HB 1655CS

CHAMBER ACTION



1The Committee on Health Care recommends the following:
2
3     Committee Substitute
4     Remove the entire bill and insert:
5
A bill to be entitled
6An act relating to health care advance directive and
7blood-type recordation; amending s. 322.051, F.S.;
8providing a fee for persons applying for an identification
9card who choose to participate in the health care advance
10directive and blood-type registry; amending s. 322.08,
11F.S.; providing a fee for persons applying for a driver's
12license who choose to participate in the health care
13advance directive and blood-type registry; creating s.
14322.0812, F.S.; providing a fee for persons participating
15in the health care advance directive and blood-type
16registry; requiring certain uses for funds generated by
17the fee; creating s. 765.3061, F.S.; requiring the Agency
18for Health Care Administration and the Department of
19Highway Safety and Motor Vehicles to develop and implement
20a voluntary program for health care advance directive and
21blood-type recordation; requiring certain health care
22employees to confirm a principal's blood type; providing
23for noting an individual's blood type and health care
24advance directive relative to life-prolonging procedures
25on the individual's driver's license or identification
26card upon request; requiring the Division of Driver
27Licenses offices to make forms available to the public;
28requiring forms to be accessible electronically on the
29Internet; requiring certain forms to contain certain
30information; requiring the department to distribute
31certain forms for the indication of health care directives
32and blood type; providing a recordkeeping system;
33requiring the agency to provide funds for certain
34supplies; requiring the department to provide funds for
35the recordkeeping system; creating s. 765.3062, F.S.;
36establishing a health care advance directive and blood-
37type registry; requiring the department to collect data
38and provide collected data to the agency for the registry;
39requiring the registry to record certain health care
40advance directive and blood-type information; providing
41access to the registry by certain persons; providing
42guidelines for the processing of certain forms; providing
43criteria for revocation or amendment of registry
44information by certain individuals; providing for
45recording certain documents with the registry; providing
46criteria for certain health care advance directives being
47submitted; requiring the department and the agency to
48develop and implement a living will registry; creating s.
49765.3063, F.S.; providing means to amend or revoke a
50health care advance directive or blood type from the
51registry; providing for the responsibility of the
52principal to update forms; providing standards for
53controlling forms and recordings; creating s. 765.3064,
54F.S.; providing certain health care employees with civil
55and criminal immunity from acts performed in conjunction
56with certain information provided by the department;
57expressing the sovereign immunity of the agency, the
58department, and their employees from criminal prosecution
59and civil liability for certain acts or forms; creating s.
60765.3065, F.S.; requiring the agency, subject to the
61concurrence of the department, to develop a continuing
62education program relating to health care advance
63directives and the health care advance directive and
64blood-type registry; creating s. 765.3066, F.S.; providing
65for appointment of an education panel to create an end-of-
66life public education campaign; providing campaign
67criteria; providing contractual power for programs aimed
68at educating certain health care professionals; requiring
69a study to be conducted by the agency; providing for a
70report to the Legislature; providing issues for the study
71to address; providing effective dates.
72
73Be It Enacted by the Legislature of the State of Florida:
74
75     Section 1.  Subsection (8) is added to section 322.051,
76Florida Statutes, to read:
77     322.051  Identification Cards.--
78     (8)  A fee of $10 shall be assessed for any person choosing
79to submit an initial application to participate in the health
80care advance directive and blood-type registry pursuant to s.
81322.0812.
82     Section 2.  Paragraph (f) is added to subsection (6) of
83section 322.08, Florida Statutes, to read:
84     322.08  Application for license.--
85     (6)  The application form for a driver's license or
86duplicate thereof shall include language permitting the
87following:
88     (f)  Assessment of a fee of $10 for any person choosing to
89submit an initial application to participate in the health care
90advance directive and blood-type registry pursuant to s.
91322.0812.
92
93A statement providing an explanation of the purpose of the trust
94funds shall also be included.
95     Section 3.  Section 322.0812, Florida Statutes, is created
96to read:
97     322.0812  Additional fee imposed for persons participating
98in health care advance directive and blood-type registry.--
99     (1)  Persons submitting initial application forms for
100participation in the health care advance directive and blood-
101type registry created under s. 765.3062 shall be assessed a fee
102of $10.
103     (2)  The fee provided for in subsection (1) shall be used
104by the Agency for Health Care Administration to establish and
105maintain the health care advance directive and blood-type
106registry. Funds received by the agency from such fees shall be
107used to:
108     (a)  Obtain equipment and software to expand or improve the
109database for the registry and the organ donor program
110established under part V of chapter 765.
111     (b)  Employ persons necessary to ensure the proper
112operation of the equipment used to maintain the registry.
113     (c)  Fund health care advance directive education efforts
114as authorized in ss. 765.3065 and 765.3066.
115     Section 4.  Section 765.3061, Florida Statutes, is created
116to read:
117     765.3061  Health care advance directives and blood-type
118indication as part of driver's license or identification card
119process.--
120     (1)  The Agency for Health Care Administration and the
121Department of Highway Safety and Motor Vehicles shall develop
122and implement a program encouraging and allowing a person, at
123the person's request, to voluntarily make a health care advance
124directive, as well as to voluntarily provide his or her blood
125type, both of which may be noted on the person's driver's
126license or identification card, upon issuance or renewal of
127these documents.
128     (2)  The health care advance directive form and blood-type
129confirmation form, both of which are to be distributed by the
130department, shall be developed by the agency in consultation
131with the department. The health care advance directive form
132shall include the living will specified in s. 765.303, which
133must be executed in accordance with s. 765.302. The blood-type
134confirmation form must be signed by a person's physician or an
135agent of a blood bank or laboratory that has documentation of
136the person's blood type. The health care advance directive and
137blood-type confirmation forms may require additional information
138and may include additional material as deemed necessary by the
139agency and the department. An individual completing a health
140care advance directive form or blood-type confirmation form
141shall have included on his or her driver's license or
142identification card a notation on the front of the card clearly
143indicating the individual's intent concerning life-prolonging
144procedures and the individual's blood type. A notation on an
145individual's driver's license or identification card that the
146individual has a health care advance directive or that provides
147the individual's blood type is sufficient to satisfy all
148requirements concerning life-prolonging procedures and necessary
149blood-type information for health care providers.
150     (3)(a)  All forms relating to the execution, amendment, or
151revocation of a health care advance directive or blood-type
152confirmation for the purpose of participating in the registry
153shall be made available to the public at all offices of the
154Division of Driver Licenses, as well as electronically on the
155Internet.
156     (b)  The forms relating to the execution of a health care
157advance directive or confirmation of blood type, for purposes of
158participating in the registry, shall:
159     1.  Require an express declaration that the principal has
160read the form and understands its contents.
161     2.  Require an express waiver of any privacy rights granted
162under state or federal law.
163     3.  Require an express waiver of liability for health care
164providers who rely upon the information contained on the
165principal's driver's license or identification card or the
166registry.
167     4.  Require an acknowledgment from the principal that it is
168the responsibility of the principal to submit an amendment form
169or revocation form to the Division of Driver Licenses if it is
170the principal's desire to change or remove any document recorded
171in the registry.
172     5.  Require acknowledgment from the principal that a
173reasonable delay will occur in the recording of a newly executed
174form in the registry by the agency and department, regardless of
175whether it is a health care advance directive or blood-type
176confirmation form, or any amendment or revocation thereof, and
177that health care providers will rely on the information in the
178registry available at the time such information is obtained by a
179health care provider.
180     (4)  The agency shall provide the necessary supplies and
181forms through funds appropriated from general revenue, any
182authorized fees, or contributions from interested, voluntary,
183nonprofit organizations. The department shall provide the
184necessary recordkeeping system through funds appropriated from
185general revenue.
186     Section 5.  Section 765.3062, Florida Statutes, is created
187to read:
188     765.3062  Health care advance directive and blood-type
189registry; use of forms and delivery of documents.--
190     (1)  There is established a health care advance directive
191and blood-type registry. This registry shall be an expansion of
192the organ and tissue donor registry that is created,
193administered, and maintained in accordance with part V of this
194chapter.
195     (2)  The forms to be recorded in the registry shall be
196collected by the Department of Highway Safety and Motor Vehicles
197and provided to the Agency for Health Care Administration in a
198manner similar to the forms and information collected for
199anatomical gifts as provided in part V of this chapter. The
200registry shall record, through electronic means, health care
201advance directive and blood-type documents submitted through the
202driver's license identification program or obtained from other
203sources. The registry shall be maintained in a manner that will
204allow, through electronic and telephonic methods, immediate
205access to health care advance directive and blood-type documents
20624 hours a day, 7 days a week. Hospitals and other parties
207identified by rule of the agency shall be allowed access,
208through coded means, to the information stored in the registry.
209     (3)  If a health care advance directive is made through the
210program established under s. 765.3061, the completed health care
211advance directive shall be delivered to the department and
212processed in the manner specified in subsection (4). Delivery of
213the health care advance directive is not necessary for the
214validity of the health care advance directive. If a person
215amends or revokes a health care advance directive in accordance
216with s. 765.3063, the records of the department shall be updated
217to reflect such status of the health care advance directive.
218     (4)  If a health care advance directive is made by an
219individual, other than through the program established by the
220agency and the department, the document may be recorded in the
221registry administered by the agency and noted on an individual's
222driver's license, if the individual follows the procedure and
223the health care advance directive meets the criteria set forth
224in this chapter and in any rules of the department and the
225agency.
226     (5)  The agency and the department shall develop and
227implement a living will registry as an expansion and improvement
228of the organ donor database maintained by the agency.
229     Section 6.  Section 765.3063, Florida Statutes, is created
230to read:
231     765.3063  Amendment to or revocation of a health care
232advance directive or removal of blood type from the registry;
233responsibility of the participant; last documents submitted and
234recorded are controlling documents.--
235     (1)  A person may amend or revoke a health care advance
236directive by the execution and delivery of the appropriate form,
237signed and properly executed, to the Department of Highway
238Safety and Motor Vehicles to be transmitted to the Agency for
239Health Care Administration for recording in or removal from the
240registry.
241     (2)  If a person participates in the health care advance
242directive and blood-type registry, it is the responsibility of
243the principal to complete and submit the appropriate forms
244needed to amend or revoke the health care advance directive or
245blood-type information. If a person chooses to participate in
246the registry, the most recently submitted forms recorded in the
247registry shall be considered the controlling documents of the
248participant in any dispute or decision by a health care
249provider.
250     (3)  A person may remove the record of his or her blood
251type from the registry by signing a form provided by the
252department, as developed in conjunction with the agency, that is
253signed in the presence of an employee of the department.
254     (4)  Nothing in this section shall affect a principal's
255right to amend or revoke a health care advance directive or
256designation of a surrogate as authorized under s. 765.104 if the
257principal is not participating in the agency's health care
258advance directive and blood-type registry.
259     Section 7.  Section 765.3064, Florida Statutes, is created
260to read:
261     765.3064  Immunity from liability.--
262     (1)  Notwithstanding the express waiver of liability signed
263by the person who chooses to participate in the health care
264advance directive and blood-type registry, a health care
265facility or a health care provider, or any other person acting
266under the direction of a health care facility or health care
267provider, carrying out a health care decision made in accordance
268with a properly recorded health care advance directive or blood-
269type confirmation transmitted by the Department of Highway
270Safety and Motor Vehicles, is not subject to criminal
271prosecution or civil liability and will not be deemed to have
272engaged in unprofessional conduct.
273     (2)  The Agency for Health Care Administration and the
274Department of Highway Safety and Motor Vehicles and any
275employees acting within the scope of their employment are immune
276from criminal prosecution and civil liability for any acts or
277forms recorded in compliance with the provisions of this
278chapter.
279     Section 8.  Section 765.3065, Florida Statutes, is created
280to read:
281     765.3065  Education program relating to health care advance
282directives and blood-type registries.--The Agency for Health
283Care Administration, subject to the concurrence of the
284Department of Highway Safety and Motor Vehicles, shall develop a
285continuing education program to educate and inform health care
286professionals, including emergency medical personnel, law
287enforcement agencies and officers, state and local government
288employees, and the public regarding the laws of this state
289relating to the health care advance directives and the health
290care advance directive and blood-type registry as described in
291this chapter.
292     Section 9.  Section 765.3066, Florida Statutes, is created
293to read:
294     765.3066  Health care advance directives education panel.-?
295The Legislature recognizes that every competent adult has the
296fundamental right of self-determination regarding decisions
297pertaining to his or her health. This includes the right to
298choose or refuse medical treatment. A panel of three members
299appointed by the secretary of the Department of Elderly Affairs,
300the secretary of the Agency for Health Care Administration, and
301the secretary of the Department of Health shall jointly create a
302campaign on end-of-life care for purposes of educating the
303public. This campaign shall include culturally sensitive
304programs to improve understanding of end-of-life issues.
305Existing community resources, when available, shall be used to
306support the program, and volunteers and health care
307professionals may assist in the program to the maximum extent
308possible. The program aimed at educating health care
309professionals may be implemented by contract with one or more
310medical schools located in the state.
311     Section 10.  Effective upon this act becoming a law, the
312Agency for Health Care Administration shall conduct a study on
313how to implement the health care advance directive and blood-
314type registry and report its findings and recommendations to the
315Speaker of the House of Representatives and the President of the
316Senate by January 1, 2005. The study shall, at a minimum,
317examine and make recommendations concerning the following:
318     (1)  The nonrecurring capital outlay and recurring
319operational funding necessary to establish and maintain the
320health care advance directive and blood-type registry.
321     (2)  The efficiency and cost-effectiveness of databases and
322procedures used to maintain the data in the registry and to
323transfer forms between the Department of Highway Safety and
324Motor Vehicles and the Agency for Health Care Administration.
325     (3)  The reasonable timeframes necessary to record forms
326and other information in the registry and make such information
327available to health care facilities and appropriate
328professionals.
329     (4)  The types of disclosures and disclaimers necessary to
330be included in the forms used for the health care advance
331directive and blood-type registry.
332     (5)  The projected number of persons who may participate in
333the health care advance directive and blood-type registry and
334the sufficiency of the fees assessed to fund the registry and
335health care advance directive education efforts.
336     (6)  The most effective and cost-efficient means to
337implement the educational requirements contained in ss. 765.3065
338and 765.3066, Florida Statutes.
339     Section 11.  Except as otherwise provided herein, this act
340shall take effect September 1, 2005.


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