BILL NUMBER: SB 19	AMENDED
	BILL TEXT

	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 Section 4788 to 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.
   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 a physician or  physician  
physician's  designee.  The bill would require the agency to
implement these provisions only after it determines that sufficient
nonstate finds have been received for development of the registry and
any related startup costs.  A physician or  physician
  physician's  designee who completes 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   would define 
"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 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, as specified.
   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 and their designees.
   (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)  (1)   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 physician or  physician   physician's
 designee and disseminating the information in the form to an
authorized user.  The  
   (2) The agency shall implement this section only after determining
that sufficient nonstate funds have been received to allow for the
development of the registry and any related startup costs. 
    (3)     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) 
    (A)  The means by which an initial or subsequent POLST
form may be submitted to, or withdrawn from, the registry, which
shall include a method for electronic delivery of this information
and the use of legally sufficient electronic signatures. 
   (2) 
    (B)  Appropriate and timely methods by which the
information in the registry may be disseminated to an authorized
user. 
   (3) 
    (C)  Procedures for verifying the identity of an
authorized user. 
   (4) 
    (D)  Procedures to ensure the accuracy of, and to
appropriately protect the confidentiality of, POLST forms submitted
to the registry. 
   (5) 
    (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
has been received by the registry. 
   (6) 
    (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. 
   (7) 
    (G)  The ability of a patient, or, when appropriate, his
or her legally recognized health care decisionmaker, to withdraw a
POLST form from the registry.
   (c) The operation of the registry 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 physician or  physician  physician's
 designee 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 physician or
 physician   physician's  designee 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) A health care provider who honors a patient's request
regarding resuscitative measures obtained from the registry shall not
be subject to criminal prosecution, civil liability, discipline for
unprofessional conduct, administrative sanction, or any other
sanction as set forth in Section 4782 of the Probate Code.