BILL NUMBER:  S3998

 TITLE OF BILL :  An act to amend the insurance law, in relation to
requiring health insurance companies to provide health care proxy
forms to the insured and to store completed proxies on behalf of the
insured and to amend the social services law, in relation to requiring
the department of social services to provide health care proxy forms
and instructions to applicants for Medicaid

 PURPOSE OF GENERAL IDEA OF BILL :

To require health insurance providers in New York State to issue and
store health care proxy forms and written descriptions of its purpose
for policyholders.

 SUMMARY :

Section one adds a new subsection (g) to Section 3217-a of the
insurance law to require health insurance providers to give the health
proxy form to all policy holders upon request and every two years.
Completion of the form by the policy holder is not mandatory.

Section two of this bill adds a new section 3242 which requires the
health insurance provider to receive and store the completed proxy
form with the enrollees other records. The insurance carrier shall
provide the proxy form to the healthcare institutions/medical
              

personnel who need to contact the proxy named on the form in the
course of the policyholder's care.

Section 366-a of the social services law is amended to require the
department to provide health care proxy forms with instructions to
complete the forms to individuals applying for Medicaid. The
department shall accept and store the completed proxy form from the
applicant. In addition the department shall supply the form to the
medical facility treating the applicant.

 JUSTIFICATION :

Healthcare proxies have been legal documents in New York State since
1991. A proxy allows a person to designate someone to be their
surrogate decision-maker in a healthcare setting should they be unable
to speak or make decisions for themselves. The State Department of
Health website has forms, extensive instructions and information on
healthcare proxies. Unfortunately, very few people in the State have
completed this form, or even know that it exists.

Currently, hospitals are required by law to provide this form to
anyone being admitted, although it may not be an ideal time for the
patient to make important healthcare decisions. A person entering a
hospital may be in no condition to fill out paperwork or consider who
best understands or knows their wishes. Even if a hospitalization is
planned, it can be a stressful time for an individual and people close
to them, making them unwilling to complete the document or to make the
best choice regarding the identity of their healthcare proxy.

For those who do have a healthcare proxy, there is no set system for
making this form available to the healthcare institution caring for
the Proxy-holder. If one fills out a proxy form at a healthcare
institution, is discharged, and then some time later is admitted to a
different institution, a new form would likely be needed. If one has
supplied a completed form to one's primary care physician's office,
there is no guarantee that it will be transferred to an admitting
hospital in a timely manner. Because there is no standardized system
for storing this information, there have also been situations in which
a person's most updated proxy has not been available, and therefore a

former proxy no longer appropriate (for example, a divorced spouse)
was the legal agent.

Because it is clear that the people who are closest to a person are
best suited to represent that individual and make decisions regarding
their care, New York has recently passed into law the Family
Healthcare Decisions Act (FHDA). While this certainly represents
progress in our efforts to achieve quality patient care, it also
highlights the fact that for some the person who would be their
designated agent per FHDA may not be the one they would choose as
their healthcare proxy. Furthermore, FHDA only applies to certain
healthcare settings, while a Proxy applies to all settings. For
example, if a person suffering from dementia wished to be represented
by their spouse at their community clinic, this would be possible
under current law only if the person had designated their spouse as
their proxy.

Individuals, families, healthcare institutions, and health insurance
companies are all best served by patients and their loved ones being
satisfied that a person is receiving the individual care that they
would choose. Having a current healthcare proxy is the ideal way to
accomplish this. The only way for more people to complete this
document and update it if their life circumstances change, is to
increase exposure to the document.

Whenever a person is admitted to a healthcare institution, that
institution always contacts their insurance provider for personal
information and reimbursement purposes. In the process of such a
transaction, it would be convenient for the policy provider to make
available the Proxy's identity and contact information in whatever
format they are providing other data needed by the health care
institution (phone, fax, etc.)

 FISCAL IMPLICATIONS FOR THE STATE :

To be determined.

 EFFECTIVE DATE :
This act shall take effect on the sixtieth day after it shall become
law; provided, however, that effective immediately, the addition,
amendment and/or repeal of any rule or regulation necessary for the
implementation of this act on its effective date are authorized and
directed to be made and completed on or before such effective date.