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Consent

Overview

Consent

Consent issues arise in a wide variety of circumstances including informed consent to medical procedures, release of patient information, advance health directives, research, and reporting requirements.  CHA provides assistance to members in meeting consent requirements and advocates legislation that makes consent requirements more useful and understandable.

Consent issues arise in a wide variety of circumstances including informed consent to medical procedures, release of patient information, advance health directives, research, and reporting requirements.  CHA provides assistance to members in meeting consent requirements and advocates legislation that makes consent requirements more useful and understandable.

CHA News Article

New Law Addresses Voluntary Psychiatric Care in Emergency Departments

Sheree Lowe Lois Richardson

The California Department of Public Health reminds general acute care hospitals and acute psychiatric hospitals that, effective Jan. 1, they may not require, as a condition of admission, a person who voluntarily seeks care to be placed on an involuntary hold under Section 5150 of the Welfare and Institutions Code.

CHA News Article

Hospitals Required to Offer Declaration of Paternity Forms

Lois Richardson

State law requires birthing hospitals to offer fathers — if available — the opportunity to complete a Declaration of Paternity form when the mother is unmarried.

Hospitals must attempt to have the parents complete all required data elements on the Declaration of Paternity form (CS 909) prior to submission to the California Department of Child Support Services (DCSS). DCSS has asked CHA to remind hospitals that the Social Security number (SSN) field must be completed. Individuals who do not have a SSN should check the box on the form that states, “By checking this box, I declare under penalty of perjury under the laws of the State of California that I do not have a Social Security number.” If a parent declines to provide a SSN or select the check box, the Declaration of Paternity form may not be used to establish paternity. Incomplete forms should not be sent to DCSS.

Additional details about the Declaration of Paternity form and process are included in CHA’s Consent Manual – A Reference for Consent and Related Healthcare Law. Questions about the Declaration of Paternity form should be directed to the California Paternity Opportunity Program at askpop@dcss.ca.gov or (916) 464-1982.

CHA News Article

CDC Updates Information Statements for Certain Vaccines

Lois Richardson

The Centers for Disease Control and Prevention (CDC) has released an updated vaccine information statement for DTaP and meningococcal ACWY. Federal law requires that health care providers give the relevant vaccine information statement to each patient (or parent/legal representative) who is vaccinated. CDC provides the informational handouts in more than 40 different languages at www.cdc.gov/vaccines/hcp/vis/.

Ideally, providers should begin using the updated statements immediately; however, CDC has stated that existing stocks may be used until depleted. To subscribe to the CDC’s email notification service about vaccine information statements, register online.

CHA’s Consent Manual — A Reference for Consent and Related Health Care Law includes a complete discussion of vaccination handouts, consent and required documentation.

CHA News Article

CHA Publications Help Hospitals Comply with Complicated Laws

Lois Richardson

CHA’s publications include numerous legal manuals, forms and other documents to help California hospitals understand and comply with the law — and save time and money.

 “CHA brings together state and federal statutes and regulations in one place to make hospitals’ job easier,” said Lois Richardson, Esq., CHA vice president and legal counsel. “The manuals don’t just repeat the law; they explain complex legal requirements in clear and concise language to tell you exactly what you need to do to comply.”

Publications cover a variety of health care topics, including health information privacy, consent law, mental health law, hospital compliance, charity care and discount policies, minors, patient “anti-dumping” laws, records retention and other key issues.

All legal manuals are regularly reviewed and updated as needed to ensure legal accuracy. Recent updates include the standard-setting Consent Manual, revised to cover legal changes through January 2018, and the 2018 EMTALA Manual. For the latest editions, visit www.calhospital.org/Publications. New this year, some publications are available in an electronic format.  

CHA News Article

Two Tests Added to Newborn Screening Program
CDPH increases fee to cover costs

Lois Richardson

The California Department of Public Health (CDPH) has added two tests, effective July 19, to California’s Newborn Screening Program. To cover the costs of the additional tests — for Mucopolysaccharidosis Type I (MPS I) and Pompe disease — CDPH has increased the fee from $129.25 to $141.25.

California’s statewide newborn testing program screens for over 80 genetic and metabolic disorders that can lead to severe intellectual and physical disabilities. For many of these disorders, irreversible damage has taken place by the time symptoms are observable. This can be prevented or minimized with early diagnosis through newborn screening, coupled with appropriate treatment. All California hospitals must collect a blood specimen from each newborn to send to the state-approved lab in the hospital’s service area. For details about California’s newborn screening program, see Chapter 13 of CHA’s Consent Manual – A Reference for Consent and Related Healthcare Law, or visit www.cdph.ca.gov/programs/cfh/dgds/pages/nbs/about-nbs-page.aspx. 

CHA News Article

Court of Appeal Grants CHA Request for Published Opinion
Court ruled in favor of hospital, physicians in wrongful death suit

Lois Richardson

The California Court of Appeal last week granted CHA’s request to publish its opinion in Alexander v. Scripps Memorial Hospital La Jolla et al. CHA requested that the court publish the decision because of the important legal issues it addresses, and because having it published allows attorneys in future cases to rely on it.

In the case, a patient with incurable stage four pancreatic cancer was transferred to a hospital from a skilled-nursing facility (SNF) for evaluation. The transferring physician did not believe she would return to the SNF, as he believed her death was imminent. The patient had completed an advance directive and a Physician Orders for Life Sustaining Treatment (POLST) form electing to have all measures taken to prolong her life, including full resuscitation if necessary. All physicians caring for the patient agreed that cardiac compression would be futile and cause harm and suffering. The family said they understood her condition was terminal, but still wanted full resuscitation.

CHA News Article

CHA Requests Published Opinion From California Court of Appeal
Court ruled in favor of hospital, physicians in wrongful death suit

Lois Richardson

CHA filed a request yesterday with the California Court of Appeal to publish its opinion in Alexander v. Scripps Memorial Hospital La Jolla et al. In that case, a patient with incurable stage four pancreatic cancer was transferred to a hospital from a skilled-nursing facility (SNF) for evaluation. The transferring physician did not believe she would return to the SNF, as he believed her death was imminent. The patient had completed an advance directive and a Physician Orders for Life Sustaining Treatment form electing to have all measures taken to prolong her life, including full resuscitation if necessary. All physicians caring for the patient agreed that cardiac compression would be futile and cause harm and suffering. The family said they understood her condition was terminal, but still wanted full resuscitation.

The physicians consulted the hospital’s Appropriate Care Committee, which met at the patient’s bedside, reviewed her medical records and spoke with her physicians. The committee explained to the family that doctors could not embark on ineffective care. The patient died three days after admission, having received palliative care and pain control, but without receiving cardiac compression. She died about an hour before she was scheduled to be transferred to another facility that the family believed would comply with its directions. The family sued, alleging 16 different causes of action, including malpractice, wrongful death, elder abuse, misrepresentation, infliction of emotional distress and violations of state law regarding advance directives.

CHA News Article

2018 Consent Manual Released – Now Available Electronically
Registration also open for Consent Law seminars

CHA is pleased to announce the 2018 Consent Manual is now available. Updated to reflect changes to state and federal health care law through January 2018, the Consent Manual is the most comprehensive resource available on consent for medical treatment, covering minors, mental health, end-of-life care, advance health care directives, patients’ rights, privacy basics, reporting requirements and related health care law.

The 2018 Consent Manual has been updated to address:

  • Requirements specific to prescribing opioids
  • A new law requiring hospitals to prohibit Immigration and Customs Enforcement agents in parts of the hospital
  • New requirements for hospitals to notify ambulance personnel when they bring a patient with a communicable disease to the emergency department
  • Information about overlapping surgeries
  • Updates on California’s medical and recreational marijuana laws, and more

One complimentary copy of this acclaimed publication will be sent to each member CEO this week.

CHA News Article

CURES Database Ready for Statewide Use
Mandatory consultation begins Oct. 2

Lois Richardson David Perrott, MD, DDS

This week the Department of Justice certified that the Controlled Substance Utilization Review and Evaluation System (CURES) version 2.0 is ready for statewide use. CURES is a database that contains records of prescriptions for Schedule II, III and IV controlled substances dispensed in the state.

Senate Bill 482 (Chapter 708, Statutes of 2016) required health practitioners to consult a patient’s history in CURES before prescribing him or her a Schedule II, III or IV controlled substance for the first time, and then at least once every four months as long as the prescription continued to be renewed. Consultation is not required when controlled substances are administered to inpatients or to certain other patients treated in a health facility.

The bill delayed implementation of this requirement until six months from the date the Department of Justice certified that the database is ready for statewide use and that the program has adequate staff. Therefore, mandatory CURES consultation will take effect Oct. 2. For additional information, visit https://oag.ca.gov/cures.

CHA’s 2018 Consent Manual – A Reference for Consent and Related Healthcare Law includes a complete discussion of the CURES requirements and exceptions, as well as information about the Medical Board of California’s guidelines for prescribing opioids. For more information about the manual, or to order, go to www.calhospital.org/publication/2018-consent-manual.

CHA News Article

CDC Releases Updated Rotavirus Vaccine Statement

Lois Richardson

The Centers for Disease Control and Prevention (CDC) has released an updated vaccine information statement for rotavirus. Federal law requires that health care providers give the relevant vaccine information statement to each patient (or parent/legal representative) who is vaccinated. CDC provides the informational handouts in more than 40 different languages at www.cdc.gov/vaccines/hcp/vis/. CHA’s Consent Manual — A Reference for Consent and Related Health Care Law includes a complete discussion of vaccination handouts, consent and required documentation. CDC released updated statements for recombinant zoster, MMR, MMRV, varicella and live zoster earlier in February.  

Ideally, providers should begin using the updated statements immediately; however, CDC has stated that existing stocks may be used until depleted. To subscribe to the CDC’s email notification service about vaccine information statements, register online.

CHA News Article

CDC Issues Updated Vaccine Information

The Centers for Disease Control and Prevention has made available updated vaccine information statements in more than 40 different languages.

Recording

Advanced Decision Making for EMTALA Webinar
EMTALA principles, case scenario learning, surveyor compliance tips

Webinar Recorded Live on November 14, 2014

Overview

Whether you are a sending or receiving hospital, many factors must be considered when dealing with a potential EMTALA situation. Knowing the right thing to do isn’t easy, especially in a stressful or busy emergency department.

Recording

Minors Health Care — The Basics of Consent, Privacy and More Webinar
Learn about the rules, exceptions to the rules, practical solutions to common problems

Webinar Recorded Live on October 29, 2014

Overview

This scenario plays out in hospitals every day: grandmother, teacher, neighbor or concerned friend brings a minor to the hospital. No parent in sight. Now what?

Can you treat the minor? Whose consent do you need? Who should you talk to about the minor’s treatment options? These are all too common questions that often challenge the most seasoned health care providers.

Commands