SENATE FLOOR VERSION - HB3815 SFLR Page 1
(Bold face denotes Committee Amendments) 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
SENATE FLOOR VERSION
April 12, 2022
ENGROSSED HOUSE
BILL NO. 3815 By: Stinson and Davis of the
House
and
Howard of the Senate
An Act relating to health care power of attor ney;
creating the Oklahoma Health Care Ag ent Act;
providing short title; defining terms; authorizing
execution of power of attorney for health care;
establishing requirements for execution of power of
attorney for health care; specifying when power of
attorney for health care is effective; es tablishing
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 certain information; requiring certain
compliance by health care provider; providing
exceptions; requiring notice of certain
noncompliance; authorizing access to certain
information; establishing immu nity from liability for
certain actions; creating certain presumption;
stating effectiveness of copy; constru ing 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, 3105.4, 3131.3 and 3131.5, wh ich relate to
the Home Care Act, the Oklahoma Advance Directive
Act, the Physician Orders for Life -Sustaining
Treatment Act, and the Oklahoma Do -Not-Resuscitate
Act; updating statutory references; provid ing for
codification; and declaring a n emergency.
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SENATE FLOOR VERSION - HB3815 SFLR Page 2
(Bold face denotes Committee Amendments) 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
SECTION 1. NEW LAW A new sec tion of law to be codified
in the Oklahoma Statutes as Section 3111.1 of Title 63, unless there
is created a duplication in numb ering, reads as follows:
This act shall be known and may be cited as the "Oklahoma Health
Care Agent Act".
SECTION 2. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Se ction 3111.2 of Title 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 h ealth care decision, to
make an informed choice regar ding the alternatives presented
including understanding and appreciat ing the significant benefits
and risks, and to make and communicate a health care decision in an
unambiguous manner;
SENATE FLOOR VERSION - HB3815 SFLR Page 3
(Bold face denotes Committee Amendments) 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
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 individual'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, treat ment, service,
or procedure to maintain, diagnose, or othe rwise
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 se q. of Title 63 of the
Oklahoma Statutes.
Health care decision shall not include the ability of the agent to
make decisions about the wi thholding or withdrawal of nutrition or
hydration;
7. "Health care facility" means any public or private
organization, corporation, authority, partnership, sole
proprietorship, association, age ncy, network, joint venture, or
other entity that is established and appropriately licensed in this
state to administer or provid e health care services . Health care
facility includes but is not l imited to hospitals, medical centers,
SENATE FLOOR VERSION - HB3815 SFLR Page 4
(Bold face denotes Committee Amendments) 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
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 a ge or older
or a minor who may consent to have services provid ed 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 individual
granting the power;
13. "Reasonably available" means readily able to be conta cted
without undue effort and willing and able to act in a timely manner
considering the urgency of the patient's health care needs; and
SENATE FLOOR VERSION - HB3815 SFLR Page 5
(Bold face denotes Committee Amendments) 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
14. "State" means a state of the United States, the District of
Columbia, the Commonwealth of Pu erto Rico, or a territ ory or insular
possession subject to the jurisdicti on of the United States.
SECTION 3. NEW LAW A new secti on of law to be codified
in the Oklahoma Statutes as Section 3111.3 of Title 63, unless there
is created a duplication in numb ering, reads as follows:
A. A person with capacity may give an oral or written
individual instruction. The instruction may be li mited to take
effect only if a specified condition arises.
B. A person with capacity may execute a power of attorney for
health care, which may authorize the agent to make any health care
decision the principal could have made while having capacity other
than the withholding or withdrawal of life -sustaining treatment,
nutrition, or hydration, which may only be authori zed in compliance
with the Oklahoma Advance Directive Act; provided, however, the
power of attorney for health care may authorize the agent to sign a
do-not-resuscitate consent in accordance with the provisions of the
Oklahoma Do-Not-Resuscitate Act, Section 3131.1 e t seq. of Title 63
of the Oklahoma Statutes . The power shall be in writing and signed
by the principal. The power remains in effect notwithstanding the
principal's later incapacity and may include indi vidual
instructions. Unless related to the principa l by blood, marriage,
or adoption, an agent may not be an owner, operator, or employee of
SENATE FLOOR VERSION - HB3815 SFLR Page 6
(Bold face denotes Committee Amendments) 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
a residential long-term health care institution at which the
principal is receiving care.
C. Unless otherwise spe cified in a power of attorney for health
care, the authority of an agent becomes effective only upon a
determination that the principal lacks capacity and ceases to be
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 has recovered
capacity, or that another condition exists that affects an
individual instruction or the authority of an agent, shall be made
by the attending physician.
E. An agent shall make health care decisions in accordance with
the principal's individual instructions, if any, and other wishes to
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 determining 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 for health care shall be signed by the
principal and witnessed by two individuals who are at least eighteen
SENATE FLOOR VERSION - HB3815 SFLR Page 7
(Bold face denotes Committee Amendments) 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
(18) years of age and who are not legatees, devise es, or heirs at
law of the principal.
H. A power of attorney for health care is valid for purposes of
this act if it is in substantial compliance with this act,
regardless of when o r where executed or c ommunicated.
SECTION 4. NEW LAW A n ew section of law to be codified
in the Oklahoma Statutes as Section 3111.4 of Title 63, unless there
is created a duplication in numbering, reads as foll ows:
A. An individual may revoke the designation of an agent by a
signed writing or by personally inf orming the health care provider
at any time and in any manner that communicates an inten t 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 car e.
C. A decree of annulment, divorce, dissolution of marriage, or
legal separation revokes a previous designatio n of a spouse 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 for health car e revokes the earlier power
of attorney to the extent of the conflict.
SENATE FLOOR VERSION - HB3815 SFLR Page 8
(Bold face denotes Committee Amendments) 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
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 numb ering, reads as follows:
The following form may, but need not, be used to create a power
of attorney for health care. The other sections of t his act govern
the effect of this form or any other writing used to create a power
of attorney for health care . An individual may complete o r modify
all or any part of the following form to the extent consistent with
subsection B of Section 3 of this act:
HEALTH CARE POWER OF ATTORNEY
You have the right to give instructions about your own health
care. You also have the r ight to name someone else to make health
care decisions for you. Thi s 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 attorney for health care that lets you
name another individual as agent to make health care decisions 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 wil ling, able, or reasonably
available to make dec isions 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 care.
SENATE FLOOR VERSION - HB3815 SFLR Page 9
(Bold face denotes Committee Amendments) 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
Unless the form you sign limits the authority 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 decisions that may have to be made. If
you choose not to limit the authority of your agent, your ag ent will
have the right to:
1. Consent or refuse consent to any c are, treatment, service,
or procedure to maintain, diagnose, or o therwise affect a physica l
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
directing the withholding of life-sustaining treatment, nutrition,
or hydration, which may only be authorized in c ompliance with the
Oklahoma Advance Directive Act. This form may authorize the agent
to sign a do-not-resuscitate consent.
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 old and not relat ed to you or
named to inherit from you. Give a copy of the signed and completed
form to your physician, to any o ther health care providers you may
have, to any health care facility at which you are rece iving care,
SENATE FLOOR VERSION - HB3815 SFLR Page 10
(Bold face denotes Committee Amendments) 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
and to any health care agents you have na med. You should talk to
the person you have named as agent to mak e sure that he or she
understands your wishe s and is willing to take the responsibility.
You have the right to r evoke this power of attorney for health
care or replace this form at any time.
POWER OF ATTORNEY FOR HEALTH CARE
1. DESIGNATION OF AGENT: I designate the following individual
as my agent to make health care decisions for me:
_____________________________________________________ ______________
(name of individual you choose as agent )
________________________________________________________________ ___
(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 availa ble to make a health care
decision for me, I designate as my first alternate agent:
___________________________________________________________________
(name of individual you choose as first alternate agent)
_____________________________________________ ______________________
(address) (city) (state) (zip code )
______________________________________________________________ _____
(home phone) (work phone)
SENATE FLOOR VERSION - HB3815 SFLR Page 11
(Bold face denotes Committee Amendments) 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
OPTIONAL: If I revoke the authority of my agent and first
alternate agent or if neither is willing, able, or reasonably
available to make a heal th care decision for me, I designate as my
second alternate agent:
____________________________________________________ _______________
(name of individual you choose as second alternate agent)
_______________________________________________________________ ____
(address) (city) (state) (zip code)
_____________________________________________ ______________________
(home phone) (work phone)
2. AGENT'S AUTHORITY: My agent is authorized to make all
health care decisions (not to include the withholding or withdrawal
of life-sustaining treatment) for me that I could make if I were
able, except as I state here:
________________________________________________ ___________________
___________________________________________________________________
___________________________________________________________________
(Add additional sheets if needed.)
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 own 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 .
_____________
SENATE FLOOR VERSION - HB3815 SFLR Page 12
(Bold face denotes Committee Amendments) 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
(Initials)
4. AGENT'S OBLIGATION: My agent shall make health care
decisions for me in accordance with this power of attorney for
health care and my other wishes to the extent known to my agent. To
the extent my wishes are unknown, my age nt shall make health care
decisions for me in accordance with what my agent determines to be
in my best interest. In determining my best interest, my agent
shall consider the decisions I would have made myself to the extent
known to my agent.
_____________
(Initials)
5. RELIEF FROM PAIN: Except a s I state in the following space,
I direct that treatment for alleviation of pain or discomfort be
provided at all times, e ven if it hastens my death:
_______________________________________________________ _________
________________________________________ ________________________
6. OTHER WISHES: (If you do not agree with any of the optional
choices above and wish to write y our 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.)
SENATE FLOOR VERSION - HB3815 SFLR Page 13
(Bold face denotes Committee Amendments) 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
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
______________________________ _______________________________
(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:
SENATE FLOOR VERSION - HB3815 SFLR Page 14
(Bold face denotes Committee Amendments) 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
A. Before implementing a health care decision made for a
patient, the attending physician, if possible, shall promptly
communicate to the patient the decision made and the identity o f the
person making the decision.
B. An attending physician who knows of the existence of a power
of attorney for health c are or a revocation of a power of attorney
for health care shall promptly record its existence in the patient'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 informed of a
determination that a patient lacks or has recovered capacity shall
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 care 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 t he patient and
with a reasonable interpretation of that instruction made by a
person then authorized to make health 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
SENATE FLOOR VERSION - HB3815 SFLR Page 15
(Bold face denotes Committee Amendments) 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
to the same extent as if the decision had been made by the patient
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 instruction 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 care 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
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 patie nt, if possible, and any person
then authorized to make health care decisions for the patient;
2. Provide continuing care t o the patient until a transfer can
be effected; and
3. Unless the patient or person then authorized to make health
care decisions for the patient r efuses assistance, immediately make
all reasonable efforts to a ssist in the transfer of the patient to
SENATE FLOOR VERSION - HB3815 SFLR Page 16
(Bold face denotes Committee Amendments) 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
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.
H. The provisions of this section shall not be constru ed to
supersede or authorize noncompliance with the requirements of the
Oklahoma Advance Directive Act as provided in Section 3101.9 of
Title 63 of the Oklahoma S tatutes.
SECTION 7. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3111.7 of Title 63, unless there
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 rights as the patient to request, receive,
examine, copy, and conse nt to the disclosure of medical or any other
health care information.
SECTION 8. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3111.8 of Title 63, unless there
is created a duplication in numbering, reads as follows:
A. A health care provider or facility acting in good faith and
in accordance with gener ally accepted health care standards
applicable to the health care provider or facility shall not be
SENATE FLOOR VERSION - HB3815 SFLR Page 17
(Bold face denotes Committee Amendments) 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
subject to civil or criminal liability or to disc ipline for
unprofessional conduct for:
1. Complying with a health care decision of a person apparently
having authority to make a health care decision for a patient;
2. Declining to comply with a health care decision of a person
based on a belief that th e 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 shall not be
subject to civil or criminal liability or to discipline fo r
unprofessional conduct for health care decisions made in good faith.
SECTION 9. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3111.9 of Title 63, unless there
is created a duplication in numb ering, reads as follows:
A. This act shall not be construed to affect the right of an
individual to make health care decisions while having capacity to do
so.
B. An individual is presumed to have capacity to mak e a health
care decision and to give or revoke powers of attorney for health
care.
SECTION 10. NEW LAW A n ew section of law to be codified
in the Oklahoma Statutes as Section 3111.10 of Title 63, unless
there is created a duplication in numbering, reads as follows:
SENATE FLOOR VERSION - HB3815 SFLR Page 18
(Bold face denotes Committee Amendments) 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
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 codified
in the Oklahoma Statutes as Section 3111.11 of Title 63, unless
there is created a duplication in numb ering, reads as follows:
A. This act shall not be construed to create a presumption
concerning the intention of an individual who has 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 provide health care contrary to
generally accepted health care standards applicable to the health
care provider or facility; provided, this provision shall not be
construed to supersede or authorize noncompliance with the
requirements of the Oklaho ma Advance Directive Act as provided in
Section 3101.9 of Title 63 of the Oklahoma Statutes.
C. This act shall not be construed to authorize an agent to
consent to the admission of an individual to a mental health care
facility unless the individual's written directive expressly so
provides.
D. This act shall not affect other statutes 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.
SENATE FLOOR VERSION - HB3815 SFLR Page 19
(Bold face denotes Committee Amendments) 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
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 sectio n 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 substantial compliance with the
requirements of the Oklahoma Health Care Agen t Act shall have full
force and effect including such documents made prior to the
effective date of this act .
SECTION 14. AMENDATORY 63 O.S. 2021, Section 1-1973, is
amended to read as follows:
Section 1-1973. A. Patients who are capabl e of self-
administering their own medications without assistance sh all be
encouraged and allowed to do so. How ever, a certified nurse aide
may assist a patient whose condition is medically stable with the
self-administration of routine, regularly schedule d medications that
are intended to be self-administered, if the fol lowing conditions
are met:
SENATE FLOOR VERSION - HB3815 SFLR Page 20
(Bold face denotes Committee Amendments) 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
1. For an oral medication, the medication shall have been
placed in a medication planner by a registered n urse, a relative of
the patient or nursing staff of an Oklahoma licensed home health or
hospice agency that is currently s erving the patient; and
2. For all other fo rms, the certified nurse aide shall assist
with self-administration consistent with a disp ensed prescription's
label or the package directions of an over-the-counter medication.
B. For purposes of this section, self-administered medications
include both legend and over-the-counter oral dosage forms, topical
dosage forms and topical ophthalmic, otic and nasal dosage forms,
including solutions, susp ensions, sprays and inhalers.
C. Assistance with self -administration of medication by a
certified nurse aide m ay 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;
2. Placing an oral dosage in the patient's hand or placing the
dosage in another container and helping the patient by lifting the
container to his or her mouth;
3. If ordered by a phy sician, placing an oral medication in
food before the patient self-administers;
SENATE FLOOR VERSION - HB3815 SFLR Page 21
(Bold face denotes Committee Amendments) 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
4. Crushing an oral medication pursuant to orders given by a
physician or health care professional;
5. Applying topical medication s; and
6. Keeping a record of when a patien t receives assistance with
self-administration pursuant to this section.
E. For purposes of this section, assistance with self-
administration of medication does not include:
1. Removing oral medication from any container other than a
pill planner;
2. Mixing, compounding, converting or calculating medication
doses;
3. The preparation of syri nges for injection or the
administration of medications by any injectable route;
4. Administration of medications through intermittent positive
pressure breathing ma chines;
5. Administration of medications by way of a tube inserted in a
cavity of the body;
6. Administration of parenteral preparations;
7. Irrigations or debriding agents used in the treatment of a
skin condition;
8. Rectal, urethral, or vaginal prep arations;
9. Medications ordered by the physician or health care
professional with prescr iptive authority to be given "as needed",
unless the order is written with specific parameters that preclude
SENATE FLOOR VERSION - HB3815 SFLR Page 22
(Bold face denotes Committee Amendments) 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
independent judgment on the part of the certified nurse a ide, and at
the request of a competent patient;
10. Medications for which the time of adm inistration, the
amount, the strength of dosage, the me thod of administration or the
reason for administration requires ju dgment 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 ho me care
services as provided for in Section 1 -890.8 of Title 63 of the
Oklahoma Statutes this title.
F. Assistance with t he self-administration of medication by a
certified nurse aide as described in this sectio n does not
constitute administration as defined in S ection 353.1 of Title 59 of
the Oklahoma Statute s.
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 section:
1. "Informed consent" means advising the patient, or the
patient's surrogate, guardian or 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 Act, Sections
SENATE FLOOR VERSION - HB3815 SFLR Page 23
(Bold face denotes Committee Amendments) 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
1071 through 1077 of Title 58 of the Oklahoma Statutes Oklahoma
Health Care Agent Act, with authority to act regarding the pat ient'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.
SECTION 15. AMENDATORY 63 O.S. 2021, Se ction 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 service s provided
by health professionals under Section 2602 of this title is
persistently unconsci ous, incompetent or otherwise mentally or
physically incapable of communicating, a person who is re asonably
available and willing in the following classes, in the o rder of
priority set forth in this subsection, shall be authorized to make
health care decisions for the patient under the same standard as
that applicable to making life-sustaining treatment decisions under
Section 3101.16 of this title, excluding any per son who is
disqualified from exercising such authority by Section 3102.5 of
this title. If those within a class disagree, a majority within th e
class may make a health care decision for the patient. However, a
provider of health care to the patient or an y member or members of
any of the following classes may petition a court that would have
jurisdiction over a guardianship proceeding concerning the patient
under Section 1-115 of Title 30 of the Oklahoma Statutes to seek an
SENATE FLOOR VERSION - HB3815 SFLR Page 24
(Bold face denotes Committee Amendments) 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
order directing a different heal th care decision on the ground that
the health care decision or decisions made violate the s tandard
required by this section, granting another member or other members
from among the following classes (notwithstanding the statutory
order of priority) superv ening authority to make health care
decisions for the patient on the ground that clear and c onvincing
evidence demonstrates they are more likel y to adhere to that
standard, or both. Upon mot ion by any party, the court shall issue
an order requiring that p ending its decision on the merits and the
resolution of any appeal the patient be provided w ith health care of
which denial, in reasonable medi cal 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 Ok lahoma Statutes
or a limited guardian of the person appointed pur suant to subsection
B of Section 3-112 of Title 30 of the Oklahoma Statutes with
authority to make personal medical decisions as determined und er
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 Sectio n
3101.3 of Title 63 of the Oklahoma Sta tutes this title;
SENATE FLOOR VERSION - HB3815 SFLR Page 25
(Bold face denotes Committee Amendments) 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
3. An attorney-in-fact authorized to act pursuant t o the
Uniform Durable Power of Attorney Act, Sections 1071 throu gh 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;
4. The patient's spouse;
5. Adult children of the patient;
6. Parents of the patient;
7. Adult siblings;
8. Other adult relatives of the patient in order of kinship; or
9. Close friends of the pat ient 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 docu menting such contact
constitutes prima facie evidence of close f riendship.
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 p leaded no
contest to the crimes of abuse, verbal abuse, neglect or financial
SENATE FLOOR VERSION - HB3815 SFLR Page 26
(Bold face denotes Committee Amendments) 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
exploitation by a care giver; exploitation of an elderly person or
disabled adult; or a buse, neglect, exploitation or sexual abuse of a
child;
I have not been found to have committ ed abuse, verbal abuse 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 cha rged as a person responsible for
the care of a vulnerable adult with a crime resulting in the death
or near death of a vul nerable 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 f or 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
1071 through 1077 of Title 58 o f the Oklahoma Statutes Oklahoma
Health Care Agent Act, with authority to act regarding the patient's
health and medical care decisions, subje ct to the limitations under
paragraph 1 of subsection B of Section 1072.1 of Title 58 of the
Oklahoma Statutes the Oklahoma Health C are Agent Act;
2. "Guardian" means a general guardian of the person appointed
pursuant to subsection A of Section 3-112 of Title 30 of the
SENATE FLOOR VERSION - HB3815 SFLR Page 27
(Bold face denotes Committee Amendments) 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
Oklahoma Statutes or a l imited guardian of the person appointed
pursuant to subsection B of Section 3 -112 of Title 30 of the
Oklahoma Statutes with the author ity to make personal medical
decisions as determined under paragraph 5 of subsecti on 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 s tate to
administer health care in the ordinary course of bu siness 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 authoriz ed person" means a person, other than
a minor's custodial parent or guardian, the patient or the pat ient's
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. 202 1, Section 3105.4, is
amended to read as follows:
Section 3105.4 1. At the top of the first page of the
standardized format Oklahoma physician orders for life-sustaining
treatment form the following wording in al l capitals shall appear
against a contrasting color background: "FORM SHALL ACCOMPANY
SENATE FLOOR VERSION - HB3815 SFLR Page 28
(Bold face denotes Committee Amendments) 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
PERSON WHEN TRANSFERRED OR DISCHARGED"; at the bottom of the first
page the following wording in all capitals shall appear against a
contrasting color background: "HIPAA PERMITS DISCLOSURE TO HEALTH
CARE PROFESSIONALS AND PROXY DECISION MAKERS AS NECESSARY FOR
TREATMENT".
2. There shall be an introductory section, the left block of
which shall contain the name "Oklahoma Physician Orders for Life-
Sustaining Treatment (POL ST)" followed by the words, "This Physician
Order set is based on the patient's current medical condi tion and
wishes and is to be reviewed for potential replacemen t in the case
of a substantial change in either, as well as in other cases listed
under F. Any section not completed indicates full tr eatment for
that section. Photocopy or fax copy of this fo rm is legal and
valid." and the right block of which shall con tain lines for the
patient's name, the patient's date of birth and the effective date
of the form followed by the statement, "Form must be reviewed at
least annually."
3. In Section A of the fo rm, the left block shall contain, in
bold font, "A. Check One", and the right block shall be headed, in
bold font, "Cardiopulmonary Resuscitation (CPR): Person has no
pulse and is not breathing. " below which there shall be a checkbox
followed by "Attempt Resuscitation (CPR)", then a checkbox followed
by "Do Not Attempt Resuscitation (DNR/ no CPR)", and below which
SENATE FLOOR VERSION - HB3815 SFLR Page 29
(Bold face denotes Committee Amendments) 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
shall be the words, "When not in cardiopul monary arrest, follow
orders in B, C and D below."
4. In Section B of the form, the left block shall contain, in
bold, "B. Check One", and the right block shall be headed, in bold,
"Medical Interventions: Person has pulse and/or is breathing. "
Below this there shall be a checkbox followed by, in bold, "Full
Treatment" followed by, "Includes the use of intubation, advanced
airway interventions, mechanical ventila tion, defibrillation or
cardio version as indicated, medical treatment, intravenous fluids,
and cardiac monitor as indicated. Transfer to hospital if
indicated. Include intensive care. Includ es treatment listed under
"Limited Interventions " and "Comfort Measures", followed by, in
bold, "Treatment Goal: Attempt to preserve life by all medically
effective means."
Below this there shall be a checkbox followed by, in bold,
"Limited Interventions " followed by, "Includes the use of medical
treatment, oral and intravenous medications, intravenous fluids,
cardiac monitoring as indicated, noninvasive bi -level positive
airway pressure, a bag val ve mask or other advanced airway
interventions. Includes t reatment listed under "Comfort Measures",
followed by, "Do not use intubation or mechanical ventilation.
Transfer to hospital if indicated. Avoid intensi ve care." followed
by, in bold, "Treatment Goal: Attempt to preserve life by basic
medical treatments."
SENATE FLOOR VERSION - HB3815 SFLR Page 30
(Bold face denotes Committee Amendments) 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
Below this there shall be a checkbox followed by, in bold,
"Comfort Measures only" followed by, "Includes keeping the patient
clean, warm and dry; use of medication by any route; positioning,
wound care and other measures to relieve pain and suffering. Use
oxygen, suction and manual treatment of airway obstructi on as needed
for comfort. Transfer from current location to intermediate
facility only if needed and adequate to meet comfort needs an d to
hospital only if comfort needs cannot otherwise be met in the
patient's current location (e.g., hip fracture; if int ravenous route
of comfort measures is required)."
Below this there shall be, in italics, "Additional Orders:"
followed by an underlined space for other instructions.
5. In Section C of the form , the left block shall contain, in
bold, "C. Check One" and the right block shall be headed, in bold,
"Antibiotics".
Below this there shall be a checkbox followed by, in bold, "Use
antibiotics to preserve life."
Below this there shall be a checkbox follow ed by, in bold,
"Trial period of antibiotics if and when infec tion occurs." After
this there shall be, in italics, "*Include goals below in E. "
Below this there shall be a checkbox followed by, in bold,
"Initially, use antibiotics only to relieve pain and discomfort."
After this there shall be, in italics, "+Contact patient or
patient's representative for further direction."
SENATE FLOOR VERSION - HB3815 SFLR Page 31
(Bold face denotes Committee Amendments) 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
Below this there shall be, in it alics, "Additional Orders:"
followed by an underlined space for other instructions.
6. In Section D of the form, the left block shall contain, in
bold, "D. Check One in Each Column", and the right block shall be
headed in bold, "Assisted Nutrition and Hy dration", below which
shall be "Administer oral fluids and nutrition, if necessary by
spoon feeding, if physically possible." Below these the right block
shall be divided into three columns.
The leftmost column shall be headed, "TPN (Total Parenteral
Nutrition-provision of nutrition into blood ve ssels)." Below this
there shall be a checkbox followed by, in bold, "TPN long-term"
followed by "if needed". Below this there shall be a checkbox
followed by, in bold, "TPN for a trial period* ". Below this there
shall be a checkbox followed by, in bold, "Initially, no TPN+".
The middle column shall be headed "Tube Feeding". Below this
there shall be a checkbox followed b y, in bold, "Long-term feeding
tube" followed by "if needed". Below this there shall be a ch eckbox
followed by, in bold, "Feeding tube for a trial period*". Below
this there shall be a checkbo x followed by, in bold, "Initially, no
feeding tube".
The rightmost column shall be headed, "Intravenous (IV) Fluids
for Hydration". Below this there shal l be a checkbox followed by,
in bold, "Long-term IV fluids" followed by "if needed". Below this
there shall be a checkbox followed by, in bold, "IV fluids for a
SENATE FLOOR VERSION - HB3815 SFLR Page 32
(Bold face denotes Committee Amendments) 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
trial period*". Below this there shall be a checkbox followed by,
in bold, "Initially, no IV fluids+".
Running below all the columns th ere shall be, in italics,
"Additional Orders:" followed by an underlined space for other
instructions, followed by, in it alics, "*Include goals below in E.
+Contact patient or patient's representative for further d irection."
7. In Section E of the form, t he left block shall contain, in
bold, "E. Check all that a pply" and the right block shall be
headed, in bold, "Patient Preferences as a Basis for this POLST
Form" shall include the following:
a. below the heading there shall be a box including the
words, in bold, "Patient Goals/Medical Condition:"
followed by an adequate space for such information,
b. below this there shall be a checkbox followed by, "The
patient has an advance directive for health care in
accordance with Sections 3101.4 or 3101.14 of Titl e 63
of the Oklahoma Statutes." Below that there shall be
a checkbox followed by, "The patient has a durable
power of attorney for health care decisions in
accordance with paragraph 1 of subsection B of Section
1072.1 of Title 58 of the Oklahoma Statutes the
Oklahoma Health Care Agent Act." Below that shall be
the indented words, "Date of execution" followed by an
underlined space. Below that shall be the words, "If
SENATE FLOOR VERSION - HB3815 SFLR Page 33
(Bold face denotes Committee Amendments) 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
POLST not being executed by patient: We certify that
this POLST is in accordance with the patient's advance
directive." Below this there shall be a n underlined
space underneath which shall be positioned the wo rds,
"Name and Position (print) Signature" and "Signature
of Physician",
c. below these shall be the words, "Directions given by:"
and below that a checkbox followed by "Patient", a
checkbox followed by "Minor's custodial parent or
guardian", a checkbox followed by "Attorney-in-fact",
a checkbox followed by "Health care proxy", and a
checkbox followed by "Other legally authorized
person:" followed by an underlined space. Beneath or
beside the checkbox and "Other legally authorized
person:" and the underlined space shall be the words
"Basis of Authority:" followed by an underlined space,
and
d. below these shall be a four-column table with four
rows. In the top row the first column shall be blank ;
the second column shall have the words, "Printed
Name"; the third column shall have the word,
"Signature", and the fourth column shall have the
word, "Date". In the remaining rows the second
through fourth columns shall be blank. In the first
SENATE FLOOR VERSION - HB3815 SFLR Page 34
(Bold face denotes Committee Amendments) 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
column of these rows, in the second row shall be the
words, "Attending physician"; in the third row shall
be the words, "Patient or other individual checked
above (patient's representative)"; and in the fourth
row shall be the words, "Health care professional
preparing form (besides doctor)."
8. Section F of the form, which shall have the heading, in
bold, "Information for Patient or Representative of Patient Named on
this Form", shall include the following language, appearing in bold
on the form:
"The POLST form is always voluntary and is usually for persons
with advanced illness. Before providing information for or signing
it, carefully read "Information for Patie nts and Their Families -
Your Medical Treatment Rights Under Oklahoma Law", which the health
care provider must give you. It is especially important to read the
sections on CPR and food and fluids, which have summaries of
Oklahoma laws that may control th e directions you may give. POLST
records your wishes for medical treatment in your current state of
health. Once initial medical treatment is begun and the risks and
benefits of further therapy are clear, your treatment wishes may
change. Your medical c are and this form can be changed to reflec t
your new wishes at any time. However, no form can addres s all the
medical treatment decisions that may need to be made . An advance
health care directive is recommended, regardless of your health
SENATE FLOOR VERSION - HB3815 SFLR Page 35
(Bold face denotes Committee Amendments) 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
status. An advance directive allows you to document in d etail your
future health care instructions and/or name a he alth care agent to
speak for you if you are unable to speak fo r yourself.
The State of Oklahoma affirms that the lives of all are of equal
dignity regardless of age or disability and emphasizes tha t no one
should ever feel pressured to agree to forego life -preserving
medical treatment because of age, disability or fear of being
regarded as a burden.
If this form is for a minor for whom you are authorized to make
health care decisions, you may not di rect denial of medical
treatment in a manner that would vio late the child abuse and neglect
laws of Oklahoma. In particu lar, you may not direct the withholding
of medically indicated treatment from a disabled infa nt with life-
threatening conditions, as th ose terms are defined in 42 U.S.C.,
Section 5106g or regulations implementing it and 42 U.S.C., Section
5106a."
9. Section G of the form, which shall have the heading, in
bold, "Directions for Completing and Imple menting Form", shall
include the following three subdivisions:
a. the first subdivision, entitled "COMPLETING POLST",
shall have the following language with the wo rds, "The
signature of the patient or the patient's
representative is required " appearing in bold on the
form:
SENATE FLOOR VERSION - HB3815 SFLR Page 36
(Bold face denotes Committee Amendments) 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
"POLST must be reviewed and prepared in consultation
with the patient or the patien t's representative after
that person has been given a copy of "Information for
Patients and Their Families - Your Medical Treatment
Rights Under Oklahoma L aw". POLST must be reviewed
and signed by a physician to be valid. Be sure to
document the basis fo r concluding the patient had or
lacked capacity at the time of execution of the form
in the patient's medical record. If the patient lacks
capacity, any current advance directive form must be
reviewed and the patient's representative and
physician must both certify that POLST complies with
it. The signature of the patient or the patient's
representative is required; however, if the patient 's
representative is not reasonably available to sign the
original form, a copy of the completed form with the
signature of the patient's representative must be
placed in the medical record as soon as practicable
and "on file" must be written on the appropriate
signature line on this form.",
b. the second subdivision, entitled "IMPLEMENTING POLST",
shall have the followin g language:
"If a minor protests a directive to deny the minor
life-preserving medical treatment, the denial of
SENATE FLOOR VERSION - HB3815 SFLR Page 37
(Bold face denotes Committee Amendments) 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
treatment may not be implemented pending is suance of a
judicial order resolving the c onflict. A health care
provider unwilling to comply with P OLST must comply
with the transfer and treatment pending trans fer
requirements of Section 3101.9 of Title 63 of the
Oklahoma Statutes as well as those of t he
Nondiscrimination in Treatment Act, Sec tions 3090.2
and 3090.3 of Title 63 of the Oklahoma Statute s", and
c. the third subdivision, entitled "REVIEWING POLST",
shall have the following language:
"This POLST must be reviewed at least annually or
earlier if:
The patient is admitted to or discharg ed from a
medical care facility; there is substantial chang e in
the patient's health status; or the treatment
preferences of the patient or patient's representative
change."
The same requirements for participation of the patient or
patient's representative, and signature by both a physician and the
patient or the patient's representative, that are described under
"COMPLETING POLST" shall also apply when POLST is reviewed, and must
be documented in Section I.
SENATE FLOOR VERSION - HB3815 SFLR Page 38
(Bold face denotes Committee Amendments) 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
10. Section H of the form, which shall have the heading, in
bold, "REVOCATION OF POLST", shall have the fol lowing language, with
the words specified below appearing in b old on the form:
"If POLST is revised or becomes invalid, write in bold the word
"VOID" in large letters on the front of the form. Aft er voiding the
form a new form may be completed. A patient with capacity or the
individual or individuals authorized to sign on behalf of the
patient in Section E of this form may void this form. If no new
form is completed, full treatment and resuscitat ion is to be
provided, except as otherwise authorized by Ok lahoma law."
11. Section I of the form, which shall have the heading, in
bold, "REVIEW SECTION", followed by: "Periodic review confirms
current form or may require completion of new form," shall include
the following columns and a number of rows determine d by the Office
of the Attorney General:
a. Date of Review,
b. Location of Review,
c. Patient or Representative Signature,
d. Physician Signature, and
e. Outcome of Review.
Each row in column (5) s hall include a checkbox followed by,
"FORM CONFIRMED - No Change", below which there shall be a checkbox
followed by, "FORM VOIDED, see updated form.", below which there
shall be a checkbox followed by, "FORM VOIDED, no new form."
SENATE FLOOR VERSION - HB3815 SFLR Page 39
(Bold face denotes Committee Amendments) 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
A final section of the fo rm, which shall have the heading, in
bold, "Contact Information:", shall include two rows of four
columns. In the first column, the first row shall include
"Patient/Representative" followed by an adequate space fo r such
information, and the second column shall include "Health Care
Professional Preparing Form" followed by an adequate space for such
information. In the secon d column both rows shall include
"Relationship" followed by an adequate space for such inform ation;
in the third column both rows shall include "Phone Number" followed
by an adequate space for s uch information; and in the fourth column
both rows shall incl ude "Email Address" followed by an adequate
space for such information.
SECTION 18. AMENDATORY 63 O.S. 2021, S ection 3131.3, is
amended to read as follows:
Section 3131.3 As used in the Oklah oma Do-Not-Resuscitate Act:
1. "Attending physician" means a licensed physician who has
primary responsibility for treatment or care of the person. If more
than one physician shares that responsibility, any of those
physicians may act as the attending ph ysician under the provisions
of the Oklahoma Do-Not-Resuscitate Act;
2. "Cardiopulmonary resuscitation" means those measures used to
restore or support cardiac or respirator y function in the event of a
cardiac or respiratory arrest;
SENATE FLOOR VERSION - HB3815 SFLR Page 40
(Bold face denotes Committee Amendments) 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
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 particul ar person;
5. "Emergency medical services person nel" means firefighters,
law enforcement officers, emergenc y medical technicians, paramedics,
or other emergency service s personnel, providers, or entities,
acting within the usual course of their profession s;
6. "Health care decision" means a decision to give, withhold,
or withdraw informed consent to any type o f health care including ,
but not limited to, medical and surg ical treatments including life-
prolonging interventions, nursing care, hospitalization, treatment
in a nursing home or other extended ca re facility, home health care,
and the gift or donation of a body 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 not limited to,
hospitals, medical centers, ambulatory health care facilities,
physicians' offices and clinics, extended ca re facilities operated
in connection with hospitals, nursing homes, extended care
SENATE FLOOR VERSION - HB3815 SFLR Page 41
(Bold face denotes Committee Amendments) 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
facilities operated in connection with rehabilitation centers, home
care agencies and hospices;
8. "Health care provider" means any physician, dentist, nurse,
paramedic, psychologist, or other person providing medical, dental,
nursing, psychological, hospice, or other health care services of
any kind;
9. "Incapacity" means the inability, because of physical or
mental impairment, to appre ciate the nature and implications of a
health care decision, to make an informed choice regarding the
alternatives presented, and to communicate that choice in an
unambiguous manner; and
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 Advance Directive Act, or a guardian of the
person appointed under the Oklahoma Guardianship and Conserva torship
Act.
SECTION 19. AMENDATORY 63 O.S. 2021, Section 3131.5, is
amended to read as follows:
Section 3131.5 A. For persons under the care of a hea lth care
agency, a do-not-resuscitate order shall, if issued, be in
accordance with the policies and procedures of the health care
SENATE FLOOR VERSION - HB3815 SFLR Page 42
(Bold face denotes Committee Amendments) 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
agency as long as not in conflict with the provisi ons 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, _________________________, request limited health care as
described in this document. If my heart stops beating or if I stop
breathing, no medical procedure to re store breathing or heart
function will be instituted by any health care provider including,
but not limited to, emergency medical services (EMS) personnel.
I understand that this decision will not prevent me from
receiving other heal th care such as the Hei mlich maneuver or oxygen
and other comfort care measure s.
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 person, and notifying my
attending physician of the revocation;
SENATE FLOOR VERSION - HB3815 SFLR Page 43
(Bold face denotes Committee Amendments) 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
3. If I am incapacitated and under the care of a health care
agency, my representative may revoke the do-not-resuscitate consent
by written notification to a physician or other health care provider
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 do-not-resuscitate
consent by destroying the do-not-resuscitate form, remo ving all do-
not-resuscitate identification from my person, and notifying my
attending physician of the revocation.
I give permission for this information to be given to EMS
personnel, doctors, nurses, and other health care providers. I
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 under 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 Oklaho ma
Guardianship and Conservatorship Act.)
SENATE FLOOR VERSION - HB3815 SFLR Page 44
(Bold face denotes Committee Amendments) 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
This DNR consent form was 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 by an atten ding physician only to
certify that an incapacitated person without a represen tative would
not have consented to the administration of cardiopulmonary
resuscitation in the event of cardiac or respiratory arrest. An
attending physician of an incapacitated person without a
representative must know by clear and convincing evidence tha t the
incapacitated person, when competent, decided on the basis of
information sufficient to constitut e informed consent that such
person would not have consented to the adminis tration of
cardiopulmonary resuscitation in the event of cardiac or respirator y
arrest. Clear and convincing evidence for this purpose shall
include oral, written, or other acts of communication between the
patient, when competent, and family members, hea lth care providers,
or others close to the patient with knowledge of the patie nt's
desires.)
SENATE FLOOR VERSION - HB3815 SFLR Page 45
(Bold face denotes Committee Amendments) 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
I hereby certify, based on clear and convincing evidence
presented to me, that I believe that ___________________________
Name of Incapacitated Person
would not have consented to the adm inistration of cardiopulmonary
resuscitation in the eve nt of cardiac or respiratory arrest.
Therefore, in the event of cardiac or respiratory arrest, no ches t
compressions, artificial ventilation, intubations, defibrillation,
or emergency cardiac medicati ons are to be initiated.
__________________________ _____________________________
Physician's Signature/Date Physician's Name (PRINT)
________________________ ________________________________________
Physician's Address/Phone
C. Witnesses must be individua ls who are eighteen (18) years of
age or older who are not legatees, devisees or heirs at law.
D. It is the intention of the Legislature that the preferred,
but not required, do-not-resuscitate form in Oklahoma shall be the
form set out in subsection B of this section.
SECTION 20. It being immediately necessary for the preservation
of the public peace, health or safety, an emergency is hereby
declared to exist, by reason whereof this act shall take effect and
be in full force from and after its passage and approval.
COMMITTEE REPORT BY: COMMITTEE ON JUDICIARY
April 12, 2022 - DO PASS