BP BHEAD INT S

AN ACT Relating to the patient self-determination act; and adding a new chapter to Title 70 RCW.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION. Sec. 1. The intent of this chapter is to incorporate requirements of the Patient Self-Determination Act (Omnibus Budget Reconciliation Act of 1990, P.L. 101 through 508, and 42 U.S.C. Sec. 1396a(a) (Supp. 1991) into Washington law and to supplement those requirements in certain respects.

NEW SECTION. Sec. 2. This chapter shall apply to all institutional health care providers in the state of Washington, including but not limited to hospitals, skilled nursing facilities, home health agencies, hospices, and prepaid health care organizations.

NEW SECTION. Sec. 3. Every institutional health care provider must have written policies and procedures applicable to all adults receiving care, that identify and explain the rights of adults to make decisions concerning their medical care, including the right to accept or refuse treatment, and the right to withdraw consent previously given for treatment that is ongoing. Policies must include the right to make advance directives, including either instructional directives or health care durable powers of attorney, or both, that direct health care providers to withhold or withdraw life-sustaining treatment as the document provides. Procedures must describe how policies are implemented.

NEW SECTION. Sec. 4. Every competent adult patient, or if the patient is incompetent then his or her surrogate, identified in RCW 7.70.065, must be given a printed summary of the written policies and procedures of the facility regarding consent for treatment and advance directives described in section 3 of this act. The summary shall be provided at the time of admission to an institutional health care provider facility, or in the case of a prepaid health care organization, at the time of enrolling in the organization, or in the case of a home health provider, including home hospice, before the person comes under the care of the provider. If requested by a patient or surrogate, the provider shall furnish a copy of its full policies and procedures. This section applies to outpatients as well as inpatients.

NEW SECTION. Sec. 5. Every competent adult patient, or if the patient is incompetent then his or her surrogate, identified in RCW 7.70.065, must be given a printed description of rights regarding consent for medical treatment, including refusal of unwanted treatment and advance directives. The description shall be one to be issued by the office of the attorney general within sixty days of enactment of this law and updated as appropriate. A provider may give an additional descriptive statement if it wishes to do so. The description or descriptions shall be provided at the time of admission to an institutional health care provider facility, or in the case of a prepaid health care organization, at the time of enrolling in the organization, or in the case of a home health care provider, including home hospice, before the person comes under the care of the provider. This section applies to outpatients as well as inpatients.

NEW SECTION. Sec. 6. (1) Every competent adult patient, or if the patient is incompetent then his or her surrogate, identified in RCW 7.70.065, must be offered a form of advance directives, including at least the form in RCW 70.122.030 and a form of durable power of attorney for health care decisions, at the time of admission to an institutional health care provider facility, or in the case of a prepaid health care organization, at the time of enrolling in the organization, or in the case of a home health care provider, before the person comes under the care of the provider.

(2) If a patient chooses not to complete an advance directive then the provider must inform the patient of the provisions of RCW 7.70.065 so that the patient will know who will have decision-making authority if the patient becomes incapacitated.

(3) This section applies to outpatients as well as inpatients.

NEW SECTION. Sec. 7. Institutional health care providers must document in each patient's medical record whether or not the patient has executed an advance directive and who has the durable power of attorney for the patient or who is the surrogate decisionmaker under RCW 7.70.065.

NEW SECTION. Sec. 8. Institutional health care providers must conduct appropriate education for their staff concerning patients' rights regarding consent for medical treatment, including advance directives and durable power of attorney.

NEW SECTION. Sec. 9. Sections 1 through 8 of this act shall constitute a new chapter in Title 70 RCW.