Bill Text: NY S03283 | 2023-2024 | General Assembly | Introduced

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Bill Title: Makes technical, minor and coordinating amendments regarding health care agents and proxies, decisions under the family health care decisions act, and nonhospital orders not to resuscitate.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Engrossed) 2024-03-13 - referred to health [S03283 Detail]

Download: New_York-2023-S03283-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                          3283

                               2023-2024 Regular Sessions

                    IN SENATE

                                    January 30, 2023
                                       ___________

        Introduced  by  Sen.  RIVERA -- read twice and ordered printed, and when
          printed to be committed to the Committee on Health

        AN ACT to amend the public health law, in relation to making  technical,
          minor  and  coordinating  amendments  regarding health care agents and
          proxies, decisions under the family health  care  decisions  act,  and
          nonhospital orders not to resuscitate

          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:

     1    Section 1. Paragraph (b) of subdivision  1  of  section  2981  of  the
     2  public  health  law,  as  added  by  chapter 752 of the laws of 1990, is
     3  amended to read as follows:
     4    (b) For the purposes of this section, every adult  shall  be  presumed
     5  competent  to  appoint  a  health care agent unless such person has been
     6  adjudged incompetent or otherwise adjudged not competent  to  appoint  a
     7  health care agent, or unless a [committee or] guardian of the person has
     8  been  appointed for the adult pursuant to article [seventy-eight] eight-
     9  y-one of the mental hygiene law or article  seventeen-A  of  the  surro-
    10  gate's court procedure act.
    11    §  2.  Subdivision  2  of  section  2982  of the public health law, as
    12  amended by chapter 230 of the laws  of  2004,  is  amended  to  read  as
    13  follows:
    14    2. Decision-making standard. After consultation with a licensed physi-
    15  cian,   registered   nurse,  physician  assistant,  nurse  practitioner,
    16  licensed psychologist, licensed master  social  worker,  or  a  licensed
    17  clinical  social worker, the agent shall make health care decisions: (a)
    18  in accordance with the principal's  wishes,  including  the  principal's
    19  religious  and  moral  beliefs; or (b) if the principal's wishes are not
    20  reasonably known and cannot with reasonable diligence be ascertained, in
    21  accordance with the principal's best interests; provided, however,  that
    22  if  the  principal's  wishes  regarding the administration of artificial
    23  nutrition and hydration are not reasonably known and cannot with reason-

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD05270-01-3
        S. 3283                             2

     1  able diligence be ascertained, the agent shall not have the authority to
     2  make decisions regarding these measures.
     3    §  3.  Subdivision  3  of  section  2983  of the public health law, as
     4  amended by chapter 342 of the laws  of  2018,  is  amended  to  read  as
     5  follows:
     6    3. Notice of determination. Notice of a determination that a principal
     7  lacks  capacity  to  make health care decisions shall promptly be given:
     8  (a) to the principal, orally and in writing, where there  is  any  indi-
     9  cation  of the principal's ability to comprehend such notice; (b) to the
    10  agent; (c) if the principal is  in  or  is  transferred  from  a  mental
    11  hygiene  facility, to the facility director; and (d) to the [conservator
    12  for, or committee of, the principal] guardian, if any.
    13    § 4. The opening paragraph of section 2992 of the public  health  law,
    14  as  amended  by  chapter  93  of the laws of 2014, is amended to read as
    15  follows:
    16    The health care provider[, the conservator for, or committee]  of  the
    17  principal  under article eighty-one of the mental hygiene law or article
    18  seventeen-A of the surrogate's court procedure act, members of the prin-
    19  cipal's family, a close friend of the principal as defined  in  subdivi-
    20  sion  [five]  four  of  section  [two thousand nine] twenty-nine hundred
    21  [sixty-one] ninety-four-a of  this  chapter,  or  the  commissioner  [of
    22  health],  the  commissioner  of  mental  health,  or the commissioner of
    23  developmental disabilities may commence a special proceeding pursuant to
    24  article four of the civil practice law and rules, in a court  of  compe-
    25  tent  jurisdiction, with respect to any dispute arising under this arti-
    26  cle, including, but not limited to, a proceeding to:
    27    § 5. Section 2993 of the public health law, as amended by chapter  672
    28  of the laws of 2019, is amended to read as follows:
    29    §  2993.  Regulations.  The  commissioner [of health], in consultation
    30  with the commissioners of the office of mental health and the office for
    31  people with developmental disabilities, shall establish such regulations
    32  as may be necessary for the implementation of this article,  subject  to
    33  the  provisions  of subdivision two of section [two thousand nine] twen-
    34  ty-nine hundred ninety-one of this article.
    35    § 6. Subdivisions 17 and 26 of section 2994-a  of  the  public  health
    36  law,  as  added by chapter 8 of the laws of 2010, are amended to read as
    37  follows:
    38    17. "Health or social [service] services practitioner" means a  regis-
    39  tered  professional  nurse,  nurse  practitioner,  physician,  physician
    40  assistant, psychologist, licensed master social worker or licensed clin-
    41  ical social worker, licensed or certified pursuant to the education  law
    42  acting within his or her scope of practice.
    43    26.  "Person connected with the case" means the patient, any person on
    44  the surrogate list, a parent or guardian of a  minor  patient,  [the]  a
    45  hospital  administrator,  an  attending  physician,  any other health or
    46  social services practitioner who is or has been directly involved in the
    47  patient's care, and any duly  authorized  state  agency,  including  the
    48  facility  director or regional director for a patient transferred from a
    49  mental hygiene facility and the facility director for a  patient  trans-
    50  ferred from a correctional facility.
    51    §  7.  Subdivision  3  of  section 2994-e of the public health law, as
    52  amended by chapter 708 of the laws  of  2019,  is  amended  to  read  as
    53  follows:
    54    3.  Decision-making  standards  and  procedures  for emancipated minor
    55  patient. (a) If an attending practitioner determines that a  patient  is
    56  an emancipated minor patient with decision-making capacity and documents
        S. 3283                             3

     1  the  basis  for  such determination in the patient's medical record, the
     2  patient shall have the authority to decide about life-sustaining  treat-
     3  ment.  Such  authority  shall include a decision to withhold or withdraw
     4  life-sustaining  treatment  if  an attending practitioner and the ethics
     5  review committee determine that the decision accords with the  standards
     6  for  surrogate  decisions  for  adults,  and the ethics review committee
     7  approves the decision.
     8    (b) If the hospital can with reasonable efforts ascertain the identity
     9  of the parents or guardian of an emancipated minor patient, the hospital
    10  shall make diligent efforts to notify such persons, and  documents  such
    11  diligent  efforts  in the patient's medical record, prior to withholding
    12  or withdrawing life-sustaining treatment pursuant to this subdivision.
    13    § 8. Subparagraph (iv) of paragraph (b) of subdivision  4  of  section
    14  2994-m  of  the public health law, as amended by chapter 708 of the laws
    15  of 2019, is amended to read as follows:
    16    (iv)  Following  ethics  review  committee  consideration  of  a  case
    17  concerning  the  withdrawal or withholding of life-sustaining treatment,
    18  treatment shall not be withdrawn or withheld until  the  hospital  makes
    19  diligent  efforts to inform the persons identified in subparagraph (iii)
    20  of this paragraph have been informed of the committee's response to  the
    21  case  and  documents  such  diligent  efforts  in  the patient's medical
    22  record.
    23    § 9. Section 2994-u of the public health law, as added by chapter 8 of
    24  the laws of 2010, is amended to read as follows:
    25    § 2994-u. Rights to be publicized. The commissioner  shall  prepare  a
    26  statement summarizing the rights, duties, and requirements of this arti-
    27  cle  and  shall  require  that  a copy of such statement be furnished to
    28  [patients] a patient or to [persons on] the surrogate [list known to the
    29  hospital], or to the [parents or guardians]  parent  or  guardian  of  a
    30  minor  [patients]  patient, at or prior to admission to the hospital, or
    31  within a reasonable time thereafter, and to [each member of  the  hospi-
    32  tal's  staff  directly  involved  with  patient  care] any person on the
    33  surrogate list who requests a copy of such statement from the  hospital.
    34  The  statement  shall  also  be  made available to the hospital clinical
    35  staff.
    36    § 10. The commissioner of health shall revise the statement of  rights
    37  that  hospitals  are  required  to  post (known as the Patient's Bill of
    38  Rights) pursuant to paragraph (g) of subdivision 1 of  section  2803  of
    39  the  public  health law, by replacing the clause regarding orders not to
    40  resuscitate with a statement that more  generally  informs  patients  of
    41  their  right  to  receive  from  the  hospital  upon admission, and upon
    42  request, a more complete statement  of  their  rights  with  respect  to
    43  deciding  about  health  care, including appointing a health care agent,
    44  consenting to do-not-resuscitate orders and making other life-sustaining
    45  treatment decisions. The clause should also state in substance that  the
    46  hospital  will  also  provide  such statement upon request to any family
    47  member or friend of a patient who lacks decision-making capacity.
    48    § 11. Subdivisions 12 and 13 of section 2994-aa of the  public  health
    49  law,  subdivision  12  as amended by chapter 672 of the laws of 2019 and
    50  subdivision 13 as amended   by chapter 167 of  the  laws  of  2011,  are
    51  amended to read as follows:
    52    12. "Mental hygiene facility" means a residential facility operated or
    53  licensed  by  the office of mental health [or the office for people with
    54  developmental disabilities].
    55    13. "Nonhospital order not to resuscitate" means an order that directs
    56  emergency medical  services  personnel,  hospice  personnel,  home  care
        S. 3283                             4

     1  services  agency personnel and hospital emergency services personnel not
     2  to attempt cardiopulmonary resuscitation in the event a patient  suffers
     3  cardiac or respiratory arrest.
     4    §  12.  Subdivisions  2  and 6 of section 2994-dd of the public health
     5  law, as amended by chapter 708 of the laws of 2019, are amended to  read
     6  as follows:
     7    2. A nonhospital order not to resuscitate shall be issued upon a stan-
     8  dard  form  prescribed by the commissioner. [The commissioner shall also
     9  develop a] A standard bracelet or other article that may be  worn  by  a
    10  patient  with  a  nonhospital  order not to resuscitate to identify that
    11  status; provided, however, that no person may require a patient to  wear
    12  such  a bracelet and that no person may require a patient to wear such a
    13  bracelet as a condition for honoring a nonhospital order not to resusci-
    14  tate or for providing health care services.
    15    6. The commissioner may authorize the use of one or  more  alternative
    16  forms  for  issuing  a nonhospital order not to resuscitate (in place of
    17  the standard form prescribed by the commissioner under  subdivision  two
    18  of  this  section).  Such  alternative form or forms may also be used to
    19  issue a non-hospital do not intubate order. Any such  alternative  forms
    20  intended  for use for persons with developmental disabilities or persons
    21  with mental illness who are incapable of making their  own  health  care
    22  decisions  or  who  have  a guardian of the person appointed pursuant to
    23  article eighty-one of the mental hygiene law or article  seventeen-A  of
    24  the surrogate's court procedure act must also be approved by the commis-
    25  sioner  of  developmental  disabilities  or  the  commissioner of mental
    26  health, as appropriate. An alternative form under this subdivision shall
    27  otherwise conform with applicable federal and state law.  This  subdivi-
    28  sion  does  not limit, restrict or impair the use of an alternative form
    29  for issuing an order not to resuscitate in a general hospital  or  resi-
    30  dential  health care facility under article twenty-eight of this chapter
    31  or a hospital under subdivision  ten  of  section  1.03  of  the  mental
    32  hygiene  law  or  a  developmental  disabilities  services  office under
    33  section 13.17 of the mental hygiene law.
    34    § 13. Section 2994-gg of the public health law, as added by chapter  8
    35  of the laws of 2010, is amended to read as follows:
    36    §  2994-gg.  Immunity. No person shall be subjected to criminal prose-
    37  cution or civil liability, or be deemed to  have  engaged  in  unprofes-
    38  sional  conduct,  for  honoring reasonably and in good faith pursuant to
    39  this [section] article a  nonhospital  order  not  to  resuscitate,  for
    40  disregarding a nonhospital order pursuant to section twenty-nine hundred
    41  ninety-four-ee  of  this  article, or for other actions taken reasonably
    42  and in good faith pursuant to this [section] article.
    43    § 14. This act shall take effect on the ninetieth day after  it  shall
    44  have  become  a law, provided that the amendments to article 29-C of the
    45  public health law shall apply to decisions made pursuant to health  care
    46  proxies created prior to the effective date of this act as well as those
    47  created thereafter.