S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                    890
 
                        2017-2018 Regular Sessions
 
                           I N  A S S E M B L Y
 
                              January 9, 2017
                                ___________
 
 Introduced  by  M.  of  A.  GUNTHER, GOTTFRIED, BRONSON -- read once and
   referred to the Committee on Judiciary
 
 AN ACT to amend the surrogate's court  procedure  act,  in  relation  to
   making  technical  and  coordinating amendments and other improvements
   regarding health care decisions for persons with  developmental  disa-
   bilities

   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Section 1750-b of the surrogate's court procedure  act,  as
 amended  by  chapter  198  of  the  laws  of 2016, is amended to read as
 follows:
 § 1750-b. Health care decisions  for  persons  [who  are  intellectually
             disabled] WITH DEVELOPMENTAL DISABILITIES
   1.  Scope  of  authority. AS USED IN THIS SECTION, THE TERMS "DEVELOP-
 MENTAL DISABILITY" AND "DEVELOPMENTALLY DISABLED" SHALL HAVE THE MEANING
 SET FORTH IN SUBDIVISION  TWENTY-TWO  OF  SECTION  1.03  OF  THE  MENTAL
 HYGIENE LAW. Unless specifically prohibited by the court after consider-
 ation of the determination, if any, regarding a person [who is intellec-
 tually  disabled's]  WITH  A DEVELOPMENTAL DISABILITY'S capacity to make
 health care decisions, which is required by  section  seventeen  hundred
 fifty of this article, the guardian of such person appointed pursuant to
 section seventeen hundred fifty of this article shall have the authority
 to make any and all health care decisions, as defined by subdivision six
 of  section  twenty-nine  hundred  eighty  of  the public health law, on
 behalf of the person [who is intellectually disabled]  WITH  A  DEVELOP-
 MENTAL DISABILITY that such person could make if such person had capaci-
 ty.  Such  decisions may include decisions to withhold or withdraw life-
 sustaining treatment. For purposes  of  this  section,  "life-sustaining
 treatment"  means  medical treatment, including cardiopulmonary resusci-
 tation, INTUBATION  AND/OR  MECHANICAL  VENTILATION  and  nutrition  and
 hydration  provided  by means of medical treatment, which is OR WOULD BE
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD03920-01-7

 A. 890                              2
 
 sustaining life functions and without  which,  according  to  reasonable
 medical  judgment,  the  patient will die within a relatively short time
 period. Cardiopulmonary resuscitation is presumed to be  life-sustaining
 treatment  without  the  necessity of a medical judgment by an attending
 physician. The provisions of this article are not intended to permit  or
 promote suicide, assisted suicide or euthanasia; accordingly, nothing in
 this  section  shall be construed to permit a guardian to consent to any
 act or omission to which the person  [who  is  intellectually  disabled]
 WITH  A  DEVELOPMENTAL  DISABILITY  could not consent if such person had
 capacity.
   (a) For the purposes of making a  decision  to  withhold  or  withdraw
 life-sustaining  treatment  pursuant  to  this section, in the case of a
 person for whom no guardian  has  been  appointed  pursuant  to  section
 seventeen  hundred fifty or seventeen hundred fifty-a of this article, a
 "guardian" shall also mean a family member of  a  person  who  [(i)  has
 intellectual  disability,  or  (ii)]  has a developmental disability, as
 defined in section 1.03 of the mental hygiene law, which  [(A)  includes
 intellectual disability, or (B)] results in [a similar] AN impairment of
 general  intellectual  functioning  or  adaptive  behavior  so that such
 person is incapable of managing himself or herself, and/or  his  or  her
 affairs  by  reason  of  such developmental disability. Qualified family
 members shall be included in a prioritized list of said  family  members
 pursuant  to  regulations  established by the commissioner of the office
 for people with developmental disabilities.  Such  family  members  must
 have  a  significant and ongoing involvement in a person's life so as to
 have sufficient knowledge of their needs and, when reasonably  known  or
 ascertainable,  the  person's  wishes,  including  moral  and  religious
 beliefs. In the case of a person  who  was  a  resident  of  the  former
 Willowbrook  state  school on March seventeenth, nineteen hundred seven-
 ty-two and those individuals who were in community care status  on  that
 date and subsequently returned to Willowbrook or a related facility, who
 are  fully  represented  by  the consumer advisory board and who have no
 guardians appointed pursuant to this article or have no qualified family
 members to make such a decision, then a "guardian" shall also  mean  the
 Willowbrook consumer advisory board. A decision of such family member or
 the  Willowbrook  consumer  advisory board to withhold or withdraw life-
 sustaining treatment shall be subject to all of the protections,  proce-
 dures  and safeguards which apply to the decision of a guardian to with-
 hold or withdraw life-sustaining treatment pursuant to this section.
   In the case of a person for whom no guardian has been appointed pursu-
 ant to this article or for whom there is no qualified family  member  or
 the  Willowbrook  consumer advisory board available to make such a deci-
 sion, a "guardian" shall also mean, notwithstanding the  definitions  in
 section  80.03  of  the  mental hygiene law, a surrogate decision-making
 committee, as defined in article eighty of the mental hygiene  law.  All
 declarations  and  procedures, including expedited procedures, to comply
 with this section shall be established by regulations promulgated by the
 [commission on quality of care and advocacy for persons  with  disabili-
 ties] JUSTICE CENTER FOR THE PROTECTION OF PEOPLE WITH SPECIAL NEEDS, AS
 ESTABLISHED BY ARTICLE TWENTY OF THE EXECUTIVE LAW.
   (b)  Regulations establishing the prioritized list of qualified family
 members required by paragraph (a) of this subdivision shall be developed
 by the commissioner of the office for people with developmental disabil-
 ities in conjunction with  parents,  advocates  and  family  members  of
 persons  [who  are intellectually disabled] WITH DEVELOPMENTAL DISABILI-
 TIES. Regulations to implement the authority of the Willowbrook consumer

 A. 890                              3
 
 advisory board pursuant to paragraph (a)  of  this  subdivision  may  be
 promulgated  by  the commissioner of the office for people with develop-
 mental disabilities with advice from the Willowbrook  consumer  advisory
 board.
   (c)  Notwithstanding  any provision of law to the contrary, the formal
 determinations required pursuant to section seventeen hundred  fifty  of
 this article shall only apply to guardians appointed pursuant to section
 seventeen hundred fifty or seventeen hundred fifty-a of this article.
   (D)  A  PATIENT  SUBJECT TO THIS SECTION WHO IS FOUND BY THE ATTENDING
 PHYSICIAN TO HAVE CAPACITY TO MAKE HIS OR HER OWN HEALTH CARE DECISIONS,
 PURSUANT TO PARAGRAPH (A) OF SUBDIVISION  FOUR  OF  THIS  SECTION,  UPON
 NOTICE  TO  THE  CHIEF EXECUTIVE OFFICER OF A RESIDENTIAL FACILITY OPER-
 ATED, LICENSED OR AUTHORIZED BY THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL
 DISABILITIES, IN WHICH FACILITY THE PATIENT RESIDES OR FROM WHICH HE  OR
 SHE  WAS TRANSFERRED, AND THE MENTAL HYGIENE LEGAL SERVICE, MAY MAKE HIS
 OR HER OWN DECISIONS RELATING TO LIFE-SUSTAINING TREATMENT.
   (E) A PATIENT SUBJECT TO THIS SECTION WHO  HAS  A  VALID  HEALTH  CARE
 PROXY  AT  THE  TIME  OF  A  HEALTH  CARE DECISION, INCLUDING A DECISION
 INVOLVING LIFE-SUSTAINING TREATMENT, SHALL HAVE SUCH DECISIONS  MADE  IN
 ACCORDANCE  WITH  ARTICLE TWENTY-NINE-C OF THE PUBLIC HEALTH LAW. IF FOR
 ANY REASON THE AGENT OR AN ALTERNATE AGENT IS NOT REASONABLY  AVAILABLE,
 WILLING  AND COMPETENT TO SERVE AND THE PATIENT IS OTHERWISE ELIGIBLE TO
 HAVE A DECISION AS TO LIFE-SUSTAINING TREATMENT MADE  PURSUANT  TO  THIS
 SECTION,  ANY  GUARDIAN  OR  PERSON  OR  ENTITY ENTITLED TO EXERCISE THE
 AUTHORITY OF A GUARDIAN UNDER PARAGRAPH (A) OF THIS SUBDIVISION MAY MAKE
 SUCH DECISION.
   2. Decision-making standard. (a) The guardian shall base all  advocacy
 and  health  care  decision-making  solely  and  exclusively on the best
 interests of the person [who is intellectually disabled] WITH A DEVELOP-
 MENTAL DISABILITY and,  when  reasonably  known  or  ascertainable  with
 reasonable  diligence,  on [the person who is intellectually disabled's]
 SUCH PERSON'S wishes, including moral and religious beliefs.
   (b) An assessment of the person  [who  is  intellectually  disabled's]
 WITH A DEVELOPMENTAL DISABILITY'S best interests shall include consider-
 ation of:
   (i) the dignity and uniqueness of every person;
   (ii)  the  preservation, improvement or restoration of the [person who
 is intellectually disabled's] PERSON'S health;
   (iii) the relief of the  [person  who  is  intellectually  disabled's]
 PERSON'S suffering by means of palliative care and pain management;
   (iv)  the  unique  nature  of  [artificially  provided]  nutrition  or
 hydration PROVIDED BY MEANS OF MEDICAL TREATMENT, and the effect it  may
 have on the person [who is intellectually disabled]; and
   (v) the entire medical condition of the person.
   (c) No health care decision shall be influenced in any way by:
   (i)  a presumption that persons [who are intellectually disabled] WITH
 DEVELOPMENTAL DISABILITIES are  not  entitled  to  the  full  and  equal
 rights,  equal protection, respect, medical care and dignity afforded to
 persons without [an intellectual disability or a developmental disabili-
 ty] DEVELOPMENTAL DISABILITIES; or
   (ii) financial considerations of the guardian, as such  considerations
 affect the guardian, a health care provider or any other party.
   3. Right to receive information. Subject to the provisions of sections
 33.13  and  33.16 of the mental hygiene law, the guardian shall have the
 right to receive  all  medical  information  and  medical  and  clinical
 records  necessary  to make informed decisions regarding the person [who

 A. 890                              4

 is intellectually disabled's] WITH A DEVELOPMENTAL  DISABILITY'S  health
 care.
   4.  Life-sustaining treatment. The guardian shall have the affirmative
 obligation to advocate for the full and efficacious provision of  health
 care,  including life-sustaining treatment. In the event that a guardian
 [makes] INITIATES a decision to  withdraw  or  withhold  life-sustaining
 treatment from a person [who is intellectually disabled] WITH A DEVELOP-
 MENTAL DISABILITY:
   (a)  The attending physician, as defined in subdivision two of section
 twenty-nine hundred eighty of the public health law, must confirm  to  a
 reasonable degree of medical certainty that the person [who is intellec-
 tually  disabled] WITH A DEVELOPMENTAL DISABILITY lacks capacity to make
 health care decisions.  The determination thereof shall be  included  in
 the  [person  who is intellectually disabled's] PERSON'S medical record,
 and shall contain such attending physician's opinion regarding the cause
 and nature of the [person who  is  intellectually  disabled's]  PERSON'S
 incapacity  as  well  as its extent and probable duration. The attending
 physician who makes the confirmation shall consult with  another  physi-
 cian,  or a licensed psychologist, to further confirm the [person who is
 intellectually disabled's] PERSON'S  lack  of  capacity.  The  attending
 physician  who  makes  the  confirmation,  or  the physician or licensed
 psychologist with whom the attending physician  consults,  must  (i)  be
 employed  by  a  developmental  disabilities  [services] REGIONAL office
 named in section 13.17 of the mental hygiene  law  or  employed  by  the
 office  for  people with developmental disabilities to provide treatment
 and care to people with developmental disabilities, or  (ii)  have  been
 employed  for  a  minimum  of  two years to render care and service in a
 facility or program operated, licensed or authorized by the  office  for
 people  with  developmental disabilities, or (iii) have been approved by
 the commissioner of the office for people with  developmental  disabili-
 ties  in  accordance  with regulations promulgated by such commissioner.
 Such regulations shall require that a physician or licensed psychologist
 possess specialized training  or  three  years  experience  in  treating
 [intellectual  disability]  PEOPLE  WITH  DEVELOPMENTAL  DISABILITIES. A
 record of such consultation shall be included  in  the  [person  who  is
 intellectually disabled's] PERSON'S medical record.
   (b)  The attending physician, as defined in subdivision two of section
 twenty-nine hundred eighty of the public health law,  with  the  concur-
 rence  of  another  physician  with  whom such attending physician shall
 consult, must determine to a reasonable degree of medical certainty  and
 note  on  the  person [who is intellectually disabled's] WITH A DEVELOP-
 MENTAL DISABILITY'S chart that:
   (i) the person [who is intellectually disabled] has a  medical  condi-
 tion as follows:
   A.  a  terminal  condition, [as defined in subdivision twenty-three of
 section twenty-nine hundred sixty-one of the public  health  law]  WHICH
 SHALL  MEAN  AN  ILLNESS  OR INJURY FROM WHICH THERE IS NO RECOVERY, AND
 WHICH CAN REASONABLY BE EXPECTED TO CAUSE DEATH WITHIN ONE YEAR; or
   B. permanent unconsciousness; or
   C. a medical condition other than such person's [intellectual]  DEVEL-
 OPMENTAL  disability  which requires life-sustaining treatment, is irre-
 versible and which will continue indefinitely; and
   (ii) the  life-sustaining  treatment  would  impose  an  extraordinary
 burden on such person, in light of:
   A.  such  person's medical condition, other than such person's [intel-
 lectual] DEVELOPMENTAL disability; and

 A. 890                              5
 
   B. the expected outcome of  the  life-sustaining  treatment,  notwith-
 standing such person's [intellectual] DEVELOPMENTAL disability; and
   (iii)  in  the case of a decision to withdraw or withhold artificially
 provided nutrition or hydration:
   A. there is no reasonable hope of maintaining life; or
   B. the artificially provided nutrition or hydration poses an  extraor-
 dinary burden.
   (c)  The  guardian  shall  express  a decision to withhold or withdraw
 life-sustaining treatment either:
   (i) in writing, dated and signed in the presence of one witness  eigh-
 teen years of age or older who shall sign the decision, and presented to
 the  attending physician, as defined in subdivision two of section twen-
 ty-nine hundred eighty of the public health law; or
   (ii) orally, to two persons eighteen years of age or older,  at  least
 one  of  whom  is  the  person [who is intellectually disabled's] WITH A
 DEVELOPMENTAL DISABILITY'S attending physician, as defined  in  subdivi-
 sion two of section twenty-nine hundred eighty of the public health law.
   (d)  The attending physician, as defined in subdivision two of section
 twenty-nine hundred eighty of the public health  law,  who  is  provided
 with the decision of a guardian shall include the decision in the person
 [who  is  intellectually  disabled's]  WITH A DEVELOPMENTAL DISABILITY'S
 medical chart, and shall either:
   (i) promptly issue an order to withhold  or  withdraw  life-sustaining
 treatment  from  the person [who is intellectually disabled], and inform
 the staff responsible for such person's care, if any, of the order; or
   (ii) promptly object to such decision, in accordance with  subdivision
 five of this section.
   (e)  At least forty-eight hours prior to the implementation of a deci-
 sion to withdraw life-sustaining treatment, or at the earliest  possible
 time prior to the implementation of a decision to withhold life-sustain-
 ing treatment, the attending physician shall notify:
   (i)  the  person [who is intellectually disabled] WITH A DEVELOPMENTAL
 DISABILITY, except if the attending physician determines, in writing and
 in consultation with another physician or a licensed psychologist, that,
 to a reasonable degree of medical certainty,  the  person  would  suffer
 immediate and severe injury from such notification. The attending physi-
 cian  who  makes the confirmation, or the physician or licensed psychol-
 ogist with whom the attending physician consults, shall:
   A. be employed by a developmental disabilities services  office  named
 in section 13.17 of the mental hygiene law or employed by the office for
 people  with developmental disabilities to provide treatment and care to
 people with developmental disabilities, or
   B. have been employed for a minimum of two years to  render  care  and
 service in a facility operated, licensed or authorized by the office for
 people with developmental disabilities, or
   C.  have  been  approved  by the commissioner of the office for people
 with developmental disabilities in accordance with  regulations  promul-
 gated by such commissioner. Such regulations shall require that a physi-
 cian  or  licensed  psychologist  possess  specialized training or three
 years experience in  treating  [intellectual  disability]  DEVELOPMENTAL
 DISABILITIES.  A  record  of  such consultation shall be included in the
 [person who is intellectually disabled's] PERSON'S medical record;
   (ii) if the person is in or was transferred from a residential facili-
 ty operated, licensed or authorized by the office for people with devel-
 opmental disabilities, the chief executive  officer  of  the  agency  or
 organization  operating  such  facility  and  the  mental  hygiene legal

 A. 890                              6
 
 service. NOTIFICATION TO THE FACILITY DIRECTOR AND  THE  MENTAL  HYGIENE
 LEGAL  SERVICE  SHALL NOT DELAY ISSUANCE OF AN ORDER NOT TO RESUSCITATE;
 and
   (iii)  if  the  person  is  not in and was not transferred from such a
 facility or program, the commissioner of  the  office  for  people  with
 developmental disabilities, or his or her designee.
   (F) FOR A PATIENT RESIDING IN A FACILITY OPERATED, LICENSED OR AUTHOR-
 IZED BY THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES AS TO WHOM
 AN  ORDER  NOT  TO RESUSCITATE HAS BEEN ENTERED, THE ATTENDING PHYSICIAN
 SHALL REVIEW WHETHER THE ORDER IS STILL APPROPRIATE AT SUCH TIMES AND IN
 SUCH MANNER AS IS PRESCRIBED BY SUBDIVISION FOUR OF SECTION  TWENTY-NINE
 HUNDRED NINETY-FOUR-DD OF THE PUBLIC HEALTH LAW.
   5.  Objection  to  health care decision. (a) Suspension. A health care
 decision made pursuant to subdivision four  of  this  section  shall  be
 suspended,  pending  judicial  review, except if the suspension would in
 reasonable medical judgment be likely to result  in  the  death  of  the
 person [who is intellectually disabled] WITH A DEVELOPMENTAL DISABILITY,
 in the event of an objection to that decision at any time by:
   (i)  the  person [who is intellectually disabled] on whose behalf such
 decision was made; or
   (ii) a parent or adult sibling who either resides with  or  has  main-
 tained substantial and continuous contact with the person [who is intel-
 lectually disabled]; or
   (iii)  the  attending  physician,  as  defined  in  subdivision two of
 section twenty-nine hundred eighty of the public health law; or
   (iv) any other health care  practitioner  providing  services  to  the
 person  [who  is  intellectually  disabled], who is licensed pursuant to
 article one hundred thirty-one, one hundred  thirty-one-B,  one  hundred
 thirty-two,  one  hundred  thirty-three,  one  hundred  thirty-six,  one
 hundred thirty-nine, one hundred forty-one, one hundred forty-three, one
 hundred forty-four, one hundred fifty-three, one hundred fifty-four, one
 hundred fifty-six, one hundred fifty-nine or one hundred  sixty-four  of
 the education law; or
   (v)  the  chief  executive  officer identified in subparagraph (ii) of
 paragraph (e) of subdivision four of this section; or
   (vi) if the person is in or was transferred from a residential facili-
 ty or program operated, approved or licensed by the  office  for  people
 with developmental disabilities, the mental hygiene legal service; or
   (vii)  if  the  person  is  not in and was not transferred from such a
 facility or program, the commissioner of  the  office  for  people  with
 developmental disabilities, or his or her designee.
   NOTWITHSTANDING  THE FOREGOING, IN CASES WHERE THE ATTENDING PHYSICIAN
 HAS NOTIFIED THE CHIEF EXECUTIVE OFFICER OF AN  AGENCY  AND  THE  MENTAL
 HYGIENE LEGAL SERVICE OF THE ENTRY OF AN ORDER NOT TO RESUSCITATE PURSU-
 ANT  TO  SUBPARAGRAPH  (II) OF PARAGRAPH (E) OF SUBDIVISION FOUR OF THIS
 SECTION, AND IF SUCH NOTICE INCLUDES EITHER THE PHYSICIAN'S STATEMENT OF
 THE DIAGNOSTIC AND BASIS FOR THE MEDICAL DETERMINATION IN SUPPORT OF THE
 PROGNOSTIC ORDER OR AN EXCERPT FROM THE PATIENT'S MEDICAL RECORD THAT IS
 SUFFICIENT TO SUPPORT SUCH DETERMINATION, AN ORDER  NOT  TO  RESUSCITATE
 SHALL NOT BE STAYED BY AN OBJECTION BY THE PERSONS DESCRIBED IN SUBPARA-
 GRAPH  (V) OR (VI) OF THIS PARAGRAPH UNLESS THE OBJECTION IS ACCOMPANIED
 BY (A) A WRITTEN STATEMENT BY THE OBJECTING PARTY SETTING FORTH A  BASIS
 FOR ASSERTING THAT A STANDARD IN THIS ARTICLE FOR ENTERING SUCH AN ORDER
 HAS  NOT  BEEN  MET; AND (B) IF THE BASIS RELATES TO THE FAILURE TO MEET
 MEDICAL CRITERIA IN THIS ARTICLE FOR THE ISSUANCE OF THE ORDER, A  WRIT-
 TEN STATEMENT BY A HEALTH OR SOCIAL SERVICES PRACTITIONER, AS DEFINED IN

 A. 890                              7
 
 SUBDIVISION  SEVENTEEN  OF  SECTION TWENTY-NINE HUNDRED NINETY-FOUR-A OF
 THE PUBLIC HEALTH LAW SETTING FORTH THE PROFESSIONAL'S OPINION, BASED ON
 HIS OR HER REVIEW OF THE  AFOREMENTIONED  STATEMENT  OR  MEDICAL  RECORD
 EXCERPT  AND  CONSULTATION  WITH THE PATIENT'S ATTENDING PHYSICIAN, THAT
 THE MEDICAL CRITERIA IN THIS ARTICLE FOR ENTERING SUCH  ORDER  HAVE  NOT
 BEEN MET.
   (b)  Form  of objection. Such objection shall occur orally or in writ-
 ing.
   (c) Notification. In the event of the  suspension  of  a  health  care
 decision pursuant to this subdivision, the objecting party shall prompt-
 ly notify the guardian and the other parties identified in paragraph (a)
 of  this  subdivision,  and  the  attending  physician shall record such
 suspension in the person  [who  is  intellectually  disabled's]  WITH  A
 DEVELOPMENTAL DISABILITY'S medical chart.
   (d)  Dispute  mediation. In the event of an objection pursuant to this
 subdivision, at the request of the objecting party or person  or  entity
 authorized  to  act as a guardian under this section, except a surrogate
 decision making committee established pursuant to article eighty of  the
 mental hygiene law, such objection shall be referred to [a dispute medi-
 ation  system, established pursuant to section two thousand nine hundred
 seventy-two] AN ETHICS REVIEW COMMITTEE, ESTABLISHED PURSUANT TO SECTION
 TWENTY-NINE HUNDRED NINETY-FOUR-M of the public health  law  or  similar
 entity  for  mediating  disputes in a hospice, such as a patient's advo-
 cate's office[,] OR hospital chaplain's office [or ethics committee], as
 described in writing and adopted by  the  governing  authority  of  such
 hospice,  for  non-binding  mediation.  In  the  event that such dispute
 cannot be resolved within seventy-two hours or no such mediation  entity
 exists  or  is  reasonably  available  for  mediation  of a dispute, the
 objection [shall] MAY proceed to judicial review pursuant to this subdi-
 vision. The party requesting mediation  shall  provide  notification  to
 those  parties  entitled  to  notice  pursuant  to paragraph (a) of this
 subdivision.
   6. Special proceeding authorized. The guardian, the  attending  physi-
 cian,  as  defined  in  subdivision  two  of section twenty-nine hundred
 eighty of the public health law, the chief executive officer  identified
 in  subparagraph  (ii)  of  paragraph  (e)  of  subdivision four of this
 section, the mental hygiene legal service (if the person is  in  or  was
 transferred from a residential facility or program operated, approved or
 licensed  by  the  office for people with developmental disabilities) or
 the commissioner of the office for people with  developmental  disabili-
 ties  or his or her designee (if the person is not in and was not trans-
 ferred from such a facility or program) may commence a special  proceed-
 ing  in  a  court  of competent jurisdiction with respect to any dispute
 arising under this section, including objecting  to  the  withdrawal  or
 withholding  of  life-sustaining  treatment  because  such withdrawal or
 withholding is not in  accord  with  the  criteria  set  forth  in  this
 section.
   7.  Provider's  obligations.  (a)  A health care provider shall comply
 with the health care decisions made by a guardian in good faith pursuant
 to this section, to the same extent as if such decisions had  been  made
 by  the  person  [who  is  intellectually disabled] WITH A DEVELOPMENTAL
 DISABILITY, if such person had capacity.
   (b) Notwithstanding paragraph (a) of this subdivision, nothing in this
 section shall be construed to require a  private  hospital  to  honor  a
 guardian's health care decision that the hospital would not honor if the
 decision  had  been  made by the person [who is intellectually disabled]

 A. 890                              8

 WITH A DEVELOPMENTAL DISABILITY, if such person  had  capacity,  because
 the  decision  is  contrary  to a formally adopted written policy of the
 hospital expressly based on religious beliefs or  sincerely  held  moral
 convictions  central  to  the  hospital's  operating principles, and the
 hospital would be permitted by law to refuse to honor  the  decision  if
 made by such person, provided:
   (i)  the hospital has informed the guardian of such policy prior to or
 upon admission, if reasonably possible; and
   (ii) the  person  [who  is  intellectually  disabled]  is  transferred
 promptly  to  another  hospital  that is reasonably accessible under the
 circumstances and is willing to honor the guardian's  decision.  If  the
 guardian  is  unable or unwilling to arrange such a transfer, the hospi-
 tal's refusal to honor the decision of the guardian shall constitute  an
 objection pursuant to subdivision five of this section.
   (c) Notwithstanding paragraph (a) of this subdivision, nothing in this
 section shall be construed to require an individual health care provider
 to honor a guardian's health care decision that the individual would not
 honor if the decision had been made by the person [who is intellectually
 disabled]  WITH A DEVELOPMENTAL DISABILITY, if such person had capacity,
 because the decision is contrary to the individual's  religious  beliefs
 or sincerely held moral convictions, provided the individual health care
 provider  promptly informs the guardian and the facility, if any, of his
 or her refusal to honor the guardian's  decision.  In  such  event,  the
 facility  shall  promptly transfer responsibility for the person [who is
 intellectually disabled] to  another  individual  health  care  provider
 willing  to  honor  the  guardian's decision. The individual health care
 provider shall cooperate in facilitating such transfer of the patient.
   (d) Notwithstanding the provisions of  any  other  paragraph  of  this
 subdivision,  if  a  guardian  directs  the provision of life-sustaining
 treatment, the denial of which in reasonable medical judgment  would  be
 likely to result in the death of the person [who is intellectually disa-
 bled]  WITH  A DEVELOPMENTAL DISABILITY, a hospital or individual health
 care provider that does not wish to provide such treatment  shall  none-
 theless  comply  with the guardian's decision pending either transfer of
 the person [who is intellectually disabled] to  a  willing  hospital  or
 individual health care provider, or judicial review.
   (e)  Nothing in this section shall affect or diminish the authority of
 a surrogate decision-making panel to render  decisions  regarding  major
 medical treatment pursuant to article eighty of the mental hygiene law.
   8. Immunity. (a) Provider immunity. No health care provider or employ-
 ee  thereof  shall  be  subjected  to criminal or civil liability, or be
 deemed to have engaged in unprofessional conduct, for  honoring  reason-
 ably  and  in  good  faith  a health care decision by a guardian, or for
 other actions taken reasonably  and  in  good  faith  pursuant  to  this
 section.
   (b)  Guardian  immunity. No guardian shall be subjected to criminal or
 civil liability for making a health care decision reasonably and in good
 faith pursuant to this section.
   § 2. This act shall take effect on the ninetieth day  after  it  shall
 have become a law.