This chapter shall be known, and may be cited, as the California POLST eRegistry Act.
Chapter 14California POLST eRegistry Act
Section § 1860
This section introduces the name of the law, which is the California POLST eRegistry Act. This act likely involves the creation or management of an electronic registry for POLST forms, which are medical orders for end-of-life care.
California POLST eRegistry Act end-of-life care medical orders POLST forms electronic registry patient care preferences healthcare decisions patient autonomy advancement directives medical documentation statewide registry life-sustaining treatment medical consent healthcare law
Section § 1861
This section defines terms related to the handling of life-sustaining treatment orders in California. An 'authorized user' is someone allowed to send or receive information from the POLST eRegistry, which could include healthcare providers. 'CEDRS' refers to a state data system for emergency services. 'POLST' is a form outlining medical orders for life-sustaining treatment, and the 'POLST eRegistry' is a system for storing and accessing these orders electronically in conjunction with CEDRS.
For purposes of this chapter:
(a)CA Health and Safety Code § 1861(a) “Authorized user” means a person authorized by the authority to submit information to, or to receive information from, the POLST eRegistry, including health care providers, as defined in Section 4781 of the Probate Code, and their designees.
(b)CA Health and Safety Code § 1861(b) “CEDRS” means the California Emergency Medical Services Data Resource System.
(c)CA Health and Safety Code § 1861(c) “POLST” means a Physician Orders for Life Sustaining Treatment form that fulfills the requirements, in any format, of Section 4780 of the Probate Code.
(d)CA Health and Safety Code § 1861(d) “POLST
eRegistry” means the registry established pursuant to this chapter to make electronic, in addition to other modes of submission and transmission, POLST information available to authorized users in conjunction with, and as a part of, CEDRS.
authorized user POLST life-sustaining treatment POLST eRegistry health care providers California Emergency Medical Services Data Resource System CEDRS medical orders electronic registry emergency services data information submission information transmission healthcare designees medical treatment planning section 4780 requirements
Section § 1862
This law requires the creation of an electronic registry system called the POLST eRegistry. It is designed to collect and share POLST (Physician Orders for Life-Sustaining Treatment) forms, which are submitted by healthcare providers. The law mandates that the registry must ensure confidentiality and accuracy of the information, and the compliance with privacy laws.
The system must also allow for electronic submission and access of POLST forms, including handling modifications or voids, using electronic signatures. The Emergency Medical Services Authority, working alongside organizations like the Coalition for Compassionate Care of California, must establish operational regulations and hold public hearings for guidance. Lastly, the law requires healthcare providers to ensure all updated POLST forms they have signed are submitted to this registry.
(a)CA Health and Safety Code § 1862(a) The Emergency Medical Services Authority shall establish a POLST eRegistry, in consultation with the Coalition for Compassionate Care of California and other pertinent stakeholders, to operate a statewide electronic registry system for the purpose of collecting a patient’s POLST information received from a physician, nurse practitioner, physician assistant, or the designee of a physician, nurse practitioner, or physician assistant, and disseminating the information to an authorized user.
(b)CA Health and Safety Code § 1862(b) The authority shall adopt regulations for the operation of the POLST eRegistry and shall hold at least one public hearing regarding the proposed regulations. The regulations shall include, but not be limited to, standards and procedures regarding all of the following:
(1)CA Health and Safety Code § 1862(b)(1) The means by which initial or subsequent POLST information may be submitted to the POLST eRegistry, which shall include a method for electronic delivery of this information and the use of legally sufficient electronic signatures. Submitted information may include new, modified, updated, or voided POLST information.
(2)CA Health and Safety Code § 1862(b)(2) Methods by which the information in the POLST eRegistry may be disseminated to an authorized user, including a method for electronic access.
(3)CA Health and Safety Code § 1862(b)(3) Standards and procedures for verifying the identity of an authorized user.
(4)CA Health and Safety Code § 1862(b)(4) Standards and procedures to ensure the accuracy of, and to appropriately protect the confidentiality of, POLST information submitted to the POLST eRegistry, consistent with state and federal privacy laws.
(c)CA Health and Safety Code § 1862(c) The authority shall implement the POLST eRegistry in conjunction with CEDRS. The authority shall ensure all of the following requirements are met and that the timing is consistent with the CEDRS project development timeline:
(1)CA Health and Safety Code § 1862(c)(1) An authorized user shall ensure that the most current version of all POLST forms they have signed have been submitted to the POLST eRegistry.
(2)CA Health and Safety Code § 1862(c)(2) An electronic version of a POLST shall be the only acceptable format to submit a form to the POLST eRegistry. This section does not prohibit an authorized user from printing out a paper copy of a POLST form for a patient to have on hand, upon request by a patient or the patient’s legally recognized decisionmaker.
POLST forms electronic registry Emergency Medical Services Authority Coalition for Compassionate Care confidentiality standards privacy laws electronic submission electronic signatures healthcare providers public hearings regulation standards identity verification CEDRS authorized users life-sustaining treatment
Section § 1863
This law allocates $10 million from California's budget in the 2021-22 fiscal year to develop a statewide electronic registry for Physician Orders for Life-Sustaining Treatment (POLST). However, this funding will not cover the entire cost for the implementation and maintenance of the registry; these costs will be defined through the state's technology planning process known as PAL (Project Approval Life Cycle). The funding will only be used after full approval from this process is obtained.
Starting in the 2022-23 fiscal year, $750,000 will be provided annually to support the registry's operations. This includes promoting quality through education and training of health care workers, community outreach, and ensuring adherence to standards. Contracts may be used to carry out these actions.
(a)CA Health and Safety Code § 1863(a) For the 2021–22 fiscal year, the sum of ten million dollars ($10,000,000) is hereby appropriated from the General Fund to the Emergency Medical Services Authority to support the planning, development, and implementation of a statewide POLST eRegistry to be included with the CEDRS system. The ten million dollars ($10,000,000) for the 2021–22 fiscal year to support these efforts shall not fully fund the POLST eRegistry’s implementation or maintenance and operations costs. These costs will be determined through the California Department of Technology planning process, known as the Project Approval Life Cycle (PAL). The authority shall only utilize funds for development and implementation of the POLST eRegistry after it
obtains full PAL approval.
(b)CA Health and Safety Code § 1863(b) For the 2022–23 fiscal year, and annually thereafter, the sum of seven hundred fifty thousand dollars ($750,000) is hereby appropriated annually from the General Fund to the Emergency Medical Services Authority for state operations to prepare for and support the POLST eRegistry. State operations costs may include, but are not limited to, promotion of POLST quality, such as ongoing education and training of health care professionals, community education, and outreach, and adherence to quality standards. The authority may contract for these activities as necessary.
POLST eRegistry Emergency Medical Services Authority Project Approval Life Cycle PAL approval statewide electronic registry California Department of Technology planning health care professional education community education and outreach quality standards adherence state operations funding annual appropriations fiscal year 2021-22 fiscal year 2022-23 General Fund allocation healthcare training programs
