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  85S10173 JG-F
 
  By: Bonnen of Galveston H.B. No. 12
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to general procedures and requirements for
  do-not-resuscitate orders.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subchapter A, Chapter 166, Health and Safety
  Code, is amended by adding Section 166.012 to read as follows:
         Sec. 166.012.  GENERAL PROCEDURES AND REQUIREMENTS FOR
  DO-NOT-RESUSCITATE ORDERS. (a) In this section, "DNR order" means
  an order instructing a health care professional not to attempt
  cardiopulmonary resuscitation or other life-sustaining treatment
  on a patient whose circulatory or respiratory function ceases.
         (b)  This section applies to a DNR order used in a health care
  facility, including a hospital or an assisted living facility, or
  in hospice settings, including hospice services provided by a home
  and community support services agency. This section does not apply
  to an out-of-hospital DNR order as defined by Section 166.081.
         (c)  A DNR order issued for a patient is valid only if the
  order:
               (1)  is issued in compliance with:
                     (A)  the written directions of a patient who was
  competent at the time the patient wrote the directions;
                     (B)  the oral directions of a competent patient
  delivered to or observed by two competent adult witnesses, at least
  one of whom must be a person not listed under Section 166.003(2);
                     (C)  the directions in an advance directive
  enforceable under Section 166.005 or executed in accordance with
  Section 166.032, 166.034, or 166.035;
                     (D)  the directions of a patient's legal guardian
  or agent under a medical power of attorney acting in accordance with
  Subchapter D; or
                     (E)  a treatment decision made in accordance with
  Section 166.039; or
               (2)  is not contrary to the directions of a patient who
  was competent at the time the patient conveyed the directions and,
  in the reasonable medical judgment of the patient's attending
  physician:
                     (A)  the patient's death is imminent, regardless
  of the provision of cardiopulmonary resuscitation; and
                     (B)  the DNR order is medically appropriate.
         (d)  If an individual described by Section 166.039(b)(1),
  (2), or (3) arrives at the facility and notifies the facility of the
  individual's arrival after a DNR order is issued under Subsection
  (c)(2), the order must be disclosed to the individual in accordance
  with the priority established under Section 166.039(b).
         (e)  The facility may satisfy the notice requirement under
  Subsection (d) by notifying one person in accordance with the
  priority established under Section 166.039(b). The facility is not
  required to notify additional persons beyond the first person
  notified.
         (f)  A DNR order takes effect at the time the order is issued,
  provided the order is placed in the patient's medical record as soon
  as practicable.
         (g)  On admission to a health care facility or on initial
  provision of hospice services, as applicable, the facility or
  service provider shall provide to the patient or person authorized
  to make treatment decisions on behalf of the patient notice of the
  policies of the facility or service provider regarding the rights
  of the patient and person authorized to make treatment decisions on
  behalf of the patient under this section.
         SECTION 2.  The executive commissioner of the Health and
  Human Services Commission shall adopt rules necessary to implement
  Section 166.012, Health and Safety Code, as added by this Act, as
  soon as practicable after the effective date of this Act.
         SECTION 3.  Section 166.012, Health and Safety Code, as
  added by this Act, applies only to a do-not-resuscitate order
  issued on or after the effective date of this Act.
         SECTION 4.  This Act takes effect April 1, 2018.