Bill Text: NJ S2197 | 2010-2011 | Regular Session | Introduced
Bill Title: "Physician Orders for Life-Sustaining Treatment Act"; provides for use of Physician Orders for Life-Sustaining Treatment forms and requires physicians and advanced practice nurses to pursue continuing education in end-of life care. *
Spectrum: Moderate Partisan Bill (Democrat 10-2)
Status: (Passed) 2011-12-20 - Approved P.L.2011, c.145 [S2197 Detail]
Download: New_Jersey-2010-S2197-Introduced.html
Sponsored by:
Senator M. TERESA RUIZ
District 29 (Essex and Union)
Senator LORETTA WEINBERG
District 37 (Bergen)
Co-Sponsored by:
Senators Vitale and Cunningham
SYNOPSIS
"Physician Orders for Life-Sustaining Treatment Act"; provides for use of Physician Orders for Life-Sustaining Treatment forms and establishes registry.
CURRENT VERSION OF TEXT
As introduced.
An Act providing for the use of Physician Orders for Life-Sustaining Treatment forms and supplementing Title 26 of the Revised Statutes.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. This act shall be known and may be cited as the "Physician Orders for Life-Sustaining Treatment Act."
2. The Legislature finds and declares that:
a. Pursuant to the "New Jersey Advance Directives for Health Care Act," P.L.1991, c.201 (C.26:2H-53 et seq.), this State has statutorily recognized the right of competent adults to plan ahead for health care decisions through the execution of advance directives, and to have the wishes expressed in those documents respected, subject to certain limitations, in order to ensure that the right to control decisions about one's own health care is not lost if a patient loses decision-making capacity and is no longer able to participate actively in making his own health care decisions;
b. The Physician Orders for Life-Sustaining Treatment, or POLST, form complements an advance directive by converting a person's wishes regarding life-sustaining treatment, such as those set forth in an advance directive, into a medical order;
c. The POLST form: contains immediately actionable, signed medical orders on a standardized form; includes medical orders that address a range of life-sustaining interventions as well as the patient's preferred intensity of treatment for each intervention; is typically a brightly colored, clearly identifiable form; and is recognized and honored across various health care settings;
d. The use of a POLST form is particularly appropriate for persons who are frail and elderly or who have a compromised medical condition or a terminal illness, and the experience in other states has shown that the use of the POLST form helps these patients to have their health care preferences honored by health care providers;
e. The use of POLST forms can overcome many of the problems associated with advance directives, which in many cases are designed simply to name an individual to make health care decisions for the patient if the latter becomes incapacitated or otherwise lack specificity in regard to the patient's health care preferences, and are often locked away in file drawers or safe deposit boxes and unavailable to health care providers when the need arises to ensure that the patient's wishes are followed;
f. A completed POLST form is signed by, and more readily available than an advance directive to, the patient's attending physician, and provides a specific and detailed set of instructions for a health care professional or health care institution to follow in regard to the patient's preference for the use of various medical interventions;
g. To date, at least the following states, or communities within these states, have established programs providing for the use of the POLST form that have been endorsed by the National POLST Paradigm Task Force or are in the process of developing such programs: Alaska, California, Colorado, Florida, Georgia, Hawaii, Idaho, Indiana, Iowa, Kansas, Louisiana, Maine, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, Nevada, New Hampshire, New York, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania, Tennessee, Texas, Utah, Washington, West Virginia, Wisconsin, and Wyoming; and
h. The right and preference of New Jerseyans to have their health care preferences respected would be better served by the use of the POLST form in this State to augment the use of advance directives, and the enactment of this act will conduce to that end.
3. As used in this part:
"Advance directive" means an advance directive for health care as defined in section 3 of P.L.1991, c.201 (C.26:2H-55).
"Commissioner" means the Commissioner of Health and Senior Services.
"Department" means the Department of Health and Senior Services.
"Decision-making capacity" means a patient's ability to understand and appreciate the nature and consequences of a particular health care decision, including the benefits and risks of that decision, and alternatives to any proposed health care, and to reach an informed decision.
"Emergency care" means the use of resuscitative measures and other immediate treatment provided in response to a sudden, acute, and unanticipated medical crisis in order to avoid injury, impairment, or death.
"Health care decision" means a decision to accept or refuse a treatment, service, or procedure used to diagnose, treat, or care for a person's physical or mental condition, including life-sustaining treatment.
"Health care institution" means an institution, facility, or agency authorized by State law to administer health care in the ordinary course of business, including, but not limited to: a hospital, nursing home, residential health care facility, home health care agency, hospice care program; inpatient or residential facility serving persons with mental illness; or inpatient or residential facility serving persons with a developmental disability.
"Health care professional" means a physician, nurse, or physician assistant licensed to practice in this State.
"Life-sustaining treatment" means the use of any medical device or procedure, artificially provided fluids and nutrition, drugs, surgery, or therapy that uses mechanical or other artificial means to sustain, restore, or supplant a vital bodily function, and thereby increase the expected life span of a patient.
"Patient" means a person who is under the care of a physician.
"Patient's representative" means an individual who is authorized under law to make health care decisions on the patient's behalf if the patient lacks decision-making capacity.
"Physician Orders for Life-Sustaining Treatment form" or "POLST form" means a standardized printed document that is uniquely identifiable and has a uniform color, which:
a. is recommended for use on a voluntary basis by patients who have advanced chronic progressive illness or a life expectancy of less than one year, or who otherwise wish to further define their preferences for health care;
b. does not qualify as an advance directive;
c. is not valid unless it meets the requirements for a completed POLST form as set forth in this act;
d. is intended to provide direction to emergency care personnel regarding the use of emergency care, and to a health care professional regarding the use of life-sustaining treatment, with respect to the patient, by indicating the patient's preference concerning the use of specified interventions and the intensity of treatment for each intervention;
e. is intended to accompany the patient, and to be honored by all personnel attending the patient, across the full range of possible health care settings, including the patient's home, a health care institution, or otherwise at the scene of a medical emergency; and
f. may be modified or revoked at any time, in a manner prescribed by regulation of the commissioner, by a patient with decision-making capacity or the patient's representative.
"Program" means the POLST Paradigm program established pursuant to this act.
"Resuscitative measures" means cardiopulmonary resuscitation provided in the event that a patient suffers a cardiac or respiratory arrest.
4. There is established the POLST Paradigm program in the Department of Health and Senior Services for the purpose of enabling patients in this State to indicate their preferences for health care through the use of a completed POLST form as a complementary measure to the use of an advance directive, or in lieu of an advance directive if the patient has not executed such a document, in accordance with the provisions of this act and the rules and regulations adopted pursuant thereto.
5. The Commissioner of Health and Senior Services shall:
a. oversee and direct the development of the program on a Statewide basis in accordance with the recommendations of the National POLST Paradigm Task Force, and designate an individual within the department to serve as Statewide coordinator for the program;
b. prescribe, by regulation, a POLST form for use pursuant to this act, which shall be designed to reflect the considerations for development and revision of a POLST Paradigm form, and the procedures for completion, modification, and revocation of the form;
c. seek to promote awareness among health care professionals and the general public in this State about the program and the option to complete a POLST form pursuant to this act, including the provision of informational material prepared by the department that explains the difference between an advance directive and a POLST form, which a patient's attending physician shall furnish to the patient or the patient's representative prior to the completion of a POLST form for that patient;
d. encourage ongoing training of health care professionals about the goals of the program and use of the POLST form, in consultation with organizations representing, and educational programs serving, health care professionals in this State;
e. prescribe additional requirements for the completion of a POLST form that may be applicable in the case of a patient with mental illness or a developmental disability;
f. provide for ongoing evaluation of the implementation and operation of the program, for which purpose the commissioner shall provide by regulation for the annual reporting to the department by health care institutions, and the gathering by other means as the commissioner determines necessary, of such data as the commissioner determines reasonably necessary to oversee and evaluate the operation of the program; and
g. seek to minimize any record-keeping burden imposed on a health care institution pursuant to this act and take such actions as are necessary to ensure the confidentiality of any such data furnished to the department that may contain patient-specific information.
6. a. A health care professional or health care institution shall treat a patient who has a completed POLST form in accordance with the information contained therein, except as otherwise provided in this act.
b. A POLST form shall be deemed to be completed, and therefore valid for the purposes of this act, if it:
(1) contains information indicating a patient's health care preferences;
(2) has been voluntarily signed by a patient with decision-making capacity, or by the patient's representative at the patient's direction, after the receipt of informational material pursuant to subsection c. of section 5 of this act;
(3) includes the signature of the patient's attending physician and the date of that signature; and
(4) meets any other requirements to be deemed valid for the purposes of this act as prescribed by regulation of the commissioner.
c. A document executed in another state, which meets the requirements of this act and those prescribed by regulation of the commissioner for a POLST form, shall be deemed to be completed and valid for the purposes of this act to the same extent as a POLST form completed in this State.
7. a. If the goals of care of a patient with a completed POLST form change, the patient's attending physician may, after conducting an evaluation of the patient and, to the maximum extent practicable, acting in consultation with the patient or the patient's representative, issue a new order that modifies or supersedes the completed POLST form consistent with the most current information available about the patient's health status and goals of care.
b. A patient with decision-making capacity, may, at any time, modify or revoke the patient's completed POLST form or otherwise request alternative treatment to the treatment that was ordered on the form.
c. If the orders in a patient's completed POLST form regarding the use of any intervention specified therein conflict with the patient's more recent verbal or written directive to the patient's attending physician, the physician shall honor the more recent directive from the patient.
d. If a patient who has a completed POLST form has lost decision-making capacity, the patient's representative may, at any time, after consultation with the patient's attending physician, request the physician to modify or revoke the completed POLST form, or otherwise request alternative treatment to the treatment that was ordered on the form, as the patient's representative deems necessary to reflect the patient's health status or goals of care.
8. a. In the event of a disagreement among the patient, the patient's representative, and the patient's attending physician concerning the patient's decision-making capacity or the appropriate interpretation and application of the terms of a completed POLST form to the patient's course of treatment, the parties may seek to resolve the disagreement by means of procedures and practices established by the health care institution, including, but not limited to, consultation with an institutional ethics committee, or with a person designated by the health care institution for this purpose, or may seek resolution by a court of competent jurisdiction.
b. A health care professional involved in the patient's care, other than the attending physician, or an administrator of a health care institution may also invoke the applicable procedures and practices established by the health care institution to seek to resolve a disagreement concerning the patient's decision-making capacity or the appropriate interpretation and application of the terms of a completed POLST form to the patient's course of treatment, or may seek resolution by a court of competent jurisdiction.
9. Nothing in this act shall be construed to:
a. abridge a patient's right to refuse treatment under either the United States Constitution or the Constitution of the State of New Jersey;
b. impair the obligations of a health care professional to provide for the care and comfort of the patient and to alleviate pain, in accordance with accepted medical and nursing standards;
c. impair the legal validity of a written order not to attempt cardiopulmonary resuscitation on a patient in the event that the patient suffers a cardiac or respiratory arrest, which is not part of a completed POLST form, if the order was signed by a physician prior to or after the effective date of this act and would be deemed valid under State law or regulation in effect prior to the date of enactment of this act;
d. require a health care professional or health care institution to participate in the beginning, continuing, withholding, or withdrawing of health care in a manner contrary to law or accepted medical standards; or
e. require a private, religiously-affiliated health care institution to participate in the withholding or withdrawing of specified measures utilized to sustain life in a manner contrary to any of its written institutional policies and practices, except that the health care institution shall, with respect to a patient with a completed POLST form:
(1) properly communicate its institutional policies and practices to the patient, or to the patient's representative as applicable, prior to or upon the patient's admission, or as soon after admission as is practicable; and
(2) if its institutional policies and practices appear to conflict with the patient's legal rights, attempt to resolve the conflict and, if a mutually satisfactory accommodation cannot be reached, take all reasonable steps to effect the appropriate, timely, and respectful transfer of the patient to the care of another health care institution appropriate to the patient's needs, and assure that the patient is not abandoned or treated disrespectfully.
10. a. A patient's representative shall not be subject to criminal or civil liability for any action taken by that individual to carry out the terms of a completed POLST form that is performed in good faith and in accordance with the provisions of this act.
b. A health care professional shall not be subject to criminal or civil liability or to discipline by a health care institution or the applicable State licensing board for professional misconduct for any action taken by the health care professional to carry out the terms of a completed POLST form that is performed in good faith and in accordance with the provisions of this act, any rules and regulations established by the commissioner pursuant to this act, and accepted professional standards.
c. A health care institution shall not be subject to criminal or civil liability for any action taken by the institution to carry out the terms of a completed POLST form that is performed in good faith and in accordance with the provisions of this act.
d. The withholding or withdrawing of life-sustaining treatment pursuant to a completed POLST form, when performed in good faith and in accordance with the terms of that form and the provisions of this act, shall not constitute homicide, suicide, assisted suicide, or active euthanasia.
11. a. A health care professional who intentionally fails to act in accordance with the requirements of this act is subject to discipline for professional misconduct pursuant to section 8 of P.L.1978, c.73 (C.45:1-21).
b. A health care institution that intentionally fails to act in accordance with the requirements of this act shall be liable to a civil penalty of not more than $1,000 for each offense. For the purposes of this subsection, each violation shall constitute a separate offense. The civil penalty shall be collected in a summary proceeding, brought in the name of the State in a court of competent jurisdiction pursuant to the "Penalty Enforcement Law of 1999," P.L.1999, c.274 (C.2A:58-10 et seq.).
c. A person who commits any of the following acts is guilty of a crime of the fourth degree:
(1) willfully concealing, canceling, defacing, obliterating, or withholding personal knowledge of a completed POLST form or a modification or revocation thereof, without the patient's consent;
(2) falsifying or forging a completed POLST form or a modification or revocation thereof of another person;
(3) coercing or fraudulently inducing the completion of a POLST form or a modification or revocation thereof; or
(4) requiring or prohibiting the completion of a POLST form or a modification or revocation thereof as a condition of coverage under any policy of health or life insurance or an annuity, or a public benefits program, or as a condition of the provision of health care.
d. The commission of an act identified in paragraphs (1), (2), or (3) of subsection c. of this section, which results in the involuntary earlier death of a patient, shall constitute a crime of the fourth degree.
e. The provisions of this section shall not be construed to repeal any sanctions applicable under any other law.
12. a. The commissioner shall establish and operate a Statewide registry, to be designated as the New Jersey POLST Registry, for the collection and dissemination of completed POLST forms in order to help ensure that the health care preferences of each patient who has completed a POLST form are honored.
b. The commissioner, in consultation with the POLST Registry Advisory Committee established pursuant to this section, shall adopt regulations for the implementation, operation, and evaluation of the registry, including, but not limited to, those that:
(1) require submission of the following documents to the registry, unless the patient has requested to opt out of the registry in a manner to be prescribed by regulation of the commissioner:
(a) a copy of each completed POLST form;
(b) a copy of each modified POLST form; and
(c) notice of any known revocation of a completed POLST form;
(2) prescribe the manner for submitting a document, as specified in paragraph (1) of this subsection, to the registry;
(3) require the release of information from the registry to authorized recipients for patient treatment purposes; and authorize notification by the registry to specified persons of the receipt, modification, or revocation of a POLST form; and
(4) establish procedures to ensure the accuracy and confidentiality of information submitted to the registry.
c. The commissioner may permit qualified researchers to access data in the registry in accordance with regulations that the commissioner shall adopt governing such access, which shall include, but not be limited to:
(1) the process for a qualified researcher to request access to data contained in the registry;
(2) the types of data that a qualified researcher may be provided from the registry, except that the data which may be provided shall contain no information that could be used to identify any patient, health care professional, or health care institution; and
(3) any additional confidentiality requirements with respect to the data that the commissioner deems necessary.
d. The commissioner may contract with a public or private entity to implement or operate the registry.
e. Except to the extent necessary to effectuate the purposes of paragraph (3) of subsection b. of this section, as prescribed by regulation of the commissioner, all information collected or developed by the registry that identifies or could be used to identify a patient, health care professional, or health care institution shall be confidential and shall not be subject to civil or administrative subpoena or discovery in a civil action, including, but not limited to, a judicial, administrative, arbitration, or mediation proceeding.
f. A person who reports information to the registry or acts on information obtained from the registry in good faith, and in accordance with the provisions of this act and the rules and regulations adopted pursuant thereto, shall be immune from any civil or criminal liability that might otherwise be incurred or imposed with respect to those actions.
g. The commissioner shall establish the POLST Registry Advisory Committee to advise the commissioner regarding the implementation, operation, and evaluation of the POLST registry.
(1) The advisory committee shall include nine members as follows:
(a) two persons employed by the department, at least one of whom shall be the Director of the Office of Emergency Medical Services or his designee, as ex officio members; and
(b) seven public members who are residents of this State, to be appointed by the commissioner, including: a paramedic providing emergency medical services in this State; one person who represents licensed hospice care programs in this State; a physician licensed to practice in this State who has had experience in the provision of end-of-life care in this State; one person who represents general hospitals in this State; one person who represents nursing homes in this State; and two members of the general public with expertise or interest in end-of-life care who are not licensed health care professionals, at least one of whom is a member of a minority racial or ethnic group.
(2) The advisory committee shall select a chairperson from among its members and a secretary who need not be a member of the advisory committee.
(3) Of the public members of the advisory committee first appointed, three shall be appointed for a term of three years, three for a term of two years, and one for a term of one year. Thereafter, the public members shall be appointed for terms of three years. The public members shall be eligible for reappointment and shall serve until the appointment and qualification of their successors.
(4) Vacancies in the advisory committee shall be filled for the unexpired terms in the same manner as the original appointments were made.
(5) The members of the advisory committee shall not receive any compensation, but shall be reimbursed for expenses incurred in the performance of their duties.
(6) The advisory committee shall meet at least quarterly, at a time and place to be specified by the commissioner.
(7) The department shall provide such staff and other support to the advisory committee as it deems necessary to perform its duties.
13. The Commissioner of Health and Senior Services, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), shall adopt such rules and regulations as are necessary to effectuate the purposes of this act.
14. This act shall take effect on the first day of the seventh month after the date of enactment, but the Commissioner of Health and Senior Services may take such anticipatory administrative action in advance thereof as shall be necessary for the implementation of this act.
STATEMENT
This bill, which is designated the "Physician Orders for Life-Sustaining Treatment Act," provides for the use of Physician Orders for Life-Sustaining Treatment (POLST) forms in New Jersey.
The bill provides specifically as follows:
· The POLST Paradigm program is established in the Department of Health and Senior Services (DHSS) to enable patients in this State to indicate their preferences for health care through a completed POLST form as a complementary measure to the use of an advance directive for health care, or in lieu of an advance directive if the patient has not executed such a document.
· The Commissioner of Health and Senior Services is to:
-- oversee and direct the development of the program on a Statewide basis in accordance with the recommendations of the National POLST Paradigm Task Force, and designate an individual within DHSS to serve as Statewide coordinator for the program;
-- prescribe, by regulation, a POLST form for use pursuant to the bill and the procedures for completion, modification, and revocation of the form;
-- seek to promote awareness among health care professionals and the general public in this State about the POLST form;
-- encourage ongoing training of health care professionals about the POLST form;
-- prescribe additional requirements for the completion of a POLST form applicable to a patient with mental illness or a developmental disability;
-- require that health care institutions annually report to DHSS such data as the commissioner determines reasonably necessary to oversee and evaluate the program; and
-- seek to minimize any record-keeping burden imposed on a health care institution pursuant to the bill and ensure the confidentiality of data furnished to DHSS that may contain patient-specific information.
· A health care professional or health care institution is to treat a patient who has a completed POLST form in accordance with the information contained therein, except as otherwise provided in the bill.
· A POLST form is to be deemed completed, and therefore valid for the purposes of the bill, if it:
-- contains information indicating a patient's health care preferences;
-- has been voluntarily signed by a patient with decision-making capacity, or by the patient's representative at the patient's direction, after receiving, from the patient's attending physician, informational material prepared by DHSS that explains the difference between an advance directive and a POLST form;
-- includes the signature of the patient's attending physician and the date of that signature; and
-- meets any other requirements to be deemed valid as prescribed by regulation of the commissioner.
· The bill provides for changes relating to a completed POLST form, as follows:
-- If the goals of care of a patient with a completed POLST form change, the patient's attending physician may, after evaluating the patient and, to the maximum extent practicable, acting in consultation with the patient or the patient's representative, issue a new order that modifies or supersedes the completed POLST form.
-- A patient with decision-making capacity, may, at any time, modify or revoke the patient's completed POLST form or otherwise request alternative treatment to that ordered on the form.
-- If the orders in a patient's completed POLST form regarding the use of any intervention specified therein conflict with the patient's more recent verbal or written directive to the patient's attending physician, the physician is to honor the more recent directive.
-- If a patient who has a completed POLST form has lost decision-making capacity, the patient's representative may, at any time, after consultation with the patient's attending physician, request the physician to modify or revoke the completed POLST form, or otherwise request alternative treatment to that ordered on the form, as the patient's representative deems necessary to reflect the patient's health status or goals of care.
· The bill provides for the resolution of disputes relating to POLST forms, as follows:
-- If a disagreement arises among the patient, the patient's representative, and the patient's attending physician concerning the patient's decision-making capacity or the appropriate interpretation and application of the terms of a completed POLST form to the patient's treatment, the parties may seek to resolve the disagreement through the procedures and practices of the health care institution.
-- A health care professional involved in the patient's care, other than the attending physician, or an administrator of a health care institution may also invoke those procedures and practices to seek to resolve a disagreement concerning the patient's decision-making capacity or the use of a completed POLST form.
· Nothing in the bill is to be construed to:
-- abridge a patient's right to refuse treatment under the federal or State Constitution;
-- impair a health care professional's obligations to provide for a patient's care and comfort and to alleviate pain, in accordance with accepted medical and nursing standards;
-- impair the legal validity of an otherwise valid do-not-resuscitate order that is not part of a completed POLST form;
-- require a health care professional or health care institution to participate in the beginning, continuing, withholding, or withdrawing of health care in a manner contrary to law or accepted medical standards; or
-- require a private, religiously-affiliated health care institution to participate in the withholding or withdrawing of specified measures utilized to sustain life in a manner contrary to any of its written institutional policies and practices.
· The bill provides certain liability protections as follows:
-- A patient's representative is not subject to criminal or civil liability for any action to carry out the terms of a completed POLST form that is performed in good faith and in accordance with the bill.
-- A health care professional is not subject to criminal or civil liability or to discipline by a health care institution or the applicable State licensing board for professional misconduct for any action to carry out the terms of a completed POLST form that is performed in good faith and in accordance with the bill, any rules and regulations of the commissioner pursuant to the bill, and accepted professional standards.
-- A health care institution is not subject to criminal or civil liability for any action to carry out the terms of a completed POLST form that is performed in good faith and in accordance with the bill.
-- The withholding or withdrawing of life-sustaining treatment pursuant to a completed POLST form, when performed in good faith and in accordance with the bill, does not constitute homicide, suicide, assisted suicide, or active euthanasia.
· The bill provides for certain civil and criminal penalties as follows:
-- A health care professional who intentionally fails to act as required in the bill is subject to discipline for professional misconduct under section 8 of P.L.1978, c.73 (C.45:1-21).
-- A health care institution that intentionally fails to act as required in the bill is liable to a civil penalty of not more than $1,000 for each offense.
-- A person is guilty of a crime of the fourth degree (punishable by a fine of up to $10,000 or imprisonment for up to 18 months, or both) if the person: willfully conceals, cancels, defaces, obliterates, or withholds personal knowledge of a completed POLST form or a modification or revocation thereof, without the patient's consent; falsifies or forges a completed POLST form or a modification or revocation thereof of another person; coerces or fraudulently induces the completion of a POLST form or a modification or revocation thereof; requires or prohibits the completion of a POLST form or a modification or revocation thereof as a condition of coverage under a policy of health or life insurance or an annuity, or a public benefits program, or as a condition of the provision of health care; or commits an act as specified in the bill which results in a patient's involuntary earlier death.
· The commissioner is to establish and operate the New Jersey POLST Registry, for the collection and dissemination of completed POLST forms in order to help ensure that the health care preferences of each patient who has completed a POLST form are honored.
-- The commissioner, in consultation with the POLST Registry Advisory Committee established under the bill, is to adopt regulations for the implementation, operation, and evaluation of the registry, including, but not limited to, those that:
(1) require submission of completed or modified POLST forms, or notices of POLST form revocations, to the registry, unless the patient has requested to opt out of the registry as prescribed by regulation of the commissioner;
(2) govern submissions of documents to the registry;
(3) require the release of information from the registry to authorized recipients for patient treatment purposes; and authorize notification by the registry to specified persons of the receipt, modification, or revocation of a POLST form; and
(4) establish procedures to ensure the accuracy and confidentiality of information submitted to the registry.
-- The commissioner may permit qualified researchers to access data in the registry in accordance with regulations governing such access, except that the data provided is to contain no information that could be used to identify any patient, health care professional, or health care institution.
-- Except to the extent necessary to provide information from the registry to authorized recipients for patient treatment purposes and to notify specified persons of the receipt, modification, or revocation of a POLST form, as prescribed by regulation of the commissioner, all information collected or developed by the registry that could identify a patient, health care professional, or health care institution is to be confidential and not subject to civil or administrative subpoena or discovery in a civil action.
-- A person who reports information to the registry or acts on information obtained from the registry in good faith, and in accordance with the provisions of the bill and the rules and regulations adopted pursuant thereto, is immune from any civil or criminal liability that might otherwise be incurred or imposed with respect to those actions.
-- The commissioner is to establish the POLST Registry Advisory Committee to advise the commissioner regarding the implementation, operation, and evaluation of the POLST registry.
-- The advisory committee is to include nine members as follows: two persons employed by DHSS, including the Director of the Office of Emergency Medical Services or his designee, as ex officio members; and seven public members residing in this State, to be appointed by the commissioner, including: a paramedic; a hospice representative; a physician with experience in the provision of end-of-life care; a hospital representative; a nursing home representative; and two members of the general public with expertise or interest in end-of-life care who are not health care professionals, at least one of whom is a member of a minority racial or ethnic group.
-- The advisory committee is to meet at least quarterly, at a time and place to be specified by the commissioner, and DHSS is to provide staff and other support to the advisory committee.
· The bill takes effect on the first day of the seventh month after enactment, but the commissioner may take administrative action in advance as necessary for its implementation.
