Senate Bill S5259A

Signed By Governor

2011-2012 Legislative Session

Relates to extending the provisions of the Family Health Care Decisions act

download bill text pdf

Archive: Last Bill Status Via A7343 - Signed by Governor

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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Actions

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Date of Action	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jul 20, 2011	signed chap.167
Jul 08, 2011	delivered to governor
Jun 20, 2011	returned to assembly passed senate 3rd reading cal.1134 substituted for s5259a
Jun 20, 2011	substituted by a7343a
Jun 14, 2011	advanced to third reading
Jun 13, 2011	2nd report cal. amended (t) 5259a
Jun 07, 2011	1st report cal.1134
May 03, 2011	referred to health

Votes

- Jun 20, 2011 - Floor Vote
  A7343
  
  Aye
  
  61
  
  Nay
  
  1
  
  Absent
  
  0
  
  Excused
  
  0
  
  Abstained
  
  0
  - - Floor Vote: Jun 20, 2011
      
      aye (61)
      
      Adams
      
      Addabbo Jr.
      
      Alesi
      
      Avella
      
      Ball
      
      Bonacic
      
      Breslin
      
      Carlucci
      
      DeFrancisco
      
      Dilan
      
      Duane
      
      Espaillat
      
      Farley
      
      Flanagan
      
      Fuschillo
      
      Gallivan
      
      Gianaris
      
      Golden
      
      Griffo
      
      Grisanti
      
      Hannon
      
      Hassell-Thompson
      
      Huntley
      
      Johnson
      
      Kennedy
      
      Klein
      
      Krueger
      
      Kruger
      
      LaValle
      
      Lanza
      
      Larkin
      
      Libous
      
      Little
      
      Marcellino
      
      Martins
      
      Maziarz
      
      McDonald
      
      Montgomery
      
      Nozzolio
      
      O'Mara
      
      Oppenheimer
      
      Parker
      
      Peralta
      
      Perkins
      
      Ranzenhofer
      
      Ritchie
      
      Rivera
      
      Robach
      
      Saland
      
      Sampson
      
      Savino
      
      Serrano
      
      Seward
      
      Skelos
      
      Smith
      
      Squadron
      
      Stavisky
      
      Stewart-Cousins
      
      Valesky
      
      Young
      
      Zeldin
      
      nay (1)
      
      Diaz
  Jun 7, 2011 - Health Committee Vote
  S5259A
  
  Aye
  
  12
  
  Nay
  
  2
  
  Aye with Reservations
  
  3
  
  Absent
  
  0
  
  Excused
  
  0
  
  Abstained
  
  0
  - - Health Committee Vote: Jun 7, 2011
      
      aye (12)
      
      Ball
      
      Farley
      
      Fuschillo
      
      Golden
      
      Hannon
      
      Larkin
      
      McDonald
      
      Montgomery
      
      Rivera
      
      Seward
      
      Smith
      
      Young
      
      nay (2)
      
      Duane
      
      Gianaris
      
      aye wr (3)
      
      Adams
      
      Kruger
      
      Stewart-Cousins

Bill Amendments

2011-S5259 - Details

See Assembly Version of this Bill:: A7343
Law Section:: Public Health Law
Laws Affected:: Amd §§2994-a - 2994-d, 2994-g, 2994-m & 2994-aa, Pub Health L

2011-S5259 - Summary

Extends provisions of the Family Health Care Decisions Act to decisions regarding hospice care.

2011-S5259 - Sponsor Memo

                                BILL NUMBER:S5259

TITLE OF BILL:

An act
to amend chapter 8 of the laws of 2010,
amending the public health law
and other laws relating to directing the New York state task force on
life and law to form a special advisory committee to consider the
procedures and practices for withholding or withdrawal of life
sustaining treatment for patients with mental illness or mental
retardation and developmental disabilities,
in relation to the time frame for
recommendations to the legislature

PURPOSE:

To clarify the date upon which the New York State Task Force on
Life and the Law must report the regulatory and statutory
recommendations relating to the
Family Health Care Decisions Act (FHCDA) required by the 2010
chapter.

SUMMARY OF PROVISIONS:

Section 1 of the bill amends Section 28 of

Chapter 8 of the laws of 2010 to clarify that The New York State Task
Force on Life and the Law, which is charged with making
recommendations relating to various aspects of the FHCDA including
withdrawal or withholding of life-sustaining treatment from patients
with mental illness or developmental disabilities and whether the act
should apply to health care decision in settings other than general
hospitals and residential health care facilities, shall do so by June
1, 2011.

Section 2 of the bill provides for an effective date.

JUSTIFICATION:
In 2010 The Family Health Care Decision Act was signed
into law which establishes a decision-making process, applicable to
decisions in general hospitals and nursing homes, whereby a surrogate
is selected and empowered to make health care decisions for patients
who lack capacity to make their own health care decisions and who
have not otherwise appointed an agent to make health care decisions
pursuant to article 29-C of the public health law or provided clear
and convincing evidence of their treatment wishes.

As part of that law, the NYS Task Force on Life and the Law (which was
created by Executive Order in 1984) was directed to consider and make
regulatory and statutory recommendations relating to the FHCDA
including withdrawal or withholding of life-sustaining treatment from
patients with mental illness or developmental disabilities and
whether the act should apply to health care decision in settings
other than general hospitals and residential health care facilities.
The bill was silent as to when such recommendations should be made
and to whom.


This bill clarifies that the Task Force should make such
recommendations to the temporary president of the senate, the speaker
of the assembly and the governor no later than June 1, 2011. Given
the bill was signed into law March 16, 2010, the Task Force will have
had more than a year to consider the FHCDA and develop its
recommendations. A June 1, 2011 reporting date will also provide the
legislature with the opportunity to make
any amendments to the statute that maybe appropriate before the close
of the 2011 Legislative Session.

LEGISLATIVE HISTORY:
New Bill.

FISCAL IMPLICATIONS:
None.

EFFECTIVE DATE:
Immediately.

2011-S5259 - Bill Text download pdf

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  5259

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                               May 3, 2011
                               ___________

Introduced  by  Sen.  HANNON -- read twice and ordered printed, and when
  printed to be committed to the Committee on Health

AN ACT to amend chapter 8 of the  laws  of  2010,  amending  the  public
  health  law  and  other  laws relating to directing the New York state
  task force on life and law to form a  special  advisory  committee  to
  consider the procedures and practices for withholding or withdrawal of
  life  sustaining  treatment for patients with mental illness or mental
  retardation and developmental disabilities, in relation  to  the  time
  frame for recommendations to the legislature

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. Section 28 of chapter 8 of the laws of 2010,  amending  the
public  health  law  and  other  laws relating to directing the New York
state task force on life and law to form a special advisory committee to
consider the procedures and practices for withholding or  withdrawal  of
life  sustaining  treatment  for  patients with mental illness or mental
retardation and  developmental  disabilities,  is  amended  to  read  as
follows:
  S  28.  Issues to be considered by the task force on life and the law;
special advisory committee.  The New York state task force on  life  and
the  law  (referred  to  in  this  section  as the "task force"), a body
created by executive order number 56 (issued December 20,  1984),  shall
consider and make regulatory and statutory recommendations TO THE TEMPO-
RARY PRESIDENT OF THE SENATE, THE SPEAKER OF THE ASSEMBLY AND THE GOVER-
NOR NO LATER THAN JUNE FIRST, TWO THOUSAND ELEVEN relating to the family
health  care  decisions  act  (article  29-CC  of the public health law,
referred to in this section as the "FHCDA"), including the following:
  1. The task force shall consider whether the FHCDA should  be  amended
to  incorporate  procedures, standards and practices for decisions about
the withdrawal or withholding of life-sustaining treatment from patients
with mental illness or mental retardation or developmental disabilities,

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD11440-01-1

S. 5259                             2

and from patients residing in mental health facilities.  The task  force
shall  form a special advisory committee to advise the task force in its
work under  this  subdivision.  The  special  advisory  committee  shall
consist  of  six  task  force members, selected by the chair of the task
force, three persons selected by  the  commissioner  of  the  office  of
mental  health,  and  three  persons selected by the commissioner of the
office [of mental retardation and] FOR PEOPLE WITH  developmental  disa-
bilities.  The  special advisory committee shall solicit comments from a
broader range of interested persons.
  2. The task force shall consider whether the FHCDA should  be  amended
to  apply to health care decisions in settings other than general hospi-
tals and residential health care facilities.
  S 2. This act shall take effect immediately.

2011-S5259A (ACTIVE) - Details

See Assembly Version of this Bill:: A7343
Law Section:: Public Health Law
Laws Affected:: Amd §§2994-a - 2994-d, 2994-g, 2994-m & 2994-aa, Pub Health L

2011-S5259A (ACTIVE) - Summary

Extends provisions of the Family Health Care Decisions Act to decisions regarding hospice care.

2011-S5259A (ACTIVE) - Sponsor Memo

                                BILL NUMBER:S5259A

TITLE OF BILL:
An act
to amend the public health law, in relation to extending the
provisions of the Family Health Care Decisions act to decisions
regarding hospice care

PURPOSE OR GENERAL IDEA OF BILL:
To authorize family members to make
decisions regarding hospice care for patients who lack
decision-making capacity, in accordance with the provisions of the
Family Health Care Decisions Act, PHL Article 29-CC (FHCDA).

SUMMARY OF SPECIFIC PROVISIONS:
Section 1 amends various subdivisions in PHL §2994-a (Definitions) to
add definitions for "decisions regarding hospice care" and "hospice,"
and to amend the definition of "hospital" to include hospice.

Section 2 amends PHL §2994-b, subdivision 1 to make the FHCDA apply to
decisions regarding hospice care.

Section 3 amends PHL §2994-c, subdiv. 3(b) to provide that with
respect to a concurring determination regarding hospice care for a
patient in a general hospital or residential health care facility,
the health or social services practitioner must be employed by or

otherwise affiliated with the facility.

Section 4 amends PHL §2994-d, subdiv. 5 to clarify that decisions to
withdraw or withhold life sustaining treatment include decisions to
accept a hospice plan of care that provides for the withdrawal or
withholding of life-sustaining treatment.

Section 5 amends PHL §2994-g, subdiv. 4(b)(iii) and of the public
health law to require a concurring opinion with respect to decisions
to provide major medical treatment for hospice patients who do not
have a surrogate.

Section 6 amends PHL §2994-g, subdiv. 5 to provide that with respect
to a decision to withdraw or withhold life-sustaining treatment from
a hospice patient who does not have a surrogate and who is in a
general hospital or residential health care facility, the second
physician must be designated by the general hospital or residential
health care facility.

Section 7 amends PHL §2994-m, subdiv. 4 regarding the responsibility
of a hospital or residential ethics committee to review a decision
regarding a hospice patient in such facility.

Section 8 amends §2994-aa, subdiv. 13 to provide that a non-hospital
order not to resuscitate also applies to hospice personnel.

Section 9 provides for the act to become effective on the sixtieth day
after it shall have become a law.

JUSTIFICATION:


By enacting the Family Health Care Decisions Act, Ch. 8, Laws of 2010
(the FHCDA), the Legislature significantly improved decision-making
in New York for patients who lack capacity and who do not have a
health care agent. Specifically, the FHCDA recognized the authority
of a "surrogate" decision-maker, i.e., a close family member or
friend, to make health care decisions for the incapable patient in
such cases, subject to ethically sound standards and safeguards.

While the FHCDA by its terms only applies to health care decisions
regarding health care provided in a hospital or nursing home, PHL
§2994-d.1, from the outset the Legislature recognized the need to
consider extending the FHCDA to other settings. To that end, it
directed the NYS Task Force on Life and the Law to make
recommendations regarding "whether the FHCDA should be amended to
apply to health care decisions in settings other than general
hospital and residential health care facilities." Ch. 8, L. 2010,
§28.2.

On November 30, 2010, after hearing various views and engaging in a
deliberative process, the Task Force issued an initial recommendation
regarding extending the FHCDA: it recommended amending the FHCDA to
provide surrogates with authority to make decisions on behalf of
incapable patients regarding hospice care. See NYS Task Force on Life
and the Law, "Recommendations Regarding the Extension of the Family
Health Care Decisions Act to Include Hospice."
(www.health.state.ny.us/ regulations/taskJorce/docs/20 1 0-12-22_
extension_ of_family _ health_care_decisions _ act.pdt:).

As the Task Force report explained:

The current wording of the FHCDA creates a barrier to the utilization
of hospice by terminally ill individuals because the authority it
bestows upon surrogates is limited to care provided in hospitals or
nursing homes. The FHCDA does not permit a surrogate to elect hospice
care for a loved one who is being cared for outside of a covered
facility at the time of the election decision. Even when a patient is
successfully enrolled in hospice, a surrogate lacks the ability to
make decisions about on-going care so long as that care is to be
provided outside of a covered facility, for example, where hospice
care will be provided in a stand-alone hospice facility or in the
home. Therefore, the ability of a patient without decision-making
capacity to access hospice care will depend upon where care is
currently provided or will be provided going forward. Instead, the
focus should be solely on ensuring that the individual's known
preferences or best interests are honored at this crucial time.

The addition of hospice also fits well into the structure of the FHCDA
as it currently stands, without requiring extensive changes. Hospices
are federally certified and highly regulated at the state level. The
safeguards and oversight mechanisms in the FHCDA, including the
procedures for determining capacity, the procedures for end-of-life
decision-making, and the requirements of ethics review committees
will translate into hospice settings. Hospices have physicians and
other interdisciplinary professionals on staff to fulfill the
statutory requirements in these areas, and most hospices have their
Own ethics committee, or have access to an ethics committee (e.g.,
through an affiliated institution or other agreement).


PRIOR LEGISLATIVE HISTORY:
None.

FISCAL IMPLICATIONS:
None.

EFFECTIVE DATE:
The act will take effect on the sixtieth day after it
becomes a law.

2011-S5259A (ACTIVE) - Bill Text download pdf

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 5259--A
    Cal. No. 1134

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                               May 3, 2011
                               ___________

Introduced  by  Sen.  HANNON -- read twice and ordered printed, and when
  printed to be committed to the Committee on Health -- reported favora-
  bly from said committee, ordered to first  report,  amended  on  first
  report,  ordered  to  a second report and ordered reprinted, retaining
  its place in the order of second report

AN ACT to amend the public health law,  in  relation  to  extending  the
  provisions  of  the  Family  Health  Care  Decisions  act to decisions
  regarding hospice care

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1.  Subdivision 18 of section 2994-a of the public health law,
as added by chapter 8 of the laws of 2010 is amended, and two new subdi-
visions 5-a and 17-a are added to read as follows:
  5-A.  "DECISIONS  REGARDING HOSPICE CARE" MEANS THE DECISION TO ENROLL
OR DISENROLL IN HOSPICE, AND CONSENT TO THE HOSPICE  PLAN  OF  CARE  AND
MODIFICATIONS TO THAT PLAN.
  17-A.    "HOSPICE" MEANS A HOSPICE AS DEFINED IN ARTICLE FORTY OF THIS
CHAPTER, WITHOUT REGARD TO WHERE THE HOSPICE CARE IS PROVIDED.
  18. "Hospital" means a general hospital  [or],  a  residential  health
care facility, OR HOSPICE.
  S  2.  Subdivision  1  of  section 2994-b of the public health law, as
added by chapter 8 of the laws of 2010, is amended to read as follows:
  1. This article shall apply to health care decisions regarding  health
care  provided  in  a  hospital [to], AND TO DECISIONS REGARDING HOSPICE
CARE WITHOUT REGARD TO WHERE THE DECISION IS MADE OR WHERE THE  CARE  IS
PROVIDED,  FOR  a  patient who lacks decision-making capacity, except as
limited by this section.
  S 3. Paragraph (b) of subdivision 3 of section 2994-c  of  the  public
health  law,  as  added  by chapter 8 of the laws of 2010, is amended to
read as follows:

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD11440-02-1

S. 5259--A                          2

  (b) (i) In a residential health care  facility,  a  health  or  social
services  practitioner employed by or otherwise formally affiliated with
the facility must independently determine whether an adult patient lacks
decision-making capacity.
  (ii)  In  a  general hospital a health or social services practitioner
employed by or otherwise formally  affiliated  with  the  facility  must
independently  determine  whether an adult patient lacks decision-making
capacity if the surrogate's decision concerns the  withdrawal  or  with-
holding of life-sustaining treatment.
  (III)  WITH  RESPECT TO DECISIONS REGARDING HOSPICE CARE FOR A PATIENT
IN A GENERAL HOSPITAL OR RESIDENTIAL HEALTH CARE FACILITY, THE HEALTH OR
SOCIAL SERVICES PRACTITIONER MUST BE EMPLOYED BY OR  OTHERWISE  FORMALLY
AFFILIATED  WITH THE GENERAL HOSPITAL OR RESIDENTIAL HEALTH CARE FACILI-
TY.
  S 4. The opening paragraph of subdivision 5 of section 2994-d  of  the
public health law, as added by chapter 8 of the laws of 2010, is amended
to read as follows:
  Decisions  to withhold or withdraw life-sustaining treatment. In addi-
tion to the standards set forth in subdivision  four  of  this  section,
decisions  by  surrogates to withhold or withdraw life-sustaining treat-
ment (INCLUDING DECISIONS TO ACCEPT A HOSPICE PLAN OF CARE THAT PROVIDES
FOR THE WITHDRAWAL OR WITHHOLDING OF LIFE-SUSTAINING TREATMENT) shall be
authorized only if the following conditions are satisfied,  as  applica-
ble:
  S  5.  Subparagraph (iii) of paragraph (b) of subdivision 4 of section
2994-g of the public health law, as added by chapter 8 of  the  laws  of
2010, is amended to read as follows:
  (iii) In a residential health care facility, AND FOR A HOSPICE PATIENT
NOT  IN  A  GENERAL  HOSPITAL,  the  medical director of the facility OR
HOSPICE, or a physician designated by the medical director,  must  inde-
pendently  determine  that  he or she concurs that the recommendation is
appropriate; provided that if the  medical  director  is  the  patient's
attending physician, a different physician designated by the residential
health  care  facility  OR  HOSPICE  must make this independent determi-
nation. Any health or social services practitioner employed by or other-
wise formally affiliated with the facility  OR  HOSPICE  may  provide  a
second  opinion for decisions about physical restraints made pursuant to
this subdivision.
  S 6. Subdivision 5 of section 2994-g  of  the  public  health  law  is
amended by adding a new paragraph (c) to read as follows:
  (C) WITH RESPECT TO A DECISION REGARDING HOSPICE CARE FOR A PATIENT IN
A  GENERAL  HOSPITAL  OR  RESIDENTIAL  HEALTH  CARE FACILITY, THE SECOND
PHYSICIAN MUST BE DESIGNATED BY  THE  GENERAL  HOSPITAL  OR  RESIDENTIAL
HEALTH CARE FACILITY.
  S  7.  Subdivision  4  of  section  2994-m of the public health law is
amended by adding a new paragraph (c) to read as follows:
  (C) WHEN AN ETHICS REVIEW COMMITTEE IS CONVENED  TO  REVIEW  DECISIONS
REGARDING  HOSPICE  CARE FOR A PATIENT IN A GENERAL HOSPITAL OR RESIDEN-
TIAL HEALTH CARE FACILITY, THE RESPONSIBILITIES OF THIS SECTION SHALL BE
CARRIED OUT BY THE ETHICS REVIEW COMMITTEE OF THE  GENERAL  HOSPITAL  OR
RESIDENTIAL  HEALTH  CARE  FACILITY,  PROVIDED THAT SUCH COMMITTEE SHALL
INVITE A REPRESENTATIVE FROM HOSPICE TO PARTICIPATE.
  S 8. Subdivision 13 of section 2994-aa of the public  health  law,  as
added by chapter 8 of the laws of 2010, is amended to read as follows:
  13. "Nonhospital order not to resuscitate" means an order that directs
emergency  medical  services  personnel,  HOSPICE PERSONNEL and hospital

S. 5259--A                          3

emergency services personnel not  to  attempt  cardiopulmonary  resusci-
tation in the event a patient suffers cardiac or respiratory arrest.
  S  9.  This  act  shall take effect on the sixtieth day after it shall
have become a law.

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Senate Bill S5259A

Signed By Governor

Sponsored By

Archive: Last Bill Status Via A7343 - Signed by Governor

Actions

Votes

Jun 20, 2011 - Floor Vote

Floor Vote: Jun 20, 2011

Jun 7, 2011 - Health Committee Vote

Health Committee Vote: Jun 7, 2011

Bill Amendments

2011-S5259 - Details

2011-S5259 - Summary

2011-S5259 - Sponsor Memo

2011-S5259 - Bill Text download pdf

2011-S5259A (ACTIVE) - Details

2011-S5259A (ACTIVE) - Summary

2011-S5259A (ACTIVE) - Sponsor Memo

2011-S5259A (ACTIVE) - Bill Text download pdf

Comments

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Senate Bill S5259A

Signed By Governor

Share this bill

Sponsored By

Kemp Hannon

Archive: Last Bill Status Via A7343 - Signed by Governor

Actions

Votes

Bill Amendments

2011-S5259 - Details

2011-S5259 - Summary

2011-S5259 - Sponsor Memo

2011-S5259 - Bill Text download pdf

2011-S5259A (ACTIVE) - Details

2011-S5259A (ACTIVE) - Summary

2011-S5259A (ACTIVE) - Sponsor Memo

2011-S5259A (ACTIVE) - Bill Text download pdf

Comments