HB-4174, As Passed House, June 20, 2017

SUBSTITUTE FOR

HOUSE BILL NO. 4174

     A bill to amend 1996 PA 193, entitled

"Michigan do-not-resuscitate procedure act,"

by amending sections 2 and 11 (MCL 333.1052 and 333.1061), as

amended by 2013 PA 155, and by adding section 11a.

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

     Sec. 2. As used in this act:

     (a) "Actual notice" includes the physical presentation of an

order, a revocation of an order, or other another written document

authorized under this act from or on behalf of a declarant.

     (b) "Attending physician" means the physician who has primary

responsibility for the treatment and care of a declarant.

     (c) "Declarant" means an individual who has executed a do-not-

resuscitate order on his or her own behalf or on whose behalf a do-

not-resuscitate order has been executed as provided in this act.

     (d) "Delegatee" means an individual to whom a physician has

delegated the authority to perform 1 or more selected acts, tasks,

or functions under section 16215 of the public health code, MCL

333.16215.

     (e) "Do-not-resuscitate identification bracelet" or

"identification bracelet" means a wrist bracelet that meets the

requirements of section 7 and that is worn by a declarant while a

do-not-resuscitate order is in effect.

     (f) "Do-not-resuscitate order" or "order" means a document

executed under this act directing that, if an individual suffers

cessation of both spontaneous respiration and circulation in a

setting outside of a hospital, resuscitation will not be initiated.

     (g) "Emergency medical technician" means that term as defined

in section 20904 of the public health code, MCL 333.20904.

     (h) "Emergency medical technician specialist" means that term

as defined in section 20904 of the public health code, MCL

333.20904.

     (i) "Guardian" means that term as defined in section 1104 of

the estates and protected individuals code, 1998 PA 386, MCL

700.1104.

     (j) "Hospital" means that term as defined in section 20106 of

the public health code, MCL 333.20106.

     (k) "Medical first responder" means that term as defined in

section 20906 of the public health code, MCL 333.20906.

     (l) "Nurse" means an individual licensed or otherwise

authorized to engage in the practice of nursing or practice of

nursing as a licensed practical nurse under part 172 of the public

health code, MCL 333.17201 to 333.17242.

     (m) "Organization" means a company, corporation, firm,

partnership, association, trust, or other business entity or a

governmental agency.

     (n) "Paramedic" means that term as defined in section 20908 of

the public health code, MCL 333.20908.

     (o) "Patient advocate" means an individual designated to make

medical treatment decisions for a patient under sections 5506 to

5515 of the estates and protected individuals code, 1998 PA 386,

MCL 700.5506 to 700.5515.

     (p) "Physician" means an individual licensed or otherwise

authorized to engage in the practice of medicine or the practice of

osteopathic medicine and surgery under article 15 of the public

health code, MCL 333.16101 to 333.18838.

     (q) "Physician's assistant" means an individual who is

licensed as a physician's assistant under part 170 or part 175 of

the public health code, MCL 333.17001 to 333.17084 and 333.17501 to

333.17556.

(r) (q) "Public health code" means the public health code,

1978 PA 368, MCL 333.1101 to 333.25211.

(s) (r) "Vital sign" means a pulse or evidence of respiration.

(t) (s) "Ward" means that term as defined in section 1108 of

the estates and protected individuals code, 1998 PA 386, MCL

700.1108.

Sec. 11. (1) One or more of the following health professionals

who arrive at a declarant's location outside of a hospital shall

determine if the declarant has 1 or more vital signs, whether or

not the health professional views or has actual notice of an order

that is alleged to have been executed by the declarant or other

person authorized to execute an order on the declarant's behalf:

     (a) A paramedic.

     (b) An emergency medical technician.

     (c) An emergency medical technician specialist.

     (d) A physician.

     (e) A nurse.

     (f) A medical first responder.

     (g) A respiratory therapist.

     (h) A physician's assistant.

     (2) If the health professional determines under subsection (1)

that the declarant has no vital signs, and if the health

professional determines that the declarant is wearing a do-not-

resuscitate identification bracelet or has actual notice of a do-

not-resuscitate order for the declarant, he or she subject to

section 11a, the health professional shall not attempt to

resuscitate the declarant.

     Sec. 11a. (1) If a health professional described in section 11

has actual notice of a do-not-resuscitate order and is aware of the

existence of a validly executed POST form under part 56B of the

public health code, MCL 333.5671 to 333.5685, that contains a

medical order regarding the initiation of resuscitation if the

individual suffers cessation of both spontaneous respiration and

circulation, the health professional shall comply with the most

recent order or form.

     (2) As used in this section, "POST form" means that term as

defined in section 5674 of the public health code, MCL 333.5674.

     Enacting section 1. This amendatory act takes effect 90 days

after the date it is enacted into law.

     Enacting section 2. This amendatory act does not take effect

unless House Bill No. 4170 of the 99th Legislature is enacted into

law.