PRINTER'S NO. 2996
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No.
2111
Session of
2019
INTRODUCED BY BERNSTINE, RYAN, PICKETT, TOPPER, KEEFER,
YOUNGBLOOD, CIRESI AND DeLUCA, DECEMBER 9, 2019
REFERRED TO COMMITTEE ON HEALTH, DECEMBER 9, 2019
AN ACT
Amending the act of July 19, 1979 (P.L.130, No.48), entitled "An
act relating to health care; prescribing the powers and
duties of the Department of Health; establishing and
providing the powers and duties of the State Health
Coordinating Council, health systems agencies and Health Care
Policy Board in the Department of Health, and State Health
Facility Hearing Board in the Department of Justice;
providing for certification of need of health care providers
and prescribing penalties," in licensing of health care
facilities, providing for do-not-resuscitate orders for
minors.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. The act of July 19, 1979 (P.L.130, No.48), known
as the Health Care Facilities Act, is amended by adding a
section to read:
Section 806.5. Do-not-resuscitate orders for minors.
(a) Prohibition.--A health care provider may not implement a
do-not-resuscitate order without engaging in a discussion with a
parent or legal guardian of the minor about all of the
following:
(1) The minor's care plan, including the implementation
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of a do-not-resuscitate order and what the do-not-resuscitate
order means for the minor.
(2) The rights of a parent or legal guardian of a minor
specified under subsection (e).
(b) Witnesses and records.--The discussion under subsection
(a) shall be made with a witness present, other than a parent or
legal guardian of the minor, who is willing to confirm that the
discussion under subsection (a) took place. The provider shall
ask a parent or legal guardian of the minor to sign a written
acknowledgment of the discussion. The provider shall immediately
document and record the following information about the
discussion in the minor's medical record:
(1) The individuals who engaged in the discussion.
(2) Each witness to the discussion, not including a
parent or legal guardian of the minor.
(3) The date and time of the discussion.
(c) Failure to contact.--The requirements under subsections
(a) and (b) shall not apply if the health care provider makes a
reasonably diligent and documented effort to contact a parent or
legal guardian of the minor and the provider is unable to
contact a parent or legal guardian of the minor within a 48-hour
period.
(d) Execution of orders.--
(1) If a health care provider enters a do-not-
resuscitate order for a minor, the provider shall document
the reason for the do-not-resuscitate order in the minor's
medical record.
(2) Nothing in this section shall be construed to
require a health care provider to implement resuscitative
measures or continue to implement resuscitative measures on a
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minor if the measures are medically inappropriate in the
provider's reasonable medical judgment because the measures
would:
(i) create a greater risk of causing or hastening
the minor's death; or
(ii) be potentially harmful or cause unnecessary
pain, suffering or injury to the minor.
(e) Rights of parents or guardians.--
(1) A parent or legal guardian of a minor may request
that the minor be transferred to another health care facility
at any time during the process specified under subsections
(a) and (b). If the parent or legal guardian requests a
transfer under this paragraph, the health care provider shall
provide a reasonable time for the parent or legal guardian to
find another provider that will accept the minor before
implementing a do-not-resuscitate order. The provider shall
furnish the minor's medical records to a health care facility
that requires the medical records to determine whether the
health care facility is willing to care for the minor. If a
health care facility is willing to accept the minor, the
provider shall make reasonable efforts to facilitate the
transfer to the health care facility.
(2) A parent or legal guardian may petition a court of
competent jurisdiction where the minor resides or where the
minor is receiving treatment for an order enjoining an action
that violates this section or to resolve a conflict between
the minor's parents or legal guardians regarding a do-not-
resuscitate order under this section. Upon receiving a
petition under this paragraph, the court shall issue an order
fixing the date, time and place of a hearing on the petition
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and order that notice of the hearing be given to the
interested parties. A preliminary hearing may be held without
notice if the court determines that holding a preliminary
hearing without notice is necessary to prevent imminent
danger to the minor's life. In the court's discretion, a
hearing may be conducted in a courtroom, the health care
facility where the minor is receiving treatment or at some
other suitable location. A provider may not implement a do-
not-resuscitate order until the final determination is made
by the court under this paragraph, including any pending
appeal.
(f) Policy disclosures.--Upon request of a patient or
resident or a prospective patient or resident, a health care
provider shall disclose in writing any policies involving
resuscitation or life-sustaining measures, including any
policies relating to measures deemed nonbeneficial, ineffective,
futile or inappropriate. Nothing in this subsection
shall be construed to require a provider to have a written
policy relating to resuscitation, life-sustaining measures or
measures deemed nonbeneficial, ineffective, futile or
inappropriate for patients or residents.
(g) Definitions.--As used in this section, the following
words and phrases shall have the meanings given to them in this
subsection unless the context clearly indicates otherwise:
"Comfort care." A treatment given in an attempt to protect
and enhance the quality of life of an individual without
artificially prolonging the life of the individual.
"Do-not-resuscitate order." An order in a patient's medical
record that reflects a decision to forgo cardiopulmonary
resuscitative measures. The term does not include withholding
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other medical interventions deemed necessary to provide a
patient with comfort care or to alleviate pain.
"Minor." An unemancipated individual who is under 18 years
of age and not under juvenile court supervision or in active
duty with the armed forces of the United States.
Section 2. This act shall take effect in 60 days.
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