BILL NUMBER: SB 19	AMENDED
	BILL TEXT

	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 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's designee. The bill would
require the agency to implement these provisions only after it
determines that sufficient nonstate finds  
funds  have been received for development of the registry and
any related startup costs. A physician or 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 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's designee and disseminating the information in the form to
an authorized user.
   (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:
   (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.
   (B) Appropriate and timely methods by which the information in the
registry 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 forms submitted to the
registry.
   (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.
   (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.
   (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'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'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   In accordance with Section 4782, 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.
  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.