Florida 2025 Regular Session

Florida House Bill H0353 Compare Versions

Only one version of the bill is available at this time.

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3	3	HB 353 2025
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7	7	CODING: Words stricken are deletions; words underlined are additions.
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10	10	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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14	14	A bill to be entitled 1
15	15	An act relating to patient -directed medical orders; 2
16	16	amending s. 765.101, F.S.; revising and providing 3
17	17	definitions; amending s. 765.102, F.S.; revising 4
18	18	legislative findings and intent to include palliative 5
19	19	care for progressive illnesses; creating s. 765.3041, 6
20	20	F.S.; providing purpose and requirements for a 7
21	21	patient-directed medical order; authorizing the use of 8
22	22	telehealth for a specified purpose; requiring that 9
23	23	certain health care services be provided to the 10
24	24	principal regardless of the decision to withhold or 11
25	25	withdraw life-prolonging procedures; authorizing 12
26	26	physicians, physician assistants, and advanced 13
27	27	practice registered nurses to withhold or withdraw 14
28	28	life-prolonging procedures under certain circumstances 15
29	29	without penalty; providing construction; amending ss. 16
30	30	395.1041, 400.142, 400.487, 400.605, 400.6095, 17
31	31	400.611, 401.35, 401.45, 429.255, 429.73, 744.4431, 18
32	32	752.001, 765.110, 765.204, 765.205, and 765.305, F.S .; 19
33	33	conforming cross-references and provisions to changes 20
34	34	made by the act; requiring the Agency for Health Care 21
35	35	Administration to create and update a database for the 22
36	36	storage of patient-directed medical orders; providing 23
37	37	an effective date. 24
38	38	25
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40	40	HB 353 2025
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47	47	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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49	49
50	50
51	51	Be It Enacted by the Legislature of the State of Florida: 26
52	52	27
53	53	Section 1. Subsections (15) through (22) of section 28
54	54	765.101, Florida Statutes, are renumbered as subsections (16) 29
55	55	through (23), respectively, subsections (1) and (7) are amended, 30
56	56	and a new subsection (15) is added to that section, to read: 31
57	57	765.101 Definitions. —As used in this chapter: 32
58	58	(1) "Advance directive" means a witnessed written document 33
59	59	or oral statement in which instructions are given by a principal 34
60	60	or in which the principal's desires are express ed concerning any 35
61	61	aspect of the principal's health care or health information, and 36
62	62	includes, but is not limited to, the designation of a health 37
63	63	care surrogate, a living will, or an anatomical gift made 38
64	64	pursuant to part V of this chapter. An advance directive may 39
65	65	also include a patient -directed medical order. 40
66	66	(7) "Health care facility" means a hospital, nursing home, 41
67	67	hospice, home health agency, or health maintenance organization 42
68	68	licensed in this state, a or any facility subject to part I of 43
69	69	chapter 394, or an assisted living facility or adult family -care 44
70	70	home licensed under chapter 429 . 45
71	71	(15) "Patient-directed medical order" means a medical 46
72	72	order created by the principal in collaboration with a 47
73	73	physician, a physician assistant, or an advanced practice 48
74	74	registered nurse registered under s. 464.0123 which is portable 49
75	75	across health care settings and accessible in a volunteer, 50
76	76
77	77	HB 353 2025
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84	84	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
85	85
86	86
87	87
88	88	online registry. 51
89	89	Section 2. Subsection (6) of section 765.102, Florida 52
90	90	Statutes, is amended to read: 53
91	91	765.102 Legislative findings and intent.— 54
92	92	(6) For purposes of this chapter: 55
93	93	(a) Palliative care is the comprehensive management of the 56
94	94	physical, psychological, social, spiritual, and existential 57
95	95	needs of patients. Palliative care is especially suited to the 58
96	96	care of persons who hav e incurable or, progressive illnesses. 59
97	97	(b) Palliative care may must include: 60
98	98	1. An opportunity to discuss and plan for end -of-life 61
99	99	care. 62
100	100	2. Assurance that physical and mental suffering will be 63
101	101	carefully attended to. 64
102	102	3. Assurance that preferences fo r withholding and 65
103	103	withdrawing life-sustaining interventions will be honored. 66
104	104	4. Assurance that the personal goals of the dying person 67
105	105	will be addressed. 68
106	106	5. Assurance that the dignity of the dying person will be 69
107	107	a priority. 70
108	108	6. Assurance that health care providers will not abandon 71
109	109	the dying person. 72
110	110	7. Assurance that the burden to family and others will be 73
111	111	addressed. 74
112	112	8. Assurance that advance directives for care , orders not 75
113	113
114	114	HB 353 2025
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121	121	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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123	123
124	124
125	125	to resuscitate executed pursuant to s. 401.45, and patient -76
126	126	directed medical orders executed pursuant to s. 765.3041 will be 77
127	127	respected regardless of the location of care. 78
128	128	9. Assurance that organizational mechanisms are in place 79
129	129	to evaluate the availability and quality of end -of-life, 80
130	130	palliative, and hospice care services, includ ing the evaluation 81
131	131	of administrative and regulatory barriers. 82
132	132	10. Assurance that necessary health care services will be 83
133	133	provided and that relevant reimbursement policies are available. 84
134	134	11. Assurance that the goals expressed in subparagraphs 85
135	135	1.-10. will be accomplished in a culturally appropriate manner. 86
136	136	Section 3. Section 765.3041, Florida Statutes, is created 87
137	137	to read: 88
138	138	765.3041 Patient-directed medical orders. — 89
139	139	(1) To facilitate a principal's instructions concerning 90
140	140	treatment preferences, a pati ent-directed medical order may be 91
141	141	executed in advance to direct the actions of health care 92
142	142	providers and health care facilities. 93
143	143	(2) A valid patient -directed medical order must: 94
144	144	(a) Be on a form adopted by rule of the Department of 95
145	145	Health and may be co mbined with an order not to resuscitate 96
146	146	executed pursuant to s. 401.45. The form must: 97
147	147	1. Address medical interventions to be withheld or 98
148	148	withdrawn when the application of life -prolonging procedures 99
149	149	would serve only to prolong artificially the process of dying. 100
150	150
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155	155	CODING: Words stricken are deletions; words underlined are additions.
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158	158	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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162	162	2. Be signed by the principal and the principal's 101
163	163	physician, physician assistant, or advanced practice registered 102
164	164	nurse registered under s. 464.0123. 103
165	165	a. If the principal is physically unable to sign the form, 104
166	166	the physician, physician assistant, or advanced practice 105
167	167	registered nurse present at the discussion as required by 106
168	168	subparagraph (b)2. may subscribe the principal's signature in 107
169	169	the principal's presence and at the principal's direction. If 108
170	170	telehealth is used, the physician, physician assista nt, or 109
171	171	advanced practice registered nurse may be present at either 110
172	172	location where telehealth is being administered. 111
173	173	b. If the principal is incapacitated, the form may be 112
174	174	signed by the principal's health care surrogate or proxy, court -113
175	175	appointed guardian a s provided in chapter 744, or attorney in 114
176	176	fact under a durable power of attorney as provided in chapter 115
177	177	709. The court-appointed guardian or attorney in fact must be 116
178	178	delegated authority to make health care decisions on behalf of 117
179	179	the principal. 118
180	180	c. All signatures may be electronic signatures. 119
181	181	(b) Clearly express the principal's preferences and 120
182	182	instructions for care, which may include all treatments 121
183	183	available, modified treatments that are not prolonged or 122
184	184	burdensome, or comfort measures that do not pursue or continue 123
185	185	interventions. 124
186	186	1. The principal and a physician, a physician assistant, 125
187	187
188	188	HB 353 2025
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190	190
191	191
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195	195	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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197	197
198	198
199	199	or an advanced practice registered nurse registered under s. 126
200	200	464.0123 must discuss the principal's medical treatment wishes 127
201	201	relating to medical interventions to be withhe ld or withdrawn 128
202	202	based on the principal's values and preferences in the event the 129
203	203	principal becomes unable to make her or his own decisions. 130
204	204	2. The discussion must be in person and may be conducted 131
205	205	using telehealth. 132
206	206	(3) Regardless of the decision to wit hhold or withdraw 133
207	207	life-prolonging procedures, necessary health care services must 134
208	208	be provided for the care and comfort of the principal or to 135
209	209	alleviate pain. 136
210	210	(4) A physician, a physician assistant, or an advanced 137
211	211	practice registered nurse registered unde r s. 464.0123 may 138
212	212	withhold or withdraw cardiopulmonary resuscitation or other 139
213	213	life-prolonging procedures if presented with an order not to 140
214	214	resuscitate executed pursuant to s. 401.45 or a patient -directed 141
215	215	medical order executed pursuant to this section whic h contains 142
216	216	an order not to resuscitate or an order to withhold or withdraw 143
217	217	life-prolonging procedures. A physician, a physician assistant, 144
218	218	or an advanced practice registered nurse registered under s. 145
219	219	464.0123 is not subject to any disciplinary action under s. 146
220	220	456.072 or criminal prosecution or civil liability, or 147
221	221	considered to have engaged in negligent or unprofessional 148
222	222	conduct, for withholding or withdrawing cardiopulmonary 149
223	223	resuscitation or other life -prolonging procedures pursuant to 150
224	224
225	225	HB 353 2025
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232	232	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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234	234
235	235
236	236	such orders. The abse nce of an order not to resuscitate executed 151
237	237	pursuant to s. 401.45 or a patient -directed medical order 152
238	238	executed pursuant to this section does not preclude a physician, 153
239	239	a physician assistant, or an advanced practice registered nurse 154
240	240	registered under s. 464.0 123 from withholding or withdrawing 155
241	241	cardiopulmonary resuscitation or other life -prolonging 156
242	242	procedures as otherwise authorized by law. 157
243	243	Section 4. Paragraph (l) of subsection (3) of section 158
244	244	395.1041, Florida Statutes, is amended to read: 159
245	245	395.1041 Access to and ensurance of emergency services; 160
246	246	transfers; patient rights; diversion programs; reports of 161
247	247	controlled substance overdoses. — 162
248	248	(3) EMERGENCY SERVICES; DISCRIMINATION; LIABILITY OF 163
249	249	FACILITY OR HEALTH CARE PERSONNEL. — 164
250	250	(l) Hospital personnel may wit hhold or withdraw 165
251	251	cardiopulmonary resuscitation or other life-prolonging 166
252	252	procedures if presented with an order not to resuscitate 167
253	253	executed pursuant to s. 401.45 or a patient-directed medical 168
254	254	order executed pursuant to s. 765.3041 which contains an order 169
255	255	not to resuscitate or an order to withhold or withdraw life -170
256	256	prolonging procedures . Facility staff and facilities are shall 171
257	257	not be subject to criminal prosecution or civil liability, or 172
258	258	nor be considered to have engaged in negligent or unprofessional 173
259	259	conduct, for withholding or withdrawing cardiopulmonary 174
260	260	resuscitation or other life-prolonging procedures pursuant to 175
261	261
262	262	HB 353 2025
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269	269	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
270	270
271	271
272	272
273	273	such orders an order. The absence of an order not to resuscitate 176
274	274	executed pursuant to s. 401.45 or a patient-directed medical 177
275	275	order executed pursuant to s. 765.3041 does not preclude a 178
276	276	physician from withholding or withdrawing cardiopulmonary 179
277	277	resuscitation or other life-prolonging procedures as otherwise 180
278	278	authorized permitted by law. 181
279	279	Section 5. Subsection (3) of section 400.142, Florida 182
280	280	Statutes, is amended to read: 183
281	281	400.142 Emergency medication kits; orders not to 184
282	282	resuscitate and patient-directed medical orders .— 185
283	283	(3) Facility staff may withhold or withdraw 186
284	284	cardiopulmonary resuscitation or other life-prolonging 187
285	285	procedures if presented with an order not to resuscitate 188
286	286	executed pursuant to s. 401.45 or a patient-directed medical 189
287	287	order executed pursuant to s. 765.3041 which contains an order 190
288	288	not to resuscitate or an order to withhold or withdraw life -191
289	289	prolonging procedures . Facility staff and facilities are not 192
290	290	subject to criminal prosecution or civil liability, or 193
291	291	considered to have engaged in negligent or unprofession al 194
292	292	conduct, for withholding or withdrawing cardiopulmonary 195
293	293	resuscitation or other life-prolonging procedures pursuant to 196
294	294	such orders order. The absence of an order not to resuscitate 197
295	295	executed pursuant to s. 401.45 or a patient-directed medical 198
296	296	order executed pursuant to s. 765.3041 does not preclude a 199
297	297	physician from withholding or withdrawing cardiopulmonary 200
298	298
299	299	HB 353 2025
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303	303	CODING: Words stricken are deletions; words underlined are additions.
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306	306	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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310	310	resuscitation or other life-prolonging procedures as otherwise 201
311	311	authorized permitted by law. 202
312	312	Section 6. Subsection (7) of section 400.487, Florida 203
313	313	Statutes, is amended to read: 204
314	314	400.487 Home health service agreements; physician's, 205
315	315	physician assistant's, and advanced practice registered nurse's 206
316	316	treatment orders; patient assessment; establishment and review 207
317	317	of plan of care; provision of services; order s not to 208
318	318	resuscitate and patient-directed medical orders .— 209
319	319	(7) Home health agency personnel may withhold or withdraw 210
320	320	cardiopulmonary resuscitation or other life-prolonging 211
321	321	procedures if presented with an order not to resuscitate 212
322	322	executed pursuant to s. 4 01.45 or a patient-directed medical 213
323	323	order executed pursuant to s. 765.3041 which contains an order 214
324	324	not to resuscitate or an order to withhold or withdraw life -215
325	325	prolonging procedures . The agency shall adopt rules providing 216
326	326	for the implementation of such orde rs. Home health personnel and 217
327	327	agencies are shall not be subject to criminal prosecution or 218
328	328	civil liability, or nor be considered to have engaged in 219
329	329	negligent or unprofessional conduct, for withholding or 220
330	330	withdrawing cardiopulmonary resuscitation or other life-221
331	331	prolonging procedures pursuant to such orders an order and rules 222
332	332	adopted by the agency. The absence of an order not to 223
333	333	resuscitate executed pursuant to s. 401.45 or a patient -directed 224
334	334	medical order executed pursuant to s. 765.3041 does not preclude 225
335	335
336	336	HB 353 2025
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340	340	CODING: Words stricken are deletions; words underlined are additions.
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343	343	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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347	347	a physician from withholding or withdrawing cardiopulmonary 226
348	348	resuscitation or other life -prolonging procedures as otherwise 227
349	349	authorized by law. 228
350	350	Section 7. Paragraph (e) of subsection (1) of section 229
351	351	400.605, Florida Statutes, is amended to read: 230
352	352	400.605 Administration; forms; fees; rules; inspections; 231
353	353	fines.— 232
354	354	(1) The agency shall by rule establish minimum standards 233
355	355	and procedures for a hospice pursuant to this part. The rules 234
356	356	must include: 235
357	357	(e) Procedures relating to the implementation of advance 236
358	358	advanced directives, patient-directed medical orders executed 237
359	359	pursuant to s. 765.3041, and do-not-resuscitate orders not to 238
360	360	resuscitate executed pursuant to s. 401.45 . 239
361	361	Section 8. Subsection (8) of section 400.6095, Florida 240
362	362	Statutes, is amended to read: 241
363	363	400.6095 Patient admission; assessment; plan of care; 242
364	364	discharge; death.— 243
365	365	(8) The hospice care team may withhold or withdraw 244
366	366	cardiopulmonary resuscitation or other life-prolonging 245
367	367	procedures if presented with an order not to resuscitate 246
368	368	executed pursuant to s. 401.45 or a patient-directed medical 247
369	369	order executed pursuant to s. 765.3041 which contains an order 248
370	370	not to resuscitate or an order to withhold or withdraw life -249
371	371	prolonging procedures . The agency shall adopt rules providing 250
372	372
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380	380	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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382	382
383	383
384	384	for the implementation of s uch orders. Hospice staff are shall 251
385	385	not be subject to criminal prosecution or civil liability, or 252
386	386	nor be considered to have engaged in negligent or unprofessional 253
387	387	conduct, for withholding or withdrawing cardiopulmonary 254
388	388	resuscitation or other life-prolonging procedures pursuant to 255
389	389	such orders an order and applicable rules. The absence of an 256
390	390	order not to resuscitate executed pursuant to s. 401.45 or a 257
391	391	patient-directed medical order executed pursuant to s. 765.3041 258
392	392	does not preclude a physician from withholdin g or withdrawing 259
393	393	cardiopulmonary resuscitation or other life-prolonging 260
394	394	procedures as otherwise authorized permitted by law. 261
395	395	Section 9. Paragraph (b) of subsection (4) of section 262
396	396	400.611, Florida Statutes, is amended to read: 263
397	397	400.611 Interdisciplinar y records of care; 264
398	398	confidentiality; release of records. — 265
399	399	(4) A hospice may not release a patient's 266
400	400	interdisciplinary record or any portion thereof, unless the 267
401	401	person requesting the information provides to the hospice: 268
402	402	(b) In the case of an incapacitate d patient, a patient 269
403	403	authorization executed before prior to the patient's death by 270
404	404	the patient's then acting legal guardian, health care surrogate 271
405	405	as defined in s. 765.101 s. 765.101(21), health care proxy as 272
406	406	defined in s. 765.101 s. 765.101(19), or agent under power of 273
407	407	attorney; 274
408	408	Section 10. Subsection (4) of section 401.35, Florida 275
409	409
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417	417	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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420	420
421	421	Statutes, is amended to read: 276
422	422	401.35 Rules.—The department shall adopt rules, including 277
423	423	definitions of terms, necessary to carry out the purposes of 278
424	424	this part. 279
425	425	(4) The rules must establish circumstances and procedures 280
426	426	under which emergency medical technicians and paramedics may 281
427	427	honor orders not to resuscitate executed pursuant to s. 401.45 282
428	428	or patient-directed medical orders executed pursuant to s. 283
429	429	765.3041 which contains an order not to resuscitate or an order 284
430	430	to withhold or withdraw life -prolonging procedures by the 285
431	431	patient's physician, physician assistant, or advanced practice 286
432	432	registered nurse registered under s. 464.0123 not to resuscitate 287
433	433	and the documentation and repo rting requirements for handling 288
434	434	such orders requests. 289
435	435	Section 11. Paragraphs (a) and (b) of subsection (3) of 290
436	436	section 401.45, Florida Statutes, are amended to read: 291
437	437	401.45 Denial of emergency treatment; civil liability. — 292
438	438	(3)(a) Resuscitation may be withheld or withdrawn from a 293
439	439	patient by An emergency medical technician or paramedic may 294
440	440	withhold or withdraw cardiopulmonary resuscitation or other 295
441	441	life-prolonging procedures if presented with evidence of an 296
442	442	order not to resuscitate executed pursuant to this subsection or 297
443	443	a patient-directed medical order executed pursuant to s. 298
444	444	765.3041 which contains an order not to resuscitate or an order 299
445	445	to withhold or withdraw life -prolonging procedures by the 300
446	446
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454	454	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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458	458	patient's physician or physician assistant is presented to the 301
459	459	emergency medical technician or paramedic . An order not to 302
460	460	resuscitate executed pursuant to this subsection or a patient -303
461	461	directed medical order executed pursuant to s. 765.3041 which 304
462	462	contains an order not to resuscitate or an order to withhold or 305
463	463	withdraw life-prolonging procedures , to be valid, must be on the 306
464	464	form adopted by rule of the department. The form must be signed 307
465	465	by the patient's physician , or physician assistant, or advanced 308
466	466	practice registered nurse registered under s. 464.0123 and by 309
467	467	the patient or, if the patient is incapacitated, the patient's 310
468	468	health care surrogate or proxy as provided in chapter 765, 311
469	469	court-appointed guardian as provided in chapter 744, or attorney 312
470	470	in fact under a durable power of attorney as provided in chap ter 313
471	471	709. The court-appointed guardian or attorney in fact must have 314
472	472	been delegated authority to make health care decisions on behalf 315
473	473	of the patient. 316
474	474	(b) Any licensee, physician, medical director, or 317
475	475	emergency medical technician or paramedic who acts unde r the 318
476	476	direction of a medical director is not subject to criminal 319
477	477	prosecution or civil liability, and has not engaged in negligent 320
478	478	or unprofessional conduct, as a result of the withholding or 321
479	479	withdrawal of cardiopulmonary resuscitation or other life-322
480	480	prolonging procedures from a patient pursuant to this subsection 323
481	481	and rules adopted by the department. 324
482	482	Section 12. Subsection (4) of section 429.255, Florida 325
483	483
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491	491	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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494	494
495	495	Statutes, is amended to read: 326
496	496	429.255 Use of personnel; emergency care. — 327
497	497	(4) Facility staff may wi thhold or withdraw 328
498	498	cardiopulmonary resuscitation , or the use of an automated 329
499	499	external defibrillator , or other life-prolonging procedures if 330
500	500	presented with an order not to resuscitate executed pursuant to 331
501	501	s. 401.45 or a patient-directed medical order execut ed pursuant 332
502	502	to s. 765.3041 which contains an order not to resuscitate or an 333
503	503	order to withhold or withdraw life -prolonging procedures . The 334
504	504	agency shall adopt rules providing for the implementation of 335
505	505	such orders. Facility staff and facilities are may not be 336
506	506	subject to criminal prosecution or civil liability, or nor be 337
507	507	considered to have engaged in negligent or unprofessional 338
508	508	conduct, for withholding or withdrawing cardiopulmonary 339
509	509	resuscitation, the or use of an automated external 340
510	510	defibrillator, or other life-prolonging procedures pursuant to 341
511	511	such orders an order and rules adopted by the agency. The 342
512	512	absence of an order not to resuscitate executed pursuant to s. 343
513	513	401.45 or a patient-directed medical order executed pursuant to 344
514	514	s. 765.3041 does not preclude a phys ician from withholding or 345
515	515	withdrawing cardiopulmonary resuscitation , the or use of an 346
516	516	automated external defibrillator , or other life-prolonging 347
517	517	procedures as otherwise authorized permitted by law. 348
518	518	Section 13. Subsection (3) of section 429.73, Florida 349
519	519	Statutes, is amended to read: 350
520	520
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523	523
524	524
525	525	CODING: Words stricken are deletions; words underlined are additions.
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528	528	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
529	529
530	530
531	531
532	532	429.73 Rules and standards relating to adult family -care 351
533	533	homes.— 352
534	534	(3) The agency shall adopt rules providing for the 353
535	535	implementation of orders not to resuscitate and patient-directed 354
536	536	medical orders. The provider may withhold or withdraw 355
537	537	cardiopulmonary resuscitation or other life-prolonging 356
538	538	procedures if presented with an order not to resuscitate 357
539	539	executed pursuant to s. 401.45 or a patient-directed medical 358
540	540	order executed pursuant to s. 765.3041 which contains an order 359
541	541	not to resuscitate or an order to withhold or withdraw life -360
542	542	prolonging procedures . The provider is shall not be subject to 361
543	543	criminal prosecution or civil liability, or nor be considered to 362
544	544	have engaged in negligent or unprofessional conduct, for 363
545	545	withholding or withdrawing cardiopulmonary resuscitation or 364
546	546	other life-prolonging procedures pursuant to such orders an 365
547	547	order and applicable rules. The absence of an order not to 366
548	548	resuscitate executed pursuant to s. 401.45 or a patient -directed 367
549	549	medical order executed pursuan t to s. 765.3041 does not preclude 368
550	550	a physician from withholding or withdrawing cardiopulmonary 369
551	551	resuscitation or other life -prolonging procedures as otherwise 370
552	552	authorized by law. 371
553	553	Section 14. Subsections (1), (7), and (8) of section 372
554	554	744.4431, Florida Statutes, are amended to read: 373
555	555	744.4431 Guardianship power regarding life -prolonging 374
556	556	procedures.— 375
557	557
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560	560
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565	565	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
566	566
567	567
568	568
569	569	(1) Except as provided in this section, decisions by a 376
570	570	professional guardian, as defined in s. 744.102, to withhold or 377
571	571	withdraw life-prolonging procedures from, or to execute an order 378
572	572	not to resuscitate pursuant to s. 401.45 or a patient -directed 379
573	573	medical order pursuant to s. 765.3041 which contains an order 380
574	574	not to resuscitate or an order to withhold or withdraw life -381
575	575	prolonging procedures for, a ward must be approved by the court. 382
576	576	A professional guardian appointed to act on behalf of a ward's 383
577	577	person must petition the court pursuant to the Florida Probate 384
578	578	Rules for authority to consent to withhold or withdraw life -385
579	579	prolonging procedures or to execute an order n ot to resuscitate 386
580	580	pursuant to s. 401.45 or a patient -directed medical order 387
581	581	pursuant to s. 765.3041. Court approval must be obtained before 388
582	582	taking such action, except as provided in subsection (7). 389
583	583	(7) Court approval is not required for the following 390
584	584	decisions: 391
585	585	(a) A decision to withhold or withdraw life -prolonging 392
586	586	procedures made by a professional guardian to whom authority has 393
587	587	been granted by the court under s. 744.3115 to carry out the 394
588	588	instructions in or to take actions consistent with the ward's 395
589	589	advance directive, order not to resuscitate executed pursuant to 396
590	590	s. 401.45, or patient -directed medical order executed pursuant 397
591	591	to s. 765.3041 which contains an order not to resuscitate or an 398
592	592	order to withhold or withdraw life -prolonging procedures , as 399
593	593	long as there are no known objections from the ward; the ward's 400
594	594
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597	597
598	598
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602	602	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
603	603
604	604
605	605
606	606	attorney; the ward's next of kin, if known; and any other 401
607	607	interested persons as the court may direct based on s. 402
608	608	765.105(1). 403
609	609	(b) A decision by a professional guardian who has been 404
610	610	delegated health care decisionmaking authority to execute an 405
611	611	order not to resuscitate pursuant to s. 401.45 or a patient -406
612	612	directed medical order pursuant to s. 765.3041 , as described in 407
613	613	s. 401.45(3)(a), if the ward is in a hospital and the following 408
614	614	conditions are met: 409
615	615	1. The ward's primary treating physician and at least one 410
616	616	other consulting physician document in the ward's medical record 411
617	617	that: 412
618	618	a. There is no reasonable medical probability for recovery 413
619	619	from or a cure of the ward's underlying medical condition; 414
620	620	b. The ward is in an end-stage condition, a terminal 415
621	621	condition, or a persistent vegetative state as those terms are 416
622	622	defined in s. 765.101, and that the ward's death is imminent; 417
623	623	and 418
624	624	c. Resuscitation will cause the ward physical harm or 419
625	625	additional pain. 420
626	626	2. The professional guardian has notified the ward's next 421
627	627	of kin, if known, and any interested persons as the court may 422
628	628	direct and the decision is not contrary to the ward's expressed 423
629	629	wishes and there are no known objections from the ward; the 424
630	630	ward's attorney; the ward's next of kin, if known; or any other 425
631	631
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634	634
635	635
636	636	CODING: Words stricken are deletions; words underlined are additions.
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639	639	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
640	640
641	641
642	642
643	643	interested persons as the court may direct on the basis of s. 426
644	644	765.105(1). 427
645	645	(8) Within 2 business days after executing an order not to 428
646	646	resuscitate pursuant to s. 401.45 or a patient -directed medical 429
647	647	order pursuant to s. 765.3041 which contains an order not to 430
648	648	resuscitate or an order to withhold or withdraw life -prolonging 431
649	649	procedures under paragraph (7)(b) , a professional guardian must 432
650	650	notify the court in writing of all of the following: 433
651	651	(a) The date the order not to resuscitate or patient-434
652	652	directed medical order was executed. 435
653	653	(b) The location of the ward when the order not to 436
654	654	resuscitate or patient-directed medical order was executed. 437
655	655	(c) The names of the physicians who documented the ward's 438
656	656	condition in the ward's medical record. 439
657	657	Section 15. Subsection (3) of section 752.001, Florida 440
658	658	Statutes, is amended to read: 441
659	659	752.001 Definitions. —As used in this chapter, the term: 442
660	660	(3) "Persistent vegetative state" has the same meaning as 443
661	661	provided in s. 765.101 s. 765.101(15). 444
662	662	Section 16. Subsections (1) and (4) of section 765.110, 445
663	663	Florida Statutes, are amended to read: 446
664	664	765.110 Health care facilities and providers; discipline. — 447
665	665	(1) A health care facility must, pursuant to Pub. L. No. 448
666	666	101-508, ss. 4206 and 4751, shall provide to each patient 449
667	667	written information concerning the individual's rights 450
668	668
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672	672
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676	676	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
677	677
678	678
679	679
680	680	concerning advance directives , orders not to resuscitate 451
681	681	executed pursuant to s. 401.45, or patient -directed medical 452
682	682	orders executed pursuant to s. 765.3041 which co ntains an order 453
683	683	not to resuscitate or an order to withhold or withdraw life -454
684	684	prolonging procedures and the health care facility's policies 455
685	685	respecting the implementation of such rights, and shall document 456
686	686	in the patient's medical records whether or not the individual 457
687	687	has executed an advance directive , an order not to resuscitate 458
688	688	pursuant to s. 401.45, or a patient -directed medical order 459
689	689	pursuant to s. 765.3041 which contains an order not to 460
690	690	resuscitate or an order to withhold or withdraw life -prolonging 461
691	691	procedures. 462
692	692	(4) The Department of Health, in consultation with the 463
693	693	Department of Elderly Affairs, for health care providers; the 464
694	694	Agency for Health Care Administration for hospitals, hospices, 465
695	695	nursing homes, home health agencies, assisted living facilities, 466
696	696	adult family-care homes, and health maintenance organizations; 467
697	697	and the Department of Children and Families for facilities 468
698	698	subject to part I of chapter 394 shall adopt rules to implement 469
699	699	this section. 470
700	700	Section 17. Subsection (3) of section 765.204, Florida 471
701	701	Statutes, is amended to read: 472
702	702	765.204 Capacity of principal; procedure. — 473
703	703	(3) The surrogate's authority commences either upon a 474
704	704	determination under subsection (2) that the principal lacks 475
705	705
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708	708
709	709
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713	713	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
714	714
715	715
716	716
717	717	capacity or upon a stipulation of such authority pursuant to s. 476
718	718	765.101 s. 765.101(21). Such authority remains in effect until a 477
719	719	determination that the principal has regained such capacity, if 478
720	720	the authority commenced as a result of incapacity, or until the 479
721	721	authority is revoked, if the authority commenced immediately 480
722	722	pursuant to s. 765.101 s. 765.101(21). Upon commencement of the 481
723	723	surrogate's authority, a surrogate who is not the principal's 482
724	724	spouse shall notify the principal's spouse or adult children of 483
725	725	the principal's designation of the surrogate. Except if the 484
726	726	principal provided immediately exercisable authority to the 485
727	727	surrogate pursuant to s. 765.101 s. 765.101(21), in the event 486
728	728	that the primary or attending physician determines that the 487
729	729	principal has regained capacity, the authority of the surrogate 488
730	730	shall cease, but recommences if the principal subsequently loses 489
731	731	capacity as determined pursuant to this section. A health care 490
732	732	provider is not liable for relying upon health care decisions 491
733	733	made by a surrogate while the principal lacks capacity. At any 492
734	734	time when a principal lacks capacity, a health care decision 493
735	735	made on the principal's behalf by a surrogate is effective to 494
736	736	the same extent as a decision made by the principal. If a 495
737	737	principal possesses capacity, health care decisions of the 496
738	738	principal take precedence over decisi ons made by the surrogate 497
739	739	that present a material conflict. 498
740	740	Section 18. Paragraph (c) of subsection (1) of section 499
741	741	765.205, Florida Statutes, is amended to read: 500
742	742
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745	745
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750	750	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
751	751
752	752
753	753
754	754	765.205 Responsibility of the surrogate. — 501
755	755	(1) The surrogate, in accordance with the pr incipal's 502
756	756	instructions, unless such authority has been expressly limited 503
757	757	by the principal, shall: 504
758	758	(c) Provide written consent using an appropriate form 505
759	759	whenever consent is required, including the execution of an a 506
760	760	physician's order not to resuscitate pursuant to s. 401.45 or a 507
761	761	patient-directed medical order pursuant to s. s. 765.3041 which 508
762	762	contains an order not to resuscitate or an order to withhold or 509
763	763	withdraw life-prolonging procedures . 510
764	764	Section 19. Subsection (2) of section 765.305, Florida 511
765	765	Statutes, is amended to read: 512
766	766	765.305 Procedure in absence of a living will. — 513
767	767	(2) Before exercising the incompetent patient's right to 514
768	768	forego treatment, including the execution of an order not to 515
769	769	resuscitate pursuant to s. 401.45 or a patient -directed medical 516
770	770	order pursuant to s. 765.3041 which contains an order not to 517
771	771	resuscitate or an order to withhold or withdraw life -prolonging 518
772	772	procedures, the surrogate must be satisfied that: 519
773	773	(a) The patient does not have a reasonable medical 520
774	774	probability of recov ering capacity so that the right could be 521
775	775	exercised by the patient. 522
776	776	(b) The patient has an end -stage condition, the patient is 523
777	777	in a persistent vegetative state, or the patient's physical 524
778	778	condition is terminal. 525
779	779
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789	789
790	790
791	791	Section 20. The Agency for Health Care A dministration 526
792	792	shall create and update a database for the storage of patient -527
793	793	directed medical orders, which shall be stored solely at the 528
794	794	option of the patient in electronic form by the agency. 529
795	795	Section 21. This act shall take effect July 1, 2025. 530