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STATE OF OKLAHOMA
2nd Session of the 58th Legislature (20 22)
COMMITTEE SUBSTITUTE
FOR
HOUSE BILL NO. 3815 By: Stinson
COMMITTEE SUBSTITUTE
An Act relating to health care power of attorney;
creating the Oklahoma Heal th Care Agent Act; defining
terms; authorizing execution of power of attorney for
health care; establishing requirements for exe cution
of power of attorney for health care; specifying when
power of attorney for health care is effective;
establishing requirements for revocation of power of
attorney for health care; creating optional form for
execution of power of attorney for health care;
requiring certain communication by health care
provider; requiring record of certa in information;
requiring certain compliance b y health care provider;
providing exceptions; requiring notice of certain
noncompliance; authorizing access to certain
information; establishing immunity from liability for
certain actions; creating certain pre sumption;
stating effectiveness of copy; const ruing provisions;
providing for judicial relief; requiring retroactive
application of provisions to certain documents;
amending 63 O.S. 2021, Sections 1 -1973, 3102.4,
3105.2, 3131.3, and 3131.5, which relate to the Home
Care Act, the Oklahoma Advance Direc tive Act, the
Physician Orders for Life -Sustaining Treatment Act,
and the Oklahoma Do-Not-Resuscitate Act; updatin g
statutory references; providing for codification; and
declaring an emergency.
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLA HOMA:
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SECTION 1. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3111.1 of Title 63, unless there
is created a duplication in numbering, reads as follows:
This act shall be known and may be cited as t he "Oklahoma Health
Care Agent Act".
SECTION 2. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3111.2 of Tit le 63, unless there
is created a duplication in numbering, reads as follows:
As used in the Oklahoma Health Care Agent Act:
1. "Advance directive for health care " means any writing
executed in accordance with the requirements of Section 3101.4 of
Title 63 of the Oklahoma Statutes;
2. "Agent" means an individual designated in a power of
attorney for health care to make a health care decision for the
individual granting the power;
3. "Attending physician" means the physician who has primary
responsibility for the treatment and care of a patient;
4. "Capacity" means an individual's ability to understand and
appreciate the nature and implications of a health care decision, to
make an informed choice regarding the alternatives presented
including understandin g and appreciating the significant benefits
and risks, and to make and communicate a health care decision in an
unambiguous manner;
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5. "Health care" means any care, treatment, service, or
procedure to maintain, diagnose, or otherwise affect an individual 's
physical or mental condition;
6. "Health care decision" means a decision made by an
individual or the indivi dual's agent regarding the individual 's
health care including:
a. selection and discharge of health care providers and
facilities,
b. consent to or refusal of any care, treatment, service,
or procedure to maintain, diagnose, or otherwis e
affect a physical or mental condition, and
c. signing a do-not-resuscitate consent in accordance
with the provisions of the Oklahoma Do -Not-Resuscitate
Act, Section 3131.1 et seq. of Title 63 of the
Oklahoma Statutes.
Health care decision shall not inclu de the ability of th e agent to
make decisions about the withholding or withdrawal of nutrition or
hydration;
7. "Health care facility " means any public or private
organization, corporation, authority, partnership , sole
proprietorship, association, agency, network, joint venture, or
other entity that is established and appropriately licensed in this
state to administer or provide health care services. Health care
facility includes but is not limited to hospitals, medical centers,
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ambulatory surgery centers , physicians' offices, clinics, nursing
homes, rehabilitation centers, home care agencies, hospices, and
long-term care agencies;
8. "Health care provider " means a person who is licensed,
certified, or otherwise authorized by the laws of this state to
administer health care in the ordinary course of business or
practice of a profession;
9. "Individual instruction " means an individual's direction
concerning a health care decision for the individual;
10. "Person" means a person eighteen (18) years of age o r older
or a minor who may consent to have services provided by health
professionals pursuant to Section 2602 of Title 63 of the Oklahoma
Statutes;
11. "Physician" means an individual authorized to practice
medicine or osteopathy pursuant to Chapter 11 or Chapter 14 of Title
59 of the Oklahoma Statutes;
12. "Power of attorney for health care " means the designation
of an agent to make health care decisions for the in dividual
granting the power;
13. "Reasonably available" means readily able to be contacted
without undue effort and willing and able to act in a timely manner
considering the urgency of the patient 's health care needs; and
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14. "State" means a state of the United States, the District of
Columbia, the Commonwealth of Puerto Rico, or a territory or insular
possession subject to the jurisdiction of the United States.
SECTION 3. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3111.3 of Title 63, unless there
is created a duplication in numberin g, reads as follows:
A. A person with capacity may give an oral or written
individual instruction. The instruction may be limited to take
effect only if a specifie d condition arises.
B. A person with capacity m ay execute a power of attorney for
health care, which may autho rize the agent to make any health care
decision the principal could have made while having capacity, except
the withholding or withdrawal of nutr ition or hydration, which may
only be authorized in compliance with the Oklahoma Advance Di rective
Act. The power remains in effect notwithstanding the principal 's
later incapacity and may include individual instructions. Unless
related to the principal b y blood, marriage, or adoption, an agent
may not be an owner, operator, or employee of a r esidential long-
term health care institution at which the principal is receiving
care.
C. Unless otherwise specified in a power of attorney for health
care, the authority of an agent becomes effective only upon a
determination that the principal lacks cap acity and ceases to be
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effective upon a determination that the principal has recovered
capacity.
D. Unless otherwise specified in a power of attorney for health
care, a determination that an individual lacks or h as recovered
capacity, or that another cond ition exists that af fects an
individual instruction or the authority of an agent, shall be made
by the attending physician.
E. An agent shall make health care decisi ons in accordance with
the principal's individual instructions, if any, and other wishes t o
the extent known to the agent. Otherwise, the agent shall make the
decision in accordance with the agent 's determination of the
principal's best interest. In dete rmining the principal 's best
interest, the agent shall consider the principal's personal values
to the extent known to the agent.
F. A health care decision made by an agent for a principal is
effective without judicial approval.
G. A power of attorney fo r health care shall be signed by the
principal and witnessed by two individuals who are at least eighteen
(18) years of age and who are not legatees, devisees, or heirs at
law of the principal.
H. A power of attorney for health care is valid for purpo ses of
this act if it is in substantial compliance with this act,
regardless of when or where executed or communic ated.
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SECTION 4. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3111.4 of Title 63, u nless there
is created a duplication in numbering, reads as follows:
A. An individual may rev oke the designation of an agent by a
signed writing or by personally informing the health care provider
at any time and in any manner that communicates an intent to revoke.
B. A health care provider or agent who is informed of a
revocation shall promptly communicate the fact of the revocation to
the attending physician and to any health care facility at which the
patient is receiving care.
C. A decree of annulmen t, divorce, dissolution of marriage, or
legal separation revokes a previous designation of a s pouse as agent
unless otherwise specified in the decree or specifically enumerated
in a power of attorney for health care.
D. A power of attorney for health care that conflicts with an
earlier power of attorney f or health care revokes the earlier power
of attorney to the extent of the conflict.
SECTION 5. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3111.5 of Title 63, unless there
is created a duplication in numbering, reads as follows:
The following form may, but ne ed not, be used to create a power
of attorney for health care. The other sections of this act govern
the effect of this form or any other wri ting used to create a power
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of attorney for health care. An individual may complete or modify
all or any part of the following form:
HEALTH CARE POWER OF ATTORNEY
You have the right to give instructions about your own health
care. You also have the right to name someone else to make health
care decisions for you. This form lets you do either or both of
these things. If you use this form, you may complete or modify all
or any part of it. You are free to use a different form.
This form is a power of atto rney for health care that lets you
name another individual as agent to make health care decisi ons for
you if you become incapable of making your own decisions or if you
want someone else to make those decisions for you now even though
you are still capable . You may also name an alternate agent to act
for you if your first choice is not willing, ab le, or reasonably
available to make decisions for you. Unless related to you, your
agent may not be an owner, operator, or employee of a residential
long-term health care institution at which you are receiving ca re.
Unless the form you sign limits the aut hority of your agent ,
your agent may make all health care decisions for you. This form
has a place for you to limit the authority of your agent. You need
not limit the authority of your agent if you wish to rely on your
agent for all health care decision s that may have to b e made. If
you choose not to limit the authority of your agent, your agent will
have the right to:
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1. Consent or refuse consent to any care, treatment, service,
or procedure to maintain, diag nose, or otherwise affect a physical
or mental condition;
2. Select or discharge health care providers and facilities;
and
3. Sign a do-not-resuscitate consent.
This form does not authorize the agent to make any decisions
regarding the withholding or wit hdrawal of nutrition or hydration.
After completing this form, sign and date the form at the end.
It is required that two other individuals sign as witnesses. These
witnesses must be at least 18 years ol d and not related to you or
named to inherit from y ou. Give a copy of the signed and complete d
form to your physician, to any other health care providers you may
have, to any health care facility at which you are receiving care,
and to any health care age nts you have named. You should talk to
the person you have named as agent to make sure that h e or she
understands your wishes and is willing to take the responsibility.
You have the right to revoke this power of attorney for health
care or replace this fo rm at any time.
POWER OF ATTORNEY FOR HEALTH CARE
1. DESIGNATION OF AGENT: I designate the f ollowing individual
as my agent to make health care decisions for me:
___________________________________________________________________
(name of individual you choose as agent)
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__________________________________ _________________________________
(address) (city) (state) (zip code)
___________________________________________________________________
(home phone) (work phone)
OPTIONAL: If I revoke my agent 's authority or if my agent is
not willing, able, or reasonably a vailable to make a health care
decision for me, I designate as my first alternate agent:
_____________________________________________________ ______________
(name of individual you choose as fi rst alternate agent)
______________________ ____________________ _________________________
(address) (city) (state) (zip code)
_______________________________________________ ____________________
(home phone) (work phone)
OPTIONAL: If I revok e the authority of m y agent and first
alternate agent or if neither is willing, able, or reasonably
available to make a health care decision for me, I designate a s my
second alternate agent:
______________________ ___________________________________________ __
(name of individual you choose as second alternate agent)
___________________________________________________________________
(address) (city) (state) (zip code)
__________________________________________________________ _________
(home phone) (work phone)
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2. AGENT'S AUTHORITY: My agent is authorized to make all
health care decisions (not to include the withholding or withdrawal
of nutrition or hydratio n) for me that I could make if I were able,
except as I state here:
___________________________________________________________________
___________________________________________________________________
____________________________________________________ _______________
(Add additional sheets if n eeded.)
3. WHEN AGENT'S AUTHORITY BECOMES EFFECTIVE: My agent 's
authority becomes effective when my attending physician determines
that I am unable to make my o wn health care decisions unless I mark
the following box. If I mark this box [ ], my agent 's authority
to make health care decisions for me takes effect immediately.
_____________
(Initials)
4. AGENT'S OBLIGATION: My agent shall make health care
decisions for me in accordance with this power of attorn ey for
health care and my other wishes to t he extent known to m y agent. To
the extent my wishes are unknown, my agent shall make health care
decisions for me in accordance with what my agent determines to be
in my best interest. In determining my best in terest, my agent
shall consider the decisions I would have made myself to the extent
known to my agent.
_____________
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(Initials)
5. RELIEF FROM PAIN: Except as I state in the following space,
I direct that treatment for alleviation of pain or discomfort be
provided at all times, even if it hasten s my death:
___________________________________________________________________ _
___________________________________________________________________ _
6. OTHER WISHES: (If you do not agree with any of the optiona l
choices above and wish to write your own, or if you wish to add to
the instructions you have given above, you may do so here.) I
direct that:
___________________________________________________________________
___________________________________________ ________________________
(Add additional sheets if needed.)
7. EFFECT OF COPY: A copy of this form has the same effect as
the original.
8. SIGNATURES: Sign and date the form here:
_____________________________ __ ______________________________
(date) (sign your name)
_______________________________ ______________________________
(address) (print your name)
________________________ _______
(city) (state)
SIGNATURES OF WITNESSES:
First witness Second witness
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______________________________ _______________________________
(print name) (print name)
______________________ ________ ____________________________ ___
(address) (address)
______________________________ ______________________________
(city) (state) (city) (state)
______________________________ ________________ ______________
(signature of witness) (signature of witness)
______________________________ ______________________________
(date) (date)
SECTION 6. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3111.6 of Title 63, unless there
is created a duplication in numbering, reads as follows:
A. Before implementing a health care decision made for a
patient, the attending physician, if possible, shall promptly
communicate to the patient the decisi on made and the identity of the
person making the decision.
B. An attending physician who knows of the existence of a power
of attorney for health ca re or a revocation of a power of attorney
for health care shall promptly record its ex istence in the patie nt's
medical record and, if it is in writing, shall request a copy and if
one is furnished shall arrange for its maintenance in the medical
record. An attending physician who makes or is infor med of a
determination that a patient lacks or has recovered capacity shall
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promptly record the determination in the patient 's medical record
and communicate the determination to the patient, if possible, and
to any person then authorized to make health ca re decisions for the
patient.
C. Except as provided in subsections D and E of this section, a
health care provider or facility providing care to a patient shall:
1. Comply with an individual instruction of the p atient and
with a reasonable interpretation of that instruction made by a
person then authorized to make h ealth care decisions for the
patient; and
2. Comply with a health care decision for the patient made by a
person then authorized to make health care decisions for the patient
to the same extent as if the decision had been made by the p atient
while having capacity.
D. An attending physician or health care provider may decline
to comply with an individual instruction or health care decision for
reasons of conscience. A health care facility may decline to comply
with an individual instru ction or health care decision if the
instruction or decision is contrary to a policy of the facility
which is expressly based on reasons of conscience and if the policy
was timely communicated to the patient or to a person then
authorized to make health ca re decisions for the patient.
E. A health care provider or facility may decline to comply
with an individual instruction or health care decision that requires
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medically ineffective or nonbeneficial health care or health care
contrary to generally accepted health care standards applicable to
the health care provider or facility.
F. A health care provider or facility that declines to comply
with an individual instruction or health care decision shall:
1. Promptly so inform the patient, if possible, and any person
then authorized to make health care decisions for the patient;
2. Provide continuing care to the patient until a transfer can
be effected; and
3. Unless the patient or person then authorized to make heal th
care decisions for the patient refuses a ssistance, immediate ly make
all reasonable efforts to assist in the transfer of the patient to
another health care provider or facility that is willing to comply
with the instruction or decision.
G. A health care provider or facility may not require or
prohibit the execution or revocation of an advance health care
directive as a condition for providing health care.
SECTION 7. NEW LAW A new section of law to be codified
in the Oklahoma Statu tes as Section 3111.7 of Title 63, unless t here
is created a duplication in numbering, reads as follows:
Unless otherwise specified in a power of attorney for health
care, a person then authorized to make health care decisions for a
patient has the same ri ghts as the patient to request, receive,
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examine, copy, and con sent to the disclosure of medical or any other
health care information.
SECTION 8. NEW LAW A new section of law to be codifie d
in the Oklahoma Statutes as Section 3111.8 of Title 63, unless there
is created a duplication in numberin g, reads as follows:
A. A health care provider or facility acting in good faith and
in accordance with generally accepted health care standards
applicable to the health care provider or facili ty shall not be
subject to civil or crimina l liability or to di scipline for
unprofessional conduct for:
1. Complying with a health care decision of a person apparently
having authority to make a health care deci sion for a patient;
2. Declining to comply with a health care decision of a person
based on a belief that the person then lacked authority; or
3. Complying with a power of attorney for health care and
assuming that the designation was valid when made and has not been
revoked or terminated.
B. An individual acting as agent under this act s hall not be
subject to civil or criminal liability or to discipline for
unprofessional conduct for health care decisions made in good faith.
SECTION 9. NEW LAW A new section of law to be co dified
in the Oklahoma Statutes as Section 3111.9 of Title 63, unless there
is created a duplication in numbering, reads as follows:
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A. This act shall not be construed to affect the right of an
individual to make health care decisions while having capacit y to do
so.
B. An individual is presumed t o have capacity to m ake a health
care decision and to give or revoke powers of attorney for health
care.
SECTION 10. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as S ection 3111.10 of Title 63, unless
there is created a duplication in numbering, reads as follows:
A copy of a written power of attorney for health care or
revocation of a power of attorney for health care has the same
effect as the original.
SECTION 11. NEW LAW A new section of law to be codifie d
in the Oklahoma Statutes as Section 3111.11 of Title 63, unless
there is created a duplication in numbering, reads as follows:
A. This act shall n ot be construed to create a presumption
concerning the intention of an individual who h as not made or who
has revoked a power of attorney for health care.
B. This act shall not be construed to authorize or require a
health care provider or facility to pro vide health care contrary to
generally accepted health care standards applicable to the health
care provider or facility.
C. This act shall not be construed to authorize an agent to
consent to the admission of an individual to a mental health care
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facility unless the individual 's written directive expressly so
provides.
D. This act shall n ot affect other stat utes of this state
governing treatment for mental illness of an individual
involuntarily committed to a mental health care facility under
Chapter 1 of Title 43A of the Oklahoma Statutes.
SECTION 12. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3111.12 of Title 63, unless
there is created a duplication in numbering, reads as follows:
On petition of a patient, the patient 's agent, or a health care
provider or facility involved with the patient's care, the court may
enjoin or direct a health care decision or order other equitable
relief. A proceeding under this section shall be governed by Title
12 of the Oklahoma Statutes.
SECTION 13. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3111.13 of Title 63, unless
there is created a duplication in numbering, reads as follows:
Any document made in su bstantial compliance with the
requirements of the Oklahoma Health Care Agent Act, regardless of
date, shall have full force and effect.
SECTION 14. AMENDATORY 63 O.S. 2021, Section 1 -1973, is
amended to read as follows:
Section 1-1973. A. Patients who are capable of self -
administering their own medications without assistance shall be
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encouraged and allowed to do so. However, a certified nurse aide
may assist a patient whose condition is medically stable with the
self-administration of routine, regularly scheduled medicatio ns that
are intended to be self-administered, if the following conditions
are met:
1. For an oral medication, the medication shall have been
placed in a medication planner by a registered nurse, a relative of
the patient or nursing staff of an Oklahoma li censed home health or
hospice agency that i s currently serving the patient; and
2. For all other forms, the certified nurse aide shall assist
with self-administration consistent with a dispensed prescription's
label or the package directions of an over -the-counter medication.
B. For purposes of t his section, self-administered medications
include both legend and over -the-counter oral dosage forms, topical
dosage forms and topical ophthalmic, otic and nasal dosag e forms,
including solutions, suspensions, sp rays and inhalers.
C. Assistance with self -administration of medication by a
certified nurse aide may occur only upon a documented request by,
and the written informed consent of, a patient or the patient's
surrogate, guardian or attorney -in-fact.
D. For purposes of this section, assistance with self-
administration of medication includes:
1. Taking an oral medication out of a pill planner and bringing
it to the patient;
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2. Placing an oral dosage in the patien t's hand or placing the
dosage in another con tainer and helping the patient by lifting t he
container to his or her mouth;
3. If ordered by a physician, placing an oral medication in
food before the patient self -administers;
4. Crushing an oral medication pursuant to orders given by a
physician or health care professional;
5. Applying topical medications; and
6. Keeping a record of when a patient receives assistance with
self-administration pursuant to this section.
E. For purposes of this section, assi stance with self-
administration of medication does not include:
1. Removing oral medica tion from any contai ner other than a
pill planner;
2. Mixing, compounding, converting or calculating medication
doses;
3. The preparation of syringes for injection or the
administration of medications by any inj ectable route;
4. Administration of medica tions through interm ittent positive
pressure breathing machines;
5. Administration of medications by way of a tube inserted in a
cavity of the body;
6. Administration of parenteral preparations;
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7. Irrigations or debriding agents used in the treatment o f a
skin condition;
8. Rectal, urethral, or vaginal preparations;
9. Medications ordered by the physician or health care
professional with prescriptive authority to b e given "as needed",
unless the order is writ ten with specific parameters that preclude
independent judgment on the part of the certified nurse aide, and at
the request of a competent patient;
10. Medications for which the time of administration, the
amount, the strength of dosage, the method of adm inistration or the
reason for administratio n requires judgment or discretion on the
part of the certified nurse aide; or
11. Assistance with the self -administration of medication by a
certified nurse aide in an assisted living center through home care
services as provided for in Section 1-890.8 of Title 63 of the
Oklahoma Statutes this title.
F. Assistance with the self -administration of medication by a
certified nurse aide as described in this section does not
constitute administration as defined in Sect ion 353.1 of Title 59 of
the Oklahoma Statutes.
G. The State Commissioner of Health may by rule establish
procedures and interpret terms as necessary to implement the
provisions of this section.
H. For purposes of this s ection:
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1. "Informed consent" mea ns advising the patient, or the
patient's surrogate, guardian o r attorney-in-fact, that the patient
may be receiving assistance with self -administration of medication
from a certified nurse aide; and
2. "Attorney-in-fact" means an attorney-in-fact authorized to
act pursuant to the Uniform Durable Power of Attorney Ac t, Sections
1071 through 1077 of Title 58 of the Oklahoma Statutes Oklahoma
Health Care Agent Act , with authority to act regarding the patient's
health and medical care decisions, subject to th e limitations under
paragraph 1 of subsection B of Section 1072 .1 of Title 58 of the
Oklahoma Statutes the Oklahoma Health Care Agent Act .
SECTION 15. AMENDATORY 63 O.S. 2021, Section 3102.4, is
amended to read as follows:
Section 3102.4 A. When an adult patient or a person under
eighteen (18) years of age who may consent to have services provided
by health professionals under Section 2602 of this title is
persistently unconscious, incompetent o r otherwise mentally or
physically incapable of communicating, a person who is reasonably
available and willing in the following classes, in the order of
priority set forth in this subsection, shall be authorized to make
health care decisions for the patie nt under the same standard as
that applicable to making life-sustaining treatment decisions under
Section 3101.16 of this title, excluding any person who is
disqualified from exercising such authority by Section 3102.5 of
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this title. If those within a cla ss disagree, a majority within the
class may make a health care decision for the patient. However, a
provider of health care to the patient or any member or members of
any of the following classes may petition a court that would have
jurisdiction over a g uardianship proceeding concerning th e patient
under Section 1-115 of Title 30 of the Oklahoma Statu tes to seek an
order directing a different health care decision on the ground that
the health care decision or decisions made violate the standard
required by this section, granting another mem ber or other members
from among the following classes (notwiths tanding the statutory
order of priority) supervening authority to make health care
decisions for the patient on the ground that clear and convincing
evidence demonstrates they are more likely t o adhere to that
standard, or both. Upon motion by any party, the court shall issue
an order requiring that pending its decision on the merits and the
resolution of any appeal the patient be provided with health care of
which denial, in reasonable medical judgment, would be likely to
result in or hasten the death of the patient, unless its provision
would require denial of the same health care to another patient.
The classes are as follows:
1. A general guardian of the person appointed pursuant to
subsection A of Section 3-112 of Title 30 of the Oklahoma Statutes
or a limited guardian of the person appointed pursuant to subsection
B of Section 3-112 of Title 30 of the Oklahoma Statutes with
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authority to make personal me dical decisions as determined under
paragraph 5 of subsection B of Section 3-113 of Title 30 of the
Oklahoma Statutes;
2. A health care proxy, or alternate health care proxy,
designated by the patient, as defined in paragraph 6 of Section
3101.3 of Title 63 of the Oklahoma Statutes this title;
3. An attorney-in-fact authorized to act pursuant to the
Uniform Durable Power of Attorney Act, Sections 1071 through 1077 of
Title 58 of the Oklahoma Statutes Oklahoma Health Care Agent Act ,
with authority to act regarding th e patient's health and me dical
care decisions, subject to the limitations under paragraph 1 of
subsection B of Section 1072.1 of Title 58 of the Oklahoma Statutes
the Oklahoma Health Care Agent Act ;
4. The patient's spouse;
5. Adult children of the patie nt;
6. Parents of the pa tient;
7. Adult siblings;
8. Other adult relatives of the pat ient in order of kinship; or
9. Close friends of the patient who have maintained regular
contact with the patient sufficient to be familiar with the
patient's personal values. Execution of an affidavit stating
specific facts and circumstances documenting such contact
constitutes prima facie evidence of close friendship.
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B. Prior to making a health care decision for a patient
pursuant to subsection A of this section, a person shall provide to
the health care provider or health care entity a signed copy of the
following statement to be entered into the patient's medical record:
"I hereby certify that:
I have not been convicted of, pleaded guilty to or pleaded no
contest to the crimes of abuse, v erbal abuse, neglect or financial
exploitation by a caregiver; exploitation of an elderly person or
disabled adult; or abuse, neglect, exploitation or sexual abuse of a
child;
I have not been found to have committed abuse, verbal a buse or
exploitation by a final investigative finding of the State
Department of Health or Department of Human Services or by a finding
of an administrative law judge, unless it was overturned on appeal;
and
I have not been criminally charged as a person r esponsible for
the care of a vulnerable adult with a crime resulting in the death
or near death of a vulnerable adult ".
SECTION 16. AMENDATORY 63 O.S. 2021, Section 3105.2, is
amended to read as follows:
Section 3105.2 As used in the Physician Orders for Life-
Sustaining Treatment Act:
1. "Attorney-in-fact" means an attorney-in-fact authorized to
act pursuant to the Uniform Durable Power of Attorney Act, Sections
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1071 through 1077 of Title 58 of the Oklahoma Statutes Oklahoma
Health Care Agent Act, with authority to act regarding the patient's
health and medical care decisions, subject to the limitations under
paragraph 1 of subsection B of Section 1072.1 of Title 58 of the
Oklahoma Statutes the Oklahoma Health Care Agent Act ;
2. "Guardian" means a general guardian of the person appointed
pursuant to subsection A of S ection 3-112 of Title 30 of the
Oklahoma Statutes or a limited guardian of the person appointed
pursuant to subsection B of Section 3 -112 of Title 30 of the
Oklahoma Statutes with the authority to make personal medical
decisions as determined under paragra ph 5 of subsection B of Section
3-113 of Title 30 of the Oklahoma Statutes;
3. "Health care provider" means a person who is licensed,
certified or otherwise authorized by the laws of this stat e to
administer health care in the ordinary course of business or
practice of a profession;
4. "Health care proxy" means a health care proxy (or alternate
health care proxy) authorized to act pursuant to the Oklahoma
Advance Directive Act, Sections 3101.1 through 3101.16 of Title 63
of the Oklahoma Statutes this title, as defined in paragraph 6 of
Section 3101.3 of Title 63 of the Oklahoma Statutes this title; and
5. "Other legally authorized person" means a person, other than
a minor's custodial parent or guardian, the patient or the patient's
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attorney-in-fact, guardian or health care proxy, who has authority
to make health care decisions for the patient under common law.
SECTION 17. AMENDATORY 63 O.S. 2021, Section 3131.3, is
amended to read as follows:
Section 3131.3 As used in the Oklahoma Do -Not-Resuscitate Act:
1. "Attending physician" means a licensed physician who has
primary responsibility for treatment or care of th e person. If more
than one physician shares that responsibility, any of those
physicians may act as the attending physician under the provisions
of the Oklahoma Do-Not-Resuscitate Act;
2. "Cardiopulmonary resuscitation" means those measures used to
restore or support cardiac or respirato ry function in the event of a
cardiac or respiratory arrest;
3. "Do-not-resuscitate identification" means a standardized
identification necklace, bracelet, or card as set forth in the
Oklahoma Do-Not-Resuscitate Act that signifies that a do-not-
resuscitate consent or order has been executed for the possessor;
4. "Do-not-resuscitate order" means an order issued by a
licensed physician that cardiopulmonary resuscitation should not be
administered to a particular person;
5. "Emergency medical services perso nnel" means firefighters,
law enforcement officers, emergency m edical technicians, paramedics,
or other emergency services personnel, providers, or entities,
acting within the usual course of their professions;
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6. "Health care decision" means a decision t o give, withhold,
or withdraw informed consent to any type of h ealth care including,
but not limited to, medical and surgical treatments including life -
prolonging interventions, nursing care, hospitalization, treatment
in a nursing home or other extended c are facility, home health care,
and the gift or donation of a b ody organ or tissue;
7. "Health care agency" means an agency established to
administer or provide health care services and which is commonly
known by a wide variety of titles including, but no t limited to,
hospitals, medical centers, ambulatory health car e facilities,
physicians' offices and clinics, extended care facilities operated
in connection with hospitals, nursing homes, extended care
facilities operated in connection with rehabilitation centers, home
care agencies and hospices;
8. "Health care pro vider" means any physician, dentist, nurse,
paramedic, psychologist, or other person providing medical, dental,
nursing, psychological, hospice, or other healt h care services of
any kind;
9. "Incapacity" means the inability, because of physical or
mental impairment, to appreciate the nature and implications of a
health care decision, to make an informed choice regarding the
alternatives presented, and to commun icate that choice in an
unambiguous manner; and
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10. "Representative" means an attorney-in-fact for health care
decisions acting pursuant to the Uniform Durable Power of Attorney
Act Oklahoma Health Care Agent Act , a health care proxy acting
pursuant to the Oklahoma Rights of the Terminally Ill or
Persistently Unconscious Act Oklahoma Advance Directiv e Act, or a
guardian of the person appointed under the Oklahoma Guardianship and
Conservatorship Act.
SECTION 18. AMENDATORY 63 O.S. 2 021, Section 3131.5, is
amended to read as follows:
Section 3131.5 A. For persons under the car e of a health care
agency, a do-not-resuscitate order shall, if issued, be in
accordance with the policies and procedures of the health care
agency as long as not in conflict with the provision s of the
Oklahoma Do-Not-Resuscitate Act.
B. The do-not-resuscitate consent form shall be in
substantially the following form:
FRONT PAGE
OKLAHOMA DO-NOT-RESUSCITATE (DNR) CONSENT FORM
I, _________________________, requ est limited health care as
described in this document. If my heart stops beating or if I stop
breathing, no medical procedure to restore breathing or heart
function will be instituted by any health care provider including,
but not limited to, emergency me dical services (EMS) personnel.
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I understand that this decision will not prevent me from
receiving other health care such as the Heimlich maneuver or oxygen
and other comfort care measures.
I understand that I may revoke this consent at any time in one
of the following ways:
1. If I am under the care of a health care agency, by making an
oral, written, or other act of communication to a physician or other
health care provider of a health care agency;
2. If I am not under the care of a health care agency, by
destroying my do-not-resuscitate form, removing all do-not-
resuscitate identification from my pe rson, and notifying my
attending physician of the revocation;
3. If I am incapacitated and under the care of a health care
agency, my representative may rev oke the do-not-resuscitate consent
by written notification to a physician or other health care prov ider
of the health care agency or by oral notification to my attending
physician; or
4. If I am incapacitated and not under the care of a health
care agency, my representative may revoke the d o-not-resuscitate
consent by destroying the do-not-resuscitate form, removing all do -
not-resuscitate identification from my person, and notifying my
attending physician of the revocation.
I give permission for this infor mation to be given to EMS
personnel, doctors, nurses, and other health care providers. I
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hereby state that I am making an informed decision and agree to a
do-not-resuscitate order.
____________________ OR ________________________________
Signature of Person Signature of Representative
(Limited to an attorney-in-fact for
health care decisions acting und er the
Durable Power of Attorney Act Oklahoma
Health Care Agent Act , a health care
proxy acting under the Oklahoma Advance
Directive Act or a guardian of the
person appointed under the Oklahoma
Guardianship and Conservatorship Act.)
This DNR consent form w as signed in my
presence.
______________ ______________________ _____________
Date Signature of Witness Address
______________________ _____________
Signature of Witness Address
BACK OF PAGE
CERTIFICATION OF PHYSICIAN
(This form is to be used b y an attending physician only to
certify that an incapacitated person without a representative would
not have consented to the administration of cardiopulmon ary
resuscitation in the event of ca rdiac or respiratory arrest. An
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attending physician of an inca pacitated person without a
representative must know by clear and convincing evidence that the
incapacitated person, when competent, decided on the basis of
information sufficient to constitute informed consent that such
person would not have consented to the administration of
cardiopulmonary resuscitation in the event of cardiac or respiratory
arrest. Clear and convincing evidence for this purpose shall
include oral, written, or other acts of c ommunication between the
patient, when competent, and family me mbers, health care providers,
or others close to the patient with knowledge of the patient's
desires.)
I hereby certify, based on clear and convincing eviden ce
presented to me, that I believe t hat ___________________________
Name of Incapacitated Person
would not have consented to the administration of cardiopulmonary
resuscitation in the event of cardiac or respiratory arrest.
Therefore, in the event of card iac or respiratory arrest, no chest
compressions, artificial ventilation, intubations, defibrillati on,
or emergency cardiac medications are to be initiated.
__________________________ _____________________________
Physician's Signature/Date Physician's Name (PRINT)
__________________________ ______________________________________
Physician's Address/Phon e
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C. Witnesses must be individuals who are eighteen (18) years of
age or older who are not legatees, devisees or heirs at law.
D. It is the intention of th e Legislature that the preferred,
but not required, do-not-resuscitate form in Oklahoma shall be th e
form set out in subsection B of this section.
SECTION 19. It being immediately necessary for the preservation
of the public peace, health o r safety, an emergency is hereby
declared to exist, by reason whereof this act shall take effect an d
be in full force from and after its passage and approval.
58-2-10797 GRS 03/01/22