Bill Amendment: FL S1052 | 2015 | Regular Session

NOTE: For additional amemendments please see the Bill Drafting List

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Bill Title: Experimental Treatments for Terminal Conditions

Status: 2015-04-27 - Laid on Table, companion bill(s) passed, see CS/CS/HB 269 (Ch. 2015-107) [S1052 Detail]

Download: Florida-2015-S1052-Senate_Committee_Amendment_482400.html

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       Florida Senate - 2015                        COMMITTEE AMENDMENT
       Bill No. SB 1052
       
       
       
       
       
       
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                              LEGISLATIVE ACTION                        
                    Senate             .             House              
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       The Committee on Health Policy (Garcia) recommended the
       following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Delete line 205
    4  and insert:
    5         Section 1. Paragraph (l) of subsection (3) of section
    6  395.1041, Florida Statutes, is amended to read:
    7         395.1041 Access to emergency services and care.—
    8         (3) EMERGENCY SERVICES; DISCRIMINATION; LIABILITY OF
    9  FACILITY OR HEALTH CARE PERSONNEL.—
   10         (l) Hospital personnel may withhold or withdraw
   11  cardiopulmonary resuscitation if presented with an order not to
   12  resuscitate executed pursuant to s. 401.45 or a Physician Order
   13  for Life Sustaining Treatment (POLST). Facility staff and
   14  facilities shall not be subject to criminal prosecution or civil
   15  liability, nor be considered to have engaged in negligent or
   16  unprofessional conduct, for withholding or withdrawing
   17  cardiopulmonary resuscitation pursuant to either such an order.
   18  The absence of an order not to resuscitate executed pursuant to
   19  s. 401.45 or a POLST does not preclude a physician from
   20  withholding or withdrawing cardiopulmonary resuscitation as
   21  otherwise permitted by law.
   22         Section 2. Subsection (3) of section 400.142, Florida
   23  Statutes, is amended to read
   24         400.142 Emergency medication kits; orders not to
   25  resuscitate.—
   26         (3) Facility staff may withhold or withdraw cardiopulmonary
   27  resuscitation if presented with an order not to resuscitate
   28  executed pursuant to s. 401.45 or a Physician Order for Life
   29  Sustaining Treatment (POLST). Facility staff and facilities are
   30  not subject to criminal prosecution or civil liability, or
   31  considered to have engaged in negligent or unprofessional
   32  conduct, for withholding or withdrawing cardiopulmonary
   33  resuscitation pursuant to either such order. The absence of an
   34  order not to resuscitate executed pursuant to s. 401.45 or a
   35  POLST does not preclude a physician from withholding or
   36  withdrawing cardiopulmonary resuscitation as otherwise permitted
   37  by law.
   38         Section 3. Subsection (7) of section 400.487, Florida
   39  Statutes, is amended to read:
   40         400.487 Home health service agreements; physician’s,
   41  physician assistant’s, and advanced registered nurse
   42  practitioner’s treatment orders; patient assessment;
   43  establishment and review of plan of care; provision of services;
   44  orders not to resuscitate; physician orders for life sustaining
   45  treatment.—
   46         (7) Home health agency personnel may withhold or withdraw
   47  cardiopulmonary resuscitation if presented with an order not to
   48  resuscitate executed pursuant to s. 401.45 or a Physician Order
   49  for Life Sustaining Treatment (POLST). The agency shall adopt
   50  rules providing for the implementation of such orders. Home
   51  health personnel and agencies shall not be subject to criminal
   52  prosecution or civil liability, nor be considered to have
   53  engaged in negligent or unprofessional conduct, for withholding
   54  or withdrawing cardiopulmonary resuscitation pursuant to such
   55  orders an order and rules adopted by the agency.
   56         Section 4. Paragraph (e) of subsection (1) of section
   57  400.605, Florida Statutes, is amended to read:
   58         400.605 Administration; forms; fees; rules; inspections;
   59  fines.—
   60         (1) The agency, in consultation with the department, may
   61  adopt rules to administer the requirements of part II of chapter
   62  408. The department, in consultation with the agency, shall by
   63  rule establish minimum standards and procedures for a hospice
   64  pursuant to this part. The rules must include:
   65         (e) Procedures relating to the implementation of advanced
   66  directives; physician orders for life sustaining treatments; and
   67  do-not-resuscitate orders.
   68         Section 5. Subsection (8) of section 400.6095, Florida
   69  Statutes, is amended to read:
   70         400.6095 Patient admission; assessment; plan of care;
   71  discharge; death.—
   72         (8) The hospice care team may withhold or withdraw
   73  cardiopulmonary resuscitation if presented with an order not to
   74  resuscitate executed pursuant to s. 401.45 or a Physician Order
   75  for Life Sustaining Treatment (POLST). The department shall
   76  adopt rules providing for the implementation of such orders.
   77  Hospice staff shall not be subject to criminal prosecution or
   78  civil liability, nor be considered to have engaged in negligent
   79  or unprofessional conduct, for withholding or withdrawing
   80  cardiopulmonary resuscitation pursuant to such an order and
   81  applicable rules. The absence of an order to resuscitate
   82  executed pursuant to s. 401.45 or a POLST does not preclude a
   83  physician from withholding or withdrawing cardiopulmonary
   84  resuscitation as otherwise permitted by law.
   85         Section 6. Subsection (4) of section 401.35, Florida
   86  Statutes, is amended to read:
   87         401.35 Rules.—The department shall adopt rules, including
   88  definitions of terms, necessary to carry out the purposes of
   89  this part.
   90         (4) The rules must establish circumstances and procedures
   91  under which emergency medical technicians and paramedics may
   92  honor orders by the patient’s physician not to resuscitate and a
   93  Physician’s Order for Life Sustaining Treatment (POLST) and the
   94  documentation and reporting requirements for handling such
   95  requests.
   96         Section 7. Paragraphs (a) and (c) of subsection (3) of
   97  section 401.45, Florida Statutes, are amended to read:
   98         401.45 Denial of emergency treatment; civil liability.—
   99         (3)(a) Resuscitation or other forms of medical intervention
  100  may be withheld or withdrawn from a patient by an emergency
  101  medical technician, or paramedic, or other health care
  102  professional if evidence of a Physician Life Sustaining Order
  103  (POLST) or an order not to resuscitate is presented to that
  104  professional. A POLST, to be valid , must be on the form adopted
  105  by rule of the department, must be signed by the patient’s
  106  physician, based on consultation with the patient’s guardian or
  107  legally authorized proxy or surrogate.by the patient’s physician
  108  is presented to the emergency medical technician or paramedic.
  109  An order not to resuscitate, to be valid, must be on the form
  110  adopted by rule of the department. The form must be signed by
  111  the patient’s physician and by the patient or, if the patient is
  112  incapacitated, the patient’s health care surrogate or proxy as
  113  provided in chapter 765, court-appointed guardian as provided in
  114  chapter 744, or attorney in fact under a durable power of
  115  attorney as provided in chapter 709. The court-appointed
  116  guardian or attorney in fact must have been delegated authority
  117  to make health care decisions on behalf of the patient.
  118         (c) The department, in consultation with the Department of
  119  Elderly Affairs and the Agency for Health Care Administration,
  120  shall develop a standardized do-not-resuscitate identification
  121  system with devices that signify, when carried or worn, that the
  122  possessor is a patient for whom a physician has issued an order
  123  not to administer cardiopulmonary resuscitation. The department
  124  may charge a reasonable fee to cover the cost of producing and
  125  distributing such identification devices. Use of such devices
  126  shall be voluntary.
  127         Section 8. Subsection (4) of section 429.255, Florida
  128  Statutes, is amended to read:
  129         429.255 Use of personnel; emergency care.—
  130         (4) Facility staff may withhold or withdraw cardiopulmonary
  131  resuscitation or the use of an automated external defibrillator
  132  if presented with an order not to resuscitate executed pursuant
  133  to s. 401.45 or a Physician Life Sustaining Order (POLST). The
  134  department shall adopt rules providing for the implementation of
  135  such orders. Facility staff and facilities shall not be subject
  136  to criminal prosecution or civil liability, nor be considered to
  137  have engaged in negligent or unprofessional conduct, for
  138  withholding or withdrawing cardiopulmonary resuscitation or use
  139  of an automated external defibrillator pursuant to such orders
  140  an order and rules adopted by the department. The absence of an
  141  order to resuscitate executed pursuant to s. 401.45 or a POLST
  142  does not preclude a physician from withholding or withdrawing
  143  cardiopulmonary resuscitation or use of an automated external
  144  defibrillator as otherwise permitted by law.
  145         Section 9. Subsection (3) of section 429.73, Florida
  146  Statutes, is amended to read:
  147         429.73 Rules and standards relating to adult family-care
  148  homes.—
  149         (3) The department shall adopt rules providing for the
  150  implementation of orders not to resuscitate and Physician Orders
  151  for Life Sustaining Treatment (POLST). The provider may withhold
  152  or withdraw cardiopulmonary resuscitation if presented with an
  153  order not to resuscitate executed pursuant to s. 401.45 or a
  154  POLST. The provider shall not be subject to criminal prosecution
  155  or civil liability, nor be considered to have engaged in
  156  negligent or unprofessional conduct, for withholding or
  157  withdrawing cardiopulmonary resuscitation pursuant to such
  158  orders an order and applicable rules.
  159         Section 10. Paragraph (c) of subsection (1) of section
  160  765.205, Florida Statutes, is amended to read:
  161         765.205 Responsibility of the surrogate.—
  162         (1) The surrogate, in accordance with the principal’s
  163  instructions, unless such authority has been expressly limited
  164  by the principal, shall:
  165         (c) Provide written consent using an appropriate form
  166  whenever consent is required, including a physician’s order not
  167  to resuscitate or Physician Orders for Life Sustaining Treatment
  168  (POLST).
  169  ================= T I T L E  A M E N D M E N T ================
  170  And the title is amended as follows:
  171         Delete line 59
  172  and insert:
  173         training relating to the clearinghouse; amending s.
  174  395.1041, F.S.; authorizing hospital personnel to withhold or
  175  withdraw cardiopulmonary resuscitation if an individual has a
  176  Physician Order for Life Sustaining Treatment; amending s.
  177  400.142, F.S., authorizing nursing home facility staff to
  178  withhold or withdraw cardiopulmonary resuscitation if an
  179  individual has a Physician Order for Life Sustaining Treatment;
  180  amending s. 400.487, F.S.; authorizing home health agency
  181  personnel to withhold or withdraw cardiopulmonary resuscitation
  182  if an individual has a Physician Order for Life Sustaining
  183  Treatment; amending s. 400.605, F.S.; requiring implementation
  184  procedures for Physician Orders for Life Sustaining Treatment in
  185  hospice care; amending s. 400.6095, F.S.; authorizing a hospice
  186  care team to withhold or withdraw cardiopulmonary resuscitation
  187  if an individual has a Physician Order for Life Sustaining
  188  Treatment; amending s. 401.35, F.S.; requiring the Department of
  189  Health to establish circumstances and procedures for honoring
  190  Physician Orders for Life Sustaining Treatment; amending s.
  191  401.45, F.S.; authorizing emergency medical transportation
  192  providers to withhold or withdraw cardiopulmonary resuscitation
  193  or other medical interventions if an individual has a Physician
  194  Order for Life Sustaining Treatment; provides requirements for
  195  the validity of a Physician Order for Life Sustaining Treatment;
  196  amending s. 429.255, F.S.; authorizing assisted living facility
  197  staff to withhold or withdraw cardiopulmonary resuscitation if
  198  an individual has a Physician Order for Life Sustaining
  199  Treatment; amending s. 429.73, F.S.; requiring the department to
  200  adopt rules for the implementation of Physician Orders for Life
  201  Sustaining Treatment in adult family day cares; providing an
  202