PRINTER'S NO. 739 THE GENERAL ASSEMBLY OF PENNSYLVANIA HOUSE BILL No.720 Session of 2025 INTRODUCED BY BERNSTINE, HAMM, KAUFFMAN, CIRESI, SMITH, ZIMMERMAN, GILLEN, KUTZ AND WATRO, FEBRUARY 24, 2025 REFERRED TO COMMITTEE ON HEALTH, FEBRUARY 24, 2025 AN ACT Amending the act of July 19, 1979 (P.L.130, No.48), entitled "An act relating to health care; prescribing the powers and duties of the Department of Health; establishing and providing the powers and duties of the State Health Coordinating Council, health systems agencies and Health Care Policy Board in the Department of Health, and State Health Facility Hearing Board in the Department of Justice; providing for certification of need of health care providers and prescribing penalties," in licensing of health care facilities, providing for do-not-resuscitate orders for minors. This act shall be known and may be cited as Simon's Law. The General Assembly of the Commonwealth of Pennsylvania hereby enacts as follows: Section 1. The act of July 19, 1979 (P.L.130, No.48), known as the Health Care Facilities Act, is amended by adding a section to read: Section 806.5. Do-not-resuscitate orders for minors. (a) Prohibited actions.--Subject to subsection (d)(2), a health care facility, health care provider or health care practitioner may not: (1) Withhold, withdraw or place any restrictions on 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 life-sustaining measures for a minor in the care of the health care facility, health care provider or health care practitioner without the written consent of at least one parent or legal guardian of the minor. (2) Institute, either orally or in writing, a do-not- resuscitate order or similar order for a minor in the care of the health care facility, health care provider or health care practitioner without the written consent of at least one parent or legal guardian of the minor. (b) Disagreement.--If the parents or legal guardians disagree regarding life-sustaining measures or the do-not- resuscitate order under subsection (a), the health care facility, health care provider or health care practitioner shall implement life-sustaining measures on the minor in accordance with this section. (c) Revocation.-- (1) A parent or legal guardian who previously gave consent in accordance with subsection (a) may revoke the consent by providing a written revocation to the health care facility, health care provider or health care practitioner. (2) A revocation under this subsection shall take precedence over any prior consent to implement a do-not- resuscitate order or similar order. (d) Contact.-- (1) A health care facility, health care provider or health care practitioner shall: (i) Make a good faith effort to contact a parent or legal guardian of the minor to obtain consent regarding life-sustaining measures and a do-not-resuscitate order under subsection (a). 20250HB0720PN0739 - 2 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 (ii) If the health care facility, health care provider or health care practitioner is unable to satisfy the requirement under subparagraph (i), document the name of each individual who was the subject of the unsuccessful attempt to contact and the date and time of each unsuccessful attempt to contact. (2) The requirements under subsection (a) shall not apply if the health care facility, health care provider or health care practitioner makes a good faith effort in accordance with paragraph (1)(i) but is unable to contact the parent or legal guardian within a 48-hour period. (e) Medical record.--A health care facility, health care provider or health care practitioner shall include in the medical record of a minor in the care of the health care facility, health care provider or health care practitioner the following, as applicable: (1) A written consent made in accordance with subsection (a), which must include: (i) The name of the individual who gave the consent, along with the relationship between the individual and the minor. (ii) The names of applicable witnesses to the consent. (iii) The date and time that the consent was obtained. (2) A written revocation made in accordance with subsection (c), which must include: (i) The name of the individual who withdrew the consent, along with the relationship between the individual and the minor. 20250HB0720PN0739 - 3 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 (ii) The names of applicable witnesses to the revocation. (iii) The date and time that the revocation was obtained. (3) The information specified under subsection (d)(1) (ii). (f) Other medical opinions, transfer and access.--A health care facility, health care provider or health care practitioner may not interfere with the efforts of a parent or legal guardian of a minor in the care of the health care facility, health care provider or health care practitioner to obtain other medical opinions or a transfer of the minor to another health care facility, health care provider or health care practitioner selected by the parent or legal guardian. The health care facility, health care provider or health care practitioner: (1) Shall provide immediate access to the minor and the medical records of the minor by the other health care facility, health care provider or health care practitioner, upon request by the parent or legal guardian or the other health care facility, health care provider or health care practitioner. (2) May not hinder or delay any necessary measures, mechanisms or procedures required to facilitate a transfer of the minor to the other health care facility, health care provider or health care practitioner. (3) Shall continue the provision of life-sustaining procedures and life-sustaining artificially administered nutrition and hydration to the minor until the transfer is initiated. (4) Shall make every reasonable effort to assist the 20250HB0720PN0739 - 4 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 requesting parent or legal guardian in the transfer process. (g) Judicial intervention prohibited.--A court of competent jurisdiction may not withdraw life-sustaining measures from a minor over the objection of a parent or legal guardian of the minor unless there is clear medical evidence of destruction of the circulatory or respiratory system of the minor. (h) Policy disclosures.-- (1) Upon request of a patient or prospective patient, including a parent or legal guardian of a patient or prospective patient who is a minor, a health care facility, health care provider or health care practitioner shall disclose in writing any policy involving resuscitation or life-sustaining measures, including any policies relating to measures that the health care facility, health care provider or health care practitioner deems nonbeneficial, ineffective, futile or inappropriate. (2) Nothing in this subsection shall be construed to require a health care facility, health care provider or health care practitioner to have any policy described under paragraph (1). (i) Construction.--Nothing in this section shall be construed to require: (1) A health care facility, health care provider or health care practitioner to implement resuscitative measures or continue to implement resuscitative measures on a minor if the measures are medically inappropriate based on reasonable medical judgment because the measures would: (i) create a greater risk of causing or hastening the death of the minor; or (ii) be potentially harmful or cause unnecessary 20250HB0720PN0739 - 5 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 pain, suffering or injury to the minor. (2) A health insurer to provide coverage for health care services, including a transfer of a minor to another health care facility, health care provider or health care practitioner, that would not otherwise be a covered benefit under an eligible patient's health insurance policy. (j) Definitions.--As used in this section, the following words and phrases shall have the meanings given to them in this subsection unless the context clearly indicates otherwise: "Do-not-resuscitate order." An order in a patient's medical record that reflects a decision to forgo cardiopulmonary resuscitative or other life-sustaining measures. "Minor." An unemancipated individual who is under 18 years of age and who is not: (1) under juvenile court supervision; (2) in active State military duty; or (3) in active military duty in the armed forces of the United States. "Reasonable medical judgment." Medical judgment that would be made by a reasonably prudent health care practitioner who is knowledgeable about the case at issue and any sound treatment possibilities with respect to the medical conditions involved. Section 2. This act shall take effect in 60 days. 20250HB0720PN0739 - 6 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23