HB 1655

1
A bill to be entitled
2An act relating to health care advance directive and
3blood-type recordation; creating s. 320.08049, F.S.;
4providing a fee for persons participating in the health
5care advance directive and blood-type registry; requiring
6certain uses for funds generated by the fee; amending s.
7322.051, F.S.; providing a fee for persons applying for an
8identification card who choose to participate in the
9health care advance directive and blood-type registry;
10amending s. 322.08, F.S.; providing a fee for persons
11applying for a driver's license who choose to participate
12in the health care advance directive and blood-type
13registry; creating s. 765.3061, F.S.; requiring the Agency
14for Health Care Administration and the Department of
15Highway Safety and Motor Vehicles to develop and implement
16a voluntary program for health care advance directive and
17blood-type recordation; requiring certain health care
18employees to confirm a principal's blood type; providing
19for noting an individual's blood type and health care
20advance directive relative to life-prolonging procedures
21on the individual's driver's license or identification
22card upon request; requiring the Division of Driver
23Licenses offices to make forms available to the public;
24requiring forms to be accessible electronically on the
25Internet; requiring certain forms to contain certain
26information; requiring the department to distribute
27certain forms for the indication of health care directives
28and blood type; providing a recordkeeping system;
29requiring the agency to provide funds for certain
30supplies; requiring the department to provide funds for
31the recordkeeping system; creating s. 765.3062, F.S.;
32establishing a health care advance directive and blood-
33type registry; requiring the department to collect data
34and provide collected data to the agency for the registry;
35requiring the registry to record certain health care
36advance directive and blood-type information; providing
37access to the registry by certain persons; providing
38guidelines for the processing of certain forms; providing
39criteria for revocation or amendment of registry
40information by certain individuals; providing for
41recording certain documents with the registry; providing
42criteria for certain health care advance directives being
43submitted; requiring the department and the agency to
44develop and implement a living will registry; creating s.
45765.3063, F.S.; providing means to amend or revoke a
46health care advance directive or blood type from the
47registry; providing for the responsibility of the
48principal to update forms; providing standards for
49controlling forms and recordings; creating s. 765.3064,
50F.S.; providing certain health care employees with civil
51and criminal immunity from acts performed in conjunction
52with certain information provided by the department;
53expressing the sovereign immunity of the agency, the
54department, and their employees from criminal prosecution
55and civil liability for certain acts or forms; creating s.
56765.3065, F.S.; requiring the agency, subject to the
57concurrence of the department, to develop a continuing
58education program relating to health care advance
59directives and the health care advance directive and
60blood-type registry; creating s. 765.3066, F.S.; providing
61for appointment of an education panel to create an end-of-
62life public education campaign; providing campaign
63criteria; providing contractual power for programs aimed
64at educating certain health care professionals; requiring
65a study to be conducted by the agency; providing for a
66report to the Legislature; providing issues for the study
67to address; providing an effective date.
68
69Be It Enacted by the Legislature of the State of Florida:
70
71     Section 1.  Section 320.08049, Florida Statutes, is created
72to read:
73     320.08049  Additional fee imposed for persons participating
74in health care advance directive and blood-type registry.--
75     (1)  Persons submitting initial application forms for
76participation in the health care advance directive and blood-
77type registry created under s. 765.3062 shall be assessed a fee
78of $10.
79     (2)  The fee provided for in subsection (1) shall be used
80by the Agency for Health Care Administration to establish and
81maintain the health care advance directive and blood-type
82registry. Funds received by the agency from such fees shall be
83used to:
84     (a)  Obtain equipment and software to expand or improve the
85database for the registry and the organ donor program
86established under part V of chapter 765.
87     (b)  Employ persons necessary to ensure the proper
88operation of the equipment used to maintain the registry.
89     (c)  Fund health care advance directive education efforts
90as authorized in ss. 765.3065 and 765.3066.
91     Section 2.  Subsection (8) is added to section 322.051,
92Florida Statutes, to read:
93     322.051  Identification Cards.--
94     (8)  A fee of $10 shall be assessed for any person choosing
95to submit an initial application to participate in the health
96care advance directive and blood-type registry pursuant to s.
97320.08049.
98     Section 3.  Paragraph (f) is added to subsection (6) of
99section 322.08, Florida Statutes, to read:
100     322.08  Application for license.--
101     (6)  The application form for a driver's license or
102duplicate thereof shall include language permitting the
103following:
104     (f)  Assessment of a fee of $10 for any person choosing to
105submit an initial application to participate in the health care
106advance directive and blood-type registry pursuant to s.
107320.08049.
108
109A statement providing an explanation of the purpose of the trust
110funds shall also be included.
111     Section 4.  Section 765.3061, Florida Statutes, is created
112to read:
113     765.3061  Health care advance directives and blood-type
114indication as part of driver's license or identification card
115process.--
116     (1)  The Agency for Health Care Administration and the
117Department of Highway Safety and Motor Vehicles shall develop
118and implement a program encouraging and allowing a person, at
119the person's request, to voluntarily make a health care advance
120directive, as well as to voluntarily provide his or her blood
121type, both of which may be noted on the person's driver's
122license or identification card, upon issuance or renewal of
123these documents.
124     (2)  The health care advance directive form and blood-type
125confirmation form, both of which are to be distributed by the
126department, shall be developed by the agency in consultation
127with the department. The health care advance directive form
128shall include the living will specified in s. 765.303, which
129must be executed in accordance with s. 765.302. The blood-type
130confirmation form must be signed by a person's physician or an
131agent of a blood bank or laboratory that has documentation of
132the person's blood type. The health care advance directive and
133blood-type confirmation forms may require additional information
134and may include additional material as deemed necessary by the
135agency and the department. An individual completing a health
136care advance directive form or blood-type confirmation form
137shall have included on his or her driver's license or
138identification card a notation on the front of the card clearly
139indicating the individual's intent concerning life-prolonging
140procedures and the individual's blood type. A notation on an
141individual's driver's license or identification card that the
142individual has a health care advance directive or that provides
143the individual's blood type is sufficient to satisfy all
144requirements concerning life-prolonging procedures and necessary
145blood-type information for health care providers.
146     (3)(a)  All forms relating to the execution, amendment, or
147revocation of a health care advance directive or blood-type
148confirmation for the purpose of participating in the registry
149shall be made available to the public at all offices of the
150Division of Driver Licenses, as well as electronically on the
151Internet.
152     (b)  The forms relating to the execution of a health care
153advance directive or confirmation of blood type, for purposes of
154participating in the registry, shall:
155     1.  Require an express declaration that the principal has
156read the form and understands its contents.
157     2.  Require an express waiver of any privacy rights granted
158under state or federal law.
159     3.  Require an express waiver of liability for health care
160providers who rely upon the information contained on the
161principal's driver's license or the registry.
162     4.  Require an acknowledgment from the principal that it is
163the responsibility of the principal to submit an amendment form
164or revocation form to the Division of Driver Licenses if it is
165the principal's desire to change or remove any document recorded
166in the registry.
167     5.  Require acknowledgment from the principal that a
168reasonable delay will occur in the recording of a newly executed
169form in the registry by the agency and department, regardless of
170whether it is a health care advance directive or blood-type
171confirmation form, or any amendment or revocation thereof, and
172that health care providers will rely on the information in the
173registry available at the time such information is obtained by a
174health care provider.
175     (4)  The agency shall provide the necessary supplies and
176forms through funds appropriated from general revenue, any
177authorized fees, or contributions from interested, voluntary,
178nonprofit organizations. The department shall provide the
179necessary recordkeeping system through funds appropriated from
180general revenue.
181     Section 5.  Section 765.3062, Florida Statutes, is created
182to read:
183     765.3062  Health care advance directive and blood-type
184registry; use of forms and delivery of documents.--
185     (1)  There is established a health care advance directive
186and blood-type registry. This registry shall be an expansion of
187the organ and tissue donor registry that is created,
188administered, and maintained in accordance with part V of this
189chapter.
190     (2)  The forms to be recorded in the registry shall be
191collected by the Department of Highway Safety and Motor Vehicles
192and provided to the Agency for Health Care Administration in a
193manner similar to the forms and information collected for
194anatomical gifts as provided in part V of this chapter. The
195registry shall record, through electronic means, health care
196advance directive and blood-type documents submitted through the
197driver's license identification program or obtained from other
198sources. The registry shall be maintained in a manner that will
199allow, through electronic and telephonic methods, immediate
200access to health care advance directive and blood-type documents
20124 hours a day, 7 days a week. Hospitals and other parties
202identified by rule of the agency shall be allowed access,
203through coded means, to the information stored in the registry.
204     (3)  If a health care advance directive is made through the
205program established under s. 765.3061, the completed health care
206advance directive shall be delivered to the department and
207processed in the manner specified in subsection (4). Delivery of
208the health care advance directive is not necessary for the
209validity of the health care advance directive. If a person
210amends or revokes a health care advance directive in accordance
211with s. 765.3063, the records of the department shall be updated
212to reflect such status of the health care advance directive.
213     (4)  If a health care advance directive is made by an
214individual, other than through the program established by the
215agency and the department, the document may be recorded in the
216registry administered by the agency and noted on an individual's
217driver's license, if the individual follows the procedure and
218the health care advance directive meets the criteria set forth
219in this chapter and in any rules of the department and the
220agency.
221     (5)  The agency and the department shall develop and
222implement a living will registry as an expansion and improvement
223of the organ donor database maintained by the agency.
224     Section 6.  Section 765.3063, Florida Statutes, is created
225to read:
226     765.3063  Amendment to or revocation of a health care
227advance directive or removal of blood type from the registry;
228responsibility of the participant; last documents submitted and
229recorded are controlling documents.--
230     (1)  A person may amend or revoke a health care advance
231directive by the execution and delivery of the appropriate form,
232signed and properly executed, to the Department of Highway
233Safety and Motor Vehicles to be transmitted to the Agency for
234Health Care Administration for recording in or removal from the
235registry.
236     (2)  If a person participates in the health care advance
237directive and blood-type registry, it is the responsibility of
238the principal to complete and submit the appropriate forms
239needed to amend or revoke the health care advance directive or
240blood-type information. If a person chooses to participate in
241the registry, the most recently submitted forms recorded in the
242registry shall be considered the controlling documents of the
243participant in any dispute or decision by a health care
244provider.
245     (3)  A person may remove the record of his or her blood
246type from the registry by signing a form provided by the
247department, as developed in conjunction with the agency, that is
248signed in the presence of an employee of the department.
249     (4)  Nothing in this section shall affect a principal's
250right to amend or revoke a health care advance directive or
251designation of a surrogate as authorized under s. 765.104 if the
252principal is not participating in the agency's health care
253advance directive and blood-type registry.
254     Section 7.  Section 765.3064, Florida Statutes, is created
255to read:
256     765.3064  Immunity from liability.--
257     (1)  Notwithstanding the express waiver of liability signed
258by the person who chooses to participate in the health care
259advance directive and blood-type registry, a health care
260facility or a health care provider, or any other person acting
261under the direction of a health care facility or health care
262provider, carrying out a health care decision made in accordance
263with a properly recorded health care advance directive or blood-
264type confirmation transmitted by the Department of Highway
265Safety and Motor Vehicles, is not subject to criminal
266prosecution or civil liability and will not be deemed to have
267engaged in unprofessional conduct.
268     (2)  The Agency for Health Care Administration and the
269Department of Highway Safety and Motor Vehicles and any
270employees acting within the scope of their employment are immune
271from criminal prosecution and civil liability for any acts or
272forms recorded in compliance with the provisions of this
273chapter.
274     Section 8.  Section 765.3065, Florida Statutes, is created
275to read:
276     765.3065  Education program relating to health care advance
277directives and blood-type registries.--The Agency for Health
278Care Administration, subject to the concurrence of the
279Department of Highway Safety and Motor Vehicles, shall develop a
280continuing education program to educate and inform health care
281professionals, including emergency medical personnel, law
282enforcement agencies and officers, state and local government
283employees, and the public regarding the laws of this state
284relating to the health care advance directives and the health
285care advance directive and blood-type registry as described in
286this chapter.
287     Section 9.  Section 765.3066, Florida Statutes, is created
288to read:
289     765.3066  Health care advance directives education panel.-?
290The Legislature recognizes that every competent adult has the
291fundamental right of self-determination regarding decisions
292pertaining to his or her health. This includes the right to
293choose or refuse medical treatment. A panel of three members
294appointed by the secretary of the Department of Elderly Affairs,
295the secretary of the Agency for Health Care Administration, and
296the secretary of the Department of Health shall jointly create a
297campaign on end-of-life care for purposes of educating the
298public. This campaign shall include culturally sensitive
299programs to improve understanding of end-of-life issues.
300Existing community resources, when available, shall be used to
301support the program, and volunteers and health care
302professionals may assist in the program to the maximum extent
303possible. The program aimed at educating health care
304professionals may be implemented by contract with one or more
305medical schools located in the state.
306     Section 10.  Effective upon this act becoming a law, the
307Agency for Health Care Administration shall conduct a study of
308the implementation of the health care advance directive and
309blood-type registry and report its findings and recommendations
310to the Speaker of the House of Representatives and the President
311of the Senate by January 1, 2005. The study shall, at a minimum,
312examine and make recommendations concerning the following:
313     (1)  The nonrecurring capital outlay and recurring
314operational funding necessary to establish and maintain the
315health care advance directive and blood-type registry.
316     (2)  The efficiency and cost-effectiveness of databases and
317procedures used to maintain the data in the registry and to
318transfer forms between the Department of Highway Safety and
319Motor Vehicles and the Agency for Health Care Administration.
320     (3)  The reasonable timeframes necessary to record forms
321and other information in the registry and make such information
322available to health care facilities and appropriate
323professionals.
324     (4)  The types of disclosures and disclaimers necessary to
325be included in the forms used for the health care advance
326directive and blood-type registry.
327     (5)  The projected number of persons who may participate in
328the health care advance directive and blood-type registry and
329the sufficiency of the fees assessed to fund the registry and
330health care advance directive education efforts.
331     Section 11.  This act shall take effect upon becoming a
332law.


CODING: Words stricken are deletions; words underlined are additions.