Relates to orders not to resuscitate; repealer

BILL NUMBER:S4792

Title of bill

An act to amend the public health law, in relation to orders not to resuscitate; and to repeal article 29-B of the public health law relating to orders not to resuscitate for residents of mental hygiene facilities

Purpose

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

Summary of provisions

Section 1 repeals Public Health Law Article 29-B.

Section 2 amends § 2994-b to add subdivision 1-a to make the FHCDA applicable to decisions regarding orders not to resuscitate for a patient in an OMH licensed psychiatric hospitals and psychiatric units of general hospitals.

Section 3 amends PHL § 2994-cc(5) to delete a reference to PHL Article 29-B. Section 4 amends PHL § 2994-ff to delete a reference to PHL Article 29-B. Section 5 sets forth the effective date.

Justification

This bill repeals PHL Art 29-B Orders Not To Resuscitate For Residents Of Mental Hygiene Facilities.

Prior to 2010, PHL Art. 29-B governed DNR orders in hospitals, nursing homes, mental hygiene facilities and elsewhere. Ch. 8, L. 2010 (i) replaced the DNR Law with the FHCDA in hospitals and nursing homes, (ii) amended PHL Art. 29-B to make it applicable only to residents of mental hygiene facilities, i.e., psychiatric hospitals, psychiatric units of general hospitals, and OPWDD operated developmental centers,

and (iii) created PHL Art. 29-CCC - Nonhospital Orders Not To Resuscitate, to cover all other settings.

It soon became clear that there is no need for a separate DNR law for residents of mental hygiene facilities. First, DNR orders for residents of OPWDD-operated developmental centers were already governed by SCPA § 1750-b, making PHL Art. 29-B redundant. Second, DNR orders in psychiatric hospitals and general hospital mental health units were more appropriately governed by the provisions in the FHCDA. Moreover variations in DNR procedures and standards especially between the procedures and standards in hospital medical units and hospital mental health units have become a source of confusion and complexity.

Accordingly section 1 of this bill repeals PHL Art. 29-B. Related amendments in this bill provide that DNR decisions for patients in psychiatric hospitals and units are governed by the FHCDA and confirm that DNR decisions for all persons with developmental disabilities are governed by SCPA 1750-b (§§ 2 - 4).

Legislative history

S.7152 of 2014 S.5321 (Sen. Hannon) (2013)/ A.7371 (M. of A. Gottfried)(2013) included all of these provisions, as well as other provisions.

Fiscal implications

None.

Effective date

This act shall take effect on the ninetieth day after it shall have become a law.