HLS 10RS-593 ORIGINAL
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Regular Session, 2010
HOUSE BILL NO. 635
BY REPRESENTATIVE MILLS
WILLS/TESTAMENTS: Provides for the LaPOST program
AN ACT1
To enact Part XXIV-C of Chapter 5 of Title 40 of the Louisiana Revised Statutes of 1950,2
to be comprised of R.S. 40:1299.64.1 through 1299.64.6, relative to Louisiana3
Physician Order for Scope of Treatment; to provide for the Louisiana Physician4
Order for Scope of Treatment program and form; to provide for definitions; to5
provide for the promulgation of rules and regulations; and to provide for related6
matters.7
Be it enacted by the Legislature of Louisiana:8
Section 1. Part XXIV-C of Chapter 5 of Title 40 of the Louisiana Revised Statutes9
of 1950, comprised of R.S. 40:1299.64.1 through 1299.64.6 is hereby enacted to read as10
follows:11
PART XXIV-C. Louisiana Physician Order for Scope of Treatment12
§1299.64.1. Legislative purpose, findings and intent13
A. The legislature finds and declares all of the following:14
(1) It is important for people to make health care decisions before a medical15
crisis presents itself.16
(2) Health care planning is a process, rather than a single decision, that helps17
individuals to consider the kind of care they would want if they become seriously ill18
or incapacitated, and encourages them to talk to their family members or legal19
representative about such issues.20 HLS 10RS-593 ORIGINAL
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(3) The Louisiana Physician Order for Scope of Treatment "LaPOST" form1
complements a declaration concerning life-sustaining procedures, as provided for in2
R.S. 40:1299.58.1 through R.S. 40:1299.58.10, by taking the wishes of the individual3
regarding life-sustaining treatment and converting those wishes into a medical order.4
(4) The hallmarks of the LaPOST form are the following:5
(a) Immediately actionable, signed medical orders on a standardized form.6
(b) Orders that address a range of life-sustaining interventions as well as the7
patient's preferred intensity or treatment for each intervention.8
(c) A brightly colored, clearly identifiable form.9
(d) A form that is recognized, adopted, and honored across treatment10
settings.11
B.(1) The legislature intends that the provisions of this Part are permissive12
and voluntary. The legislature further intends that the completion of the Louisiana13
Physician Order for Scope of Treatment form merely illustrates a means of14
documenting a decision of a patient relative to withholding or withdrawal of medical15
treatment or life-sustaining procedures.16
(2) It is the intent of the legislature that nothing in this Part shall be17
construed to require the completion of a Louisiana Physician Order for Scope of18
Treatment form pursuant to this Part.19
(3) It is the intent of the legislature that nothing in this Part shall be20
construed to be the exclusive means by which life-sustaining procedures may be21
withheld or withdrawn, nor shall this Part be construed to require the application of22
medically inappropriate treatment or life-sustaining procedures to any patient.23
§1299.64.2. Definitions24
As used in this Part, the following terms shall have the meanings ascribed to25
them unless the context clearly states otherwise:26
(1) "Attending physician" means the physician who has primary27
responsibility for the treatment and care of the patient.28 HLS 10RS-593 ORIGINAL
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(2) "Certified emergency medical technician" means a certified emergency1
medical technician as defined in R.S. 40:1231.2
(3) "Certified first responder" means any person who has successfully3
completed a training course developed and promulgated by the United States4
Department of Transportation and adopted by the bureau of emergency medical5
services of the Department of Health and Hospitals and who is certified by the6
bureau.7
(4) "Health care provider" means any health maintenance organization, home8
health agency, hospice, hospital, or nursing facility.9
(5) "LaPOST" means Louisiana Physician Order for Scope of Treatment.10
(6) "Life-sustaining procedure" means any medical procedure or intervention11
which, within reasonable medical judgment, would serve only to prolong the dying12
process for a person diagnosed as having a terminal or irreversible condition,13
including such procedures as the invasive administration of nutrition and hydration14
and the administration of cardiopulmonary resuscitation. A "life-sustaining15
procedure" shall not include any measure deemed as comfort care.16
(7) "Louisiana Physician Order for Scope of Treatment" means a form17
executed by a patient and his physician which is a physician's order that provides for18
the wishes of a patient concerning end-of-life care.19
(8) "Personal health care representative" means a person who has authority20
in accordance with Louisiana law to act on behalf of an individual who is an adult21
or an emancipated minor in making decisions related to health care because of22
incapacity.23
(9) "Physician" means a physician or surgeon licensed by the Louisiana State24
Board of Medical Examiners or by the official licensing authority of another state.25
§1299.64.3. Louisiana Physician Order for Scope of Treatment26
A. The secretary of the Department of Health and Hospitals is hereby27
authorized and directed to promulgate and publish rules, regulations, and standards,28 HLS 10RS-593 ORIGINAL
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in accordance with the Administrative Procedure Act, to provide for the Louisiana1
Physician Order for Scope of Treatment "LaPOST" program.2
B. The rules and regulations shall include but not be limited to the following:3
(1) Promulgation of a LaPOST form and model of care which is in4
accordance with the national Physician Orders for Life Sustaining Treatment5
"POLST" paradigm.6
(2) Requirements that shall be met in order for a LaPOST form to be valid,7
including but not limited to situations in which the personal health care8
representative of a patient may execute the LaPOST form.9
(3) Methods for revocation.10
(4) Requirements which relate to a patient's informed consent upon11
executing a LaPOST form.12
(5) Requirements for periodic review of the LaPOST form by the patient and13
his physician.14
(6) Penalties.15
C. Nothing in this Part shall be construed in any manner to prevent the16
withholding or the withdrawal of life-sustaining procedures from an adult person17
who is comatose, incompetent, or otherwise physically or mentally incapable of18
communication and has not executed a prior LaPOST form in accordance with this19
Part.20
D. The Louisiana Physician Order for Scope of Treatment or LaPOST form21
is not a declaration concerning life-sustaining procedures and therefore shall not22
have to comply with the provisions of R.S. 40:1299.58.1 through 1299.58.10 in order23
to be valid and enforceable.24
§1299.64.4. Physician, health care provider, certified emergency technician, and25
certified first responder responsibility26
A. Any attending physician who refuses to comply with the provisions of a27
duly executed LaPOST form executed pursuant to this Part shall make a reasonable28
effort to transfer the patient to another physician.29 HLS 10RS-593 ORIGINAL
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B. No provision of this Part imposes a duty upon the physician or health care1
provider to make a search of whether a patient has executed a LaPOST form.2
C. If the policies of a health care provider preclude compliance with the3
LaPOST form executed under this Part or preclude compliance with the provisions4
pertaining to a representative acting on behalf of a patient, then the health care5
provider shall take all reasonable steps to transfer the patient to a health care6
provider with which the provisions of this Part can be effectuated.7
D. Certified emergency medical technicians and certified first responders8
shall make a reasonable effort to detect the presence of an executed LaPOST form.9
§1299.64.5. Immunity from liability10
A.(1) Any health care provider, physician, or other person acting under the11
direction of a physician shall not be subject to criminal prosecution or civil liability12
or be deemed to have engaged in unprofessional conduct as a result of the13
withholding or withdrawal of life-sustaining procedures from a patient who has duly14
executed a LaPOST form in accordance with the provisions of this Part.15
(2) Any person, health care provider, physician, or other person acting under16
the direction of a physician who authorizes the withholding or withdrawal of life-17
sustaining procedures in accordance with a duly executed LaPOST form, or as18
otherwise provided in this Part, shall not be subject to criminal prosecution or civil19
liability for such action.20
(3) A duly executed LaPOST form made in accordance with this Part shall21
be presumed to have been made voluntarily.22
B.(1) A certified emergency medical technician or a certified first responder23
shall not be subject to criminal prosecution or civil liability for withholding life-24
sustaining procedures from a patient who has duly executed a LaPOST form.25
(2) A certified emergency medical technician or a certified first responder26
shall not be subject to criminal prosecution or civil liability for administering life-27
sustaining procedures to a patient who has duly executed a LaPOST form when there28
is no reasonable means by which the certified emergency medical technician or29 HLS 10RS-593 ORIGINAL
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certified first responder could know or should have known that the patient had1
executed such LaPOST form.2
§1299.64.6. General application3
A. Nothing in this Part shall be construed to condone, authorize, or approve4
mercy killing or euthanasia or to permit any affirmative or deliberate act or omission5
to end life other than to permit the natural process of dying.6
B.(1) The withholding or withdrawal of life-sustaining procedures from a7
patient who has duly executed a LaPOST form in accordance with the provisions of8
this Part shall not, for any purpose, constitute a suicide.9
(2) The execution of a LaPOST form pursuant to this Part shall not affect10
the sale, procurement, or issuance of any life insurance policy, nor shall it be deemed11
to modify the terms of an existing policy.12
(3) No policy shall be legally impaired or invalidated by the withholding or13
withdrawal of life-sustaining procedures from an insured who has duly executed a14
LaPOST form, notwithstanding any term of the policy to the contrary.15
(4) A person shall not be required to execute a LaPOST form as a condition16
for being insured or for receiving health care services.17
(5) The removal of life support systems or the failure to administer cardio-18
pulmonary resuscitation under this Part shall not be deemed the cause of death for19
purposes of insurance coverage or the denial of insurance coverage.20
C. The provisions of this Part are cumulative with existing law pertaining to21
an individual's right to consent or refuse to consent to medical or surgical treatment.22
D. A LaPOST form or Physician Order For Life Sustaining Treatments23
(POLST) properly executed in and under the laws of another state shall be deemed24
to be validly executed for purposes of this Part.25
E. It is the policy of the state of Louisiana that human life is of the highest26
and inestimable value through natural death. When interpreting this Part, any27
ambiguity shall be interpreted to preserve human life. 28 HLS 10RS-593 ORIGINAL
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DIGEST
The digest printed below was prepared by House Legislative Services. It constitutes no part
of the legislative instrument. The keyword, one-liner, abstract, and digest do not constitute
part of the law or proof or indicia of legislative intent. [R.S. 1:13(B) and 24:177(E)]
Mills HB No. 635
Abstract: Establishes the Louisiana Physician Order for Scope of Treatment (LaPOST)
program.
Proposed law establishes the LaPOST program and form, which constitute a means by which
a person may convert his wishes concerning life-sustaining medical treatment into a standing
medical order.
Proposed law directs the Dept. of Health and Hospitals to promulgate rules, regulations, and
standards to provide for the LaPOST program and form.
Proposed law provides for responsibilities of physicians, health care providers, certified
emergency technicians, and certified first responders regarding LaPOST.
Proposed law provides for immunity from liability for health care providers, physicians, and
persons acting under the direction of a physician who act in accordance with a duly executed
LaPOST form.
Proposed law intends for the LaPOST form to complement other declarations concerning
life-sustaining procedures as provided for in present law.
Proposed law stipulates that the LaPOST form is not a declaration concerning life-sustaining
procedures and shall not have to comply with the provisions of present law in order to be
valid and enforceable.
(Adds R.S. 40:1299.64.1-1299.64.6)