| 1 | 1 | | 85S10173 JG-F |
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| 2 | 2 | | By: Bonnen of Galveston H.B. No. 12 |
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| 3 | 3 | | |
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| 4 | 4 | | |
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| 5 | 5 | | A BILL TO BE ENTITLED |
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| 6 | 6 | | AN ACT |
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| 7 | 7 | | relating to general procedures and requirements for |
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| 8 | 8 | | do-not-resuscitate orders. |
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| 9 | 9 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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| 10 | 10 | | SECTION 1. Subchapter A, Chapter 166, Health and Safety |
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| 11 | 11 | | Code, is amended by adding Section 166.012 to read as follows: |
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| 12 | 12 | | Sec. 166.012. GENERAL PROCEDURES AND REQUIREMENTS FOR |
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| 13 | 13 | | DO-NOT-RESUSCITATE ORDERS. (a) In this section, "DNR order" means |
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| 14 | 14 | | an order instructing a health care professional not to attempt |
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| 15 | 15 | | cardiopulmonary resuscitation or other life-sustaining treatment |
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| 16 | 16 | | on a patient whose circulatory or respiratory function ceases. |
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| 17 | 17 | | (b) This section applies to a DNR order used in a health care |
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| 18 | 18 | | facility, including a hospital or an assisted living facility, or |
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| 19 | 19 | | in hospice settings, including hospice services provided by a home |
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| 20 | 20 | | and community support services agency. This section does not apply |
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| 21 | 21 | | to an out-of-hospital DNR order as defined by Section 166.081. |
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| 22 | 22 | | (c) A DNR order issued for a patient is valid only if the |
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| 23 | 23 | | order: |
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| 24 | 24 | | (1) is issued in compliance with: |
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| 25 | 25 | | (A) the written directions of a patient who was |
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| 26 | 26 | | competent at the time the patient wrote the directions; |
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| 27 | 27 | | (B) the oral directions of a competent patient |
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| 28 | 28 | | delivered to or observed by two competent adult witnesses, at least |
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| 29 | 29 | | one of whom must be a person not listed under Section 166.003(2); |
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| 30 | 30 | | (C) the directions in an advance directive |
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| 31 | 31 | | enforceable under Section 166.005 or executed in accordance with |
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| 32 | 32 | | Section 166.032, 166.034, or 166.035; |
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| 33 | 33 | | (D) the directions of a patient's legal guardian |
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| 34 | 34 | | or agent under a medical power of attorney acting in accordance with |
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| 35 | 35 | | Subchapter D; or |
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| 36 | 36 | | (E) a treatment decision made in accordance with |
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| 37 | 37 | | Section 166.039; or |
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| 38 | 38 | | (2) is not contrary to the directions of a patient who |
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| 39 | 39 | | was competent at the time the patient conveyed the directions and, |
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| 40 | 40 | | in the reasonable medical judgment of the patient's attending |
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| 41 | 41 | | physician: |
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| 42 | 42 | | (A) the patient's death is imminent, regardless |
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| 43 | 43 | | of the provision of cardiopulmonary resuscitation; and |
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| 44 | 44 | | (B) the DNR order is medically appropriate. |
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| 45 | 45 | | (d) If an individual described by Section 166.039(b)(1), |
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| 46 | 46 | | (2), or (3) arrives at the facility and notifies the facility of the |
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| 47 | 47 | | individual's arrival after a DNR order is issued under Subsection |
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| 48 | 48 | | (c)(2), the order must be disclosed to the individual in accordance |
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| 49 | 49 | | with the priority established under Section 166.039(b). |
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| 50 | 50 | | (e) The facility may satisfy the notice requirement under |
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| 51 | 51 | | Subsection (d) by notifying one person in accordance with the |
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| 52 | 52 | | priority established under Section 166.039(b). The facility is not |
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| 53 | 53 | | required to notify additional persons beyond the first person |
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| 54 | 54 | | notified. |
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| 55 | 55 | | (f) A DNR order takes effect at the time the order is issued, |
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| 56 | 56 | | provided the order is placed in the patient's medical record as soon |
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| 57 | 57 | | as practicable. |
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| 58 | 58 | | (g) On admission to a health care facility or on initial |
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| 59 | 59 | | provision of hospice services, as applicable, the facility or |
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| 60 | 60 | | service provider shall provide to the patient or person authorized |
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| 61 | 61 | | to make treatment decisions on behalf of the patient notice of the |
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| 62 | 62 | | policies of the facility or service provider regarding the rights |
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| 63 | 63 | | of the patient and person authorized to make treatment decisions on |
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| 64 | 64 | | behalf of the patient under this section. |
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| 65 | 65 | | SECTION 2. The executive commissioner of the Health and |
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| 66 | 66 | | Human Services Commission shall adopt rules necessary to implement |
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| 67 | 67 | | Section 166.012, Health and Safety Code, as added by this Act, as |
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| 68 | 68 | | soon as practicable after the effective date of this Act. |
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| 69 | 69 | | SECTION 3. Section 166.012, Health and Safety Code, as |
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| 70 | 70 | | added by this Act, applies only to a do-not-resuscitate order |
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| 71 | 71 | | issued on or after the effective date of this Act. |
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| 72 | 72 | | SECTION 4. This Act takes effect April 1, 2018. |
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