Bill Text: CA AB2452 | 2013-2014 | Regular Session | Amended
Bill Title: Advance health care directive registry.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Engrossed - Dead) 2014-06-18 - From committee chair, with author's amendments: Amend, and re-refer to committee. Read second time, amended, and re-referred to Com. on JUD. [AB2452 Detail]
Download: California-2013-AB2452-Amended.html
BILL NUMBER: AB 2452 AMENDED
BILL TEXT
AMENDED IN SENATE JUNE 18, 2014
AMENDED IN ASSEMBLY MAY 23, 2014
AMENDED IN ASSEMBLY MAY 6, 2014
AMENDED IN ASSEMBLY APRIL 8, 2014
AMENDED IN ASSEMBLY MARCH 20, 2014
INTRODUCED BY Assembly Member Pan
FEBRUARY 21, 2014
An act to amend Sections 4800, 4801, 4802, and 4806 of, and to add
Sections 4801.5 and 4807 to, the Probate Code, relating to advance
health care directives.
LEGISLATIVE COUNSEL'S DIGEST
AB 2452, as amended, Pan. Advance health care directive registry.
Existing law directs the Secretary of State to establish an
Advance Health Care Directive Registry to receive and release
specified information from a person who has executed a written
advance health care directive. Existing law requires the Secretary of
State to charge a fee to each registrant in an amount such that,
when all fees charged to registrants are aggregated, the aggregated
fees do not exceed the actual cost of establishing and maintaining
the registry. Existing law provides that failure to register with the
Secretary of State does not affect the validity of an advance health
care directive.
This bill would require, commencing
require the Secretary of State to transfer the contents of
its Advance Health Care Directive's Registry to the State Department
of Public Health on January 1, 2016. The bill would require the
department to maintain a health care decision registry, to be
referred to as the California Health Care Decisions Online Registry,
and commencing on January 1, 2016, the Secretary of
State to establish and maintain access, as specified, to a
secure portion of the Secretary of State's
department's Internet Web site that provides an electronic
reproduction of an advance health care directive and other specified
documents submitted to the registry system. The bill would require
this access to include the ability to view the electronic
reproduction on the Internet Web site, as well as download, print,
and otherwise retrieve a copy of the electronic reproduction. The
bill would, among other things, require the secretary
department to establish procedures to register,
replace, and remove an advance health care directive, as specified.
The bill would require that on or before January 1, 2020, the
registry be fully supported by fees charged by the Secretary
of State Department of Public Health to each
registrant. The bill would require the Secretary of
State Department of Public Health to develop and
submit to the Legislature a financial sustainability plan, as
specified, on or before January 1, 2018.
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. Section 4800 of the Probate Code is amended to read:
4800. (a) (1) The Secretary of State
Department of Public Health shall establish a registry system
through which a person who has executed a written advance health care
directive directive, physician order for
life-sustaining treatment form, a durable power of attorney document,
or any other legally recognized and executed instrument for
conveying a patient's health care intentions, may register in a
central information center, center
information regarding the advance directive,
health care decision, making that information available
electronically upon request to any health care provider, the
public guardian, or the legal representative of
the registrant. registrant, or other entity
as determined by the State Department of Public Health.
(2) Commencing on January 1, 2016, the Secretary of
State Department of Public Health shall
establish and maintain access, as prescribed by this part, to a
secure portion of the Secretary of State's
State Department of Public Health's Internet Web site that
provides an electronic reproduction of an advance health care
directive and other documents described in subdivision (c) submitted
to the registry system. This access shall include the ability to view
the electronic reproduction on the Internet Web site, as well as
download, print, and otherwise retrieve a copy of the electronic
reproduction.
(3) The registry shall be referred to as the California Health
Care Decisions Online Registry or the registry.
(4) It is the intent of the Legislature that the department
contract with the Regents of the University of California to develop
and maintain the registry.
(5) Funds appropriated to the department for the development and
maintenance of the registry shall be distributed to the Health
System, University of California, Davis.
(b) Commencing on January 1, 2016, the Secretary of
State Department of Public Health shall
establish a process to register an advance health care directive and
submit personal information and documents to the registry either by
electronic submission or submission of paper documents. Commencing on
January 1, 2016, the Secretary of State
Department of Public Health shall establish a process to merge
documents in the registry prior to January 1, 2016, with the access
system established in paragraph (2) of subdivision (a). This process
shall require a person who registers an advance health care directive
or other document described in paragraph (2) to submit to the
Secretary of State all of the following:
(1) An application in a form prescribed by the Secretary
of State Department of Public Health .
(2) A copy or electronic reproduction of any of the following:
(A) The registrant's advance health care directive.
(B) A values statement, questionnaire, or other document that
supplements the advance health care directive.
(C) Durable power of attorney form.
(D) A physician orders for life-sustaining treatment (POLST) form.
(E) The intended place of deposit or safekeeping of a written
advance health care directive and any other document described in
this paragraph.
(F) The name and telephone number of the agent and any alternative
agent.
(3) Any fee established by the Secretary of
State Department of Public Health pursuant to subdivision
(f).
(c) Information that may be received shall be limited to all of
the following regarding the registrant:
(1) Name.
(2) Social security number.
(3) Driver's license number, or other state-issued individual
identifying number established by law, if any.
(4) Address.
(5) Date and place of birth.
(d) When the Secretary of State Department
of Public Health receives the items described in subdivision
(b) from a registrant, the secretary
department shall do all of the following:
(1) Assign a registration number and password to access the
registry to the registrant.
(2) Issue the registrant an Advance Health Care Directive Registry
registration card indicating that an advance health care directive,
or information regarding an advance health care directive, has been
deposited with the registry. The information on the card shall
include, but not be limited to, the registrant's name, registration
number, and password to access the registry. Costs associated with
issuance of the card shall be offset by the fee charged by the
Secretary of State Department of Public
Health to receive and register information at the registry.
(3) Make or transfer an electronic reproduction of the advance
health care directive and other documents described in paragraph (2)
of subdivision (b) and post it to the registry.
(e) The Secretary of State Department of
Public Health , at the request of the registrant or his or her
legal representative, shall transmit the information received
regarding the written advance health care directive to the registry
system of another jurisdiction as identified by the registrant, or
his or her legal representative.
(f) The Secretary of State Department of
Public Health shall charge a fee to each registrant in an
amount such that, when all fees charged to registrants are
aggregated, the aggregated fees do not exceed the actual cost of
establishing and maintaining the registry. On or before January 1,
2020, the registry shall be fully supported by fees charged pursuant
to this subdivision.
(g) On or before January 1, 2018, the Secretary of
State Department of Public Health shall develop
and submit to the Legislature a financial sustainability plan
detailing all of the following:
(1) The amount of revenue generated by the fee charged pursuant to
subdivision (f).
(2) The estimated ongoing costs of maintaining the registry.
(3) The number of participants in the registry and the projected
participation in future years.
(4) A plan for ensuring that the revenue from fees charged
pursuant to subdivision (f) fully support the ongoing costs of
maintaining the registry.
(h) (1) The requirement for submitting a report imposed under
subdivision (g) is inoperative on January 1, 2022, pursuant to
Section 10231.5 of the Government Code.
(2) A report submitted pursuant to subdivision (g) shall be
submitted in compliance with Section 9795 of the Government Code.
SEC. 2. Section 4801 of the Probate Code is amended to read:
4801. (a) Notwithstanding any other law, the Secretary
of State Department of Public Health shall limit
access to the registry, including a registrant's advance health care
directive, personal information, and other documents received, to
when all of the following occur:
(1) The assigned registration number and password are provided.
(2) Access to the advance health care directive is required
pursuant to a lawful order of a court of competent jurisdiction,
requested by the registrant or the registrant's legal representative,
requested by the public guardian, or requested by a provider of
health care to the registrant only for the purpose of providing
health care to the registrant.
(3) The Secretary of State Department of
Public Health determines that providing access to the advance
health care directive is in the best interest of the registrant.
However, a registrant or legal representative of the registrant may
access the advance health care directive of the registrant for any
purpose.
(b) The Secretary of State Department of
Public Health shall establish procedures to verify the
identities of health care providers, the public guardian, and other
authorized persons requesting information pursuant to Section 4800.
No fee shall be charged to any health care provider, the public
guardian, or other authorized person requesting information pursuant
to Section 4800.
(c) A request for access pursuant to this part shall state the
need for the information.
(d) The Secretary of State Department of
Public Health shall respond by the close of business on the
next business day to a request for information made pursuant to
Section 4717 by the emergency department of a general acute care
hospital when the request is made by means other than through the
Secretary of State's State Department of
Public Health's Internet Web site.
(e) Information that may be released upon request shall not
include the registrant's social security number except when necessary
to verify the identity of the registrant.
(f) The registry and the information it contains shall be the
property of the state and any disclosure of information in the system
shall be made in a manner consistent with the federal Health
Insurance Portability and Accountability Act of 1996 (Public Law
104-191).
(g) A health care provider who completes any health care decision
document with a patient or his or her legally recognized health care
decisionmaker shall include the document in the patient's official
medical record and submit a copy of the document to the registry
unless the patient or the decisionmaker chooses not to participate in
the registry.
(h) For the purposes of Section 4740, a health care decision or
advance health care directive obtained from the registry shall
include a physician order for life sustaining treatment form, a
durable power of attorney document, or any other legally recognized
and executed instrument for conveying a patient's health care
intentions.
SEC. 3. Section 4801.5 is added to the Probate Code, to read:
4801.5. The Secretary of State Department
of Public Health shall establish procedures for all of the
following:
(a) The registration of an advance health care directive or other
document described in Section 4800 that replaces an advance health
care directive or other document that is posted on the registry.
(b) The removal from the registry of an advance health care
directive or other document described in Section 4800 that has been
revoked following the revocation of the advance health care directive
or other document or the death of the registrant.
(c) The issuance of a duplicate registration card or the provision
of other access to the registrant's registration number and password
if a registration card issued pursuant to this section is lost,
stolen, destroyed, or otherwise unavailable.
SEC. 4. Section 4802 of the Probate Code is amended to read:
4802. The Secretary of State Department
of Public Health shall establish procedures to advise each
registrant of the following:
(a) A health care provider may not honor a written advance health
care directive until it receives a copy from the registrant or
accesses the advance health care directive from the registry.
(b) Each registrant must notify the registry upon revocation of
the advance health care directive.
(c) Each registrant must reregister upon execution of a subsequent
advance health care directive.
SEC. 5. Section 4806 of the Probate Code is amended to read:
4806. (a) The Secretary of State
Department of Public Health shall work with the State
Department of Public Health and the office Office
of the Attorney General to develop information about
end-of-life care, advance health care directives, and registration of
the advance health care directives at the registry established
pursuant to subdivision (a) of Section 4800. This information shall
be developed utilizing existing information developed by the office
of the Attorney General.
(b) Links to the information specified in subdivision (a) and to
the registry shall be available on the Internet Web sites of the
Secretary of State, the State Department of Public Health, the
Department of Motor Vehicles, the office of the Attorney General, the
Department of Managed Health Care, the Department of Insurance, the
Board of Registered Nursing, and the Medical Board of California.
SEC. 6. Section 4807 is added to the Probate Code, to read:
4807. Commencing on January 1, 2016, the Secretary of
State Department of Public Health shall, while
establishing and maintaining electronic access to the registry and to
the extent practicable, consult with any entity licensed pursuant to
Division 2 (commencing with Section 1200) of the Health and Safety
Code, to integrate a process for retrieving documents and information
stored in the Advance Health Care Directive Registry from a
statewide health information exchange system.
SEC. 7. Commencing on January 1, 2016, the
Secretary of State shall transfer all of the contents of its Advance
Health Care Directive's Registry to the State Department of Public
Health. The Advance Health Care Directives Registry shall be excluded
from the California Business Connect Project in the Office of the
Secretary of State.
