87R576 SCL-D

By: Raymond H.B. No. 936

A BILL TO BE ENTITLED

AN ACT

relating to certain advance directives.

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 Sections 166.012 and 166.013 to read as follows:

Sec. 166.012. PRESUMPTION OF VALIDITY; LIMITATION OF LIABILITY. (a) In the absence of actual knowledge to the contrary, a physician, health care provider or residential care provider as those terms are defined by Section 166.151, or person acting as an agent for or under the physician's or provider's control may presume that an advance directive is valid under this chapter and has been validly executed by a person authorized to execute the advance directive.

(b) The physician, health care provider, residential care provider, or other person described by Subsection (a) is not civilly or criminally liable or subject to review or disciplinary action by the appropriate licensing authority for following an advance directive or instructions of an advance directive that the physician, provider, or person presumes is valid under this chapter.

Sec. 166.013. DESIGNATED WRITTEN DIRECTIVE OR MEDICAL POWER OF ATTORNEY. (a) The executive commissioner shall review and designate documents meeting the requirements of this section to be recognized in this state as a valid form for a written directive or medical power of attorney.

(b) A document designated under this section must:

(1) be promulgated by a state or national nonprofit organization or association;

(2) be written in plain language;

(3) include a field for:

(A) a declarant's name; and

(B) the date the document is executed;

(4) for a document to be used as a written directive, allow a declarant to provide health care instructions;

(5) for a document to be used to appoint an agent under a medical power of attorney:

(A) allow a declarant to appoint an agent;

(B) allow a declarant to specify or limit the health care decisions an agent may make for the declarant;

(C) meet the requirements of Subchapter D other than Section 166.164, including execution in accordance with Section 166.154; and

(D) prohibit the appointment of two or more agents with concurrent authority to make a health care decision on behalf of the same declarant; and

(6) require the declarant to:

(A) sign and date the document in the presence of two witnesses who qualify under Section 166.003, at least one of whom qualifies under Section 166.003(2); or

(B) sign the document and have the signature acknowledged before a notary public.

(c) On designating a document in accordance with this section, the executive commissioner shall:

(1) place in a conspicuous manner on the first page of the document the commission's logo or similar acknowledgment evidencing the document is designated as a valid form of a written directive or medical power of attorney; and

(2) post on the commission's Internet website a link to the document.

(d) The commission shall post on the commission's Internet website instructions for a state or national nonprofit organization or association to submit a document to be considered under this section. The executive commissioner shall complete a review of the document not later than six months after the date the document is submitted.

SECTION 2. Section 166.031(1), Health and Safety Code, is amended to read as follows:

(1) "Directive" means an instruction made under Section 166.032, 166.034, or 166.035 to administer, withhold, or withdraw life-sustaining treatment in the event of a terminal or irreversible condition. The term includes an instruction made in a document designated as a valid form of written directive under Section 166.013 and executed as provided by this subchapter.

SECTION 3. Section 166.032(c), Health and Safety Code, is amended to read as follows:

(c) A declarant may include in a directive directions other than those provided in a document designated as a valid form of written directive under Section 166.013 or the form prescribed by Section 166.033 and may designate in a directive a person to make a health care or treatment decision for the declarant in the event the declarant becomes incompetent or otherwise mentally or physically incapable of communication.

SECTION 4. Subchapter B, Chapter 166, Health and Safety Code, is amended by adding Sections 166.0325 and 166.0335 to read as follows:

Sec. 166.0325. PERMISSIBLE FORMS OF WRITTEN DIRECTIVE. A written directive may be:

(1) in a document designated as a valid form of written directive under Section 166.013;

(2) in a form that complies with Section 166.033; or

(3) in another form that satisfies the requirements of this chapter.

Sec. 166.0335. DIRECTIONS RELATING TO CARE OTHER THAN LIFE-SUSTAINING TREATMENT. (a) A declarant may include in a written directive instructions regarding personal, spiritual, or emotional care or additional care other than instructions to administer, withhold, or withdraw life-sustaining treatment.

(b) The instructions of a written directive described by Subsection (a) do not impose a duty, requirement, or obligation on a physician, health care provider or residential care provider as those terms are defined by Section 166.151, or person acting as an agent for or under the physician's or provider's control to comply with the instructions, but the physician, provider, or other person may make reasonable accommodations for the instructions.

SECTION 5. Section 166.036(a), Health and Safety Code, is amended to read as follows:

(a) Except as provided by Section 166.032(b-1) or 166.013(b)(6)(B), a written directive executed under Section 166.032 [166.033] or 166.035 is effective without regard to whether the document has been notarized.

SECTION 6. Section 166.102(b), Health and Safety Code, is amended to read as follows:

(b) When responding to a call for assistance, emergency medical services personnel:

(1) shall honor only a properly executed or issued out-of-hospital DNR order or prescribed DNR identification device in accordance with this subchapter; and

(2) have no duty to review, examine, interpret, or honor a person's other written directive, including a written directive in a document designated under Section 166.013 or the form prescribed by Section 166.033.

SECTION 7. Subchapter D, Chapter 166, Health and Safety Code, is amended by adding Section 166.163 to read as follows:

Sec. 166.163. PERMISSIBLE FORMS OF MEDICAL POWER OF ATTORNEY. Notwithstanding Section 166.164, a medical power of attorney may only be in a form:

(1) designated by the executive commissioner as a valid form for a medical power of attorney under Section 166.013; or

(2) substantially in compliance with the form prescribed by Section 166.164.

SECTION 8. As soon as practicable after the effective date of this Act, the executive commissioner of the Health and Human Services Commission shall develop and post on the commission's Internet website instructions for a state or national nonprofit organization or association to submit to the commission a document for consideration as a valid form for a written directive or medical power of attorney under Section 166.013, Health and Safety Code, as added by this Act.

SECTION 9. This Act takes effect September 1, 2021.