S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   8536
 
                           I N  A S S E M B L Y
 
                              January 8, 2024
                                ___________
 
 Introduced  by M. of A. GUNTHER -- read once and referred to the Commit-
   tee on Health
 
 AN ACT to amend the public health law and the surrogate's  court  proce-
   dure act, in relation to orders not to resuscitate
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:

   Section 1. The opening paragraph of subdivision 3 of section 2994-b of
 the public health law, as amended by chapter 479 of the laws of 2022, is
 amended to read as follows:
   Prior to seeking or relying upon a health care decision by a surrogate
 for a patient under this article,  if  the  attending  practitioner  has
 reason  to  believe that the patient has a history of receiving services
 for [a] AN  INTELLECTUAL  OR  developmental  disability;  it  reasonably
 appears to the attending practitioner that the patient has [a] AN INTEL-
 LECTUAL  OR  developmental  disability; or the practitioner IN A GENERAL
 HOSPITAL has reason to believe that the  patient  has  been  TEMPORARILY
 transferred  from  a mental hygiene facility operated or licensed by the
 office of mental health OR THE  OFFICE  FOR  PEOPLE  WITH  DEVELOPMENTAL
 DISABILITIES,  then  such  physician,  nurse  practitioner  or physician
 assistant shall make reasonable  efforts  to  determine  whether  [para-
 graphs]  PARAGRAPH (a), (b) or (c) of this subdivision [are] IS applica-
 ble:
   § 2. Paragraph (c) of subdivision 4 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:
   (c) if the patient IS IN A HOSPITAL AS DEFINED IN SUBDIVISION  TEN  OF
 SECTION  1.03 OF THE MENTAL HYGIENE LAW OR was transferred from a mental
 hygiene facility, to the director of the mental hygiene facility and  to
 the mental hygiene legal service under article forty-seven of the mental
 hygiene law.
   §  3.  Section  2994-l of the public health law, as amended by chapter
 708 of the laws of 2019, is amended to read as follows:
   § 2994-l. Interinstitutional transfers. 1. If a patient with an  order
 to  withhold or withdraw life-sustaining treatment is transferred from a
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD05243-02-4
 A. 8536                             2
 
 mental hygiene facility to a hospital or from a hospital to a  different
 hospital, any such order or plan shall remain effective until an attend-
 ing  practitioner  first  examines the transferred patient, whereupon an
 attending practitioner must either:
   [1.] (A) Issue appropriate orders to continue the prior order or plan.
 Such  orders may be issued without obtaining another consent to withhold
 or withdraw life-sustaining treatment pursuant to this article; or
   [2.] (B) Cancel such order, if the attending  practitioner  determines
 that  the order is no longer appropriate or authorized. Before canceling
 the order the attending practitioner shall make  reasonable  efforts  to
 notify  the  person who made the decision to withhold or withdraw treat-
 ment and the hospital staff directly responsible for the patient's  care
 of any such cancellation. If such notice cannot reasonably be made prior
 to  canceling  the  order or plan, the attending practitioner shall make
 such notice as soon as reasonably practicable after cancellation.
   2.  ORDERS TO WITHHOLD OR  WITHDRAW  LIFE-SUSTAINING  TREATMENT  SHALL
 REMAIN  EFFECTIVE  AND NO AFFIRMATIVE ACTION BY A GENERAL HOSPITAL SHALL
 BE REQUIRED PURSUANT TO THIS SECTION  WHERE  A  PATIENT  IS  TRANSFERRED
 WITHIN A GENERAL HOSPITAL BETWEEN A MEDICAL UNIT AND A WARD, WING, UNIT,
 OR  OTHER PART OF THE GENERAL HOSPITAL WHICH IS OPERATED FOR THE PURPOSE
 OF PROVIDING SERVICES FOR PERSONS WITH MENTAL  ILLNESS  PURSUANT  TO  AN
 OPERATING CERTIFICATE ISSUED BY THE COMMISSIONER OF MENTAL HEALTH.
   §  4.  Subdivision  5  of section 2994-cc of the public health law, as
 amended by a chapter of the laws of 2023 amending the public health  law
 relating  to orders not to resuscitate, as proposed in legislative bills
 numbers S. 2930 and A. 4332, is amended to read as follows:
   5. Consent by a patient or a surrogate for a patient in a  RESIDENTIAL
 facility operated or licensed by the office of mental health, OTHER THAN
 A  HOSPITAL  AS DEFINED IN SECTION 1.03 OF THE MENTAL HYGIENE LAW, shall
 be governed by this article. Consent by a patient who is  intellectually
 or  otherwise developmentally disabled and is eligible for life-sustain-
 ing treatment decision pursuant to section seventeen hundred fifty-b  of
 the surrogate's court procedure act shall be governed by that section.
   §  5.  Subparagraph  (i)  of paragraph (b) of subdivision 4 of 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:
   (i) the person who is intellectually disabled has a medical  condition
 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
 FOR  THE  PURPOSE  OF THIS SECTION MEANS AN ILLNESS OR INJURY FROM WHICH
 THERE IS NO RECOVERY, AND WHICH REASONABLY  CAN  BE  EXPECTED  TO  CAUSE
 DEATH WITHIN ONE YEAR; or
   B. permanent unconsciousness; or
   C. a medical condition other than such person's intellectual disabili-
 ty  which  requires life-sustaining treatment, is irreversible and which
 will continue indefinitely; and
   § 6. Paragraph (d) of subdivision 5 of section 1750-b  of  the  surro-
 gate's  court  procedure  act,  as amended by chapter 198 of the laws of
 2016, is amended to read as follows:
   (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]  AN  ETHICS  REVIEW  COMMITTEE,  established  pursuant  to
 A. 8536                             3
 
 section  two  thousand  nine  hundred [seventy-two] NINETY-FOUR-M of the
 public health law or similar entity for mediating disputes in a hospice,
 such as a patient's advocate's office,  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 proceed to judicial review pursuant to this
 subdivision.  The  party requesting mediation shall provide notification
 to those parties entitled to notice pursuant to paragraph  (a)  of  this
 subdivision.
   §  7.  This  act  shall  take  effect on the same date and in the same
 manner as a chapter of the laws of 2023 amending the public  health  law
 relating  to orders not to resuscitate, as proposed in legislative bills
 numbers S.  2930 and A. 4332, takes effect.