILL NUMBER: SB 1357	AMENDED
	BILL TEXT

	AMENDED IN SENATE  MARCH 27, 2014

INTRODUCED BY   Senator Wolk

                        FEBRUARY 21, 2014

   An act to  amend Section 4780 of the Probate Code,
relating to health care decisions.   add Section 4788 to
the Probate Code, relating to resuscitative measures. 


	LEGISLATIVE COUNSEL'S DIGEST


   SB 1357, as amended, Wolk.  Resuscitative measures.
  Physician Orders for Life Sustaining Treatment form:
state-wide 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  make nonsubstantive changes in these
provisions   enact the California POLST Registry Act.
The bill would require the State Department of Public Health to
establish and operate a state wide registry system, to be known as
the California POLST Registry, for the purpose of collecting POLST
forms received from individuals electing to submit the forms and
disseminating the information in the forms to authorized users,
including health care providers. The bill would require the
department to adopt rules for the operation of the registry, which
would include the means by which POLST forms would be submitted,
revised, and revoked, appropriate and timely methods for
dissemination of POLST form information, and procedures for verifying
t   he identity of users and maintaining the
confidentiality of POLST forms. 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
authorize the department to charge an appropriate fee to registrants
using the registry and   would provide immunity for people
who submit information to, and use information in, the registry and
act in good faith  .
   Vote: majority. Appropriation: no. Fiscal committee:  no
  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) "Authorized user" means a person authorized by the department
to submit information to, or to receive information from, the POLST
registry, including health care providers.
   (2) "Department" means the State Department of Public Health.
   (3) "POLST form" means a Physician Orders for Life Sustaining
Treatment form that fulfills the requirements of Section 4780.
   (4) "Registrant" means an individual who elects to submit a POLST
form to the registry.
   (5) "Registry" means the California POLST Registry established by
the department pursuant to this section.
   (b) The department 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 registrant and
disseminating the information in the form to an authorized user. The
department shall adopt all rules and regulations 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.
   (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.

   (c) The registry and the information it contains shall be the
property of the state and any disclosure of information in POLST
forms 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) The department may charge an appropriate and reasonable fee to
a registrant in an amount that, when the fees charged to registrants
are aggregated, does not exceed the actual cost of establishing and
maintaining the registry.
   (e) A registrant reporting information to the registry or 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 request would have made on
his or her own behalf under like circumstances.  
  SECTION 1.    Section 4780 of the Probate Code is
amended to read:
   4780.  (a) As used in this part:
   (1) "Request regarding resuscitative measures" means a written
document, signed by an individual with capacity, or a legally
recognized health care decisionmaker, and the individual's physician,
that directs a health care provider regarding resuscitative
measures. A request regarding resuscitative measures is not an
advance health care directive.
   (2) "Request regarding resuscitative measures" includes one, or
both of, the following:
   (A) A prehospital "do not resuscitate" form as developed by the
Emergency Medical Services Authority or other substantially similar
form.
   (B) A Physician Orders for Life Sustaining Treatment form, as
approved by the Emergency Medical Services Authority.
   (3) "Physician Orders for Life Sustaining Treatment form" means a
request regarding resuscitative measures that directs a health care
provider regarding resuscitative and life-sustaining measures.
   (b) A legally recognized health care decisionmaker may execute the
Physician Orders for Life Sustaining Treatment form only if the
individual lacks capacity, or the individual has designated that the
decisionmaker's authority is effective pursuant to Section 4682.
   (c) The Physician Orders for Life Sustaining Treatment form and
medical intervention and procedures offered by the form shall be
explained by a health care provider, as defined in Section 4621. The
form shall be completed by a health care provider based on patient
preferences and medical indications, and signed by a physician and
the patient or his or her legally recognized health care
decisionmaker. The health care provider, during the process of
completing the Physician Orders for Life Sustaining Treatment form,
should inform the patient about the difference between an advance
health care directive and the Physician Orders for Life Sustaining
Treatment form.
   (d) An individual having capacity may revoke a Physician Orders
for Life Sustaining Treatment form at any time and in any manner that
communicates an intent to revoke, consistent with Section 4695.
   (e) A request regarding resuscitative measures may also be
evidenced by a medallion engraved with the words "do not resuscitate"
or the letters "DNR," a patient identification number, and a 24-hour
toll-free telephone number, issued by a person pursuant to an
agreement with the Emergency Medical Services Authority.