Legislation

Current New York State laws and regulations pertinent to Advance Care Planning, Medical Orders for Life-Sustaining Treatment (MOLST), Pain and Palliative Care are included.

Family Health Care Decisions Act (FHCDA)

Family Health Care Decisions Act effective June 1, 2010!
Applies in hospitals and nursing homes
Allows surrogates to make medical decisions
Specific surrogate standards, clinical standards and special requirements apply
NEW! FHCDA 2994-a Subdivision 5-a and 17-a. Decisions regarding hospice care, including the withdrawal or withholding of life-sustaining treatment, effective September 19, 2011!

Medical Orders for Life-Sustaining Treatment (MOLST)

Family Health Care Decisions Act
MOLST is integrated into FHCDA
Surrogates can make decisions to withhold and/or withdraw life-sustaining treatment using surrogate standards, clinical standards and special requirements set by FHCDA.
NEW! FHCDA 2994-a Subdivision 5-a and 17-a. Decisions regarding hospice care, including the withdrawal or withholding of life-sustaining treatment, effective September 19, 2011!

Nonhospital DNR Law (Public Health Law § 2977)

MOLST is consistent with PHL§2977(13)
MOLST became Statewide and permanent July 8, 2008

MOLST Pilot Project Legislation added Public Health Law § 2977(13) (L. 2005, Ch.734; L. 2006, Ch. 325)

Permits NYS Department of Health to authorize MOLST form in lieu of Nonhospital DNR in Monroe and Onondaga Counties
“Standard form” does NOT need to be used in pilot counties
Carve-out: OMH and OMRDD

MOLST Pilot Project Chapter Amendment (Amended PHL § 2977(13) (L. 2005, Ch.734; L. 2006, Ch. 325)

Authorization for EMS to honor Do Not Intubate (DNI) instructions prior to full cardiopulmonary arrest in Monroe and Onondaga Counties during MOLST pilot
Carve-out: OMH and OMRDD

Health Care Decisions Act for Persons with Mental Retardation (Surrogate’s Court Procedure Act § 1750-b)

Patient with MR with capacity can complete MOLST form
Allows a guardian (Surrogate’s Court Procedure Act § 1750-b) of a mentally retarded person to make end-of-life health care decisions
Physician should consult legal counsel for MR patients without capacity. See Surrogate’s Court Procedure Act § 1750-b.

2005 Legislation Added Persons with Developmental Disabilities to the Health Care Decisions Act (Surrogate’s Court Procedure Act § 1750-a)

Patient with DD with capacity can complete MOLST form
Physician should consult legal counsel for DD patients without capacity. See Surrogate’s Court Procedure Act §§ 1750-a, 1750-b.

In the Matter of Westchester County Medical Center, on Behalf of Mary O'Connor. (72 N.Y.2d 517) clarifies “clear and convincing evidence”

Palliative Care

Palliative Care Access Act, 2011, NYSPHL2997-d (Effective September 27, 2011)

Hospital, nursing home, home care agencies and two types of assisted living residences (enhanced and special needs) shall
- estabilsh policies and procedures regarding palliative care, including access to information and counseling
- facilitate access to appropriate palliative care consultations and services

Palliative Care Information Act, 2010 (Effective February 9, 2011)

When a patient is diagnosed with a terminal illness, an attending health care practitioner shall offer to provide the patient with information and counseling on palliative care and end-of-life options appropriate to patient.
It shall include but not limited to: the patient with information and counseling on the prognosis, risks and benefits of the various options; and the patient's legal rights to comprehensive pain and symptom management at the end of life.
Information and counseling can be provided to a person with authority to make health care decisions for the patient if the patient lacks decision making capacity.

Palliative Care Education and Training Act Article VII bill, A.4308-C/S.2108-C, 2007-08

Establish a statewide advisory council on palliative care and pain management;
Create undergraduate and graduate palliative care training programs;
Establish state Department of Health-designated Centers for Palliative Care Excellence; and authorize the Department of Health to certify one or more palliative care resource centers to assist physicians in the treatment of patients in pain
$4.6 million is authorized annually, primarily for the training programs.