Senate Bill sb2902

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    Florida Senate - 2004                                  SB 2902

    By Senator Jones





    13-1525-04                                         See HB 1655

  1                      A bill to be entitled

  2         An act relating to health care advance

  3         directive and blood-type recordation; creating

  4         s. 320.08049, F.S.; providing a fee for persons

  5         participating in the health care advance

  6         directive and blood-type registry; requiring

  7         certain uses for funds generated by the fee;

  8         amending s. 322.051, F.S.; providing a fee for

  9         persons applying for an identification card who

10         choose to participate in the health care

11         advance directive and blood-type registry;

12         amending s. 322.08, F.S.; providing a fee for

13         persons applying for a driver's license who

14         choose to participate in the health care

15         advance directive and blood-type registry;

16         creating s. 765.3061, F.S.; requiring the

17         Agency for Health Care Administration and the

18         Department of Highway Safety and Motor Vehicles

19         to develop and implement a voluntary program

20         for health care advance directive and

21         blood-type recordation; requiring certain

22         health care employees to confirm a principal's

23         blood type; providing for noting an

24         individual's blood type and health care advance

25         directive relative to life-prolonging

26         procedures on the individual's driver's license

27         or identification card upon request; requiring

28         the Division of Driver Licenses offices to make

29         forms available to the public; requiring forms

30         to be accessible electronically on the

31         Internet; requiring certain forms to contain

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    Florida Senate - 2004                                  SB 2902
    13-1525-04                                         See HB 1655




 1         certain information; requiring the department

 2         to distribute certain forms for the indication

 3         of health care directives and blood type;

 4         providing a recordkeeping system; requiring the

 5         agency to provide funds for certain supplies;

 6         requiring the department to provide funds for

 7         the recordkeeping system; creating s. 765.3062,

 8         F.S.; establishing a health care advance

 9         directive and blood-type registry; requiring

10         the department to collect data and provide

11         collected data to the agency for the registry;

12         requiring the registry to record certain health

13         care advance directive and blood-type

14         information; providing access to the registry

15         by certain persons; providing guidelines for

16         the processing of certain forms; providing

17         criteria for revocation or amendment of

18         registry information by certain individuals;

19         providing for recording certain documents with

20         the registry; providing criteria for certain

21         health care advance directives being submitted;

22         requiring the department and the agency to

23         develop and implement a living will registry;

24         creating s. 765.3063, F.S.; providing means to

25         amend or revoke a health care advance directive

26         or blood type from the registry; providing for

27         the responsibility of the principal to update

28         forms; providing standards for controlling

29         forms and recordings; creating s. 765.3064,

30         F.S.; providing certain health care employees

31         with civil and criminal immunity from acts

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    Florida Senate - 2004                                  SB 2902
    13-1525-04                                         See HB 1655




 1         performed in conjunction with certain

 2         information provided by the department;

 3         expressing the sovereign immunity of the

 4         agency, the department, and their employees

 5         from criminal prosecution and civil liability

 6         for certain acts or forms; creating s.

 7         765.3065, F.S.; requiring the agency, subject

 8         to the concurrence of the department, to

 9         develop a continuing education program relating

10         to health care advance directives and the

11         health care advance directive and blood-type

12         registry; creating s. 765.3066, F.S.; providing

13         for appointment of an education panel to create

14         an end-of-life public education campaign;

15         providing campaign criteria; providing

16         contractual power for programs aimed at

17         educating certain health care professionals;

18         requiring a study to be conducted by the

19         agency; providing for a report to the

20         Legislature; providing issues for the study to

21         address; providing an effective date.

22  

23  Be It Enacted by the Legislature of the State of Florida:

24  

25         Section 1.  Section 320.08049, Florida Statutes, is

26  created to read:

27         320.08049  Additional fee imposed for persons

28  participating in health care advance directive and blood-type

29  registry.--

30         (1)  Persons submitting initial application forms for

31  participation in the health care advance directive and

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    Florida Senate - 2004                                  SB 2902
    13-1525-04                                         See HB 1655




 1  blood-type registry created under s. 765.3062 shall be

 2  assessed a fee of $10.

 3         (2)  The fee provided for in subsection (1) shall be

 4  used by the Agency for Health Care Administration to establish

 5  and maintain the health care advance directive and blood-type

 6  registry. Funds received by the agency from such fees shall be

 7  used to:

 8         (a)  Obtain equipment and software to expand or improve

 9  the database for the registry and the organ donor program

10  established under part V of chapter 765.

11         (b)  Employ persons necessary to ensure the proper

12  operation of the equipment used to maintain the registry.

13         (c)  Fund health care advance directive education

14  efforts as authorized in ss. 765.3065 and 765.3066.

15         Section 2.  Subsection (8) is added to section 322.051,

16  Florida Statutes, to read:

17         322.051  Identification Cards.--

18         (8)  A fee of $10 shall be assessed for any person

19  choosing to submit an initial application to participate in

20  the health care advance directive and blood-type registry

21  pursuant to s. 320.08049.

22         Section 3.  Paragraph (f) is added to subsection (6) of

23  section 322.08, Florida Statutes, to read:

24         322.08  Application for license.--

25         (6)  The application form for a driver's license or

26  duplicate thereof shall include language permitting the

27  following:

28         (f)  Assessment of a fee of $10 for any person choosing

29  to submit an initial application to participate in the health

30  care advance directive and blood-type registry pursuant to s.

31  320.08049.

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    Florida Senate - 2004                                  SB 2902
    13-1525-04                                         See HB 1655




 1  

 2  A statement providing an explanation of the purpose of the

 3  trust funds shall also be included.

 4         Section 4.  Section 765.3061, Florida Statutes, is

 5  created to read:

 6         765.3061  Health care advance directives and blood-type

 7  indication as part of driver's license or identification card

 8  process.--

 9         (1)  The Agency for Health Care Administration and the

10  Department of Highway Safety and Motor Vehicles shall develop

11  and implement a program encouraging and allowing a person, at

12  the person's request, to voluntarily make a health care

13  advance directive, as well as to voluntarily provide his or

14  her blood type, both of which may be noted on the person's

15  driver's license or identification card, upon issuance or

16  renewal of these documents.

17         (2)  The health care advance directive form and

18  blood-type confirmation form, both of which are to be

19  distributed by the department, shall be developed by the

20  agency in consultation with the department. The health care

21  advance directive form shall include the living will specified

22  in s. 765.303, which must be executed in accordance with s.

23  765.302. The blood-type confirmation form must be signed by a

24  person's physician or an agent of a blood bank or laboratory

25  that has documentation of the person's blood type. The health

26  care advance directive and blood-type confirmation forms may

27  require additional information and may include additional

28  material as deemed necessary by the agency and the department.

29  An individual completing a health care advance directive form

30  or blood-type confirmation form shall have included on his or

31  her driver's license or identification card a notation on the

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    Florida Senate - 2004                                  SB 2902
    13-1525-04                                         See HB 1655




 1  front of the card clearly indicating the individual's intent

 2  concerning life-prolonging procedures and the individual's

 3  blood type. A notation on an individual's driver's license or

 4  identification card that the individual has a health care

 5  advance directive or that provides the individual's blood type

 6  is sufficient to satisfy all requirements concerning

 7  life-prolonging procedures and necessary blood-type

 8  information for health care providers.

 9         (3)(a)  All forms relating to the execution, amendment,

10  or revocation of a health care advance directive or blood-type

11  confirmation for the purpose of participating in the registry

12  shall be made available to the public at all offices of the

13  Division of Driver Licenses, as well as electronically on the

14  Internet.

15         (b)  The forms relating to the execution of a health

16  care advance directive or confirmation of blood type, for

17  purposes of participating in the registry, shall:

18         1.  Require an express declaration that the principal

19  has read the form and understands its contents.

20         2.  Require an express waiver of any privacy rights

21  granted under state or federal law.

22         3.  Require an express waiver of liability for health

23  care providers who rely upon the information contained on the

24  principal's driver's license or the registry.

25         4.  Require an acknowledgment from the principal that

26  it is the responsibility of the principal to submit an

27  amendment form or revocation form to the Division of Driver

28  Licenses if it is the principal's desire to change or remove

29  any document recorded in the registry.

30         5.  Require acknowledgment from the principal that a

31  reasonable delay will occur in the recording of a newly

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    Florida Senate - 2004                                  SB 2902
    13-1525-04                                         See HB 1655




 1  executed form in the registry by the agency and department,

 2  regardless of whether it is a health care advance directive or

 3  blood-type confirmation form, or any amendment or revocation

 4  thereof, and that health care providers will rely on the

 5  information in the registry available at the time such

 6  information is obtained by a health care provider.

 7         (4)  The agency shall provide the necessary supplies

 8  and forms through funds appropriated from general revenue, any

 9  authorized fees, or contributions from interested, voluntary,

10  nonprofit organizations. The department shall provide the

11  necessary recordkeeping system through funds appropriated from

12  general revenue.

13         Section 5.  Section 765.3062, Florida Statutes, is

14  created to read:

15         765.3062  Health care advance directive and blood-type

16  registry; use of forms and delivery of documents.--

17         (1)  There is established a health care advance

18  directive and blood-type registry. This registry shall be an

19  expansion of the organ and tissue donor registry that is

20  created, administered, and maintained in accordance with part

21  V of this chapter.

22         (2)  The forms to be recorded in the registry shall be

23  collected by the Department of Highway Safety and Motor

24  Vehicles and provided to the Agency for Health Care

25  Administration in a manner similar to the forms and

26  information collected for anatomical gifts as provided in part

27  V of this chapter. The registry shall record, through

28  electronic means, health care advance directive and blood-type

29  documents submitted through the driver's license

30  identification program or obtained from other sources. The

31  registry shall be maintained in a manner that will allow,

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    Florida Senate - 2004                                  SB 2902
    13-1525-04                                         See HB 1655




 1  through electronic and telephonic methods, immediate access to

 2  health care advance directive and blood-type documents 24

 3  hours a day, 7 days a week. Hospitals and other parties

 4  identified by rule of the agency shall be allowed access,

 5  through coded means, to the information stored in the

 6  registry.

 7         (3)  If a health care advance directive is made through

 8  the program established under s. 765.3061, the completed

 9  health care advance directive shall be delivered to the

10  department and processed in the manner specified in subsection

11  (4). Delivery of the health care advance directive is not

12  necessary for the validity of the health care advance

13  directive. If a person amends or revokes a health care advance

14  directive in accordance with s. 765.3063, the records of the

15  department shall be updated to reflect such status of the

16  health care advance directive.

17         (4)  If a health care advance directive is made by an

18  individual, other than through the program established by the

19  agency and the department, the document may be recorded in the

20  registry administered by the agency and noted on an

21  individual's driver's license, if the individual follows the

22  procedure and the health care advance directive meets the

23  criteria set forth in this chapter and in any rules of the

24  department and the agency.

25         (5)  The agency and the department shall develop and

26  implement a living will registry as an expansion and

27  improvement of the organ donor database maintained by the

28  agency.

29         Section 6.  Section 765.3063, Florida Statutes, is

30  created to read:

31  

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    Florida Senate - 2004                                  SB 2902
    13-1525-04                                         See HB 1655




 1         765.3063  Amendment to or revocation of a health care

 2  advance directive or removal of blood type from the registry;

 3  responsibility of the participant; last documents submitted

 4  and recorded are controlling documents.--

 5         (1)  A person may amend or revoke a health care advance

 6  directive by the execution and delivery of the appropriate

 7  form, signed and properly executed, to the Department of

 8  Highway Safety and Motor Vehicles to be transmitted to the

 9  Agency for Health Care Administration for recording in or

10  removal from the registry.

11         (2)  If a person participates in the health care

12  advance directive and blood-type registry, it is the

13  responsibility of the principal to complete and submit the

14  appropriate forms needed to amend or revoke the health care

15  advance directive or blood-type information. If a person

16  chooses to participate in the registry, the most recently

17  submitted forms recorded in the registry shall be considered

18  the controlling documents of the participant in any dispute or

19  decision by a health care provider.

20         (3)  A person may remove the record of his or her blood

21  type from the registry by signing a form provided by the

22  department, as developed in conjunction with the agency, that

23  is signed in the presence of an employee of the department.

24         (4)  Nothing in this section shall affect a principal's

25  right to amend or revoke a health care advance directive or

26  designation of a surrogate as authorized under s. 765.104 if

27  the principal is not participating in the agency's health care

28  advance directive and blood-type registry.

29         Section 7.  Section 765.3064, Florida Statutes, is

30  created to read:

31         765.3064  Immunity from liability.--

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    Florida Senate - 2004                                  SB 2902
    13-1525-04                                         See HB 1655




 1         (1)  Notwithstanding the express waiver of liability

 2  signed by the person who chooses to participate in the health

 3  care advance directive and blood-type registry, a health care

 4  facility or a health care provider, or any other person acting

 5  under the direction of a health care facility or health care

 6  provider, carrying out a health care decision made in

 7  accordance with a properly recorded health care advance

 8  directive or blood-type confirmation transmitted by the

 9  Department of Highway Safety and Motor Vehicles, is not

10  subject to criminal prosecution or civil liability and will

11  not be deemed to have engaged in unprofessional conduct.

12         (2)  The Agency for Health Care Administration and the

13  Department of Highway Safety and Motor Vehicles and any

14  employees acting within the scope of their employment are

15  immune from criminal prosecution and civil liability for any

16  acts or forms recorded in compliance with the provisions of

17  this chapter.

18         Section 8.  Section 765.3065, Florida Statutes, is

19  created to read:

20         765.3065  Education program relating to health care

21  advance directives and blood-type registries.--The Agency for

22  Health Care Administration, subject to the concurrence of the

23  Department of Highway Safety and Motor Vehicles, shall develop

24  a continuing education program to educate and inform health

25  care professionals, including emergency medical personnel, law

26  enforcement agencies and officers, state and local government

27  employees, and the public regarding the laws of this state

28  relating to the health care advance directives and the health

29  care advance directive and blood-type registry as described in

30  this chapter.

31  

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    Florida Senate - 2004                                  SB 2902
    13-1525-04                                         See HB 1655




 1         Section 9.  Section 765.3066, Florida Statutes, is

 2  created to read:

 3         765.3066  Health care advance directives education

 4  panel.--The Legislature recognizes that every competent adult

 5  has the fundamental right of self-determination regarding

 6  decisions pertaining to his or her health. This includes the

 7  right to choose or refuse medical treatment. A panel of three

 8  members appointed by the secretary of the Department of

 9  Elderly Affairs, the secretary of the Agency for Health Care

10  Administration, and the secretary of the Department of Health

11  shall jointly create a campaign on end-of-life care for

12  purposes of educating the public. This campaign shall include

13  culturally sensitive programs to improve understanding of

14  end-of-life issues. Existing community resources, when

15  available, shall be used to support the program, and

16  volunteers and health care professionals may assist in the

17  program to the maximum extent possible. The program aimed at

18  educating health care professionals may be implemented by

19  contract with one or more medical schools located in the

20  state.

21         Section 10.  Effective upon this act becoming a law,

22  the Agency for Health Care Administration shall conduct a

23  study of the implementation of the health care advance

24  directive and blood-type registry and report its findings and

25  recommendations to the Speaker of the House of Representatives

26  and the President of the Senate by January 1, 2005. The study

27  shall, at a minimum, examine and make recommendations

28  concerning the following:

29         (1)  The nonrecurring capital outlay and recurring

30  operational funding necessary to establish and maintain the

31  health care advance directive and blood-type registry.

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    Florida Senate - 2004                                  SB 2902
    13-1525-04                                         See HB 1655




 1         (2)  The efficiency and cost-effectiveness of databases

 2  and procedures used to maintain the data in the registry and

 3  to transfer forms between the Department of Highway Safety and

 4  Motor Vehicles and the Agency for Health Care Administration.

 5         (3)  The reasonable timeframes necessary to record

 6  forms and other information in the registry and make such

 7  information available to health care facilities and

 8  appropriate professionals.

 9         (4)  The types of disclosures and disclaimers necessary

10  to be included in the forms used for the health care advance

11  directive and blood-type registry.

12         (5)  The projected number of persons who may

13  participate in the health care advance directive and

14  blood-type registry and the sufficiency of the fees assessed

15  to fund the registry and health care advance directive

16  education efforts.

17         Section 11.  This act shall take effect upon becoming a

18  law.

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