Bill Text: CA SB19 | 2015-2016 | Regular Session | Chaptered
Bill Title: Physician Orders for Life Sustaining Treatment form: electronic registry pilot.
Spectrum: Moderate Partisan Bill (Democrat 6-1)
Status: (Passed) 2015-10-05 - Chaptered by Secretary of State. Chapter 504, Statutes of 2015. [SB19 Detail]
Download: California-2015-SB19-Chaptered.html
BILL NUMBER: SB 19 CHAPTERED
BILL TEXT
CHAPTER 504
FILED WITH SECRETARY OF STATE OCTOBER 5, 2015
APPROVED BY GOVERNOR OCTOBER 5, 2015
PASSED THE SENATE SEPTEMBER 10, 2015
PASSED THE ASSEMBLY SEPTEMBER 8, 2015
AMENDED IN ASSEMBLY SEPTEMBER 4, 2015
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 of the Probate Code,
relating to resuscitative measures.
LEGISLATIVE COUNSEL'S DIGEST
SB 19, Wolk. Physician Orders for Life Sustaining Treatment form:
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 eRegistry Pilot Act.
The bill would require the Emergency Medical Services Authority to
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 POLST 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 authority to implement these
provisions only after it determines that sufficient nonstate funds
are available for development of the POLST eRegistry Pilot, any
related startup 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 POLST information would be
required to include the POLST information in the patient's official
medical record and would be required to submit 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 POLST eRegistry Pilot. The bill would require the
authority to adopt guidelines for, among other things, the operation
of the POLST eRegistry Pilot, including the means by which POLST
information would be submitted electronically, 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
POLST information received by the POLST eRegistry Pilot. The bill
would require that any disclosure of POLST information in the 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 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.
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 eRegistry Pilot Act.
SEC. 2. Section 4788 is added to the Probate Code, to read:
4788. (a) For purposes of this section:
(1) "Authority" means the Emergency Medical Services Authority.
(2) "Authorized user" means a person authorized by the authority
to submit information to, or to receive information from, the POLST
eRegistry Pilot, including health care providers, as defined in
Section 4781, and their designees.
(3) "POLST" means a Physician Orders for Life Sustaining Treatment
that fulfills the requirements, in any format, of Section 4780.
(4) "POLST eRegistry Pilot" means the California POLST eRegistry
Pilot Act established pursuant to this section to make electronic, in
addition to other modes of submission and transmission, POLST
information available to authorized users.
(b) (1) 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
information received from a physician or physician's designee and
disseminating the information to an authorized user.
(2) The authority shall implement this section only after
determining that sufficient nonstate funds are available to allow for
the development of the POLST eRegistry Pilot, any related startup
costs, and an evaluation of the POLST eRegistry Pilot.
(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 guidelines necessary for the
operation of the 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 initial or subsequent POLST information may
be submitted to, or withdrawn from, the POLST eRegistry 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
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 information submitted to the
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 information has
been received by the POLST eRegistry Pilot.
(F) The ability of a patient, or, when appropriate, his or her
legally recognized health care decisionmaker, with his or her health
care provider, as defined in Section 4621, 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 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) 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 POLST information with a patient
or his or her legally recognized health care decisionmaker shall
include the POLST information in the patient's official medical
record and shall submit a copy of the POLST form to, or enter the
POLST information into, the POLST eRegistry Pilot, unless the patient
or the legally recognized health care decisionmaker chooses not to
participate in the 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, as defined in Section 4781,
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.
(f) In accordance with Section 4782, a health care provider, as
defined in Section 4781, who honors a patient's request regarding
resuscitative measures obtained from the 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.
