Oklahoma 2022 Regular Session

Oklahoma House Bill HB3815 Compare Versions

Version 1 (Old)

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33	28		ENGROSSED HOUSE
34		-	BILL NO. 3815 By: Stinson and Davis of the
35		-	House
	29	+	BILL NO. 3815 By: Stinson of the House
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37	31		and
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39	33		Howard of the Senate
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43	40		An Act relating to health care power of attor ney;
44	41		creating the Oklahoma Health Care Ag ent Act;
45	42		providing short title; defining terms; authorizing
46	43		execution of power of attorney for health care;
47	44		establishing requirements for execution of power of
48	45		attorney for health care; specifying when power of
49	46		attorney for health care is effective; es tablishing
50	47		requirements for revocation of power of attorney for
51	48		health care; creating optional form for execution of
52	49		power of attorney for health care; requiring certain
53	50		communication by health care provider; requiring
54	51		record of certain information; requiring certain
55	52		compliance by health care provider; providing
56	53		exceptions; requiring notice of certain
57	54		noncompliance; authorizing access to certain
58	55		information; establishing immu nity from liability for
59	56		certain actions; creating certain presumption;
60	57		stating effectiveness of copy; constru ing provisions;
61	58		providing for judicial relief; requiring retroactive
62	59		application of provisions to certain documents;
63	60		amending 63 O.S. 2021, Sections 1-1973, 3102.4,
64	61		3105.2, 3105.4, 3131.3 and 3131.5, wh ich relate to
65	62		the Home Care Act, the Oklahoma Advance Directive
66	63		Act, the Physician Orders for Life -Sustaining
67	64		Treatment Act, and the Oklahoma Do -Not-Resuscitate
68	65		Act; updating statutory references; provid ing for
69	66		codification; and declaring a n emergency.
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73	72		BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
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101	99		SECTION 1. NEW LAW A new sec tion of law to be codified
102	100		in the Oklahoma Statutes as Section 3111.1 of Title 63, unless there
103	101		is created a duplication in numb ering, reads as follows:
104	102		This act shall be known and may be cited as the "Oklahoma Health
105	103		Care Agent Act".
106	104		SECTION 2. NEW LAW A new section of law to be codified
107	105		in the Oklahoma Statutes as Se ction 3111.2 of Title 63, unless there
108	106		is created a duplication in numbering, reads as follows:
109	107		As used in the Oklahoma Health Care Agent Act:
110	108		1. "Advance directive for health care" means any writing
111	109		executed in accordance with the requirements of Section 3101.4 of
112	110		Title 63 of the Oklahoma Statutes;
113	111		2. "Agent" means an individual designated in a power of
114	112		attorney for health care to make a health care decision for the
115	113		individual granting the power ;
116	114		3. "Attending physician" means the physician who has primary
117	115		responsibility for the treatment and care of a patient;
118	116		4. "Capacity" means an individual's ability to understand and
119	117		appreciate the nature and implications of a h ealth care decision, to
120	118		make an informed choice regar ding the alternatives presented
121	119		including understanding and appreciat ing the significant benefits
122	120		and risks, and to make and communicate a health care decision in an
123	121		unambiguous manner;
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151	148		5. "Health care" means any care, treatment, service, or
152	149		procedure to maintain, diagnose, or otherwise affect an individual 's
153	150		physical or mental condition;
154	151		6. "Health care decision" means a decision made by an
155	152		individual or the individual's agent regarding the individual 's
156	153		health care including:
157	154		a. selection and discharge of health care providers and
158	155		facilities,
159	156		b. consent to or refusal of any care, treat ment, service,
160	157		or procedure to maintain, diagnose, or othe rwise
161	158		affect a physical or mental condition, and
162	159		c. signing a do-not-resuscitate consent in accordance
163	160		with the provisions of the Oklahoma Do -Not-Resuscitate
164	161		Act, Section 3131.1 et se q. of Title 63 of the
165	162		Oklahoma Statutes.
166	163		Health care decision shall not include the ability of the agent to
167	164		make decisions about the wi thholding or withdrawal of nutrition or
168	165		hydration;
169	166		7. "Health care facility" means any public or private
170	167		organization, corporation, authority, partnership, sole
171	168		proprietorship, association, age ncy, network, joint venture, or
172	169		other entity that is established and appropriately licensed in this
173	170		state to administer or provid e health care services . Health care
174	171		facility includes but is not l imited to hospitals, medical centers,
175	172
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202	198		ambulatory surgery centers, physicians' offices, clinics, nursing
203	199		homes, rehabilitation centers, home care agencies, hospices, and
204	200		long-term care agencies;
205	201		8. "Health care provider" means a person who is licensed,
206	202		certified, or otherwise authorized by the laws of this state to
207	203		administer health care in the ordinary course of business or
208	204		practice of a profession ;
209	205		9. "Individual instruction " means an individual's direction
210	206		concerning a health care decision for the individual;
211	207		10. "Person" means a person eighteen (18) years of a ge or older
212	208		or a minor who may consent to have services provid ed by health
213	209		professionals pursuant to Section 2602 of Title 63 of the Oklahoma
214	210		Statutes;
215	211		11. "Physician" means an individual authorized to practice
216	212		medicine or osteopathy pursuant to Chapter 11 or Chapter 14 of Title
217	213		59 of the Oklahoma Statutes ;
218	214		12. "Power of attorney for health care " means the designation
219	215		of an agent to make health care decisions for the individual
220	216		granting the power;
221	217		13. "Reasonably available" means readily able to be conta cted
222	218		without undue effort and willing and able to act in a timely manner
223	219		considering the urgency of the patient's health care needs; and
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251	246		14. "State" means a state of the United States, the District of
252	247		Columbia, the Commonwealth of Pu erto Rico, or a territ ory or insular
253	248		possession subject to the jurisdicti on of the United States.
254	249		SECTION 3. NEW LAW A new secti on of law to be codified
255	250		in the Oklahoma Statutes as Section 3111.3 of Title 63, unless there
256	251		is created a duplication in numb ering, reads as follows:
257	252		A. A person with capacity may give an oral or written
258	253		individual instruction. The instruction may be li mited to take
259	254		effect only if a specified condition arises.
260	255		B. A person with capacity may execute a power of attorney for
261	256		health care, which may authorize the agent to make any health care
262	257		decision the principal could have made while having capacity other
263	258		than the withholding or withdrawal of life -sustaining treatment,
264	259		nutrition, or hydration, which may only be authori zed in compliance
265	260		with the Oklahoma Advance Directive Act; provided, however, the
266	261		power of attorney for health care may authorize the agent to sign a
267	262		do-not-resuscitate consent in accordance with the provisions of the
268	263		Oklahoma Do-Not-Resuscitate Act, Section 3131.1 e t seq. of Title 63
269	264		of the Oklahoma Statutes . The power shall be in writing and signed
270	265		by the principal. The power remains in effect notwithstanding the
271	266		principal's later incapacity and may include indi vidual
272	267		instructions. Unless related to the principa l by blood, marriage,
273	268		or adoption, an agent may not be an owner, operator, or employee of
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301	295		a residential long-term health care institution at which the
302	296		principal is receiving care.
303	297		C. Unless otherwise spe cified in a power of attorney for health
304	298		care, the authority of an agent becomes effective only upon a
305	299		determination that the principal lacks capacity and ceases to be
306	300		effective upon a determination that the principal has recovered
307	301		capacity.
308	302		D. Unless otherwise specified in a power of attorney for health
309	303		care, a determination that an individual lacks or has recovered
310	304		capacity, or that another condition exists that affects an
311	305		individual instruction or the authority of an agent, shall be made
312	306		by the attending physician.
313	307		E. An agent shall make health care decisions in accordance with
314	308		the principal's individual instructions, if any, and other wishes to
315	309		the extent known to the agent. Otherwise, the agent shall make the
316	310		decision in accordance with the agent 's determination of the
317	311		principal's best interest. In determining the principal's best
318	312		interest, the agent shall consider the principal's personal values
319	313		to the extent known to the agent.
320	314		F. A health care decision made by an agent for a principal is
321	315		effective without judicial approval.
322	316		G. A power of attorney for health care shall be signed by the
323	317		principal and witnessed by two individuals who are at least eighteen
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351	344		(18) years of age and who are not legatees, devise es, or heirs at
352	345		law of the principal.
353	346		H. A power of attorney for health care is valid for purposes of
354	347		this act if it is in substantial compliance with this act,
355	348		regardless of when o r where executed or c ommunicated.
356	349		SECTION 4. NEW LAW A n ew section of law to be codified
357	350		in the Oklahoma Statutes as Section 3111.4 of Title 63, unless there
358	351		is created a duplication in numbering, reads as foll ows:
359	352		A. An individual may revoke the designation of an agent by a
360	353		signed writing or by personally inf orming the health care provider
361	354		at any time and in any manner that communicates an inten t to revoke.
362	355		B. A health care provider or agent who is informed of a
363	356		revocation shall promptly communicate the fact of the revocation to
364	357		the attending physician and to any health care facility at which the
365	358		patient is receiving car e.
366	359		C. A decree of annulment, divorce, dissolu tion of marriage, or
367	360		legal separation revokes a previous designatio n of a spouse as agent
368	361		unless otherwise specified in the decree or specifically enumerated
369	362		in a power of attorney for health care.
370	363		D. A power of attorney for health care that conflicts with an
371	364		earlier power of attorney for health car e revokes the earlier power
372	365		of attorney to the extent of the conflict.
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400	392		SECTION 5. NEW LAW A new section of law to be codified
401	393		in the Oklahoma Statutes as Section 3111.5 of Title 63, unless there
402	394		is created a duplication in numb ering, reads as follows:
403	395		The following form may, but need not, be used to create a power
404	396		of attorney for health care. The other sections of t his act govern
405	397		the effect of this form or any other writing used to create a power
406	398		of attorney for health care . An individual may complete o r modify
407	399		all or any part of the following form to the extent consistent with
408	400		subsection B of Section 3 of this act:
409	401		HEALTH CARE POWER OF ATTORNEY
410	402		You have the right to give instructions abo ut your own health
411	403		care. You also have the r ight to name someone else to make health
412	404		care decisions for you. Thi s form lets you do either or both of
413	405		these things. If you use this form, you may complete or modify all
414	406		or any part of it. You are free to u se a different form.
415	407		This form is a power of attorney for health care that lets you
416	408		name another individual as agent to make health care decisions for
417	409		you if you become incapable of making your own decisions or if you
418	410		want someone else to make those decisions for you now even though
419	411		you are still capable. You may also name an alternate agent to act
420	412		for you if your first choice is not wil ling, able, or reasonably
421	413		available to make dec isions for you. Unless related to you, your
422	414		agent may not be an owner, operator, or employee of a residential
423	415		long-term health care institution at which you are receiving care.
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451	442		Unless the form you sign limits the authority of your agent,
452	443		your agent may make all health care decisions for you. This form
453	444		has a place for you to limit the authority of your agent. You need
454	445		not limit the authority of your agent if you wish to rely on your
455	446		agent for all health care decisions that may have to be made. If
456	447		you choose not to limit the authority of your agent, your ag ent will
457	448		have the right to:
458	449		1. Consent or refuse consent to any c are, treatment, service,
459	450		or procedure to maintain, diagnose, or o therwise affect a physica l
460	451		or mental condition;
461	452		2. Select or discharge health care providers and facilities;
462	453		and
463	454		3. Sign a do-not-resuscitate consent.
464	455		This form does not authorize the agent to make any decisions
465	456		directing the withholding of life-sustaining treatment, nutrition,
466	457		or hydration, which may only be authorized in c ompliance with the
467	458		Oklahoma Advance Directive Act. This form may authoriz e the agent
468	459		to sign a do-not-resuscitate consent.
469	460		After completing this form, sign and date the form at the end.
470	461		It is required that two other individuals sign as witnesses. These
471	462		witnesses must be at least 18 years old and not relat ed to you or
472	463		named to inherit from you. Give a copy of the signed and completed
473	464		form to your physician, to any o ther health care providers you may
474	465		have, to any health care facility at which you are rece iving care,
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502	492		and to any health care agents you have na med. You should talk to
503	493		the person you have named as agent to mak e sure that he or she
504	494		understands your wishe s and is willing to take the responsibility.
505	495		You have the right to r evoke this power of attorney for health
506	496		care or replace this form at any time.
507	497		POWER OF ATTORNEY FOR HEALTH CARE
508	498		1. DESIGNATION OF AGENT: I designate the following individual
509	499		as my agent to make health care decisions for me:
510	500		_____________________________________________________ ______________
511	501		(name of individual you choose as agent )
512	502		________________________________________________________________ ___
513	503		(address) (city) (state) (zip code)
514	504		________________________________________________________________ ___
515	505		(home phone) (work phone)
516	506		OPTIONAL: If I revoke my agent's authority or if my agent is
517	507		not willing, able, or reasonably availa ble to make a health care
518	508		decision for me, I designate as my first alternate agent:
519	509		___________________________________________________________________
520	510		(name of individual y ou choose as first alternate agent)
521	511		_____________________________________________ ______________________
522	512		(address) (city) (state) (zip code )
523	513		______________________________________________________________ _____
524	514		(home phone) (work phone)
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552	541		OPTIONAL: If I revoke the authority of my agent and first
553	542		alternate agent or if neither is willing, able, or reasonably
554	543		available to make a heal th care decision for me, I designate as my
555	544		second alternate agent:
556	545		____________________________________________________ _______________
557	546		(name of individual you choose as second alternate agent)
558	547		_______________________________________________________________ ____
559	548		(address) (city) (state) (zip code)
560	549		_____________________________________________ ______________________
561	550		(home phone) (work phone)
562	551		2. AGENT'S AUTHORITY: My agent is authorized to make all
563	552		health care decisions (not to include the withholding or withdrawal
564	553		of life-sustaining treatment) for me that I could make if I were
565	554		able, except as I state here:
566	555		________________________________________________ ___________________
567	556		___________________________________________________________________
568	557		___________________________________________________________________
569	558		(Add additional sheets if needed.)
570	559		3. WHEN AGENT'S AUTHORITY BECOMES EFFECTIVE: My agent 's
571	560		authority becomes effective when my attending physician determines
572	561		that I am unable to make my own health care decisions unless I mark
573	562		the following box. If I mark this box [ ], my agent's authority
574	563		to make health care decisions for me takes effect immediately .
575	564		_____________
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579	567		2
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602	590
603	591		(Initials)
604	592		4. AGENT'S OBLIGATION: My agent shall make health care
605	593		decisions for me in accordance with th is power of attorney for
606	594		health care and my other wishes to the extent known to my agent. To
607	595		the extent my wishes are unknown, my age nt shall make health care
608	596		decisions for me in accordance with what my agent determines to be
609	597		in my best interest. In dete rmining my best interest, my agent
610	598		shall consider the decisions I would have made myself to the extent
611	599		known to my agent.
612	600		_____________
613	601		(Initials)
614	602		5. RELIEF FROM PAIN: Except a s I state in the following space,
615	603		I direct that treatment for alleviation of p ain or discomfort be
616	604		provided at all times, e ven if it hastens my death:
617	605		_______________________________________________________ _________
618	606		________________________________________ ________________________
619	607		6. OTHER WISHES: (If you do not agree with any of t he optional
620	608		choices above and wish to write y our own, or if you wish to add to
621	609		the instructions you have given above, you may do so here.) I
622	610		direct that:
623	611		___________________________________________________________________
624	612		_________________________________ __________________________________
625	613		(Add additional sheets if needed.)
626	614
627		-	SENATE FLOOR VERSION - HB3815 SFLR Page 13
628		-	(Bold face denotes Committee Amendments) 1
	615	+	ENGR. H. B. NO. 3815 Page 13 1
629	616		2
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631	618		4
632	619		5
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648	635		21
649	636		22
650	637		23
651	638		24
652	639
653	640		7. EFFECT OF COPY: A copy of this form has the same effect as
654	641		the original.
655	642		8. SIGNATURES: Sign and date the form here:
656	643		_______________________________ ______________________________
657	644		(date) (sign your name)
658	645		_______________________________ ______________________________
659	646		(address) (print your name)
660	647		_______________________ ________
661	648		(city) (state)
662	649		SIGNATURES OF WITNESSES:
663	650		First witness Second witness
664	651		______________________________ _______________________________
665	652		(print name) (print name)
666	653		_____________________ _________ _______________________________
667	654		(address) (address)
668	655		______________________________ ______________________________
669	656		(city) (state) (city) (state)
670	657		______________________________ ______________________________
671	658		(signature of witness) (signature of witness)
672	659		______________________________ _______________________ _______
673	660		(date) (date)
674	661		SECTION 6. NEW LAW A new section of law to be codified
675	662		in the Oklahoma Statutes as Section 3111.6 of Title 63, unless there
676	663		is created a duplication in numbering, reads as follows:
677	664
678		-	SENATE FLOOR VERSION - HB3815 SFLR Page 14
679		-	(Bold face denotes Committee Amendments) 1
	665	+	ENGR. H. B. NO. 3815 Page 14 1
680	666		2
681	667		3
682	668		4
683	669		5
684	670		6
685	671		7
686	672		8
687	673		9
688	674		10
689	675		11
690	676		12
691	677		13
692	678		14
693	679		15
694	680		16
695	681		17
696	682		18
697	683		19
698	684		20
699	685		21
700	686		22
701	687		23
702	688		24
703	689
704	690		A. Before implementing a health care decision made for a
705	691		patient, the attending physician, if possible, shall promptly
706	692		communicate to the patient the decision made and the identity o f the
707	693		person making the decision.
708	694		B. An attending physician who knows of the existence of a power
709	695		of attorney for health c are or a revocation of a power of attorney
710	696		for health care shall promptly record its existence in the patient's
711	697		medical record and, if it is in writing, shall request a copy and if
712	698		one is furnished shall arrange for its maintenance in the medical
713	699		record. An attending physician who makes o r is informed of a
714	700		determination that a patient lacks or has recovered capacity shall
715	701		promptly record the determination in the patient 's medical record
716	702		and communicate the determination to the patient, if possible, and
717	703		to any person then authorized to make health care decisions for the
718	704		patient.
719	705		C. Except as provided in subsections D and E of this section, a
720	706		health care provider or facility providing care to a patient shall:
721	707		1. Comply with an individual instruction of t he patient and
722	708		with a reasonable inte rpretation of that instruction made by a
723	709		person then authorized to make health care decisions for the
724	710		patient; and
725	711		2. Comply with a health care decision for the patient made by a
726	712		person then authorized to make health care decisions for the patient
727	713
728		-	SENATE FLOOR VERSION - HB3815 SFLR Page 15
729		-	(Bold face denotes Committee Amendments) 1
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730	715		2
731	716		3
732	717		4
733	718		5
734	719		6
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736	721		8
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738	723		10
739	724		11
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741	726		13
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749	734		21
750	735		22
751	736		23
752	737		24
753	738
754	739		to the same extent as if the decision had been made by the patient
755	740		while having capacity.
756	741		D. An attending physician or health care provider may decline
757	742		to comply with an individual instruction or health care decision for
758	743		reasons of conscience. A health care facility may decline to comply
759	744		with an individual instruction or health care decision if the
760	745		instruction or decision is contrary to a policy of the facility
761	746		which is expressly based on reasons of conscience and if the policy
762	747		was timely communicated to the patient or to a person then
763	748		authorized to make health care decisions for the patient.
764	749		E. A health care provider or facility may decline to comply
765	750		with an individual instruction or health care decision that requires
766	751		medically ineffective or nonbeneficial health care or health care
767	752		contrary to generally accepted health care standards applicable to
768	753		the health care provider or facility.
769	754		F. A health care provider or facility that declines to comply
770	755		with an individual instruction or health care decision shall:
771	756		1. Promptly so inform the patie nt, if possible, and any person
772	757		then authorized to make health care decisions for the patient;
773	758		2. Provide continuing care t o the patient until a transfer can
774	759		be effected; and
775	760		3. Unless the patient or person then authorized to make health
776	761		care decisions for the patient r efuses assistance, immediately make
777	762		all reasonable efforts to a ssist in the transfer of the patient to
778	763
779		-	SENATE FLOOR VERSION - HB3815 SFLR Page 16
780		-	(Bold face denotes Committee Amendments) 1
	764	+	ENGR. H. B. NO. 3815 Page 16 1
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784	768		5
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804	788
805	789		another health care provider or facility that is willing to comply
806	790		with the instruction or decision.
807	791		G. A health care provider or facility may not require or
808	792		prohibit the execution or revocation of an advance health care
809	793		directive as a condition for providing health care.
810	794		H. The provisions of this section shall not be constru ed to
811	795		supersede or authorize noncom pliance with the requirements of the
812	796		Oklahoma Advance Directive Act as provided in Section 3101.9 of
813	797		Title 63 of the Oklahoma S tatutes.
814	798		SECTION 7. NEW LAW A new section of law to be codified
815	799		in the Oklahoma Statutes as Section 3111.7 of Title 63, unless there
816	800		is created a duplication in numbering, reads as follows:
817	801		Unless otherwise specified in a power of attorney for health
818	802		care, a person then authorized to make health care decisions for a
819	803		patient has the same rights as the patient to request, receive,
820	804		examine, copy, and conse nt to the disclosure of medical or any other
821	805		health care information.
822	806		SECTION 8. NEW LAW A new section of law to be codified
823	807		in the Oklahoma Statutes as Section 3111.8 of Title 63, unless there
824	808		is created a duplication in numbering, reads as follows:
825	809		A. A health care provider or facility acting in good faith and
826	810		in accordance with gener ally accepted health care standards
827	811		applicable to the health care provider or facility shall not be
828	812
829		-	SENATE FLOOR VERSION - HB3815 SFLR Page 17
830		-	(Bold face denotes Committee Amendments) 1
	813	+	ENGR. H. B. NO. 3815 Page 17 1
831	814		2
832	815		3
833	816		4
834	817		5
835	818		6
836	819		7
837	820		8
838	821		9
839	822		10
840	823		11
841	824		12
842	825		13
843	826		14
844	827		15
845	828		16
846	829		17
847	830		18
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850	833		21
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854	837
855	838		subject to civil or criminal liability or to disc ipline for
856	839		unprofessional conduct for:
857	840		1. Complying with a health care decision of a person apparently
858	841		having authority to make a health care decision for a patient;
859	842		2. Declining to comply with a health care decision of a person
860	843		based on a belief that th e person then lacked authority; or
861	844		3. Complying with a power of attorney for health care and
862	845		assuming that the designation was valid when made and has not been
863	846		revoked or terminated.
864	847		B. An individual acting as agent under this act shall not be
865	848		subject to civil or criminal liability or to discipline fo r
866	849		unprofessional conduct for health care decisions made in good faith.
867	850		SECTION 9. NEW LAW A new section of law to be codified
868	851		in the Oklahoma Statutes as Section 3111.9 of Title 63, unless there
869	852		is created a duplication in numb ering, reads as follows:
870	853		A. This act shall not be construed to affect the right of an
871	854		individual to make health care decisions while having capacity to do
872	855		so.
873	856		B. An individual is presumed to have capacity to mak e a health
874	857		care decision and to give or revoke powers of attorney for health
875	858		care.
876	859		SECTION 10. NEW LAW A n ew section of law to be codified
877	860		in the Oklahoma Statutes as Section 3111.10 of Title 63, unless
878	861		there is created a duplication in numbering, reads as follows:
879	862
880		-	SENATE FLOOR VERSION - HB3815 SFLR Page 18
881		-	(Bold face denotes Committee Amendments) 1
	863	+	ENGR. H. B. NO. 3815 Page 18 1
882	864		2
883	865		3
884	866		4
885	867		5
886	868		6
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888	870		8
889	871		9
890	872		10
891	873		11
892	874		12
893	875		13
894	876		14
895	877		15
896	878		16
897	879		17
898	880		18
899	881		19
900	882		20
901	883		21
902	884		22
903	885		23
904	886		24
905	887
906	888		A copy of a written power of attorney for health care or
907	889		revocation of a power of attorney for health care has the same
908	890		effect as the original.
909	891		SECTION 11. NEW LAW A new section of law to be codified
910	892		in the Oklahoma Statutes as Section 3111.11 of Title 63, unless
911	893		there is created a duplication in numb ering, reads as follows:
912	894		A. This act shall not be construed to create a presumption
913	895		concerning the intention of an individual who has not made or who
914	896		has revoked a power of attorney for health care .
915	897		B. This act shall not be construed to authorize or require a
916	898		health care provider or facility to provide health care contrary to
917	899		generally accepted health care standards applicable to the health
918	900		care provider or facility; provided, this provision shall not be
919	901		construed to supersede or authorize noncompliance with the
920	902		requirements of the Oklaho ma Advance Directive Act as provided in
921	903		Section 3101.9 of Title 63 of the O klahoma Statutes.
922	904		C. This act shall not be construed to authorize an agent to
923	905		consent to the admission of an individual to a mental health care
924	906		facility unless the individual's written directive expressly so
925	907		provides.
926	908		D. This act shall not affect other statutes of this state
927	909		governing treatment for mental illness of an individual
928	910		involuntarily committed to a mental health care facility under
929	911		Chapter 1 of Title 43A of the Oklahoma Statutes.
930	912
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	913	+	ENGR. H. B. NO. 3815 Page 19 1
933	914		2
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943	924		12
944	925		13
945	926		14
946	927		15
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949	930		18
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952	933		21
953	934		22
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955	936		24
956	937
957	938		SECTION 12. NEW LAW A new section of law to be codified
958	939		in the Oklahoma Statutes as Section 3111.12 of Title 63, unless
959	940		there is created a duplication in numbering, reads as follows:
960	941		On petition of a patient, the patient's agent, or a health care
961	942		provider or facility involved with the patient's care, the court may
962	943		enjoin or direct a health care decision or order other equitable
963	944		relief. A proceeding under this section shall be governed by Title
964	945		12 of the Oklahoma Statutes.
965	946		SECTION 13. NEW LAW A new sectio n of law to be codifie d
966	947		in the Oklahoma Statutes as Section 3111.13 of Title 63, unless
967	948		there is created a duplication in numbering, reads as follows:
968	949		Any document made in substantial compliance with the
969	950		requirements of the Oklahoma Health Care Agen t Act shall have full
970	951		force and effect including such documents made prior to the
971	952		effective date of this act .
972	953		SECTION 14. AMENDATORY 63 O.S. 2021, Section 1-1973, is
973	954		amended to read as follows:
974	955		Section 1-1973. A. Patients who are capabl e of self-
975	956		administering their own medications without assistance sh all be
976	957		encouraged and allowed to do so. How ever, a certified nurse aide
977	958		may assist a patient whose condition is medically stable with the
978	959		self-administration of routine, regularly schedule d medications that
979	960		are intended to be self-administered, if the fol lowing conditions
980	961		are met:
981	962
982		-	SENATE FLOOR VERSION - HB3815 SFLR Page 20
983		-	(Bold face denotes Committee Amendments) 1
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984	964		2
985	965		3
986	966		4
987	967		5
988	968		6
989	969		7
990	970		8
991	971		9
992	972		10
993	973		11
994	974		12
995	975		13
996	976		14
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998	978		16
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1007	987
1008	988		1. For an oral medication, the medication shall have been
1009	989		placed in a medication planner by a registered n urse, a relative of
1010	990		the patient or nursing staff of an Oklahoma licensed home health or
1011	991		hospice agency that is currently s erving the patient; and
1012	992		2. For all other fo rms, the certified nurse aide shall assist
1013	993		with self-administration consistent with a disp ensed prescription's
1014	994		label or the package directions of an over-the-counter medication.
1015	995		B. For purposes of this section, self-administered medications
1016	996		include both legend and over-the-counter oral dosage forms, topical
1017	997		dosage forms and topical ophthalmic, otic and nasal dosage forms,
1018	998		including solutions, susp ensions, sprays and in halers.
1019	999		C. Assistance with self -administration of medication by a
1020	1000		certified nurse aide m ay occur only upon a documented request by,
1021	1001		and the written informed consent of, a patient or the patient's
1022	1002		surrogate, guardian or attorney -in-fact.
1023	1003		D. For purposes of this section, assistance with self -
1024	1004		administration of medication includes:
1025	1005		1. Taking an oral medication out of a pill planner and bringing
1026	1006		it to the patient;
1027	1007		2. Placing an oral dosage in the patient's hand or placing the
1028	1008		dosage in another container and helping the patient by lifting the
1029	1009		container to his or her mouth;
1030	1010		3. If ordered by a phy sician, placing an oral medication in
1031	1011		food before the patient self-administers;
1032	1012
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1036	1015		3
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1038	1017		5
1039	1018		6
1040	1019		7
1041	1020		8
1042	1021		9
1043	1022		10
1044	1023		11
1045	1024		12
1046	1025		13
1047	1026		14
1048	1027		15
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1058	1037
1059	1038		4. Crushing an oral medication pursuant to orders given by a
1060	1039		physician or health care professional;
1061	1040		5. Applying topical medication s; and
1062	1041		6. Keeping a record of when a patien t receives assistance with
1063	1042		self-administration pursuant to this section.
1064	1043		E. For purposes of this section, assistance with self-
1065	1044		administration of medication does not i nclude:
1066	1045		1. Removing oral medication from any container other than a
1067	1046		pill planner;
1068	1047		2. Mixing, compounding, converting or calculating medication
1069	1048		doses;
1070	1049		3. The preparation of syri nges for injection or the
1071	1050		administration of medications by any injectable rou te;
1072	1051		4. Administration of medications through intermittent positive
1073	1052		pressure breathing ma chines;
1074	1053		5. Administration of medications by way of a tube inserted in a
1075	1054		cavity of the body;
1076	1055		6. Administration of parenteral preparations;
1077	1056		7. Irrigations or debridin g agents used in the treatment of a
1078	1057		skin condition;
1079	1058		8. Rectal, urethral, or vaginal prep arations;
1080	1059		9. Medications ordered by the physician or health care
1081	1060		professional with prescr iptive authority to be given "as needed",
1082	1061		unless the order is written with sp ecific parameters that preclude
1083	1062
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1085		-	(Bold face denotes Committee Amendments) 1
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1087	1065		3
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1089	1067		5
1090	1068		6
1091	1069		7
1092	1070		8
1093	1071		9
1094	1072		10
1095	1073		11
1096	1074		12
1097	1075		13
1098	1076		14
1099	1077		15
1100	1078		16
1101	1079		17
1102	1080		18
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1109	1087
1110	1088		independent judgment on the part of the certified nurse a ide, and at
1111	1089		the request of a competent patient;
1112	1090		10. Medications for which the time of adm inistration, the
1113	1091		amount, the strength of dosage, the me thod of administration or the
1114	1092		reason for administration requires ju dgment or discretion on the
1115	1093		part of the certified nurse aide; or
1116	1094		11. Assistance with the self-administration of medication by a
1117	1095		certified nurse aide in an assisted living center through ho me care
1118	1096		services as provided for in Section 1 -890.8 of Title 63 of the
1119	1097		Oklahoma Statutes this title.
1120	1098		F. Assistance with t he self-administration of medication by a
1121	1099		certified nurse aide as described in this sectio n does not
1122	1100		constitute administration as defined in Sect ion 353.1 of Title 59 of
1123	1101		the Oklahoma Statute s.
1124	1102		G. The State Commissioner of Health may by rule establish
1125	1103		procedures and interpret terms as necessary to implement the
1126	1104		provisions of this section.
1127	1105		H. For purposes of this section:
1128	1106		1. "Informed consent" means advising the patient, or the
1129	1107		patient's surrogate, guardian or attorney-in-fact, that the patient
1130	1108		may be receiving assistance with self-administration of medication
1131	1109		from a certified nurse aide; and
1132	1110		2. "Attorney-in-fact" means an attorney-in-fact authorized to
1133	1111		act pursuant to the Uniform Durable Power of Attorney Act, Sections
1134	1112
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1140	1117		5
1141	1118		6
1142	1119		7
1143	1120		8
1144	1121		9
1145	1122		10
1146	1123		11
1147	1124		12
1148	1125		13
1149	1126		14
1150	1127		15
1151	1128		16
1152	1129		17
1153	1130		18
1154	1131		19
1155	1132		20
1156	1133		21
1157	1134		22
1158	1135		23
1159	1136		24
1160	1137
1161	1138		1071 through 1077 of Title 58 of the Oklahoma Statutes Oklahoma
1162	1139		Health Care Agent Act, with authority to act regarding the pat ient's
1163	1140		health and medical care decisions, subject to th e limitations under
1164	1141		paragraph 1 of subsection B of Section 1072.1 of Title 58 of the
1165	1142		Oklahoma Statutes the Oklahoma Health Care Agent Act.
1166	1143		SECTION 15. AMENDATORY 63 O.S. 2021, Se ction 3102.4, is
1167	1144		amended to read as follows:
1168	1145		Section 3102.4 A. When an adult patient or a person under
1169	1146		eighteen (18) years of age who may consent to have service s provided
1170	1147		by health professionals under Section 2602 of this title is
1171	1148		persistently unconsci ous, incompetent or otherwise mentally or
1172	1149		physically incapable of communicating, a person who is re asonably
1173	1150		available and willing in the following classes, in the o rder of
1174	1151		priority set forth in this subsection, shall be authorized to make
1175	1152		health care decisions for the patient under the same standard as
1176	1153		that applicable to making life-sustaining treatment decisions under
1177	1154		Section 3101.16 of this title, excluding any per son who is
1178	1155		disqualified from exercising such authority by Section 3102.5 of
1179	1156		this title. If those within a class disagree, a majority within the
1180	1157		class may make a health care decision for the patient. However, a
1181	1158		provider of health care to the patient or an y member or members of
1182	1159		any of the following classes may petition a court that would have
1183	1160		jurisdiction over a guardianship proceeding concerning t he patient
1184	1161		under Section 1-115 of Title 30 of the Oklahoma Statutes to seek an
1185	1162
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1188	1164		2
1189	1165		3
1190	1166		4
1191	1167		5
1192	1168		6
1193	1169		7
1194	1170		8
1195	1171		9
1196	1172		10
1197	1173		11
1198	1174		12
1199	1175		13
1200	1176		14
1201	1177		15
1202	1178		16
1203	1179		17
1204	1180		18
1205	1181		19
1206	1182		20
1207	1183		21
1208	1184		22
1209	1185		23
1210	1186		24
1211	1187
1212	1188		order directing a different heal th care decision on the ground that
1213	1189		the health care decision or decisions made violate the s tandard
1214	1190		required by this section, granting another me mber or other members
1215	1191		from among the following classes (notwithstanding the statutory
1216	1192		order of priority) superv ening authority to make health care
1217	1193		decisions for the patient on the ground that clear and c onvincing
1218	1194		evidence demonstrates they are more likely to adhere to that
1219	1195		standard, or both. Upon mot ion by any party, the court shall issue
1220	1196		an order requiring that p ending its decision on the merits and the
1221	1197		resolution of any appeal the patient be provided w ith health care of
1222	1198		which denial, in reasonable medica l judgment, would be likely to
1223	1199		result in or hasten the death of the patient, unless its provision
1224	1200		would require denial of the same health care to another patient.
1225	1201		The classes are as follows:
1226	1202		1. A general guardian of the person appointed pursuant to
1227	1203		subsection A of Section 3-112 of Title 30 of the Ok lahoma Statutes
1228	1204		or a limited guardian of the person appointed pur suant to subsection
1229	1205		B of Section 3-112 of Title 30 of the Oklahoma Statutes with
1230	1206		authority to make personal medical decisions as determined under
1231	1207		paragraph 5 of subsection B of Section 3-113 of Title 30 of the
1232	1208		Oklahoma Statutes;
1233	1209		2. A health care proxy, or alternate health care proxy,
1234	1210		designated by the patient, as defined in paragraph 6 of Sectio n
1235	1211		3101.3 of Title 63 of the Oklahoma Sta tutes this title;
1236	1212
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1239	1214		2
1240	1215		3
1241	1216		4
1242	1217		5
1243	1218		6
1244	1219		7
1245	1220		8
1246	1221		9
1247	1222		10
1248	1223		11
1249	1224		12
1250	1225		13
1251	1226		14
1252	1227		15
1253	1228		16
1254	1229		17
1255	1230		18
1256	1231		19
1257	1232		20
1258	1233		21
1259	1234		22
1260	1235		23
1261	1236		24
1262	1237
1263	1238		3. An attorney-in-fact authorized to act pursuant t o the
1264	1239		Uniform Durable Power of Attorney Act, Sections 1071 throu gh 1077 of
1265	1240		Title 58 of the Oklahoma Statutes Oklahoma Health Care Agent Act,
1266	1241		with authority to act regarding the patient's health and medical
1267	1242		care decisions, subject to the limitations under paragraph 1 of
1268	1243		subsection B of Section 1072.1 of Title 58 of the Oklahoma Statutes
1269	1244		the Oklahoma Health Care Agent Act;
1270	1245		4. The patient's spouse;
1271	1246		5. Adult children of the patient;
1272	1247		6. Parents of the patient;
1273	1248		7. Adult siblings;
1274	1249		8. Other adult relatives of the patient in order of kinship; or
1275	1250		9. Close friends of the pat ient who have maintained regular
1276	1251		contact with the patient sufficient to be familiar with the
1277	1252		patient's personal values. Execution of an affidavit stating
1278	1253		specific facts and circumstances docu menting such contact
1279	1254		constitutes prima facie evidence of close f riendship.
1280	1255		B. Prior to making a health care decision for a patient
1281	1256		pursuant to subsection A of this section, a person shall provide to
1282	1257		the health care provider or hea lth care entity a signed copy of the
1283	1258		following statement to be entered into the patient 's medical record:
1284	1259		"I hereby certify that:
1285	1260		I have not been convicted of, pleaded guilty to or p leaded no
1286	1261		contest to the crimes of abuse, verbal abus e, neglect or financi al
1287	1262
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1290	1264		2
1291	1265		3
1292	1266		4
1293	1267		5
1294	1268		6
1295	1269		7
1296	1270		8
1297	1271		9
1298	1272		10
1299	1273		11
1300	1274		12
1301	1275		13
1302	1276		14
1303	1277		15
1304	1278		16
1305	1279		17
1306	1280		18
1307	1281		19
1308	1282		20
1309	1283		21
1310	1284		22
1311	1285		23
1312	1286		24
1313	1287
1314	1288		exploitation by a care giver; exploitation of an elderly person or
1315	1289		disabled adult; or a buse, neglect, exploitation or sexual abuse of a
1316	1290		child;
1317	1291		I have not been found to have committ ed abuse, verbal abuse or
1318	1292		exploitation by a final inv estigative finding of the State
1319	1293		Department of Health or Department of Human Services or by a finding
1320	1294		of an administrative law judge, unless it was overturned on appeal;
1321	1295		and
1322	1296		I have not been criminally cha rged as a person responsible for
1323	1297		the care of a vulner able adult with a cri me resulting in the death
1324	1298		or near death of a vul nerable adult."
1325	1299		SECTION 16. AMENDATORY 63 O.S. 2021, Section 3105.2, is
1326	1300		amended to read as follows:
1327	1301		Section 3105.2 As used in the Physician Orders for Life -
1328	1302		Sustaining Treatment Act:
1329	1303		1. "Attorney-in-fact" means an attorney-in-fact authorized to
1330	1304		act pursuant to the Uniform Durable Power of Attorney Act, Sections
1331	1305		1071 through 1077 of Title 58 o f the Oklahoma Statutes Oklahoma
1332	1306		Health Care Agent Act, with authority to act regarding the pati ent's
1333	1307		health and medical care decisions, subje ct to the limitations under
1334	1308		paragraph 1 of subsection B of Section 1072.1 of Title 58 of the
1335	1309		Oklahoma Statutes the Oklahoma Health C are Agent Act;
1336	1310		2. "Guardian" means a general guardian of the person appointed
1337	1311		pursuant to subsection A of Section 3-112 of Title 30 of the
1338	1312
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1341	1314		2
1342	1315		3
1343	1316		4
1344	1317		5
1345	1318		6
1346	1319		7
1347	1320		8
1348	1321		9
1349	1322		10
1350	1323		11
1351	1324		12
1352	1325		13
1353	1326		14
1354	1327		15
1355	1328		16
1356	1329		17
1357	1330		18
1358	1331		19
1359	1332		20
1360	1333		21
1361	1334		22
1362	1335		23
1363	1336		24
1364	1337
1365	1338		Oklahoma Statutes or a l imited guardian of the person appointed
1366	1339		pursuant to subsection B of Section 3 -112 of Title 30 of the
1367	1340		Oklahoma Statutes with the authority to make personal medical
1368	1341		decisions as determined under paragraph 5 of subsecti on B of Section
1369	1342		3-113 of Title 30 of the Oklahoma Statutes;
1370	1343		3. "Health care provider" means a person who is licensed,
1371	1344		certified or otherwise authorized by the laws of this state t o
1372	1345		administer health care in th e ordinary course of bu siness or
1373	1346		practice of a profession;
1374	1347		4. "Health care proxy" means a health care proxy (or alternate
1375	1348		health care proxy) authorized to act pursuant to the Oklahoma
1376	1349		Advance Directive Act, Sections 3101.1 through 31 01.16 of Title 63
1377	1350		of the Oklahoma Statutes this title, as defined in paragraph 6 of
1378	1351		Section 3101.3 of Title 63 of the Oklahoma Statutes this title; and
1379	1352		5. "Other legally authoriz ed person" means a person, other than
1380	1353		a minor's custodial parent or guardian, the patient or the pat ient's
1381	1354		attorney-in-fact, guardian or health care proxy, who has authority
1382	1355		to make health care decisions for the patient under common law.
1383	1356		SECTION 17. AMENDATORY 63 O.S. 2021, Section 3 105.4, is
1384	1357		amended to read as follows:
1385	1358		Section 3105.4 1. At the top of the first page of the
1386	1359		standardized format Oklahoma physician orders for life-sustaining
1387	1360		treatment form the following wording in al l capitals shall appear
1388	1361		against a contrasting color b ackground: "FORM SHALL ACCOMPANY
1389	1362
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1392	1364		2
1393	1365		3
1394	1366		4
1395	1367		5
1396	1368		6
1397	1369		7
1398	1370		8
1399	1371		9
1400	1372		10
1401	1373		11
1402	1374		12
1403	1375		13
1404	1376		14
1405	1377		15
1406	1378		16
1407	1379		17
1408	1380		18
1409	1381		19
1410	1382		20
1411	1383		21
1412	1384		22
1413	1385		23
1414	1386		24
1415	1387
1416	1388		PERSON WHEN TRANSFERRED OR DISCHARGED"; at the bottom of the first
1417	1389		page the following wording in all capitals shall appear against a
1418	1390		contrasting color background: "HIPAA PERMITS DISCLOSURE TO HEALTH
1419	1391		CARE PROFESSIONALS AND PROXY DECISION MAKERS AS NECESSARY FOR
1420	1392		TREATMENT".
1421	1393		2. There shall be an introductory section, the left block of
1422	1394		which shall contain the name "Oklahoma Physician Orders for Life-
1423	1395		Sustaining Treatment (POL ST)" followed by the words, "This Physician
1424	1396		Order set is based on the patient's current medical condi tion and
1425	1397		wishes and is to be reviewed for potential replacemen t in the case
1426	1398		of a substantial change in either, as well as in other cases listed
1427	1399		under F. Any section not completed indicates full treatment for
1428	1400		that section. Photocopy or fax copy of this fo rm is legal and
1429	1401		valid." and the right block of which shall con tain lines for the
1430	1402		patient's name, the patient's date of birth and the effective date
1431	1403		of the form followed by the statement, "Form must be reviewe d at
1432	1404		least annually."
1433	1405		3. In Section A of the fo rm, the left block shall contain, in
1434	1406		bold font, "A. Check One", and the right block shall be headed, in
1435	1407		bold font, "Cardiopulmonary Resuscitation (CPR): Person has no
1436	1408		pulse and is not breathing. " below which there shall be a checkbox
1437	1409		followed by "Attempt Resuscitation (CPR)", then a checkbox followed
1438	1410		by "Do Not Attempt Resuscitation (DNR/ no CPR)", and below which
1439	1411
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1442	1413		2
1443	1414		3
1444	1415		4
1445	1416		5
1446	1417		6
1447	1418		7
1448	1419		8
1449	1420		9
1450	1421		10
1451	1422		11
1452	1423		12
1453	1424		13
1454	1425		14
1455	1426		15
1456	1427		16
1457	1428		17
1458	1429		18
1459	1430		19
1460	1431		20
1461	1432		21
1462	1433		22
1463	1434		23
1464	1435		24
1465	1436
1466	1437		shall be the words, "When not in cardiopul monary arrest, follow
1467	1438		orders in B, C and D below. "
1468	1439		4. In Section B of the form, the left block shall contain, in
1469	1440		bold, "B. Check One", and the right block shall be headed, in bold,
1470	1441		"Medical Interventions: Person has pulse and/or is breathing. "
1471	1442		Below this there shall be a checkbox followed by, in bold, "Full
1472	1443		Treatment" followed by, "Includes the use of intubation, advanced
1473	1444		airway interventions, mechanical ventila tion, defibrillation or
1474	1445		cardio version as indicated, medical treatment, intravenous fluids,
1475	1446		and cardiac monitor as indicated. Transfer to hospita l if
1476	1447		indicated. Include intensive care. Includ es treatment listed under
1477	1448		"Limited Interventions " and "Comfort Measures", followed by, in
1478	1449		bold, "Treatment Goal: Attempt to preserve life by all medically
1479	1450		effective means."
1480	1451		Below this there shall be a checkb ox followed by, in bold,
1481	1452		"Limited Interventions " followed by, "Includes the use of medical
1482	1453		treatment, oral and intravenous medications, intravenous fluids,
1483	1454		cardiac monitoring as indicated, noninvasive bi -level positive
1484	1455		airway pressure, a bag valve mask or other advanced airway
1485	1456		interventions. Includes t reatment listed under "Comfort Measures",
1486	1457		followed by, "Do not use intubation or mechanical ventilation.
1487	1458		Transfer to hospital if indicated. Avoid intensi ve care." followed
1488	1459		by, in bold, "Treatment Goal: Att empt to preserve life by basic
1489	1460		medical treatments."
1490	1461
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1493	1463		2
1494	1464		3
1495	1465		4
1496	1466		5
1497	1467		6
1498	1468		7
1499	1469		8
1500	1470		9
1501	1471		10
1502	1472		11
1503	1473		12
1504	1474		13
1505	1475		14
1506	1476		15
1507	1477		16
1508	1478		17
1509	1479		18
1510	1480		19
1511	1481		20
1512	1482		21
1513	1483		22
1514	1484		23
1515	1485		24
1516	1486
1517	1487		Below this there shall be a checkbox followed by, in bold,
1518	1488		"Comfort Measures only" followed by, "Includes keeping the patient
1519	1489		clean, warm and dry; use of medication by any route; positioning,
1520	1490		wound care and other measures to relieve pain and suffering. Use
1521	1491		oxygen, suction and manual treatment of airway obstructi on as needed
1522	1492		for comfort. Transfer from current location to intermediate
1523	1493		facility only if needed and adequate to meet comfort needs and to
1524	1494		hospital only if comfort needs cannot otherwise be met in the
1525	1495		patient's current location (e.g., hip fracture; if int ravenous route
1526	1496		of comfort measures is required)."
1527	1497		Below this there shall be, in italics, "Additional Orders:"
1528	1498		followed by an underlined space for other instructions.
1529	1499		5. In Section C of the form , the left block shall contain, in
1530	1500		bold, "C. Check One" and the right block shall be headed, in bold,
1531	1501		"Antibiotics".
1532	1502		Below this there shall be a checkbox followed by, in bold, "Use
1533	1503		antibiotics to preserve li fe."
1534	1504		Below this there shall be a checkbox follow ed by, in bold,
1535	1505		"Trial period of antibiotics if and when infec tion occurs." After
1536	1506		this there shall be, in italics, "*Include goals below in E. "
1537	1507		Below this there shall be a checkbox followed by, in bold,
1538	1508		"Initially, use antibiotics only to relieve pain and discomfort."
1539	1509		After this there shall be, in italics, "+Contact patient or
1540	1510		patient's representative for further direction."
1541	1511
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1544	1513		2
1545	1514		3
1546	1515		4
1547	1516		5
1548	1517		6
1549	1518		7
1550	1519		8
1551	1520		9
1552	1521		10
1553	1522		11
1554	1523		12
1555	1524		13
1556	1525		14
1557	1526		15
1558	1527		16
1559	1528		17
1560	1529		18
1561	1530		19
1562	1531		20
1563	1532		21
1564	1533		22
1565	1534		23
1566	1535		24
1567	1536
1568	1537		Below this there shall be, in it alics, "Additional Orders:"
1569	1538		followed by an underlined space for other instructions.
1570	1539		6. In Section D of the form, the left block shall contain, in
1571	1540		bold, "D. Check One in Each Column", and the right block shall be
1572	1541		headed in bold, "Assisted Nutrition and Hy dration", below which
1573	1542		shall be "Administer oral fluid s and nutrition, if necessary by
1574	1543		spoon feeding, if physically possible." Below these the right block
1575	1544		shall be divided into three columns.
1576	1545		The leftmost column shall be headed, "TPN (Total Parenteral
1577	1546		Nutrition-provision of nutrition into blood vessels). " Below this
1578	1547		there shall be a checkbox followed by, in bold, "TPN long-term"
1579	1548		followed by "if needed". Below this there shall be a checkbox
1580	1549		followed by, in bold, "TPN for a trial period* ". Below this there
1581	1550		shall be a checkbox followed by, in bold, "Initially, no TPN+".
1582	1551		The middle column shall be headed "Tube Feeding". Below this
1583	1552		there shall be a checkbox followed b y, in bold, "Long-term feeding
1584	1553		tube" followed by "if needed". Below this there shall be a ch eckbox
1585	1554		followed by, in bold, "Feeding tube for a tria l period*". Below
1586	1555		this there shall be a checkbo x followed by, in bold, "Initially, no
1587	1556		feeding tube".
1588	1557		The rightmost column shall be headed, "Intravenous (IV) Fluids
1589	1558		for Hydration". Below this there shal l be a checkbox followed by,
1590	1559		in bold, "Long-term IV fluids" followed by "if needed". Below this
1591	1560		there shall be a checkbox followed by, in bold, "IV fluids for a
1592	1561
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1595	1563		2
1596	1564		3
1597	1565		4
1598	1566		5
1599	1567		6
1600	1568		7
1601	1569		8
1602	1570		9
1603	1571		10
1604	1572		11
1605	1573		12
1606	1574		13
1607	1575		14
1608	1576		15
1609	1577		16
1610	1578		17
1611	1579		18
1612	1580		19
1613	1581		20
1614	1582		21
1615	1583		22
1616	1584		23
1617	1585		24
1618	1586
1619	1587		trial period*". Below this there shall be a checkbox followed by,
1620	1588		in bold, "Initially, no IV fluids+".
1621	1589		Running below all the columns there shall b e, in italics,
1622	1590		"Additional Orders:" followed by an underlined space for other
1623	1591		instructions, followed by, in it alics, "*Include goals below in E.
1624	1592		+Contact patient or patient's representative for further d irection."
1625	1593		7. In Section E of the form, the left blo ck shall contain, in
1626	1594		bold, "E. Check all that a pply" and the right block shall be
1627	1595		headed, in bold, "Patient Preferences as a Basis for this POLST
1628	1596		Form" shall include the following:
1629	1597		a. below the heading there shall be a box including the
1630	1598		words, in bold, "Patient Goals/Medical Condition:"
1631	1599		followed by an adequate space for such information,
1632	1600		b. below this there shall be a checkbox followed by, "The
1633	1601		patient has an advance directive for health care in
1634	1602		accordance with Sections 3101.4 or 3101.14 of Title 63
1635	1603		of the Oklahoma Statutes." Below that there shall be
1636	1604		a checkbox followed by, "The patient has a durable
1637	1605		power of attorney for health care decisions in
1638	1606		accordance with paragraph 1 of subsection B of Section
1639	1607		1072.1 of Title 58 of the Oklahoma Statutes the
1640	1608		Oklahoma Health Care Agent Act." Below that shall be
1641	1609		the indented words, "Date of execution" followed by an
1642	1610		underlined space. Below that shall be the words, "If
1643	1611
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1646	1613		2
1647	1614		3
1648	1615		4
1649	1616		5
1650	1617		6
1651	1618		7
1652	1619		8
1653	1620		9
1654	1621		10
1655	1622		11
1656	1623		12
1657	1624		13
1658	1625		14
1659	1626		15
1660	1627		16
1661	1628		17
1662	1629		18
1663	1630		19
1664	1631		20
1665	1632		21
1666	1633		22
1667	1634		23
1668	1635		24
1669	1636
1670	1637		POLST not being executed by patient: We certify that
1671	1638		this POLST is in accordance with the patient 's advance
1672	1639		directive." Below this there shall be a n underlined
1673	1640		space underneath which shall be positioned the wo rds,
1674	1641		"Name and Position (print) Signature" and "Signature
1675	1642		of Physician",
1676	1643		c. below these shall be the words, "Directions given by:"
1677	1644		and below that a checkbox followed by "Patient", a
1678	1645		checkbox followed by "Minor's custodial parent or
1679	1646		guardian", a checkbox followed by "Attorney-in-fact",
1680	1647		a checkbox followed by "Health care proxy", and a
1681	1648		checkbox followed by "Other legally authorized
1682	1649		person:" followed by an underlined space. B eneath or
1683	1650		beside the checkbox and "Other legally authorized
1684	1651		person:" and the underlined space shall be the words
1685	1652		"Basis of Authority:" followed by an underlined space,
1686	1653		and
1687	1654		d. below these shall be a four-column table with four
1688	1655		rows. In the top row the firs t column shall be blank ;
1689	1656		the second column shall have the words, "Printed
1690	1657		Name"; the third column shall have the word,
1691	1658		"Signature", and the fourth column shall have the
1692	1659		word, "Date". In the remaining rows the second
1693	1660		through fourth columns shall be blank. In the first
1694	1661
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	1662	+	ENGR. H. B. NO. 3815 Page 34 1
1697	1663		2
1698	1664		3
1699	1665		4
1700	1666		5
1701	1667		6
1702	1668		7
1703	1669		8
1704	1670		9
1705	1671		10
1706	1672		11
1707	1673		12
1708	1674		13
1709	1675		14
1710	1676		15
1711	1677		16
1712	1678		17
1713	1679		18
1714	1680		19
1715	1681		20
1716	1682		21
1717	1683		22
1718	1684		23
1719	1685		24
1720	1686
1721	1687		column of these rows, in the second row shall be the
1722	1688		words, "Attending physician"; in the third row shall
1723	1689		be the words, "Patient or other individual checked
1724	1690		above (patient's representative)"; and in the fourth
1725	1691		row shall be the words, "Health care professional
1726	1692		preparing form (besides doctor)."
1727	1693		8. Section F of the form, which shall have the heading, in
1728	1694		bold, "Information for Patient or Representative of Patient Named on
1729	1695		this Form", shall include the following language, appearing in bold
1730	1696		on the form:
1731	1697		"The POLST form is always voluntary and is usually for persons
1732	1698		with advanced illness. Before providing information for or signing
1733	1699		it, carefully read "Information for Patie nts and Their Families -
1734	1700		Your Medical Treatment Right s Under Oklahoma Law", which the health
1735	1701		care provider must give you. It is especially important to read the
1736	1702		sections on CPR and food and fluids, which have summaries of
1737	1703		Oklahoma laws that may control th e directions you may give. POLST
1738	1704		records your wishes for medical treatment in your current state of
1739	1705		health. Once initial medical treatment is begun and the risks and
1740	1706		benefits of further therapy are clear, your treatment wishes may
1741	1707		change. Your medical c are and this form can be changed to reflect
1742	1708		your new wishes at any time. Howe ver, no form can addres s all the
1743	1709		medical treatment decisions that may need to be made . An advance
1744	1710		health care directive is recommended, regardless of your health
1745	1711
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1748	1713		2
1749	1714		3
1750	1715		4
1751	1716		5
1752	1717		6
1753	1718		7
1754	1719		8
1755	1720		9
1756	1721		10
1757	1722		11
1758	1723		12
1759	1724		13
1760	1725		14
1761	1726		15
1762	1727		16
1763	1728		17
1764	1729		18
1765	1730		19
1766	1731		20
1767	1732		21
1768	1733		22
1769	1734		23
1770	1735		24
1771	1736
1772	1737		status. An advance directive allows you to document in detail your
1773	1738		future health care instru ctions and/or name a he alth care agent to
1774	1739		speak for you if you are unable to speak fo r yourself.
1775	1740		The State of Oklahoma affirms that the lives of all are of equal
1776	1741		dignity regardless of age or disability and emphasizes that no one
1777	1742		should ever feel pressured to agree to forego life -preserving
1778	1743		medical treatment because of age, disability or fear of being
1779	1744		regarded as a burden.
1780	1745		If this form is for a minor for whom you are authorized to make
1781	1746		health care decisions, you may not direct denial of medical
1782	1747		treatment in a manner that would vio late the child abuse and neglect
1783	1748		laws of Oklahoma. In particu lar, you may not direct the withholding
1784	1749		of medically indicated treatment from a disabled infa nt with life-
1785	1750		threatening conditions, as those terms a re defined in 42 U.S.C.,
1786	1751		Section 5106g or regulations implementing it and 42 U.S.C., Section
1787	1752		5106a."
1788	1753		9. Section G of the form, which shall have the heading, in
1789	1754		bold, "Directions for Completing and Imple menting Form", shall
1790	1755		include the following three subdivisions:
1791	1756		a. the first subdivision, entitled "COMPLETING POLST",
1792	1757		shall have the following language with the wo rds, "The
1793	1758		signature of the patient or the patient's
1794	1759		representative is required " appearing in bold on the
1795	1760		form:
1796	1761
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1799	1763		2
1800	1764		3
1801	1765		4
1802	1766		5
1803	1767		6
1804	1768		7
1805	1769		8
1806	1770		9
1807	1771		10
1808	1772		11
1809	1773		12
1810	1774		13
1811	1775		14
1812	1776		15
1813	1777		16
1814	1778		17
1815	1779		18
1816	1780		19
1817	1781		20
1818	1782		21
1819	1783		22
1820	1784		23
1821	1785		24
1822	1786
1823	1787		"POLST must be reviewed and prepare d in consultation
1824	1788		with the patient or the patien t's representative after
1825	1789		that person has been given a copy of "Information for
1826	1790		Patients and Their Families - Your Medical Treatment
1827	1791		Rights Under Oklahoma L aw". POLST must be reviewed
1828	1792		and signed by a physicia n to be valid. Be sure t o
1829	1793		document the basis fo r concluding the patient had or
1830	1794		lacked capacity at the time of execution of the form
1831	1795		in the patient's medical record. If the patient lacks
1832	1796		capacity, any current advance directive form must be
1833	1797		reviewed and the patient's representative and
1834	1798		physician must both certify that POLST complies with
1835	1799		it. The signature of the patient or the patient's
1836	1800		representative is required; however, if the patient 's
1837	1801		representative is not reasonably available to sign the
1838	1802		original form, a copy of the complete d form with the
1839	1803		signature of the patient's representative must be
1840	1804		placed in the medical record as soon as practicable
1841	1805		and "on file" must be written on the appropriate
1842	1806		signature line on this form.",
1843	1807		b. the second subdivision, entitl ed "IMPLEMENTING POLST",
1844	1808		shall have the followin g language:
1845	1809		"If a minor protests a directive to deny the minor
1846	1810		life-preserving medical treatment, the denial of
1847	1811
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1850	1813		2
1851	1814		3
1852	1815		4
1853	1816		5
1854	1817		6
1855	1818		7
1856	1819		8
1857	1820		9
1858	1821		10
1859	1822		11
1860	1823		12
1861	1824		13
1862	1825		14
1863	1826		15
1864	1827		16
1865	1828		17
1866	1829		18
1867	1830		19
1868	1831		20
1869	1832		21
1870	1833		22
1871	1834		23
1872	1835		24
1873	1836
1874	1837		treatment may not be implemented pending is suance of a
1875	1838		judicial order resolving the conflict. A health care
1876	1839		provider unwilling to comply with P OLST must comply
1877	1840		with the transfer and treatment pending trans fer
1878	1841		requirements of Section 3101.9 of Title 63 of the
1879	1842		Oklahoma Statutes as well as those of t he
1880	1843		Nondiscrimination in Treatment Act, Sections 3090. 2
1881	1844		and 3090.3 of Title 63 of the Oklahoma Statute s", and
1882	1845		c. the third subdivision, entitled "REVIEWING POLST",
1883	1846		shall have the following language:
1884	1847		"This POLST must be reviewed at least annually or
1885	1848		earlier if:
1886	1849		The patient is admitted to or discharged from a
1887	1850		medical care facility; the re is substantial chang e in
1888	1851		the patient's health status; or the treatment
1889	1852		preferences of the patient or patient's representative
1890	1853		change."
1891	1854		The same requirements for participation of the patient or
1892	1855		patient's representative, and signa ture by both a physician and the
1893	1856		patient or the patient's representative, that are described under
1894	1857		"COMPLETING POLST" shall also apply when POLST is reviewed, and must
1895	1858		be documented in Section I.
1896	1859
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1899	1861		2
1900	1862		3
1901	1863		4
1902	1864		5
1903	1865		6
1904	1866		7
1905	1867		8
1906	1868		9
1907	1869		10
1908	1870		11
1909	1871		12
1910	1872		13
1911	1873		14
1912	1874		15
1913	1875		16
1914	1876		17
1915	1877		18
1916	1878		19
1917	1879		20
1918	1880		21
1919	1881		22
1920	1882		23
1921	1883		24
1922	1884
1923	1885		10. Section H of the form, which shall have the heading, in
1924	1886		bold, "REVOCATION OF POLST", shall have the fol lowing language, with
1925	1887		the words specified below appearing in b old on the form:
1926	1888		"If POLST is revised or becomes invalid, write in bold the word
1927	1889		"VOID" in large letters on the front of the form. After voiding the
1928	1890		form a new form may b e completed. A patient with capacity or the
1929	1891		individual or individuals authorized to sign on behalf of the
1930	1892		patient in Section E of this form may void this form. If no new
1931	1893		form is completed, full treatment and resuscitation is to b e
1932	1894		provided, except as otherwise authorized by Ok lahoma law."
1933	1895		11. Section I of the form, which shall have the heading, in
1934	1896		bold, "REVIEW SECTION", followed by: "Periodic review confirms
1935	1897		current form or may require completion of new form," shall include
1936	1898		the following columns and a n umber of rows determine d by the Office
1937	1899		of the Attorney General:
1938	1900		a. Date of Review,
1939	1901		b. Location of Review,
1940	1902		c. Patient or Representative Signature,
1941	1903		d. Physician Signature, and
1942	1904		e. Outcome of Review.
1943	1905		Each row in column (5) shall includ e a checkbox followed by,
1944	1906		"FORM CONFIRMED - No Change", below which there shall be a checkbox
1945	1907		followed by, "FORM VOIDED, see updated form.", below which there
1946	1908		shall be a checkbox followed by, "FORM VOIDED, no new form."
1947	1909
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1949		-	(Bold face denotes Committee Amendments) 1
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1950	1911		2
1951	1912		3
1952	1913		4
1953	1914		5
1954	1915		6
1955	1916		7
1956	1917		8
1957	1918		9
1958	1919		10
1959	1920		11
1960	1921		12
1961	1922		13
1962	1923		14
1963	1924		15
1964	1925		16
1965	1926		17
1966	1927		18
1967	1928		19
1968	1929		20
1969	1930		21
1970	1931		22
1971	1932		23
1972	1933		24
1973	1934
1974	1935		A final section of the form, which s hall have the heading, in
1975	1936		bold, "Contact Information:", shall include two rows of four
1976	1937		columns. In the first column, the first row shall include
1977	1938		"Patient/Representative" followed by an adequate space fo r such
1978	1939		information, and the second column shall inclu de "Health Care
1979	1940		Professional Preparing Form" followed by an adequate space for such
1980	1941		information. In the secon d column both rows shall include
1981	1942		"Relationship" followed by an adequate space for such inform ation;
1982	1943		in the third column both rows shall include "Phone Number" followed
1983	1944		by an adequate space for s uch information; and in the fourth column
1984	1945		both rows shall incl ude "Email Address" followed by an adequate
1985	1946		space for such information.
1986	1947		SECTION 18. AMENDATORY 63 O.S. 2021, Section 3131 .3, is
1987	1948		amended to read as follows:
1988	1949		Section 3131.3 As used in the Oklah oma Do-Not-Resuscitate Act:
1989	1950		1. "Attending physician" means a licensed physician who has
1990	1951		primary responsibility for treatment or care of the person. If more
1991	1952		than one physician s hares that responsibility, any of those
1992	1953		physicians may act as the attending ph ysician under the provisions
1993	1954		of the Oklahoma Do-Not-Resuscitate Act;
1994	1955		2. "Cardiopulmonary resuscitation" means those measures used to
1995	1956		restore or support cardiac or respiratory fu nction in the event of a
1996	1957		cardiac or respiratory arrest;
1997	1958
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2000	1960		2
2001	1961		3
2002	1962		4
2003	1963		5
2004	1964		6
2005	1965		7
2006	1966		8
2007	1967		9
2008	1968		10
2009	1969		11
2010	1970		12
2011	1971		13
2012	1972		14
2013	1973		15
2014	1974		16
2015	1975		17
2016	1976		18
2017	1977		19
2018	1978		20
2019	1979		21
2020	1980		22
2021	1981		23
2022	1982		24
2023	1983
2024	1984		3. "Do-not-resuscitate identification" means a standardized
2025	1985		identification necklace, bracelet, or card as set forth in the
2026	1986		Oklahoma Do-Not-Resuscitate Act that signifies that a do-not-
2027	1987		resuscitate consent or order has been executed for the possessor;
2028	1988		4. "Do-not-resuscitate order" means an order issued by a
2029	1989		licensed physician that cardiopulmonary resuscitation should not be
2030	1990		administered to a particul ar person;
2031	1991		5. "Emergency medical services personnel " means firefighters,
2032	1992		law enforcement officers, emergenc y medical technicians, paramedics,
2033	1993		or other emergency service s personnel, providers, or entities,
2034	1994		acting within the usual course of their profession s;
2035	1995		6. "Health care decision" means a decision to giv e, withhold,
2036	1996		or withdraw informed consent to any type o f health care including ,
2037	1997		but not limited to, medical and surg ical treatments including life-
2038	1998		prolonging interventions, nursing care, hospitalization, treatment
2039	1999		in a nursing home or other extended care f acility, home health care,
2040	2000		and the gift or donation of a body organ or tissue;
2041	2001		7. "Health care agency" means an agency established to
2042	2002		administer or provide health care services and which is commonly
2043	2003		known by a wide variety of titles including, but not lim ited to,
2044	2004		hospitals, medical cen ters, ambulatory health care facilities,
2045	2005		physicians' offices and clinics, extended ca re facilities operated
2046	2006		in connection with hospitals, nursing homes, extended care
2047	2007
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2050	2009		2
2051	2010		3
2052	2011		4
2053	2012		5
2054	2013		6
2055	2014		7
2056	2015		8
2057	2016		9
2058	2017		10
2059	2018		11
2060	2019		12
2061	2020		13
2062	2021		14
2063	2022		15
2064	2023		16
2065	2024		17
2066	2025		18
2067	2026		19
2068	2027		20
2069	2028		21
2070	2029		22
2071	2030		23
2072	2031		24
2073	2032
2074	2033		facilities operated in connection with rehabilitation cent ers, home
2075	2034		care agencies and hos pices;
2076	2035		8. "Health care provider" means any physician, dentist, nurse,
2077	2036		paramedic, psychologist, or other person providing medical, dental,
2078	2037		nursing, psychological, hospice, or other health care services of
2079	2038		any kind;
2080	2039		9. "Incapacity" means the inability, bec ause of physical or
2081	2040		mental impairment, to appre ciate the nature and implications of a
2082	2041		health care decision, to make an informed choice regarding the
2083	2042		alternatives presented, and to communicate that choice in an
2084	2043		unambiguous manner; and
2085	2044		10. "Representative" means an attorney-in-fact for health care
2086	2045		decisions acting pursuant to the Uniform Durable Power of Attorney
2087	2046		Act Oklahoma Health Care Agent Act, a health care proxy acting
2088	2047		pursuant to the Oklahoma Rights of the Terminally Ill or
2089	2048		Persistently Unconscious Advance Directive Act, or a guardian of the
2090	2049		person appointed under the Oklahoma Guardianship and Conserva torship
2091	2050		Act.
2092	2051		SECTION 19. AMENDATORY 63 O.S. 2021, Section 3131.5, is
2093	2052		amended to read as follows:
2094	2053		Section 3131.5 A. For persons under the care of a hea lth care
2095	2054		agency, a do-not-resuscitate order shall, if issued, be in
2096	2055		accordance with the policies and procedures of the health care
2097	2056
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	2057	+	ENGR. H. B. NO. 3815 Page 42 1
2100	2058		2
2101	2059		3
2102	2060		4
2103	2061		5
2104	2062		6
2105	2063		7
2106	2064		8
2107	2065		9
2108	2066		10
2109	2067		11
2110	2068		12
2111	2069		13
2112	2070		14
2113	2071		15
2114	2072		16
2115	2073		17
2116	2074		18
2117	2075		19
2118	2076		20
2119	2077		21
2120	2078		22
2121	2079		23
2122	2080		24
2123	2081
2124	2082		agency as long as not in conflict with the provisi ons of the
2125	2083		Oklahoma Do-Not-Resuscitate Act.
2126	2084		B. The do-not-resuscitate consent form shall be in
2127	2085		substantially the following form:
2128	2086		FRONT PAGE
2129	2087		OKLAHOMA DO-NOT-RESUSCITATE (DNR) CONSENT FORM
2130	2088		I, _________________________, request limited health care as
2131	2089		described in this document. If my heart stops beating or i f I stop
2132	2090		breathing, no medical procedure to re store breathing or heart
2133	2091		function will be instituted by any health care provider including,
2134	2092		but not limited to, emergency medical services (EMS) personnel.
2135	2093		I understand that this decision will not prevent me fr om
2136	2094		receiving other heal th care such as the Hei mlich maneuver or oxygen
2137	2095		and other comfort care measure s.
2138	2096		I understand that I may revoke this consent at any time in one
2139	2097		of the following ways:
2140	2098		1. If I am under the care of a health care agency, by making an
2141	2099		oral, written, or other act of communication to a physician or other
2142	2100		health care provider of a health care agency;
2143	2101		2. If I am not under the care of a health care agency, by
2144	2102		destroying my do-not-resuscitate form, removing all do-not-
2145	2103		resuscitate identificati on from my person, and notifying my
2146	2104		attending physician of the revocation;
2147	2105
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2150	2107		2
2151	2108		3
2152	2109		4
2153	2110		5
2154	2111		6
2155	2112		7
2156	2113		8
2157	2114		9
2158	2115		10
2159	2116		11
2160	2117		12
2161	2118		13
2162	2119		14
2163	2120		15
2164	2121		16
2165	2122		17
2166	2123		18
2167	2124		19
2168	2125		20
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2173	2130
2174	2131		3. If I am incapacitated and under the care of a health care
2175	2132		agency, my representative may revoke the do-not-resuscitate consent
2176	2133		by written notification to a physician or other hea lth care provider
2177	2134		of the health care agency or by oral notification to my attending
2178	2135		physician; or
2179	2136		4. If I am incapacitated and not under the care of a health
2180	2137		care agency, my representative may revoke the do-not-resuscitate
2181	2138		consent by destroying the do-not-resuscitate form, remo ving all do-
2182	2139		not-resuscitate identification from my person, and notifying my
2183	2140		attending physician of the revocation.
2184	2141		I give permission for this information to be given to EMS
2185	2142		personnel, doctors, nurses, and other health care providers. I
2186	2143		hereby state that I am making an informed decision and agree to a
2187	2144		do-not-resuscitate order.
2188	2145		____________________ OR ________________________________
2189	2146		Signature of Person Signature of Representative
2190	2147		(Limited to an attorney-in-fact for
2191	2148		health care decisions acting under the
2192	2149		Durable Power of Attorney Act Oklahoma
2193	2150		Health Care Agent Act, a health care
2194	2151		proxy acting under the Oklahoma Advance
2195	2152		Directive Act or a guardian of the
2196	2153		person appointed under the Oklaho ma
2197	2154		Guardianship and Conservatorship Act.)
2198	2155
2199		-	SENATE FLOOR VERSION - HB3815 SFLR Page 44
2200		-	(Bold face denotes Committee Amendments) 1
	2156	+	ENGR. H. B. NO. 3815 Page 44 1
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2224	2180
2225	2181		This DNR consent form was signed in my
2226	2182		presence.
2227	2183		______________ ______________________ _____________
2228	2184		Date Signature of Witness Address
2229	2185		______________________ _____________
2230	2186		Signature of Witness Address
2231	2187		BACK OF PAGE
2232	2188		CERTIFICATION OF PHYSICIAN
2233	2189		(This form is to be used by an atten ding physician only to
2234	2190		certify that an incapacitated person without a represen tative would
2235	2191		not have consented to the administration of cardiopulmonary
2236	2192		resuscitation in the event of cardiac or respiratory arrest. An
2237	2193		attending physician of an incapacitated person without a
2238	2194		representative must know by clear and convincing evidence tha t the
2239	2195		incapacitated person, when competent, decided on the basis of
2240	2196		information sufficient to constitut e informed consent that such
2241	2197		person would not have consented to the adminis tration of
2242	2198		cardiopulmonary resuscitation in the event of cardiac or respirator y
2243	2199		arrest. Clear and convincing evidence for this purpose shall
2244	2200		include oral, written, or other acts of communication between the
2245	2201		patient, when competent, and family members, hea lth care providers,
2246	2202		or others close to the patient with knowledge of the patie nt's
2247	2203		desires.)
2248	2204
2249		-	SENATE FLOOR VERSION - HB3815 SFLR Page 45
2250		-	(Bold face denotes Committee Amendments) 1
	2205	+	ENGR. H. B. NO. 3815 Page 45 1
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2274	2229
2275	2230		I hereby certify, based on clear and convincing evidence
2276	2231		presented to me, that I believe that ___________________________
2277	2232		Name of Incapacitated Person
2278	2233		would not have consented to the adm inistration of cardiopulmonary
2279	2234		resuscitation in the eve nt of cardiac or respiratory arrest.
2280	2235		Therefore, in the event of cardiac or respiratory arrest, no ches t
2281	2236		compressions, artificial ventilation, intubations, defibrillation,
2282	2237		or emergency cardiac medicati ons are to be initiated.
2283	2238		__________________________ _____________________________
2284	2239		Physician's Signature/Date Physician's Name (PRINT)
2285	2240		________________________ ________________________________________
2286	2241		Physician's Address/Phone
2287	2242		C. Witnesses must be individua ls who are eighteen (18) years of
2288	2243		age or older who are not legatees, devisees or heirs at law.
2289	2244		D. It is the intention of the Legislature that the preferred,
2290	2245		but not required, do-not-resuscitate form in Oklahoma shall be the
2291	2246		form set out in subsection B of this section.
2292	2247		SECTION 20. It being immediately necessary for the preservation
2293	2248		of the public peace, health or safety, an emergency is hereby
2294	2249		declared to exist, by reason whereof this act shall take effect and
2295	2250		be in full force from and after its passage and approval.
2296		-	COMMITTEE REPORT BY: COMMITTEE ON JUDICIARY
2297		-	April 12, 2022 - DO PASS
	2251	+
	2252	+
	2253	+	ENGR. H. B. NO. 3815 Page 46 1
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	2277	+
	2278	+	Passed the House of Representatives the 21st day of March, 2022.
	2279	+
	2280	+
	2281	+
	2282	+
	2283	+	Presiding Officer of the House
	2284	+	of Representatives
	2285	+
	2286	+
	2287	+	Passed the Senate the ___ day of __________, 2022.
	2288	+
	2289	+
	2290	+
	2291	+
	2292	+	Presiding Officer of the Senate
	2293	+
	2294	+