Relates to health care agents, decisions under the family care decisions act and nonhospital orders not to resuscitate

Summary of provisions

This is one of a series of seven bills, informally referred to as the "Surrogate Decision-Making Improvement Acts." The bills make technical/minor, clarifying and coordinating amendments and other improvements to the NYS laws that govern health care decisions, including life-sustaining treatment decisions, for patients who lack decision-making capacity. The SDMIAs address these topics:

*SDMIA 1 Technical / Minor Amendments

*SDMIA 2 Repeals PHL Art. 29-B Orders Not to Resuscitate for Patients in Mental Hygiene Facilities

*SDMIA 3 Determining Patient Incapacity

*SDMIA 4 Decisions by a Health Care Agent About Artificial Nutrition and Hydration

*SDMIA 5 Confirm the Primacy of a Patient's Clear Prior Decision

*SDMIA 6 Restore Medical Futility as a Basis for a DNR Order

*SDMIA 7 Life-Sustaining Treatment Decisions for Developmentally Disabled Persons

This bill, SDMIA 1, makes technical, minor and coordinating amendments to the Family Health Care Decisions Act (Chapter 8 of the Laws of 2010 - FHCDA) and related laws.

Section 1 amends PHL § 2980, subdivs. 4 and 10: to clarify that the provision of nutrition and hydration orally, without reliance on medical treatment, is not "health care" within the meaning of the article, as stated in the Family Health Care Decisions Act (FHCDA); and to substitute the name, "office for people with developmental disabilities" (hereinafter OPWDD) for the former name, office of mental retardation and developmental disabilities" (hereinafter, OMRDD).

Section 2 amends PHL § 2981(b) to delete the outdated term "committee" and to insert the correct reference to MHL Article 81.

Section 3 amends PHL § 2982(2) to add "physician assistant and nurse practitioner" to the list of professionals, one of whom an agent must consult with before making a decision.

Section 4 amends PHL § 2983(3) to replace outdated references to "the conservator for, or committee of a principal with a reference to "the guardian, if any, for the principal."

Section 5 amends PHL § 2991 (2) to substitute OPWDD for OMRDD.

Section 6 amends PHL § 2992 to replace outdated references, including changing "the conservator for, or committee of a principal with the correct reference to "the guardian" of the principal

Section 7 amends § 2993 to substitute OPWDD for OMRDD.

Section 8 amends three subdivisions in PHL § 2994-a (Definitions): Amends "Health or social services practitioner" to include "licensed master social worker." Substitutes OPWDD for OMRDD. Changes "the hospital administrator" to "a hospital administrator "

Section 9 amends PHL § 2994-b(3)(a) to change "mental retardation or a developmental disability" to "a developmental disability." Corrects a spelling error.

Section 10 amends PHL § 2994-e to clarify that the obligation a hospital has to notify the parents or guardian of an emancipated minor is to make "diligent efforts" to notify such persons, and to require documentation of the basis for the determination of emancipation and capacity, and thof the diligent efforts.

Section 11 amends PHL § 2994-m(4)(b)(iv) to clarify that the obligation an ethics committee has to notify certain persons is to make "diligent efforts" to notify such persons, and to document such efforts, Section 20 amends PHL § 2994-t(2) to substitute OPWDD for OMRDD.

Section 12 amends PHL § 2994-t to correct references to the commissioners of OMH and OPWDD.

Section 13 amends PHL § 2994-u to direct the commissioner of health to require that a copy of the statement of rights under this article be furnished "to a patient or to the surrogate, or to the parent or guardian of a minor patient, at or prior to admission to the hospital, or within a reasonable time thereafter, and to any person on the surrogate list who requests a copy of such statement from the hospital. The statement shall also be made available to the hospital clinical staff."

Section 14 directs the commissioner of health to revise the statement of rights that hospitals are required to post (known as the Patient's Bill of Rights) by replacing the clause regarding orders not to resuscitate with a statement about a broader range health care decision-making rights.

Section 15 amends § 2994-aa subdivisions 12 and 13 and adds 14-a to, substitute OPWDD for OMRDD, to provide that a nonhospital order not to

resuscitate also applies to home care services agency personnel and school health personnel, and to define "school health personnel.

Section 16 amends PHL § 2994-bb(1)(a) to make the nonhospital DNR provisions applicable to school health personnel.

Section 17 amends § 2994-dd(2) to delete a reference to the commissioner's obligation to develop a standard DNR bracelet, and to refer to a standard bracelet "or other article", and amends 2994-dd.6 to allow alternate forms for nonhospital DNR orders in developmental disability services offices.

Section 18 amends PHL § 2994-gg to substitute the word "article" for the word "section" in two places. Section 19 is the effective date ninety days after it becomes a law.

Justification

This bill amends the Family Health Care Decisions Act (Ch 8. Laws of 2010) (FHCDA). It makes technical, minor and coordinating amendments to related laws.

Legislative history

S.7151-A of 2014

Fiscal implications

None.

Effective date

This act shall take effect ninety days after the date on which this act shall have become a law. The amendments to article 29-C of the public health law shall apply to decisions made pursuant to health care proxies created prior to this act becoming law as well as those created thereafter.