Current through Register 2024 Notice Reg. No. 38, September 20, 2024
(a)
Immediately upon issuance of an order pursuant to Penal Code (PC), section
2604, by an Administrative Law
Judge (ALJ), the Medication Court Administrator shall transmit a copy of the
order to the Office of Legal Affairs, CDCR; the institution Chief Nursing
Executive; Chief Executive Officer (CEO); and Chief Medical
Executive.
(b) Upon receipt of an
order pursuant to PC, section
2604, by an ALJ, the CEO of the
institution where the patient is located shall ensure that the following
occurs:
(1) Within one day of receipt of the
order, a health care provider familiar with the case shall note in the health
record the results of the hearing and route the matter back to the
Interdisciplinary Treatment Team or the Primary Care Team, as applicable, to
have the patient's treatment plan updated to reflect both the ALJ ruling and
plan for implementation of the ruling.
(2) Within one day of receipt of the order,
ensure that the patient's health record, or medical chart if being cared for at
an outside facility, is updated to reflect the appointment of a surrogate
decisionmaker with the person's contact information, and ensure that health
care providers caring for the patient are aware that a surrogate decisionmaker
has been appointed.
(3) If a family
member is designated as a surrogate decisionmaker, a Registered Nurse (RN),
Supervising Registered Nurse (SRN) II, SRN III, health care provider, or
designee shall be assigned, within five business days of receipt of the order,
to prepare a summary limited to what is outlined in the petition as it pertains
to treatment.
(A) This summary shall be
completed within seven business days of receipt of the order.
(B) The health care provider referenced in
subsection (b)(1) shall review the summary for accuracy and completeness before
it is to be disclosed to the appointed surrogate decisionmaker.
1. A written summary shall be provided to the
designated surrogate upon appointment. Upon request of the surrogate
decisionmaker, an updated summary shall be provided on a quarterly
basis.
(C) The RN, SRN
II, SRN III, or health care provider assigned in subsection (b)(3) shall
communicate the contents of the summary with the designated surrogate
decisionmaker within 14 calendar days following the hearing.
1. Communication of the summary may either be
by phone or secure and encrypted electronic mail.
(4) The surrogate decisionmaker shall be
provided the institution's release of information phone number to be used to
make inquiries about the patient.
(A) Health
care providers shall have five business days to respond to any inquiry from an
appointed surrogate decisionmaker received through the release of information
phone line.
(5) If the
patient requires emergent care for a serious or life-threatening issue, the
outside facility or institution shall attempt to contact the appointed
surrogate decisionmaker to obtain consent.
(c) Pursuant to a valid ALJ order under PC,
section 2604, and 45 Code of Federal
Regulations, section 164.512(e), the outside facility or institution shall
timely disclose relevant protected health information of the patient to the
appointed surrogate decisionmaker where that information is directly relevant
to the patient's care and needed to allow the appointed surrogate decisionmaker
to give or withhold informed consent on behalf of the patient.
(d) If an appointed surrogate decisionmaker
gives notice that they can no longer serve, becomes incapacitated and thus
unable to serve, or if there is any indication that the appointed surrogate
decisionmaker is not appropriately fulfilling their duties, fails to respond to
communications from the outside facility or institution, or cannot be reached,
the Department shall then communicate with the alternate surrogate
decisionmaker.
(1) If the alternate appointed
surrogate decisionmaker gives notice that they can no longer serve, becomes
incapacitated and thus unable to serve, or if there is any indication that the
alternate appointed surrogate decisionmaker is not appropriately fulfilling
their duties or fails to respond to communications from the outside facility or
institution, or cannot be reached, the Department shall then place the case
back on the Office of Administrative Hearings' calendar within 45 calendar days
of receiving such information and seek appointment of a substitute and
alternate surrogate decisionmaker.
(e) Nothing in this section creates an
entitlement or exception in favor of a surrogate decisionmaker to circumvent an
institution's standard security screening, visitation procedures, and
protocols.
(f) If a patient's
health condition materially declines, or if additional factors develop that
were not originally pleaded, the Department may file a motion to modify the
original petition to include the new information.
1. New
section filed 3-1-2021; operative 3-1-2021 pursuant to Government Code section
11343.4(b)(3)
(Register 2021, No. 10).
Note: Authority cited: Section
5058, Penal
Code. Reference: Sections
2604 and
5054, Penal
Code.
