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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.

Dear Administrator Letters and Legal Opinions

Key Resources

Forms

Traditional Advance Directives

Actionable Medical Orders

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