California 2017-2018 Regular Session

California Senate Bill SB1336 Compare Versions

OldNewDifferences
1-Amended IN Senate April 02, 2018 CALIFORNIA LEGISLATURE 20172018 REGULAR SESSION Senate Bill No. 1336Introduced by Senator MorrellFebruary 16, 2018 An act to amend Sections 443.5, 443.19, 443.19 and 443.22 of the Health and Safety Code, relating to public health. LEGISLATIVE COUNSEL'S DIGESTSB 1336, as amended, Morrell. Public health: End of Life Option Act. Existing law, the End of Life Option Act, authorizes an adult who meets certain qualifications, and who has been determined by his or her attending physician to be suffering from a terminal disease, as defined, to make a request for an aid-in-dying drug for the purpose of ending his or her life. Prior to prescribing an aid-in-dying drug, existing law requires the attending physician to make certain determinations and verify, immediately before writing the prescription for an aid-in-dying drug, that the qualified individual is making an informed decision. Existing law requires the State Department of Public Health to create a report with information collected from attending physician followup forms and to post that report to its Internet Web site. Existing law requires that information to include, among other things, the underlying illness of the qualified individual. Existing law authorizes the Medical Board of California to update the attending physician checklists and forms required under these provisions.Prior to prescribing an aid-in-dying drug, this bill would require an attending physician to request that a qualified individual inform the physician orally or in writing as to the motivating reason or reasons for receiving an aid-in-dying drug, as specified. The bill would require that information to be included in the report of the department described above. The bill would further require that report to This bill would require the report described above to further include additional information about each attending physician and the length of time that he or she provided care to a patient, and the areas of practice of each physician who wrote a prescription for an aid-in-dying drug, the motivating reason or reasons behind a patients decision to request the aid-in-dying drug, as specified, and the number of patients who received a mental health specialist assessment. assessment prior to receiving the aid-in-dying drug. The bill would require the Medical Board of California to make any necessary changes to the applicable forms to conform with these requirements.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO Bill TextThe people of the State of California do enact as follows:SECTION 1.Section 443.5 of the Health and Safety Code is amended to read:443.5.(a)Before prescribing an aid-in-dying drug, the attending physician shall do all of the following:(1)Make the initial determination of all of the following:(A)(i)Whether the requesting adult has the capacity to make medical decisions.(ii)If there are indications of a mental disorder, the physician shall refer the individual for a mental health specialist assessment.(iii)If a mental health specialist assessment referral is made, no aid-in-dying drugs shall be prescribed until the mental health specialist determines that the individual has the capacity to make medical decisions and is not suffering from impaired judgment due to a mental disorder.(B)Whether the requesting adult has a terminal disease.(C)Whether the requesting adult has voluntarily made the request for an aid-in-dying drug pursuant to Sections 443.2 and 443.3.(D)Whether the requesting adult is a qualified individual pursuant to subdivision (o) of Section 443.1.(2)Confirm that the individual is making an informed decision by discussing with him or her all of the following:(A)His or her medical diagnosis and prognosis.(B)The potential risks associated with ingesting the requested aid-in-dying drug.(C)The probable result of ingesting the aid-in-dying drug.(D)The possibility that he or she may choose to obtain the aid-in-dying drug but not take it.(E)The feasible alternatives or additional treatment options, including, but not limited to, comfort care, hospice care, palliative care, and pain control.(3)Refer the individual to a consulting physician for medical confirmation of the diagnosis and prognosis, and for a determination that the individual has the capacity to make medical decisions and has complied with the provisions of this part.(4)Confirm that the qualified individuals request does not arise from coercion or undue influence by another person by discussing with the qualified individual, outside of the presence of any other persons, except for an interpreter as required pursuant to this part, whether or not the qualified individual is feeling coerced or unduly influenced by another person.(5)Counsel the qualified individual about the importance of all of the following:(A)Having another person present when he or she ingests the aid-in-dying drug prescribed pursuant to this part.(B)Not ingesting the aid-in-dying drug in a public place.(C)Notifying the next of kin of his or her request for an aid-in-dying drug. A qualified individual who declines or is unable to notify next of kin shall not have his or her request denied for that reason.(D)Participating in a hospice program.(E)Maintaining the aid-in-dying drug in a safe and secure location until the time that the qualified individual will ingest it.(6)Inform the individual that he or she may withdraw or rescind the request for an aid-in-dying drug at any time and in any manner.(7)Offer the individual an opportunity to withdraw or rescind the request for an aid-in-dying drug before prescribing the aid-in-dying drug.(8)Verify, immediately before writing the prescription for an aid-in-dying drug, that the qualified individual is making an informed decision.(9)For purposes of paragraph (7) of subdivision (b) of Section 443.19, request that the qualified individual inform the physician orally or in writing as to the motivating reason or reasons behind the individuals decision to request the aid-in-dying drug. The question used to gather this information shall allow for the selection of multiple choices pursuant to, at a minimum, the following possible choices:(A)Pain or the fear of pain.(B)Concern about being a burden to others.(C)Loss of autonomy.(D)Sense of hopelessness.(10)Confirm that all requirements are met and all appropriate steps are carried out in accordance with this part before writing a prescription for an aid-in-dying drug.(11)Fulfill the record documentation required under Sections 443.8 and 443.19.(12)Complete the attending physician checklist and compliance form, as described in Section 443.22, include it and the consulting physician compliance form in the individuals medical record, and submit both forms to the State Department of Public Health.(13)Give the qualified individual the final attestation form, with the instruction that the form be filled out and executed by the qualified individual within 48 hours prior to the qualified individual choosing to self-administer the aid-in-dying drug.(b)If the conditions set forth in subdivision (a) are satisfied, the attending physician may deliver the aid-in-dying drug in any of the following ways:(1)Dispensing the aid-in-dying drug directly, including ancillary medication intended to minimize the qualified individuals discomfort, if the attending physician meets all of the following criteria:(A)Is authorized to dispense medicine under California law.(B)Has a current United States Drug Enforcement Administration (USDEA) certificate.(C)Complies with any applicable administrative rule or regulation.(2)With the qualified individuals written consent, contacting a pharmacist, informing the pharmacist of the prescriptions, and delivering the written prescriptions personally, by mail, or electronically to the pharmacist, who may dispense the drug to the qualified individual, the attending physician, or a person expressly designated by the qualified individual and with the designation delivered to the pharmacist in writing or verbally.(c)Delivery of the dispensed drug to the qualified individual, the attending physician, or a person expressly designated by the qualified individual may be made by personal delivery, or, with a signature required on delivery, by United Parcel Service, United States Postal Service, Federal Express, or by messenger service.(d)An attending physician shall not be precluded from prescribing an aid-in-dying drug pursuant to this part under circumstances in which the qualified individual chooses not to provide an answer to the question asked pursuant to paragraph (9) of subdivision (a).SEC. 2.SECTION 1. Section 443.19 of the Health and Safety Code is amended to read:443.19. (a) The State Department of Public Health shall collect and review the information submitted pursuant to Section 443.9. The information collected shall be confidential and shall be collected in a manner that protects the privacy of the patient, the patients family, and any medical provider or pharmacist involved with the patient under the provisions of this part. The information shall not be disclosed, discoverable, or compelled to be produced in any civil, criminal, administrative, or other proceeding.(b) On or before July 1, 2017, and each year thereafter, based on the information collected in the previous year, the department shall create a report with the information collected from the attending physician followup form and post that report to its Internet Web site. The report shall include, but not be limited to, all of the following information:(1) The number of people for whom an aid-in-dying prescription was written.(2) The number of known individuals who died each year for whom aid-in-dying prescriptions were written, and the cause of death of those individuals.(3) For the period commencing January 1, 2016, to and including the previous year, cumulatively, the total number of aid-in-dying prescriptions written, the number of people who died due to use of aid-in-dying drugs, and the number of those people who died who were enrolled in hospice or other palliative care programs at the time of death.(4) The number of known deaths in California from using aid-in-dying drugs per 10,000 deaths in California.(5) The number of physicians who wrote prescriptions for aid-in-dying drugs, and the specialty or specialties of each physician. drugs and the areas of practice of each physician.(6) Of people who died due to using an aid-in-dying drug, demographic percentages organized by the following characteristics:(A) Age at death.(B) Education level.(C) Race.(D) Sex.(E) Type of insurance, including whether or not they had insurance.(F) Underlying illness.(7) The motivating reason or reasons behind a patients decision to request the aid-in-dying drug pursuant to paragraph (9) of subdivision (a) of Section 443.5. the responses given to question 15 of the attending physician followup form described in Section 443.22.(8) The number of patients who received a mental health specialist assessment prior to receiving the aid-in-dying drug.(9)The length of time the attending physician has provided care to the patient prior to prescribing the aid-in-dying drug.(c) The State Department of Public Health shall make available the attending physician checklist and compliance form, the consulting physician compliance form, and the attending physician followup form, as described in Section 443.22, by posting them on its Internet Web site.SEC. 3.SEC. 2. Section 443.22 of the Health and Safety Code is amended to read:443.22. (a) (1) The Medical Board of California may update the attending physician checklist and compliance form, the consulting physician compliance form, and the attending physician followup form, based on those provided in subdivision (b). Upon completion, the State Department of Public Health shall publish the updated forms on its Internet Web site.(2) The Medical Board of California shall make changes to the forms referenced in paragraph (1) as necessary so the forms capture the information needed to fulfill the reporting requirement in subdivision (b) of Section 443.19.(b) Unless and until updated by the Medical Board of California pursuant to this section, the attending physician checklist and compliance form, the consulting physician compliance form, and the attending physician followup form shall be in the following form:PRINTER PLEASE NOTE: TIP-IN MATERIAL TO BE INSERTED
1+CALIFORNIA LEGISLATURE 20172018 REGULAR SESSION Senate Bill No. 1336Introduced by Senator MorrellFebruary 16, 2018 An act to amend Sections 443.5, 443.19, and 443.22 of the Health and Safety Code, relating to public health. LEGISLATIVE COUNSEL'S DIGESTSB 1336, as introduced, Morrell. Public health: End of Life Option Act. Existing law, the End of Life Option Act, authorizes an adult who meets certain qualifications, and who has been determined by his or her attending physician to be suffering from a terminal disease, as defined, to make a request for an aid-in-dying drug for the purpose of ending his or her life. Prior to prescribing an aid-in-dying drug, existing law requires the attending physician to make certain determinations and verify, immediately before writing the prescription for an aid-in-dying drug, that the qualified individual is making an informed decision. Existing law requires the State Department of Public Health to create a report with information collected from attending physician followup forms and to post that report to its Internet Web site. Existing law requires that information to include, among other things, the underlying illness of the qualified individual. Existing law authorizes the Medical Board of California to update the attending physician checklists and forms required under these provisions.Prior to prescribing an aid-in-dying drug, this bill would require an attending physician to request that a qualified individual inform the physician orally or in writing as to the motivating reason or reasons for receiving an aid-in-dying drug, as specified. The bill would require that information to be included in the report of the department described above. The bill would further require that report to include additional information about each attending physician and the length of time that he or she provided care to a patient, and the number of patients who received a mental health specialist assessment. The bill would require the Medical Board of California to make any necessary changes to the applicable forms to conform with these requirements.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO Bill TextThe people of the State of California do enact as follows:SECTION 1. Section 443.5 of the Health and Safety Code is amended to read:443.5. (a) Before prescribing an aid-in-dying drug, the attending physician shall do all of the following:(1) Make the initial determination of all of the following:(A) (i) Whether the requesting adult has the capacity to make medical decisions.(ii) If there are indications of a mental disorder, the physician shall refer the individual for a mental health specialist assessment.(iii) If a mental health specialist assessment referral is made, no aid-in-dying drugs shall be prescribed until the mental health specialist determines that the individual has the capacity to make medical decisions and is not suffering from impaired judgment due to a mental disorder.(B) Whether the requesting adult has a terminal disease.(C) Whether the requesting adult has voluntarily made the request for an aid-in-dying drug pursuant to Sections 443.2 and 443.3.(D) Whether the requesting adult is a qualified individual pursuant to subdivision (o) of Section 443.1.(2) Confirm that the individual is making an informed decision by discussing with him or her all of the following:(A) His or her medical diagnosis and prognosis.(B) The potential risks associated with ingesting the requested aid-in-dying drug.(C) The probable result of ingesting the aid-in-dying drug.(D) The possibility that he or she may choose to obtain the aid-in-dying drug but not take it.(E) The feasible alternatives or additional treatment options, including, but not limited to, comfort care, hospice care, palliative care, and pain control.(3) Refer the individual to a consulting physician for medical confirmation of the diagnosis and prognosis, and for a determination that the individual has the capacity to make medical decisions and has complied with the provisions of this part.(4) Confirm that the qualified individuals request does not arise from coercion or undue influence by another person by discussing with the qualified individual, outside of the presence of any other persons, except for an interpreter as required pursuant to this part, whether or not the qualified individual is feeling coerced or unduly influenced by another person.(5) Counsel the qualified individual about the importance of all of the following:(A) Having another person present when he or she ingests the aid-in-dying drug prescribed pursuant to this part.(B) Not ingesting the aid-in-dying drug in a public place.(C) Notifying the next of kin of his or her request for an aid-in-dying drug. A qualified individual who declines or is unable to notify next of kin shall not have his or her request denied for that reason.(D) Participating in a hospice program.(E) Maintaining the aid-in-dying drug in a safe and secure location until the time that the qualified individual will ingest it.(6) Inform the individual that he or she may withdraw or rescind the request for an aid-in-dying drug at any time and in any manner.(7) Offer the individual an opportunity to withdraw or rescind the request for an aid-in-dying drug before prescribing the aid-in-dying drug.(8) Verify, immediately before writing the prescription for an aid-in-dying drug, that the qualified individual is making an informed decision.(9) For purposes of paragraph (7) of subdivision (b) of Section 443.19, request that the qualified individual inform the physician orally or in writing as to the motivating reason or reasons behind the individuals decision to request the aid-in-dying drug. The question used to gather this information shall allow for the selection of multiple choices pursuant to, at a minimum, the following possible choices:(A) Pain or the fear of pain.(B) Concern about being a burden to others.(C) Loss of autonomy.(D) Sense of hopelessness.(9)(10) Confirm that all requirements are met and all appropriate steps are carried out in accordance with this part before writing a prescription for an aid-in-dying drug.(10)(11) Fulfill the record documentation required under Sections 443.8 and 443.19.(11)(12) Complete the attending physician checklist and compliance form, as described in Section 443.22, include it and the consulting physician compliance form in the individuals medical record, and submit both forms to the State Department of Public Health.(12)(13) Give the qualified individual the final attestation form, with the instruction that the form be filled out and executed by the qualified individual within 48 hours prior to the qualified individual choosing to self-administer the aid-in-dying drug.(b) If the conditions set forth in subdivision (a) are satisfied, the attending physician may deliver the aid-in-dying drug in any of the following ways:(1) Dispensing the aid-in-dying drug directly, including ancillary medication intended to minimize the qualified individuals discomfort, if the attending physician meets all of the following criteria:(A) Is authorized to dispense medicine under California law.(B) Has a current United States Drug Enforcement Administration (USDEA) certificate.(C) Complies with any applicable administrative rule or regulation.(2) With the qualified individuals written consent, contacting a pharmacist, informing the pharmacist of the prescriptions, and delivering the written prescriptions personally, by mail, or electronically to the pharmacist, who may dispense the drug to the qualified individual, the attending physician, or a person expressly designated by the qualified individual and with the designation delivered to the pharmacist in writing or verbally.(c) Delivery of the dispensed drug to the qualified individual, the attending physician, or a person expressly designated by the qualified individual may be made by personal delivery, or, with a signature required on delivery, by United Parcel Service, United States Postal Service, Federal Express, or by messenger service.(d) An attending physician shall not be precluded from prescribing an aid-in-dying drug pursuant to this part under circumstances in which the qualified individual chooses not to provide an answer to the question asked pursuant to paragraph (9) of subdivision (a).SEC. 2. Section 443.19 of the Health and Safety Code is amended to read:443.19. (a) The State Department of Public Health shall collect and review the information submitted pursuant to Section 443.9. The information collected shall be confidential and shall be collected in a manner that protects the privacy of the patient, the patients family, and any medical provider or pharmacist involved with the patient under the provisions of this part. The information shall not be disclosed, discoverable, or compelled to be produced in any civil, criminal, administrative, or other proceeding.(b) On or before July 1, 2017, and each year thereafter, based on the information collected in the previous year, the department shall create a report with the information collected from the attending physician followup form and post that report to its Internet Web site. The report shall include, but not be limited to, all of the following based on the information that is provided to the department and on the departments access to vital statistics: following information:(1) The number of people for whom an aid-in-dying prescription was written.(2) The number of known individuals who died each year for whom aid-in-dying prescriptions were written, and the cause of death of those individuals.(3) For the period commencing January 1, 2016, to and including the previous year, cumulatively, the total number of aid-in-dying prescriptions written, the number of people who died due to use of aid-in-dying drugs, and the number of those people who died who were enrolled in hospice or other palliative care programs at the time of death.(4) The number of known deaths in California from using aid-in-dying drugs per 10,000 deaths in California.(5) The number of physicians who wrote prescriptions for aid-in-dying drugs. drugs, and the specialty or specialties of each physician.(6) Of people who died due to using an aid-in-dying drug, demographic percentages organized by the following characteristics:(A) Age at death.(B) Education level.(C) Race.(D) Sex.(E) Type of insurance, including whether or not they had insurance.(F) Underlying illness.(7) The motivating reason or reasons behind a patients decision to request the aid-in-dying drug pursuant to paragraph (9) of subdivision (a) of Section 443.5.(8) The number of patients who received a mental health specialist assessment prior to receiving the aid-in-dying drug.(9) The length of time the attending physician has provided care to the patient prior to prescribing the aid-in-dying drug.(c) The State Department of Public Health shall make available the attending physician checklist and compliance form, the consulting physician compliance form, and the attending physician followup form, as described in Section 443.22, by posting them on its Internet Web site.SEC. 3. Section 443.22 of the Health and Safety Code is amended to read:443.22. (a) (1) The Medical Board of California may update the attending physician checklist and compliance form, the consulting physician compliance form, and the attending physician followup form, based on those provided in subdivision (b). Upon completion, the State Department of Public Health shall publish the updated forms on its Internet Web site.(2) The Medical Board of California shall make changes to the forms referenced in paragraph (1) as necessary so the forms capture the information needed to fulfill the reporting requirement in subdivision (b) of Section 443.19.(b) Unless and until updated by the Medical Board of California pursuant to this section, the attending physician checklist and compliance form, the consulting physician compliance form, and the attending physician followup form shall be in the following form:
22
3- Amended IN Senate April 02, 2018 CALIFORNIA LEGISLATURE 20172018 REGULAR SESSION Senate Bill No. 1336Introduced by Senator MorrellFebruary 16, 2018 An act to amend Sections 443.5, 443.19, 443.19 and 443.22 of the Health and Safety Code, relating to public health. LEGISLATIVE COUNSEL'S DIGESTSB 1336, as amended, Morrell. Public health: End of Life Option Act. Existing law, the End of Life Option Act, authorizes an adult who meets certain qualifications, and who has been determined by his or her attending physician to be suffering from a terminal disease, as defined, to make a request for an aid-in-dying drug for the purpose of ending his or her life. Prior to prescribing an aid-in-dying drug, existing law requires the attending physician to make certain determinations and verify, immediately before writing the prescription for an aid-in-dying drug, that the qualified individual is making an informed decision. Existing law requires the State Department of Public Health to create a report with information collected from attending physician followup forms and to post that report to its Internet Web site. Existing law requires that information to include, among other things, the underlying illness of the qualified individual. Existing law authorizes the Medical Board of California to update the attending physician checklists and forms required under these provisions.Prior to prescribing an aid-in-dying drug, this bill would require an attending physician to request that a qualified individual inform the physician orally or in writing as to the motivating reason or reasons for receiving an aid-in-dying drug, as specified. The bill would require that information to be included in the report of the department described above. The bill would further require that report to This bill would require the report described above to further include additional information about each attending physician and the length of time that he or she provided care to a patient, and the areas of practice of each physician who wrote a prescription for an aid-in-dying drug, the motivating reason or reasons behind a patients decision to request the aid-in-dying drug, as specified, and the number of patients who received a mental health specialist assessment. assessment prior to receiving the aid-in-dying drug. The bill would require the Medical Board of California to make any necessary changes to the applicable forms to conform with these requirements.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO
3+ CALIFORNIA LEGISLATURE 20172018 REGULAR SESSION Senate Bill No. 1336Introduced by Senator MorrellFebruary 16, 2018 An act to amend Sections 443.5, 443.19, and 443.22 of the Health and Safety Code, relating to public health. LEGISLATIVE COUNSEL'S DIGESTSB 1336, as introduced, Morrell. Public health: End of Life Option Act. Existing law, the End of Life Option Act, authorizes an adult who meets certain qualifications, and who has been determined by his or her attending physician to be suffering from a terminal disease, as defined, to make a request for an aid-in-dying drug for the purpose of ending his or her life. Prior to prescribing an aid-in-dying drug, existing law requires the attending physician to make certain determinations and verify, immediately before writing the prescription for an aid-in-dying drug, that the qualified individual is making an informed decision. Existing law requires the State Department of Public Health to create a report with information collected from attending physician followup forms and to post that report to its Internet Web site. Existing law requires that information to include, among other things, the underlying illness of the qualified individual. Existing law authorizes the Medical Board of California to update the attending physician checklists and forms required under these provisions.Prior to prescribing an aid-in-dying drug, this bill would require an attending physician to request that a qualified individual inform the physician orally or in writing as to the motivating reason or reasons for receiving an aid-in-dying drug, as specified. The bill would require that information to be included in the report of the department described above. The bill would further require that report to include additional information about each attending physician and the length of time that he or she provided care to a patient, and the number of patients who received a mental health specialist assessment. The bill would require the Medical Board of California to make any necessary changes to the applicable forms to conform with these requirements.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO
44
5- Amended IN Senate April 02, 2018
65
7-Amended IN Senate April 02, 2018
6+
7+
88
99 CALIFORNIA LEGISLATURE 20172018 REGULAR SESSION
1010
1111 Senate Bill No. 1336
1212
1313 Introduced by Senator MorrellFebruary 16, 2018
1414
1515 Introduced by Senator Morrell
1616 February 16, 2018
1717
18- An act to amend Sections 443.5, 443.19, 443.19 and 443.22 of the Health and Safety Code, relating to public health.
18+ An act to amend Sections 443.5, 443.19, and 443.22 of the Health and Safety Code, relating to public health.
1919
2020 LEGISLATIVE COUNSEL'S DIGEST
2121
2222 ## LEGISLATIVE COUNSEL'S DIGEST
2323
24-SB 1336, as amended, Morrell. Public health: End of Life Option Act.
24+SB 1336, as introduced, Morrell. Public health: End of Life Option Act.
2525
26- Existing law, the End of Life Option Act, authorizes an adult who meets certain qualifications, and who has been determined by his or her attending physician to be suffering from a terminal disease, as defined, to make a request for an aid-in-dying drug for the purpose of ending his or her life. Prior to prescribing an aid-in-dying drug, existing law requires the attending physician to make certain determinations and verify, immediately before writing the prescription for an aid-in-dying drug, that the qualified individual is making an informed decision. Existing law requires the State Department of Public Health to create a report with information collected from attending physician followup forms and to post that report to its Internet Web site. Existing law requires that information to include, among other things, the underlying illness of the qualified individual. Existing law authorizes the Medical Board of California to update the attending physician checklists and forms required under these provisions.Prior to prescribing an aid-in-dying drug, this bill would require an attending physician to request that a qualified individual inform the physician orally or in writing as to the motivating reason or reasons for receiving an aid-in-dying drug, as specified. The bill would require that information to be included in the report of the department described above. The bill would further require that report to This bill would require the report described above to further include additional information about each attending physician and the length of time that he or she provided care to a patient, and the areas of practice of each physician who wrote a prescription for an aid-in-dying drug, the motivating reason or reasons behind a patients decision to request the aid-in-dying drug, as specified, and the number of patients who received a mental health specialist assessment. assessment prior to receiving the aid-in-dying drug. The bill would require the Medical Board of California to make any necessary changes to the applicable forms to conform with these requirements.
26+ Existing law, the End of Life Option Act, authorizes an adult who meets certain qualifications, and who has been determined by his or her attending physician to be suffering from a terminal disease, as defined, to make a request for an aid-in-dying drug for the purpose of ending his or her life. Prior to prescribing an aid-in-dying drug, existing law requires the attending physician to make certain determinations and verify, immediately before writing the prescription for an aid-in-dying drug, that the qualified individual is making an informed decision. Existing law requires the State Department of Public Health to create a report with information collected from attending physician followup forms and to post that report to its Internet Web site. Existing law requires that information to include, among other things, the underlying illness of the qualified individual. Existing law authorizes the Medical Board of California to update the attending physician checklists and forms required under these provisions.Prior to prescribing an aid-in-dying drug, this bill would require an attending physician to request that a qualified individual inform the physician orally or in writing as to the motivating reason or reasons for receiving an aid-in-dying drug, as specified. The bill would require that information to be included in the report of the department described above. The bill would further require that report to include additional information about each attending physician and the length of time that he or she provided care to a patient, and the number of patients who received a mental health specialist assessment. The bill would require the Medical Board of California to make any necessary changes to the applicable forms to conform with these requirements.
2727
2828 Existing law, the End of Life Option Act, authorizes an adult who meets certain qualifications, and who has been determined by his or her attending physician to be suffering from a terminal disease, as defined, to make a request for an aid-in-dying drug for the purpose of ending his or her life. Prior to prescribing an aid-in-dying drug, existing law requires the attending physician to make certain determinations and verify, immediately before writing the prescription for an aid-in-dying drug, that the qualified individual is making an informed decision. Existing law requires the State Department of Public Health to create a report with information collected from attending physician followup forms and to post that report to its Internet Web site. Existing law requires that information to include, among other things, the underlying illness of the qualified individual. Existing law authorizes the Medical Board of California to update the attending physician checklists and forms required under these provisions.
2929
30-Prior to prescribing an aid-in-dying drug, this bill would require an attending physician to request that a qualified individual inform the physician orally or in writing as to the motivating reason or reasons for receiving an aid-in-dying drug, as specified. The bill would require that information to be included in the report of the department described above. The bill would further require that report to This bill would require the report described above to further include additional information about each attending physician and the length of time that he or she provided care to a patient, and the areas of practice of each physician who wrote a prescription for an aid-in-dying drug, the motivating reason or reasons behind a patients decision to request the aid-in-dying drug, as specified, and the number of patients who received a mental health specialist assessment. assessment prior to receiving the aid-in-dying drug. The bill would require the Medical Board of California to make any necessary changes to the applicable forms to conform with these requirements.
30+Prior to prescribing an aid-in-dying drug, this bill would require an attending physician to request that a qualified individual inform the physician orally or in writing as to the motivating reason or reasons for receiving an aid-in-dying drug, as specified. The bill would require that information to be included in the report of the department described above. The bill would further require that report to include additional information about each attending physician and the length of time that he or she provided care to a patient, and the number of patients who received a mental health specialist assessment. The bill would require the Medical Board of California to make any necessary changes to the applicable forms to conform with these requirements.
3131
3232 ## Digest Key
3333
3434 ## Bill Text
3535
36-The people of the State of California do enact as follows:SECTION 1.Section 443.5 of the Health and Safety Code is amended to read:443.5.(a)Before prescribing an aid-in-dying drug, the attending physician shall do all of the following:(1)Make the initial determination of all of the following:(A)(i)Whether the requesting adult has the capacity to make medical decisions.(ii)If there are indications of a mental disorder, the physician shall refer the individual for a mental health specialist assessment.(iii)If a mental health specialist assessment referral is made, no aid-in-dying drugs shall be prescribed until the mental health specialist determines that the individual has the capacity to make medical decisions and is not suffering from impaired judgment due to a mental disorder.(B)Whether the requesting adult has a terminal disease.(C)Whether the requesting adult has voluntarily made the request for an aid-in-dying drug pursuant to Sections 443.2 and 443.3.(D)Whether the requesting adult is a qualified individual pursuant to subdivision (o) of Section 443.1.(2)Confirm that the individual is making an informed decision by discussing with him or her all of the following:(A)His or her medical diagnosis and prognosis.(B)The potential risks associated with ingesting the requested aid-in-dying drug.(C)The probable result of ingesting the aid-in-dying drug.(D)The possibility that he or she may choose to obtain the aid-in-dying drug but not take it.(E)The feasible alternatives or additional treatment options, including, but not limited to, comfort care, hospice care, palliative care, and pain control.(3)Refer the individual to a consulting physician for medical confirmation of the diagnosis and prognosis, and for a determination that the individual has the capacity to make medical decisions and has complied with the provisions of this part.(4)Confirm that the qualified individuals request does not arise from coercion or undue influence by another person by discussing with the qualified individual, outside of the presence of any other persons, except for an interpreter as required pursuant to this part, whether or not the qualified individual is feeling coerced or unduly influenced by another person.(5)Counsel the qualified individual about the importance of all of the following:(A)Having another person present when he or she ingests the aid-in-dying drug prescribed pursuant to this part.(B)Not ingesting the aid-in-dying drug in a public place.(C)Notifying the next of kin of his or her request for an aid-in-dying drug. A qualified individual who declines or is unable to notify next of kin shall not have his or her request denied for that reason.(D)Participating in a hospice program.(E)Maintaining the aid-in-dying drug in a safe and secure location until the time that the qualified individual will ingest it.(6)Inform the individual that he or she may withdraw or rescind the request for an aid-in-dying drug at any time and in any manner.(7)Offer the individual an opportunity to withdraw or rescind the request for an aid-in-dying drug before prescribing the aid-in-dying drug.(8)Verify, immediately before writing the prescription for an aid-in-dying drug, that the qualified individual is making an informed decision.(9)For purposes of paragraph (7) of subdivision (b) of Section 443.19, request that the qualified individual inform the physician orally or in writing as to the motivating reason or reasons behind the individuals decision to request the aid-in-dying drug. The question used to gather this information shall allow for the selection of multiple choices pursuant to, at a minimum, the following possible choices:(A)Pain or the fear of pain.(B)Concern about being a burden to others.(C)Loss of autonomy.(D)Sense of hopelessness.(10)Confirm that all requirements are met and all appropriate steps are carried out in accordance with this part before writing a prescription for an aid-in-dying drug.(11)Fulfill the record documentation required under Sections 443.8 and 443.19.(12)Complete the attending physician checklist and compliance form, as described in Section 443.22, include it and the consulting physician compliance form in the individuals medical record, and submit both forms to the State Department of Public Health.(13)Give the qualified individual the final attestation form, with the instruction that the form be filled out and executed by the qualified individual within 48 hours prior to the qualified individual choosing to self-administer the aid-in-dying drug.(b)If the conditions set forth in subdivision (a) are satisfied, the attending physician may deliver the aid-in-dying drug in any of the following ways:(1)Dispensing the aid-in-dying drug directly, including ancillary medication intended to minimize the qualified individuals discomfort, if the attending physician meets all of the following criteria:(A)Is authorized to dispense medicine under California law.(B)Has a current United States Drug Enforcement Administration (USDEA) certificate.(C)Complies with any applicable administrative rule or regulation.(2)With the qualified individuals written consent, contacting a pharmacist, informing the pharmacist of the prescriptions, and delivering the written prescriptions personally, by mail, or electronically to the pharmacist, who may dispense the drug to the qualified individual, the attending physician, or a person expressly designated by the qualified individual and with the designation delivered to the pharmacist in writing or verbally.(c)Delivery of the dispensed drug to the qualified individual, the attending physician, or a person expressly designated by the qualified individual may be made by personal delivery, or, with a signature required on delivery, by United Parcel Service, United States Postal Service, Federal Express, or by messenger service.(d)An attending physician shall not be precluded from prescribing an aid-in-dying drug pursuant to this part under circumstances in which the qualified individual chooses not to provide an answer to the question asked pursuant to paragraph (9) of subdivision (a).SEC. 2.SECTION 1. Section 443.19 of the Health and Safety Code is amended to read:443.19. (a) The State Department of Public Health shall collect and review the information submitted pursuant to Section 443.9. The information collected shall be confidential and shall be collected in a manner that protects the privacy of the patient, the patients family, and any medical provider or pharmacist involved with the patient under the provisions of this part. The information shall not be disclosed, discoverable, or compelled to be produced in any civil, criminal, administrative, or other proceeding.(b) On or before July 1, 2017, and each year thereafter, based on the information collected in the previous year, the department shall create a report with the information collected from the attending physician followup form and post that report to its Internet Web site. The report shall include, but not be limited to, all of the following information:(1) The number of people for whom an aid-in-dying prescription was written.(2) The number of known individuals who died each year for whom aid-in-dying prescriptions were written, and the cause of death of those individuals.(3) For the period commencing January 1, 2016, to and including the previous year, cumulatively, the total number of aid-in-dying prescriptions written, the number of people who died due to use of aid-in-dying drugs, and the number of those people who died who were enrolled in hospice or other palliative care programs at the time of death.(4) The number of known deaths in California from using aid-in-dying drugs per 10,000 deaths in California.(5) The number of physicians who wrote prescriptions for aid-in-dying drugs, and the specialty or specialties of each physician. drugs and the areas of practice of each physician.(6) Of people who died due to using an aid-in-dying drug, demographic percentages organized by the following characteristics:(A) Age at death.(B) Education level.(C) Race.(D) Sex.(E) Type of insurance, including whether or not they had insurance.(F) Underlying illness.(7) The motivating reason or reasons behind a patients decision to request the aid-in-dying drug pursuant to paragraph (9) of subdivision (a) of Section 443.5. the responses given to question 15 of the attending physician followup form described in Section 443.22.(8) The number of patients who received a mental health specialist assessment prior to receiving the aid-in-dying drug.(9)The length of time the attending physician has provided care to the patient prior to prescribing the aid-in-dying drug.(c) The State Department of Public Health shall make available the attending physician checklist and compliance form, the consulting physician compliance form, and the attending physician followup form, as described in Section 443.22, by posting them on its Internet Web site.SEC. 3.SEC. 2. Section 443.22 of the Health and Safety Code is amended to read:443.22. (a) (1) The Medical Board of California may update the attending physician checklist and compliance form, the consulting physician compliance form, and the attending physician followup form, based on those provided in subdivision (b). Upon completion, the State Department of Public Health shall publish the updated forms on its Internet Web site.(2) The Medical Board of California shall make changes to the forms referenced in paragraph (1) as necessary so the forms capture the information needed to fulfill the reporting requirement in subdivision (b) of Section 443.19.(b) Unless and until updated by the Medical Board of California pursuant to this section, the attending physician checklist and compliance form, the consulting physician compliance form, and the attending physician followup form shall be in the following form:PRINTER PLEASE NOTE: TIP-IN MATERIAL TO BE INSERTED
36+The people of the State of California do enact as follows:SECTION 1. Section 443.5 of the Health and Safety Code is amended to read:443.5. (a) Before prescribing an aid-in-dying drug, the attending physician shall do all of the following:(1) Make the initial determination of all of the following:(A) (i) Whether the requesting adult has the capacity to make medical decisions.(ii) If there are indications of a mental disorder, the physician shall refer the individual for a mental health specialist assessment.(iii) If a mental health specialist assessment referral is made, no aid-in-dying drugs shall be prescribed until the mental health specialist determines that the individual has the capacity to make medical decisions and is not suffering from impaired judgment due to a mental disorder.(B) Whether the requesting adult has a terminal disease.(C) Whether the requesting adult has voluntarily made the request for an aid-in-dying drug pursuant to Sections 443.2 and 443.3.(D) Whether the requesting adult is a qualified individual pursuant to subdivision (o) of Section 443.1.(2) Confirm that the individual is making an informed decision by discussing with him or her all of the following:(A) His or her medical diagnosis and prognosis.(B) The potential risks associated with ingesting the requested aid-in-dying drug.(C) The probable result of ingesting the aid-in-dying drug.(D) The possibility that he or she may choose to obtain the aid-in-dying drug but not take it.(E) The feasible alternatives or additional treatment options, including, but not limited to, comfort care, hospice care, palliative care, and pain control.(3) Refer the individual to a consulting physician for medical confirmation of the diagnosis and prognosis, and for a determination that the individual has the capacity to make medical decisions and has complied with the provisions of this part.(4) Confirm that the qualified individuals request does not arise from coercion or undue influence by another person by discussing with the qualified individual, outside of the presence of any other persons, except for an interpreter as required pursuant to this part, whether or not the qualified individual is feeling coerced or unduly influenced by another person.(5) Counsel the qualified individual about the importance of all of the following:(A) Having another person present when he or she ingests the aid-in-dying drug prescribed pursuant to this part.(B) Not ingesting the aid-in-dying drug in a public place.(C) Notifying the next of kin of his or her request for an aid-in-dying drug. A qualified individual who declines or is unable to notify next of kin shall not have his or her request denied for that reason.(D) Participating in a hospice program.(E) Maintaining the aid-in-dying drug in a safe and secure location until the time that the qualified individual will ingest it.(6) Inform the individual that he or she may withdraw or rescind the request for an aid-in-dying drug at any time and in any manner.(7) Offer the individual an opportunity to withdraw or rescind the request for an aid-in-dying drug before prescribing the aid-in-dying drug.(8) Verify, immediately before writing the prescription for an aid-in-dying drug, that the qualified individual is making an informed decision.(9) For purposes of paragraph (7) of subdivision (b) of Section 443.19, request that the qualified individual inform the physician orally or in writing as to the motivating reason or reasons behind the individuals decision to request the aid-in-dying drug. The question used to gather this information shall allow for the selection of multiple choices pursuant to, at a minimum, the following possible choices:(A) Pain or the fear of pain.(B) Concern about being a burden to others.(C) Loss of autonomy.(D) Sense of hopelessness.(9)(10) Confirm that all requirements are met and all appropriate steps are carried out in accordance with this part before writing a prescription for an aid-in-dying drug.(10)(11) Fulfill the record documentation required under Sections 443.8 and 443.19.(11)(12) Complete the attending physician checklist and compliance form, as described in Section 443.22, include it and the consulting physician compliance form in the individuals medical record, and submit both forms to the State Department of Public Health.(12)(13) Give the qualified individual the final attestation form, with the instruction that the form be filled out and executed by the qualified individual within 48 hours prior to the qualified individual choosing to self-administer the aid-in-dying drug.(b) If the conditions set forth in subdivision (a) are satisfied, the attending physician may deliver the aid-in-dying drug in any of the following ways:(1) Dispensing the aid-in-dying drug directly, including ancillary medication intended to minimize the qualified individuals discomfort, if the attending physician meets all of the following criteria:(A) Is authorized to dispense medicine under California law.(B) Has a current United States Drug Enforcement Administration (USDEA) certificate.(C) Complies with any applicable administrative rule or regulation.(2) With the qualified individuals written consent, contacting a pharmacist, informing the pharmacist of the prescriptions, and delivering the written prescriptions personally, by mail, or electronically to the pharmacist, who may dispense the drug to the qualified individual, the attending physician, or a person expressly designated by the qualified individual and with the designation delivered to the pharmacist in writing or verbally.(c) Delivery of the dispensed drug to the qualified individual, the attending physician, or a person expressly designated by the qualified individual may be made by personal delivery, or, with a signature required on delivery, by United Parcel Service, United States Postal Service, Federal Express, or by messenger service.(d) An attending physician shall not be precluded from prescribing an aid-in-dying drug pursuant to this part under circumstances in which the qualified individual chooses not to provide an answer to the question asked pursuant to paragraph (9) of subdivision (a).SEC. 2. Section 443.19 of the Health and Safety Code is amended to read:443.19. (a) The State Department of Public Health shall collect and review the information submitted pursuant to Section 443.9. The information collected shall be confidential and shall be collected in a manner that protects the privacy of the patient, the patients family, and any medical provider or pharmacist involved with the patient under the provisions of this part. The information shall not be disclosed, discoverable, or compelled to be produced in any civil, criminal, administrative, or other proceeding.(b) On or before July 1, 2017, and each year thereafter, based on the information collected in the previous year, the department shall create a report with the information collected from the attending physician followup form and post that report to its Internet Web site. The report shall include, but not be limited to, all of the following based on the information that is provided to the department and on the departments access to vital statistics: following information:(1) The number of people for whom an aid-in-dying prescription was written.(2) The number of known individuals who died each year for whom aid-in-dying prescriptions were written, and the cause of death of those individuals.(3) For the period commencing January 1, 2016, to and including the previous year, cumulatively, the total number of aid-in-dying prescriptions written, the number of people who died due to use of aid-in-dying drugs, and the number of those people who died who were enrolled in hospice or other palliative care programs at the time of death.(4) The number of known deaths in California from using aid-in-dying drugs per 10,000 deaths in California.(5) The number of physicians who wrote prescriptions for aid-in-dying drugs. drugs, and the specialty or specialties of each physician.(6) Of people who died due to using an aid-in-dying drug, demographic percentages organized by the following characteristics:(A) Age at death.(B) Education level.(C) Race.(D) Sex.(E) Type of insurance, including whether or not they had insurance.(F) Underlying illness.(7) The motivating reason or reasons behind a patients decision to request the aid-in-dying drug pursuant to paragraph (9) of subdivision (a) of Section 443.5.(8) The number of patients who received a mental health specialist assessment prior to receiving the aid-in-dying drug.(9) The length of time the attending physician has provided care to the patient prior to prescribing the aid-in-dying drug.(c) The State Department of Public Health shall make available the attending physician checklist and compliance form, the consulting physician compliance form, and the attending physician followup form, as described in Section 443.22, by posting them on its Internet Web site.SEC. 3. Section 443.22 of the Health and Safety Code is amended to read:443.22. (a) (1) The Medical Board of California may update the attending physician checklist and compliance form, the consulting physician compliance form, and the attending physician followup form, based on those provided in subdivision (b). Upon completion, the State Department of Public Health shall publish the updated forms on its Internet Web site.(2) The Medical Board of California shall make changes to the forms referenced in paragraph (1) as necessary so the forms capture the information needed to fulfill the reporting requirement in subdivision (b) of Section 443.19.(b) Unless and until updated by the Medical Board of California pursuant to this section, the attending physician checklist and compliance form, the consulting physician compliance form, and the attending physician followup form shall be in the following form:
3737
3838 The people of the State of California do enact as follows:
3939
4040 ## The people of the State of California do enact as follows:
4141
42+SECTION 1. Section 443.5 of the Health and Safety Code is amended to read:443.5. (a) Before prescribing an aid-in-dying drug, the attending physician shall do all of the following:(1) Make the initial determination of all of the following:(A) (i) Whether the requesting adult has the capacity to make medical decisions.(ii) If there are indications of a mental disorder, the physician shall refer the individual for a mental health specialist assessment.(iii) If a mental health specialist assessment referral is made, no aid-in-dying drugs shall be prescribed until the mental health specialist determines that the individual has the capacity to make medical decisions and is not suffering from impaired judgment due to a mental disorder.(B) Whether the requesting adult has a terminal disease.(C) Whether the requesting adult has voluntarily made the request for an aid-in-dying drug pursuant to Sections 443.2 and 443.3.(D) Whether the requesting adult is a qualified individual pursuant to subdivision (o) of Section 443.1.(2) Confirm that the individual is making an informed decision by discussing with him or her all of the following:(A) His or her medical diagnosis and prognosis.(B) The potential risks associated with ingesting the requested aid-in-dying drug.(C) The probable result of ingesting the aid-in-dying drug.(D) The possibility that he or she may choose to obtain the aid-in-dying drug but not take it.(E) The feasible alternatives or additional treatment options, including, but not limited to, comfort care, hospice care, palliative care, and pain control.(3) Refer the individual to a consulting physician for medical confirmation of the diagnosis and prognosis, and for a determination that the individual has the capacity to make medical decisions and has complied with the provisions of this part.(4) Confirm that the qualified individuals request does not arise from coercion or undue influence by another person by discussing with the qualified individual, outside of the presence of any other persons, except for an interpreter as required pursuant to this part, whether or not the qualified individual is feeling coerced or unduly influenced by another person.(5) Counsel the qualified individual about the importance of all of the following:(A) Having another person present when he or she ingests the aid-in-dying drug prescribed pursuant to this part.(B) Not ingesting the aid-in-dying drug in a public place.(C) Notifying the next of kin of his or her request for an aid-in-dying drug. A qualified individual who declines or is unable to notify next of kin shall not have his or her request denied for that reason.(D) Participating in a hospice program.(E) Maintaining the aid-in-dying drug in a safe and secure location until the time that the qualified individual will ingest it.(6) Inform the individual that he or she may withdraw or rescind the request for an aid-in-dying drug at any time and in any manner.(7) Offer the individual an opportunity to withdraw or rescind the request for an aid-in-dying drug before prescribing the aid-in-dying drug.(8) Verify, immediately before writing the prescription for an aid-in-dying drug, that the qualified individual is making an informed decision.(9) For purposes of paragraph (7) of subdivision (b) of Section 443.19, request that the qualified individual inform the physician orally or in writing as to the motivating reason or reasons behind the individuals decision to request the aid-in-dying drug. The question used to gather this information shall allow for the selection of multiple choices pursuant to, at a minimum, the following possible choices:(A) Pain or the fear of pain.(B) Concern about being a burden to others.(C) Loss of autonomy.(D) Sense of hopelessness.(9)(10) Confirm that all requirements are met and all appropriate steps are carried out in accordance with this part before writing a prescription for an aid-in-dying drug.(10)(11) Fulfill the record documentation required under Sections 443.8 and 443.19.(11)(12) Complete the attending physician checklist and compliance form, as described in Section 443.22, include it and the consulting physician compliance form in the individuals medical record, and submit both forms to the State Department of Public Health.(12)(13) Give the qualified individual the final attestation form, with the instruction that the form be filled out and executed by the qualified individual within 48 hours prior to the qualified individual choosing to self-administer the aid-in-dying drug.(b) If the conditions set forth in subdivision (a) are satisfied, the attending physician may deliver the aid-in-dying drug in any of the following ways:(1) Dispensing the aid-in-dying drug directly, including ancillary medication intended to minimize the qualified individuals discomfort, if the attending physician meets all of the following criteria:(A) Is authorized to dispense medicine under California law.(B) Has a current United States Drug Enforcement Administration (USDEA) certificate.(C) Complies with any applicable administrative rule or regulation.(2) With the qualified individuals written consent, contacting a pharmacist, informing the pharmacist of the prescriptions, and delivering the written prescriptions personally, by mail, or electronically to the pharmacist, who may dispense the drug to the qualified individual, the attending physician, or a person expressly designated by the qualified individual and with the designation delivered to the pharmacist in writing or verbally.(c) Delivery of the dispensed drug to the qualified individual, the attending physician, or a person expressly designated by the qualified individual may be made by personal delivery, or, with a signature required on delivery, by United Parcel Service, United States Postal Service, Federal Express, or by messenger service.(d) An attending physician shall not be precluded from prescribing an aid-in-dying drug pursuant to this part under circumstances in which the qualified individual chooses not to provide an answer to the question asked pursuant to paragraph (9) of subdivision (a).
43+
44+SECTION 1. Section 443.5 of the Health and Safety Code is amended to read:
45+
46+### SECTION 1.
47+
48+443.5. (a) Before prescribing an aid-in-dying drug, the attending physician shall do all of the following:(1) Make the initial determination of all of the following:(A) (i) Whether the requesting adult has the capacity to make medical decisions.(ii) If there are indications of a mental disorder, the physician shall refer the individual for a mental health specialist assessment.(iii) If a mental health specialist assessment referral is made, no aid-in-dying drugs shall be prescribed until the mental health specialist determines that the individual has the capacity to make medical decisions and is not suffering from impaired judgment due to a mental disorder.(B) Whether the requesting adult has a terminal disease.(C) Whether the requesting adult has voluntarily made the request for an aid-in-dying drug pursuant to Sections 443.2 and 443.3.(D) Whether the requesting adult is a qualified individual pursuant to subdivision (o) of Section 443.1.(2) Confirm that the individual is making an informed decision by discussing with him or her all of the following:(A) His or her medical diagnosis and prognosis.(B) The potential risks associated with ingesting the requested aid-in-dying drug.(C) The probable result of ingesting the aid-in-dying drug.(D) The possibility that he or she may choose to obtain the aid-in-dying drug but not take it.(E) The feasible alternatives or additional treatment options, including, but not limited to, comfort care, hospice care, palliative care, and pain control.(3) Refer the individual to a consulting physician for medical confirmation of the diagnosis and prognosis, and for a determination that the individual has the capacity to make medical decisions and has complied with the provisions of this part.(4) Confirm that the qualified individuals request does not arise from coercion or undue influence by another person by discussing with the qualified individual, outside of the presence of any other persons, except for an interpreter as required pursuant to this part, whether or not the qualified individual is feeling coerced or unduly influenced by another person.(5) Counsel the qualified individual about the importance of all of the following:(A) Having another person present when he or she ingests the aid-in-dying drug prescribed pursuant to this part.(B) Not ingesting the aid-in-dying drug in a public place.(C) Notifying the next of kin of his or her request for an aid-in-dying drug. A qualified individual who declines or is unable to notify next of kin shall not have his or her request denied for that reason.(D) Participating in a hospice program.(E) Maintaining the aid-in-dying drug in a safe and secure location until the time that the qualified individual will ingest it.(6) Inform the individual that he or she may withdraw or rescind the request for an aid-in-dying drug at any time and in any manner.(7) Offer the individual an opportunity to withdraw or rescind the request for an aid-in-dying drug before prescribing the aid-in-dying drug.(8) Verify, immediately before writing the prescription for an aid-in-dying drug, that the qualified individual is making an informed decision.(9) For purposes of paragraph (7) of subdivision (b) of Section 443.19, request that the qualified individual inform the physician orally or in writing as to the motivating reason or reasons behind the individuals decision to request the aid-in-dying drug. The question used to gather this information shall allow for the selection of multiple choices pursuant to, at a minimum, the following possible choices:(A) Pain or the fear of pain.(B) Concern about being a burden to others.(C) Loss of autonomy.(D) Sense of hopelessness.(9)(10) Confirm that all requirements are met and all appropriate steps are carried out in accordance with this part before writing a prescription for an aid-in-dying drug.(10)(11) Fulfill the record documentation required under Sections 443.8 and 443.19.(11)(12) Complete the attending physician checklist and compliance form, as described in Section 443.22, include it and the consulting physician compliance form in the individuals medical record, and submit both forms to the State Department of Public Health.(12)(13) Give the qualified individual the final attestation form, with the instruction that the form be filled out and executed by the qualified individual within 48 hours prior to the qualified individual choosing to self-administer the aid-in-dying drug.(b) If the conditions set forth in subdivision (a) are satisfied, the attending physician may deliver the aid-in-dying drug in any of the following ways:(1) Dispensing the aid-in-dying drug directly, including ancillary medication intended to minimize the qualified individuals discomfort, if the attending physician meets all of the following criteria:(A) Is authorized to dispense medicine under California law.(B) Has a current United States Drug Enforcement Administration (USDEA) certificate.(C) Complies with any applicable administrative rule or regulation.(2) With the qualified individuals written consent, contacting a pharmacist, informing the pharmacist of the prescriptions, and delivering the written prescriptions personally, by mail, or electronically to the pharmacist, who may dispense the drug to the qualified individual, the attending physician, or a person expressly designated by the qualified individual and with the designation delivered to the pharmacist in writing or verbally.(c) Delivery of the dispensed drug to the qualified individual, the attending physician, or a person expressly designated by the qualified individual may be made by personal delivery, or, with a signature required on delivery, by United Parcel Service, United States Postal Service, Federal Express, or by messenger service.(d) An attending physician shall not be precluded from prescribing an aid-in-dying drug pursuant to this part under circumstances in which the qualified individual chooses not to provide an answer to the question asked pursuant to paragraph (9) of subdivision (a).
49+
50+443.5. (a) Before prescribing an aid-in-dying drug, the attending physician shall do all of the following:(1) Make the initial determination of all of the following:(A) (i) Whether the requesting adult has the capacity to make medical decisions.(ii) If there are indications of a mental disorder, the physician shall refer the individual for a mental health specialist assessment.(iii) If a mental health specialist assessment referral is made, no aid-in-dying drugs shall be prescribed until the mental health specialist determines that the individual has the capacity to make medical decisions and is not suffering from impaired judgment due to a mental disorder.(B) Whether the requesting adult has a terminal disease.(C) Whether the requesting adult has voluntarily made the request for an aid-in-dying drug pursuant to Sections 443.2 and 443.3.(D) Whether the requesting adult is a qualified individual pursuant to subdivision (o) of Section 443.1.(2) Confirm that the individual is making an informed decision by discussing with him or her all of the following:(A) His or her medical diagnosis and prognosis.(B) The potential risks associated with ingesting the requested aid-in-dying drug.(C) The probable result of ingesting the aid-in-dying drug.(D) The possibility that he or she may choose to obtain the aid-in-dying drug but not take it.(E) The feasible alternatives or additional treatment options, including, but not limited to, comfort care, hospice care, palliative care, and pain control.(3) Refer the individual to a consulting physician for medical confirmation of the diagnosis and prognosis, and for a determination that the individual has the capacity to make medical decisions and has complied with the provisions of this part.(4) Confirm that the qualified individuals request does not arise from coercion or undue influence by another person by discussing with the qualified individual, outside of the presence of any other persons, except for an interpreter as required pursuant to this part, whether or not the qualified individual is feeling coerced or unduly influenced by another person.(5) Counsel the qualified individual about the importance of all of the following:(A) Having another person present when he or she ingests the aid-in-dying drug prescribed pursuant to this part.(B) Not ingesting the aid-in-dying drug in a public place.(C) Notifying the next of kin of his or her request for an aid-in-dying drug. A qualified individual who declines or is unable to notify next of kin shall not have his or her request denied for that reason.(D) Participating in a hospice program.(E) Maintaining the aid-in-dying drug in a safe and secure location until the time that the qualified individual will ingest it.(6) Inform the individual that he or she may withdraw or rescind the request for an aid-in-dying drug at any time and in any manner.(7) Offer the individual an opportunity to withdraw or rescind the request for an aid-in-dying drug before prescribing the aid-in-dying drug.(8) Verify, immediately before writing the prescription for an aid-in-dying drug, that the qualified individual is making an informed decision.(9) For purposes of paragraph (7) of subdivision (b) of Section 443.19, request that the qualified individual inform the physician orally or in writing as to the motivating reason or reasons behind the individuals decision to request the aid-in-dying drug. The question used to gather this information shall allow for the selection of multiple choices pursuant to, at a minimum, the following possible choices:(A) Pain or the fear of pain.(B) Concern about being a burden to others.(C) Loss of autonomy.(D) Sense of hopelessness.(9)(10) Confirm that all requirements are met and all appropriate steps are carried out in accordance with this part before writing a prescription for an aid-in-dying drug.(10)(11) Fulfill the record documentation required under Sections 443.8 and 443.19.(11)(12) Complete the attending physician checklist and compliance form, as described in Section 443.22, include it and the consulting physician compliance form in the individuals medical record, and submit both forms to the State Department of Public Health.(12)(13) Give the qualified individual the final attestation form, with the instruction that the form be filled out and executed by the qualified individual within 48 hours prior to the qualified individual choosing to self-administer the aid-in-dying drug.(b) If the conditions set forth in subdivision (a) are satisfied, the attending physician may deliver the aid-in-dying drug in any of the following ways:(1) Dispensing the aid-in-dying drug directly, including ancillary medication intended to minimize the qualified individuals discomfort, if the attending physician meets all of the following criteria:(A) Is authorized to dispense medicine under California law.(B) Has a current United States Drug Enforcement Administration (USDEA) certificate.(C) Complies with any applicable administrative rule or regulation.(2) With the qualified individuals written consent, contacting a pharmacist, informing the pharmacist of the prescriptions, and delivering the written prescriptions personally, by mail, or electronically to the pharmacist, who may dispense the drug to the qualified individual, the attending physician, or a person expressly designated by the qualified individual and with the designation delivered to the pharmacist in writing or verbally.(c) Delivery of the dispensed drug to the qualified individual, the attending physician, or a person expressly designated by the qualified individual may be made by personal delivery, or, with a signature required on delivery, by United Parcel Service, United States Postal Service, Federal Express, or by messenger service.(d) An attending physician shall not be precluded from prescribing an aid-in-dying drug pursuant to this part under circumstances in which the qualified individual chooses not to provide an answer to the question asked pursuant to paragraph (9) of subdivision (a).
51+
52+443.5. (a) Before prescribing an aid-in-dying drug, the attending physician shall do all of the following:(1) Make the initial determination of all of the following:(A) (i) Whether the requesting adult has the capacity to make medical decisions.(ii) If there are indications of a mental disorder, the physician shall refer the individual for a mental health specialist assessment.(iii) If a mental health specialist assessment referral is made, no aid-in-dying drugs shall be prescribed until the mental health specialist determines that the individual has the capacity to make medical decisions and is not suffering from impaired judgment due to a mental disorder.(B) Whether the requesting adult has a terminal disease.(C) Whether the requesting adult has voluntarily made the request for an aid-in-dying drug pursuant to Sections 443.2 and 443.3.(D) Whether the requesting adult is a qualified individual pursuant to subdivision (o) of Section 443.1.(2) Confirm that the individual is making an informed decision by discussing with him or her all of the following:(A) His or her medical diagnosis and prognosis.(B) The potential risks associated with ingesting the requested aid-in-dying drug.(C) The probable result of ingesting the aid-in-dying drug.(D) The possibility that he or she may choose to obtain the aid-in-dying drug but not take it.(E) The feasible alternatives or additional treatment options, including, but not limited to, comfort care, hospice care, palliative care, and pain control.(3) Refer the individual to a consulting physician for medical confirmation of the diagnosis and prognosis, and for a determination that the individual has the capacity to make medical decisions and has complied with the provisions of this part.(4) Confirm that the qualified individuals request does not arise from coercion or undue influence by another person by discussing with the qualified individual, outside of the presence of any other persons, except for an interpreter as required pursuant to this part, whether or not the qualified individual is feeling coerced or unduly influenced by another person.(5) Counsel the qualified individual about the importance of all of the following:(A) Having another person present when he or she ingests the aid-in-dying drug prescribed pursuant to this part.(B) Not ingesting the aid-in-dying drug in a public place.(C) Notifying the next of kin of his or her request for an aid-in-dying drug. A qualified individual who declines or is unable to notify next of kin shall not have his or her request denied for that reason.(D) Participating in a hospice program.(E) Maintaining the aid-in-dying drug in a safe and secure location until the time that the qualified individual will ingest it.(6) Inform the individual that he or she may withdraw or rescind the request for an aid-in-dying drug at any time and in any manner.(7) Offer the individual an opportunity to withdraw or rescind the request for an aid-in-dying drug before prescribing the aid-in-dying drug.(8) Verify, immediately before writing the prescription for an aid-in-dying drug, that the qualified individual is making an informed decision.(9) For purposes of paragraph (7) of subdivision (b) of Section 443.19, request that the qualified individual inform the physician orally or in writing as to the motivating reason or reasons behind the individuals decision to request the aid-in-dying drug. The question used to gather this information shall allow for the selection of multiple choices pursuant to, at a minimum, the following possible choices:(A) Pain or the fear of pain.(B) Concern about being a burden to others.(C) Loss of autonomy.(D) Sense of hopelessness.(9)(10) Confirm that all requirements are met and all appropriate steps are carried out in accordance with this part before writing a prescription for an aid-in-dying drug.(10)(11) Fulfill the record documentation required under Sections 443.8 and 443.19.(11)(12) Complete the attending physician checklist and compliance form, as described in Section 443.22, include it and the consulting physician compliance form in the individuals medical record, and submit both forms to the State Department of Public Health.(12)(13) Give the qualified individual the final attestation form, with the instruction that the form be filled out and executed by the qualified individual within 48 hours prior to the qualified individual choosing to self-administer the aid-in-dying drug.(b) If the conditions set forth in subdivision (a) are satisfied, the attending physician may deliver the aid-in-dying drug in any of the following ways:(1) Dispensing the aid-in-dying drug directly, including ancillary medication intended to minimize the qualified individuals discomfort, if the attending physician meets all of the following criteria:(A) Is authorized to dispense medicine under California law.(B) Has a current United States Drug Enforcement Administration (USDEA) certificate.(C) Complies with any applicable administrative rule or regulation.(2) With the qualified individuals written consent, contacting a pharmacist, informing the pharmacist of the prescriptions, and delivering the written prescriptions personally, by mail, or electronically to the pharmacist, who may dispense the drug to the qualified individual, the attending physician, or a person expressly designated by the qualified individual and with the designation delivered to the pharmacist in writing or verbally.(c) Delivery of the dispensed drug to the qualified individual, the attending physician, or a person expressly designated by the qualified individual may be made by personal delivery, or, with a signature required on delivery, by United Parcel Service, United States Postal Service, Federal Express, or by messenger service.(d) An attending physician shall not be precluded from prescribing an aid-in-dying drug pursuant to this part under circumstances in which the qualified individual chooses not to provide an answer to the question asked pursuant to paragraph (9) of subdivision (a).
4253
4354
4455
45-
46-(a)Before prescribing an aid-in-dying drug, the attending physician shall do all of the following:
47-
48-
56+443.5. (a) Before prescribing an aid-in-dying drug, the attending physician shall do all of the following:
4957
5058 (1) Make the initial determination of all of the following:
5159
52-
53-
5460 (A) (i) Whether the requesting adult has the capacity to make medical decisions.
55-
56-
5761
5862 (ii) If there are indications of a mental disorder, the physician shall refer the individual for a mental health specialist assessment.
5963
60-
61-
6264 (iii) If a mental health specialist assessment referral is made, no aid-in-dying drugs shall be prescribed until the mental health specialist determines that the individual has the capacity to make medical decisions and is not suffering from impaired judgment due to a mental disorder.
63-
64-
6565
6666 (B) Whether the requesting adult has a terminal disease.
6767
68-
69-
7068 (C) Whether the requesting adult has voluntarily made the request for an aid-in-dying drug pursuant to Sections 443.2 and 443.3.
71-
72-
7369
7470 (D) Whether the requesting adult is a qualified individual pursuant to subdivision (o) of Section 443.1.
7571
76-
77-
7872 (2) Confirm that the individual is making an informed decision by discussing with him or her all of the following:
79-
80-
8173
8274 (A) His or her medical diagnosis and prognosis.
8375
84-
85-
8676 (B) The potential risks associated with ingesting the requested aid-in-dying drug.
87-
88-
8977
9078 (C) The probable result of ingesting the aid-in-dying drug.
9179
92-
93-
9480 (D) The possibility that he or she may choose to obtain the aid-in-dying drug but not take it.
95-
96-
9781
9882 (E) The feasible alternatives or additional treatment options, including, but not limited to, comfort care, hospice care, palliative care, and pain control.
9983
100-
101-
10284 (3) Refer the individual to a consulting physician for medical confirmation of the diagnosis and prognosis, and for a determination that the individual has the capacity to make medical decisions and has complied with the provisions of this part.
103-
104-
10585
10686 (4) Confirm that the qualified individuals request does not arise from coercion or undue influence by another person by discussing with the qualified individual, outside of the presence of any other persons, except for an interpreter as required pursuant to this part, whether or not the qualified individual is feeling coerced or unduly influenced by another person.
10787
108-
109-
11088 (5) Counsel the qualified individual about the importance of all of the following:
111-
112-
11389
11490 (A) Having another person present when he or she ingests the aid-in-dying drug prescribed pursuant to this part.
11591
116-
117-
11892 (B) Not ingesting the aid-in-dying drug in a public place.
119-
120-
12193
12294 (C) Notifying the next of kin of his or her request for an aid-in-dying drug. A qualified individual who declines or is unable to notify next of kin shall not have his or her request denied for that reason.
12395
124-
125-
12696 (D) Participating in a hospice program.
127-
128-
12997
13098 (E) Maintaining the aid-in-dying drug in a safe and secure location until the time that the qualified individual will ingest it.
13199
132-
133-
134100 (6) Inform the individual that he or she may withdraw or rescind the request for an aid-in-dying drug at any time and in any manner.
135-
136-
137101
138102 (7) Offer the individual an opportunity to withdraw or rescind the request for an aid-in-dying drug before prescribing the aid-in-dying drug.
139103
140-
141-
142104 (8) Verify, immediately before writing the prescription for an aid-in-dying drug, that the qualified individual is making an informed decision.
143-
144-
145105
146106 (9) For purposes of paragraph (7) of subdivision (b) of Section 443.19, request that the qualified individual inform the physician orally or in writing as to the motivating reason or reasons behind the individuals decision to request the aid-in-dying drug. The question used to gather this information shall allow for the selection of multiple choices pursuant to, at a minimum, the following possible choices:
147107
148-
149-
150108 (A) Pain or the fear of pain.
151-
152-
153109
154110 (B) Concern about being a burden to others.
155111
156-
157-
158112 (C) Loss of autonomy.
159113
114+(D) Sense of hopelessness.
160115
161-
162-(D)Sense of hopelessness.
116+(9)
163117
164118
165119
166120 (10) Confirm that all requirements are met and all appropriate steps are carried out in accordance with this part before writing a prescription for an aid-in-dying drug.
167121
122+(10)
123+
168124
169125
170126 (11) Fulfill the record documentation required under Sections 443.8 and 443.19.
127+
128+(11)
171129
172130
173131
174132 (12) Complete the attending physician checklist and compliance form, as described in Section 443.22, include it and the consulting physician compliance form in the individuals medical record, and submit both forms to the State Department of Public Health.
175133
134+(12)
135+
176136
177137
178138 (13) Give the qualified individual the final attestation form, with the instruction that the form be filled out and executed by the qualified individual within 48 hours prior to the qualified individual choosing to self-administer the aid-in-dying drug.
179139
180-
181-
182140 (b) If the conditions set forth in subdivision (a) are satisfied, the attending physician may deliver the aid-in-dying drug in any of the following ways:
183-
184-
185141
186142 (1) Dispensing the aid-in-dying drug directly, including ancillary medication intended to minimize the qualified individuals discomfort, if the attending physician meets all of the following criteria:
187143
188-
189-
190144 (A) Is authorized to dispense medicine under California law.
191-
192-
193145
194146 (B) Has a current United States Drug Enforcement Administration (USDEA) certificate.
195147
196-
197-
198148 (C) Complies with any applicable administrative rule or regulation.
199-
200-
201149
202150 (2) With the qualified individuals written consent, contacting a pharmacist, informing the pharmacist of the prescriptions, and delivering the written prescriptions personally, by mail, or electronically to the pharmacist, who may dispense the drug to the qualified individual, the attending physician, or a person expressly designated by the qualified individual and with the designation delivered to the pharmacist in writing or verbally.
203151
204-
205-
206152 (c) Delivery of the dispensed drug to the qualified individual, the attending physician, or a person expressly designated by the qualified individual may be made by personal delivery, or, with a signature required on delivery, by United Parcel Service, United States Postal Service, Federal Express, or by messenger service.
207-
208-
209153
210154 (d) An attending physician shall not be precluded from prescribing an aid-in-dying drug pursuant to this part under circumstances in which the qualified individual chooses not to provide an answer to the question asked pursuant to paragraph (9) of subdivision (a).
211155
156+SEC. 2. Section 443.19 of the Health and Safety Code is amended to read:443.19. (a) The State Department of Public Health shall collect and review the information submitted pursuant to Section 443.9. The information collected shall be confidential and shall be collected in a manner that protects the privacy of the patient, the patients family, and any medical provider or pharmacist involved with the patient under the provisions of this part. The information shall not be disclosed, discoverable, or compelled to be produced in any civil, criminal, administrative, or other proceeding.(b) On or before July 1, 2017, and each year thereafter, based on the information collected in the previous year, the department shall create a report with the information collected from the attending physician followup form and post that report to its Internet Web site. The report shall include, but not be limited to, all of the following based on the information that is provided to the department and on the departments access to vital statistics: following information:(1) The number of people for whom an aid-in-dying prescription was written.(2) The number of known individuals who died each year for whom aid-in-dying prescriptions were written, and the cause of death of those individuals.(3) For the period commencing January 1, 2016, to and including the previous year, cumulatively, the total number of aid-in-dying prescriptions written, the number of people who died due to use of aid-in-dying drugs, and the number of those people who died who were enrolled in hospice or other palliative care programs at the time of death.(4) The number of known deaths in California from using aid-in-dying drugs per 10,000 deaths in California.(5) The number of physicians who wrote prescriptions for aid-in-dying drugs. drugs, and the specialty or specialties of each physician.(6) Of people who died due to using an aid-in-dying drug, demographic percentages organized by the following characteristics:(A) Age at death.(B) Education level.(C) Race.(D) Sex.(E) Type of insurance, including whether or not they had insurance.(F) Underlying illness.(7) The motivating reason or reasons behind a patients decision to request the aid-in-dying drug pursuant to paragraph (9) of subdivision (a) of Section 443.5.(8) The number of patients who received a mental health specialist assessment prior to receiving the aid-in-dying drug.(9) The length of time the attending physician has provided care to the patient prior to prescribing the aid-in-dying drug.(c) The State Department of Public Health shall make available the attending physician checklist and compliance form, the consulting physician compliance form, and the attending physician followup form, as described in Section 443.22, by posting them on its Internet Web site.
212157
158+SEC. 2. Section 443.19 of the Health and Safety Code is amended to read:
213159
214-SEC. 2.SECTION 1. Section 443.19 of the Health and Safety Code is amended to read:443.19. (a) The State Department of Public Health shall collect and review the information submitted pursuant to Section 443.9. The information collected shall be confidential and shall be collected in a manner that protects the privacy of the patient, the patients family, and any medical provider or pharmacist involved with the patient under the provisions of this part. The information shall not be disclosed, discoverable, or compelled to be produced in any civil, criminal, administrative, or other proceeding.(b) On or before July 1, 2017, and each year thereafter, based on the information collected in the previous year, the department shall create a report with the information collected from the attending physician followup form and post that report to its Internet Web site. The report shall include, but not be limited to, all of the following information:(1) The number of people for whom an aid-in-dying prescription was written.(2) The number of known individuals who died each year for whom aid-in-dying prescriptions were written, and the cause of death of those individuals.(3) For the period commencing January 1, 2016, to and including the previous year, cumulatively, the total number of aid-in-dying prescriptions written, the number of people who died due to use of aid-in-dying drugs, and the number of those people who died who were enrolled in hospice or other palliative care programs at the time of death.(4) The number of known deaths in California from using aid-in-dying drugs per 10,000 deaths in California.(5) The number of physicians who wrote prescriptions for aid-in-dying drugs, and the specialty or specialties of each physician. drugs and the areas of practice of each physician.(6) Of people who died due to using an aid-in-dying drug, demographic percentages organized by the following characteristics:(A) Age at death.(B) Education level.(C) Race.(D) Sex.(E) Type of insurance, including whether or not they had insurance.(F) Underlying illness.(7) The motivating reason or reasons behind a patients decision to request the aid-in-dying drug pursuant to paragraph (9) of subdivision (a) of Section 443.5. the responses given to question 15 of the attending physician followup form described in Section 443.22.(8) The number of patients who received a mental health specialist assessment prior to receiving the aid-in-dying drug.(9)The length of time the attending physician has provided care to the patient prior to prescribing the aid-in-dying drug.(c) The State Department of Public Health shall make available the attending physician checklist and compliance form, the consulting physician compliance form, and the attending physician followup form, as described in Section 443.22, by posting them on its Internet Web site.
160+### SEC. 2.
215161
216-SEC. 2.SECTION 1. Section 443.19 of the Health and Safety Code is amended to read:
162+443.19. (a) The State Department of Public Health shall collect and review the information submitted pursuant to Section 443.9. The information collected shall be confidential and shall be collected in a manner that protects the privacy of the patient, the patients family, and any medical provider or pharmacist involved with the patient under the provisions of this part. The information shall not be disclosed, discoverable, or compelled to be produced in any civil, criminal, administrative, or other proceeding.(b) On or before July 1, 2017, and each year thereafter, based on the information collected in the previous year, the department shall create a report with the information collected from the attending physician followup form and post that report to its Internet Web site. The report shall include, but not be limited to, all of the following based on the information that is provided to the department and on the departments access to vital statistics: following information:(1) The number of people for whom an aid-in-dying prescription was written.(2) The number of known individuals who died each year for whom aid-in-dying prescriptions were written, and the cause of death of those individuals.(3) For the period commencing January 1, 2016, to and including the previous year, cumulatively, the total number of aid-in-dying prescriptions written, the number of people who died due to use of aid-in-dying drugs, and the number of those people who died who were enrolled in hospice or other palliative care programs at the time of death.(4) The number of known deaths in California from using aid-in-dying drugs per 10,000 deaths in California.(5) The number of physicians who wrote prescriptions for aid-in-dying drugs. drugs, and the specialty or specialties of each physician.(6) Of people who died due to using an aid-in-dying drug, demographic percentages organized by the following characteristics:(A) Age at death.(B) Education level.(C) Race.(D) Sex.(E) Type of insurance, including whether or not they had insurance.(F) Underlying illness.(7) The motivating reason or reasons behind a patients decision to request the aid-in-dying drug pursuant to paragraph (9) of subdivision (a) of Section 443.5.(8) The number of patients who received a mental health specialist assessment prior to receiving the aid-in-dying drug.(9) The length of time the attending physician has provided care to the patient prior to prescribing the aid-in-dying drug.(c) The State Department of Public Health shall make available the attending physician checklist and compliance form, the consulting physician compliance form, and the attending physician followup form, as described in Section 443.22, by posting them on its Internet Web site.
217163
218-### SEC. 2.SECTION 1.
164+443.19. (a) The State Department of Public Health shall collect and review the information submitted pursuant to Section 443.9. The information collected shall be confidential and shall be collected in a manner that protects the privacy of the patient, the patients family, and any medical provider or pharmacist involved with the patient under the provisions of this part. The information shall not be disclosed, discoverable, or compelled to be produced in any civil, criminal, administrative, or other proceeding.(b) On or before July 1, 2017, and each year thereafter, based on the information collected in the previous year, the department shall create a report with the information collected from the attending physician followup form and post that report to its Internet Web site. The report shall include, but not be limited to, all of the following based on the information that is provided to the department and on the departments access to vital statistics: following information:(1) The number of people for whom an aid-in-dying prescription was written.(2) The number of known individuals who died each year for whom aid-in-dying prescriptions were written, and the cause of death of those individuals.(3) For the period commencing January 1, 2016, to and including the previous year, cumulatively, the total number of aid-in-dying prescriptions written, the number of people who died due to use of aid-in-dying drugs, and the number of those people who died who were enrolled in hospice or other palliative care programs at the time of death.(4) The number of known deaths in California from using aid-in-dying drugs per 10,000 deaths in California.(5) The number of physicians who wrote prescriptions for aid-in-dying drugs. drugs, and the specialty or specialties of each physician.(6) Of people who died due to using an aid-in-dying drug, demographic percentages organized by the following characteristics:(A) Age at death.(B) Education level.(C) Race.(D) Sex.(E) Type of insurance, including whether or not they had insurance.(F) Underlying illness.(7) The motivating reason or reasons behind a patients decision to request the aid-in-dying drug pursuant to paragraph (9) of subdivision (a) of Section 443.5.(8) The number of patients who received a mental health specialist assessment prior to receiving the aid-in-dying drug.(9) The length of time the attending physician has provided care to the patient prior to prescribing the aid-in-dying drug.(c) The State Department of Public Health shall make available the attending physician checklist and compliance form, the consulting physician compliance form, and the attending physician followup form, as described in Section 443.22, by posting them on its Internet Web site.
219165
220-443.19. (a) The State Department of Public Health shall collect and review the information submitted pursuant to Section 443.9. The information collected shall be confidential and shall be collected in a manner that protects the privacy of the patient, the patients family, and any medical provider or pharmacist involved with the patient under the provisions of this part. The information shall not be disclosed, discoverable, or compelled to be produced in any civil, criminal, administrative, or other proceeding.(b) On or before July 1, 2017, and each year thereafter, based on the information collected in the previous year, the department shall create a report with the information collected from the attending physician followup form and post that report to its Internet Web site. The report shall include, but not be limited to, all of the following information:(1) The number of people for whom an aid-in-dying prescription was written.(2) The number of known individuals who died each year for whom aid-in-dying prescriptions were written, and the cause of death of those individuals.(3) For the period commencing January 1, 2016, to and including the previous year, cumulatively, the total number of aid-in-dying prescriptions written, the number of people who died due to use of aid-in-dying drugs, and the number of those people who died who were enrolled in hospice or other palliative care programs at the time of death.(4) The number of known deaths in California from using aid-in-dying drugs per 10,000 deaths in California.(5) The number of physicians who wrote prescriptions for aid-in-dying drugs, and the specialty or specialties of each physician. drugs and the areas of practice of each physician.(6) Of people who died due to using an aid-in-dying drug, demographic percentages organized by the following characteristics:(A) Age at death.(B) Education level.(C) Race.(D) Sex.(E) Type of insurance, including whether or not they had insurance.(F) Underlying illness.(7) The motivating reason or reasons behind a patients decision to request the aid-in-dying drug pursuant to paragraph (9) of subdivision (a) of Section 443.5. the responses given to question 15 of the attending physician followup form described in Section 443.22.(8) The number of patients who received a mental health specialist assessment prior to receiving the aid-in-dying drug.(9)The length of time the attending physician has provided care to the patient prior to prescribing the aid-in-dying drug.(c) The State Department of Public Health shall make available the attending physician checklist and compliance form, the consulting physician compliance form, and the attending physician followup form, as described in Section 443.22, by posting them on its Internet Web site.
221-
222-443.19. (a) The State Department of Public Health shall collect and review the information submitted pursuant to Section 443.9. The information collected shall be confidential and shall be collected in a manner that protects the privacy of the patient, the patients family, and any medical provider or pharmacist involved with the patient under the provisions of this part. The information shall not be disclosed, discoverable, or compelled to be produced in any civil, criminal, administrative, or other proceeding.(b) On or before July 1, 2017, and each year thereafter, based on the information collected in the previous year, the department shall create a report with the information collected from the attending physician followup form and post that report to its Internet Web site. The report shall include, but not be limited to, all of the following information:(1) The number of people for whom an aid-in-dying prescription was written.(2) The number of known individuals who died each year for whom aid-in-dying prescriptions were written, and the cause of death of those individuals.(3) For the period commencing January 1, 2016, to and including the previous year, cumulatively, the total number of aid-in-dying prescriptions written, the number of people who died due to use of aid-in-dying drugs, and the number of those people who died who were enrolled in hospice or other palliative care programs at the time of death.(4) The number of known deaths in California from using aid-in-dying drugs per 10,000 deaths in California.(5) The number of physicians who wrote prescriptions for aid-in-dying drugs, and the specialty or specialties of each physician. drugs and the areas of practice of each physician.(6) Of people who died due to using an aid-in-dying drug, demographic percentages organized by the following characteristics:(A) Age at death.(B) Education level.(C) Race.(D) Sex.(E) Type of insurance, including whether or not they had insurance.(F) Underlying illness.(7) The motivating reason or reasons behind a patients decision to request the aid-in-dying drug pursuant to paragraph (9) of subdivision (a) of Section 443.5. the responses given to question 15 of the attending physician followup form described in Section 443.22.(8) The number of patients who received a mental health specialist assessment prior to receiving the aid-in-dying drug.(9)The length of time the attending physician has provided care to the patient prior to prescribing the aid-in-dying drug.(c) The State Department of Public Health shall make available the attending physician checklist and compliance form, the consulting physician compliance form, and the attending physician followup form, as described in Section 443.22, by posting them on its Internet Web site.
223-
224-443.19. (a) The State Department of Public Health shall collect and review the information submitted pursuant to Section 443.9. The information collected shall be confidential and shall be collected in a manner that protects the privacy of the patient, the patients family, and any medical provider or pharmacist involved with the patient under the provisions of this part. The information shall not be disclosed, discoverable, or compelled to be produced in any civil, criminal, administrative, or other proceeding.(b) On or before July 1, 2017, and each year thereafter, based on the information collected in the previous year, the department shall create a report with the information collected from the attending physician followup form and post that report to its Internet Web site. The report shall include, but not be limited to, all of the following information:(1) The number of people for whom an aid-in-dying prescription was written.(2) The number of known individuals who died each year for whom aid-in-dying prescriptions were written, and the cause of death of those individuals.(3) For the period commencing January 1, 2016, to and including the previous year, cumulatively, the total number of aid-in-dying prescriptions written, the number of people who died due to use of aid-in-dying drugs, and the number of those people who died who were enrolled in hospice or other palliative care programs at the time of death.(4) The number of known deaths in California from using aid-in-dying drugs per 10,000 deaths in California.(5) The number of physicians who wrote prescriptions for aid-in-dying drugs, and the specialty or specialties of each physician. drugs and the areas of practice of each physician.(6) Of people who died due to using an aid-in-dying drug, demographic percentages organized by the following characteristics:(A) Age at death.(B) Education level.(C) Race.(D) Sex.(E) Type of insurance, including whether or not they had insurance.(F) Underlying illness.(7) The motivating reason or reasons behind a patients decision to request the aid-in-dying drug pursuant to paragraph (9) of subdivision (a) of Section 443.5. the responses given to question 15 of the attending physician followup form described in Section 443.22.(8) The number of patients who received a mental health specialist assessment prior to receiving the aid-in-dying drug.(9)The length of time the attending physician has provided care to the patient prior to prescribing the aid-in-dying drug.(c) The State Department of Public Health shall make available the attending physician checklist and compliance form, the consulting physician compliance form, and the attending physician followup form, as described in Section 443.22, by posting them on its Internet Web site.
166+443.19. (a) The State Department of Public Health shall collect and review the information submitted pursuant to Section 443.9. The information collected shall be confidential and shall be collected in a manner that protects the privacy of the patient, the patients family, and any medical provider or pharmacist involved with the patient under the provisions of this part. The information shall not be disclosed, discoverable, or compelled to be produced in any civil, criminal, administrative, or other proceeding.(b) On or before July 1, 2017, and each year thereafter, based on the information collected in the previous year, the department shall create a report with the information collected from the attending physician followup form and post that report to its Internet Web site. The report shall include, but not be limited to, all of the following based on the information that is provided to the department and on the departments access to vital statistics: following information:(1) The number of people for whom an aid-in-dying prescription was written.(2) The number of known individuals who died each year for whom aid-in-dying prescriptions were written, and the cause of death of those individuals.(3) For the period commencing January 1, 2016, to and including the previous year, cumulatively, the total number of aid-in-dying prescriptions written, the number of people who died due to use of aid-in-dying drugs, and the number of those people who died who were enrolled in hospice or other palliative care programs at the time of death.(4) The number of known deaths in California from using aid-in-dying drugs per 10,000 deaths in California.(5) The number of physicians who wrote prescriptions for aid-in-dying drugs. drugs, and the specialty or specialties of each physician.(6) Of people who died due to using an aid-in-dying drug, demographic percentages organized by the following characteristics:(A) Age at death.(B) Education level.(C) Race.(D) Sex.(E) Type of insurance, including whether or not they had insurance.(F) Underlying illness.(7) The motivating reason or reasons behind a patients decision to request the aid-in-dying drug pursuant to paragraph (9) of subdivision (a) of Section 443.5.(8) The number of patients who received a mental health specialist assessment prior to receiving the aid-in-dying drug.(9) The length of time the attending physician has provided care to the patient prior to prescribing the aid-in-dying drug.(c) The State Department of Public Health shall make available the attending physician checklist and compliance form, the consulting physician compliance form, and the attending physician followup form, as described in Section 443.22, by posting them on its Internet Web site.
225167
226168
227169
228170 443.19. (a) The State Department of Public Health shall collect and review the information submitted pursuant to Section 443.9. The information collected shall be confidential and shall be collected in a manner that protects the privacy of the patient, the patients family, and any medical provider or pharmacist involved with the patient under the provisions of this part. The information shall not be disclosed, discoverable, or compelled to be produced in any civil, criminal, administrative, or other proceeding.
229171
230-(b) On or before July 1, 2017, and each year thereafter, based on the information collected in the previous year, the department shall create a report with the information collected from the attending physician followup form and post that report to its Internet Web site. The report shall include, but not be limited to, all of the following information:
172+(b) On or before July 1, 2017, and each year thereafter, based on the information collected in the previous year, the department shall create a report with the information collected from the attending physician followup form and post that report to its Internet Web site. The report shall include, but not be limited to, all of the following based on the information that is provided to the department and on the departments access to vital statistics: following information:
231173
232174 (1) The number of people for whom an aid-in-dying prescription was written.
233175
234176 (2) The number of known individuals who died each year for whom aid-in-dying prescriptions were written, and the cause of death of those individuals.
235177
236178 (3) For the period commencing January 1, 2016, to and including the previous year, cumulatively, the total number of aid-in-dying prescriptions written, the number of people who died due to use of aid-in-dying drugs, and the number of those people who died who were enrolled in hospice or other palliative care programs at the time of death.
237179
238180 (4) The number of known deaths in California from using aid-in-dying drugs per 10,000 deaths in California.
239181
240-(5) The number of physicians who wrote prescriptions for aid-in-dying drugs, and the specialty or specialties of each physician. drugs and the areas of practice of each physician.
182+(5) The number of physicians who wrote prescriptions for aid-in-dying drugs. drugs, and the specialty or specialties of each physician.
241183
242184 (6) Of people who died due to using an aid-in-dying drug, demographic percentages organized by the following characteristics:
243185
244186 (A) Age at death.
245187
246188 (B) Education level.
247189
248190 (C) Race.
249191
250192 (D) Sex.
251193
252194 (E) Type of insurance, including whether or not they had insurance.
253195
254196 (F) Underlying illness.
255197
256-(7) The motivating reason or reasons behind a patients decision to request the aid-in-dying drug pursuant to paragraph (9) of subdivision (a) of Section 443.5. the responses given to question 15 of the attending physician followup form described in Section 443.22.
198+(7) The motivating reason or reasons behind a patients decision to request the aid-in-dying drug pursuant to paragraph (9) of subdivision (a) of Section 443.5.
257199
258200 (8) The number of patients who received a mental health specialist assessment prior to receiving the aid-in-dying drug.
259201
260202 (9) The length of time the attending physician has provided care to the patient prior to prescribing the aid-in-dying drug.
261203
262-
263-
264204 (c) The State Department of Public Health shall make available the attending physician checklist and compliance form, the consulting physician compliance form, and the attending physician followup form, as described in Section 443.22, by posting them on its Internet Web site.
265205
266-SEC. 3.SEC. 2. Section 443.22 of the Health and Safety Code is amended to read:443.22. (a) (1) The Medical Board of California may update the attending physician checklist and compliance form, the consulting physician compliance form, and the attending physician followup form, based on those provided in subdivision (b). Upon completion, the State Department of Public Health shall publish the updated forms on its Internet Web site.(2) The Medical Board of California shall make changes to the forms referenced in paragraph (1) as necessary so the forms capture the information needed to fulfill the reporting requirement in subdivision (b) of Section 443.19.(b) Unless and until updated by the Medical Board of California pursuant to this section, the attending physician checklist and compliance form, the consulting physician compliance form, and the attending physician followup form shall be in the following form:PRINTER PLEASE NOTE: TIP-IN MATERIAL TO BE INSERTED
206+SEC. 3. Section 443.22 of the Health and Safety Code is amended to read:443.22. (a) (1) The Medical Board of California may update the attending physician checklist and compliance form, the consulting physician compliance form, and the attending physician followup form, based on those provided in subdivision (b). Upon completion, the State Department of Public Health shall publish the updated forms on its Internet Web site.(2) The Medical Board of California shall make changes to the forms referenced in paragraph (1) as necessary so the forms capture the information needed to fulfill the reporting requirement in subdivision (b) of Section 443.19.(b) Unless and until updated by the Medical Board of California pursuant to this section, the attending physician checklist and compliance form, the consulting physician compliance form, and the attending physician followup form shall be in the following form:
267207
268-SEC. 3.SEC. 2. Section 443.22 of the Health and Safety Code is amended to read:
208+SEC. 3. Section 443.22 of the Health and Safety Code is amended to read:
269209
270-### SEC. 3.SEC. 2.
210+### SEC. 3.
271211
272-443.22. (a) (1) The Medical Board of California may update the attending physician checklist and compliance form, the consulting physician compliance form, and the attending physician followup form, based on those provided in subdivision (b). Upon completion, the State Department of Public Health shall publish the updated forms on its Internet Web site.(2) The Medical Board of California shall make changes to the forms referenced in paragraph (1) as necessary so the forms capture the information needed to fulfill the reporting requirement in subdivision (b) of Section 443.19.(b) Unless and until updated by the Medical Board of California pursuant to this section, the attending physician checklist and compliance form, the consulting physician compliance form, and the attending physician followup form shall be in the following form:PRINTER PLEASE NOTE: TIP-IN MATERIAL TO BE INSERTED
212+443.22. (a) (1) The Medical Board of California may update the attending physician checklist and compliance form, the consulting physician compliance form, and the attending physician followup form, based on those provided in subdivision (b). Upon completion, the State Department of Public Health shall publish the updated forms on its Internet Web site.(2) The Medical Board of California shall make changes to the forms referenced in paragraph (1) as necessary so the forms capture the information needed to fulfill the reporting requirement in subdivision (b) of Section 443.19.(b) Unless and until updated by the Medical Board of California pursuant to this section, the attending physician checklist and compliance form, the consulting physician compliance form, and the attending physician followup form shall be in the following form:
273213
274-443.22. (a) (1) The Medical Board of California may update the attending physician checklist and compliance form, the consulting physician compliance form, and the attending physician followup form, based on those provided in subdivision (b). Upon completion, the State Department of Public Health shall publish the updated forms on its Internet Web site.(2) The Medical Board of California shall make changes to the forms referenced in paragraph (1) as necessary so the forms capture the information needed to fulfill the reporting requirement in subdivision (b) of Section 443.19.(b) Unless and until updated by the Medical Board of California pursuant to this section, the attending physician checklist and compliance form, the consulting physician compliance form, and the attending physician followup form shall be in the following form:PRINTER PLEASE NOTE: TIP-IN MATERIAL TO BE INSERTED
214+443.22. (a) (1) The Medical Board of California may update the attending physician checklist and compliance form, the consulting physician compliance form, and the attending physician followup form, based on those provided in subdivision (b). Upon completion, the State Department of Public Health shall publish the updated forms on its Internet Web site.(2) The Medical Board of California shall make changes to the forms referenced in paragraph (1) as necessary so the forms capture the information needed to fulfill the reporting requirement in subdivision (b) of Section 443.19.(b) Unless and until updated by the Medical Board of California pursuant to this section, the attending physician checklist and compliance form, the consulting physician compliance form, and the attending physician followup form shall be in the following form:
275215
276-443.22. (a) (1) The Medical Board of California may update the attending physician checklist and compliance form, the consulting physician compliance form, and the attending physician followup form, based on those provided in subdivision (b). Upon completion, the State Department of Public Health shall publish the updated forms on its Internet Web site.(2) The Medical Board of California shall make changes to the forms referenced in paragraph (1) as necessary so the forms capture the information needed to fulfill the reporting requirement in subdivision (b) of Section 443.19.(b) Unless and until updated by the Medical Board of California pursuant to this section, the attending physician checklist and compliance form, the consulting physician compliance form, and the attending physician followup form shall be in the following form:PRINTER PLEASE NOTE: TIP-IN MATERIAL TO BE INSERTED
216+443.22. (a) (1) The Medical Board of California may update the attending physician checklist and compliance form, the consulting physician compliance form, and the attending physician followup form, based on those provided in subdivision (b). Upon completion, the State Department of Public Health shall publish the updated forms on its Internet Web site.(2) The Medical Board of California shall make changes to the forms referenced in paragraph (1) as necessary so the forms capture the information needed to fulfill the reporting requirement in subdivision (b) of Section 443.19.(b) Unless and until updated by the Medical Board of California pursuant to this section, the attending physician checklist and compliance form, the consulting physician compliance form, and the attending physician followup form shall be in the following form:
277217
278218
279219
280220 443.22. (a) (1) The Medical Board of California may update the attending physician checklist and compliance form, the consulting physician compliance form, and the attending physician followup form, based on those provided in subdivision (b). Upon completion, the State Department of Public Health shall publish the updated forms on its Internet Web site.
281221
282222 (2) The Medical Board of California shall make changes to the forms referenced in paragraph (1) as necessary so the forms capture the information needed to fulfill the reporting requirement in subdivision (b) of Section 443.19.
283223
284224 (b) Unless and until updated by the Medical Board of California pursuant to this section, the attending physician checklist and compliance form, the consulting physician compliance form, and the attending physician followup form shall be in the following form: