tazzygirl
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Here is the section relating to advanced directives... which... is already mandatory for every health care professional, including nurses, to discuss with patients in hospitals.
5 SEC. 1233. ADVANCE CARE PLANNING CONSULTATION.
6 (a) MEDICARE.—
7 (1) IN GENERAL.—Section 1861 of the Social
8 Security Act (42 U.S.C. 1395x) is amended—
9 (A) in subsection (s)(2)—
10 (i) by striking ‘‘and’’ at the end of
11 subparagraph (DD);
12 (ii) by adding ‘‘and’’ at the end of
13 subparagraph (EE); and
14 (iii) by adding at the end the fol15
lowing new subparagraph:
16 ‘‘(FF) advance care planning consultation (as
17 defined in subsection (hhh)(1));’’; and
18 (B) by adding at the end the following new
19 subsection:
20 ‘‘Advance Care Planning Consultation
21 ‘‘(hhh)(1) Subject to paragraphs (3) and (4), the
22 term ‘advance care planning consultation’ means a con
23 sultation between the individual and a practitioner de
24 scribed in paragraph (2) regarding advance care planning,
25 if, subject to paragraph (3), the individual involved has
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•HR 3200 IH
1 not had such a consultation within the last 5 years. Such
2 consultation shall include the following:
3 ‘‘(A) An explanation by the practitioner of ad
4 vance care planning, including key questions and
5 considerations, important steps, and suggested peo
6 ple to talk to.
7 ‘‘(B) An explanation by the practitioner of ad
8 vance directives, including living wills and durable
9 powers of attorney, and their uses.
10 ‘‘(C) An explanation by the practitioner of the
11 role and responsibilities of a health care proxy.
12 ‘‘(D) The provision by the practitioner of a list
13 of national and State-specific resources to assist con
14 sumers and their families with advance care plan
15 ning, including the national toll-free hotline, the ad
16 vance care planning clearinghouses, and State legal
17 service organizations (including those funded
18 through the Older Americans Act of 1965).
19 ‘‘(E) An explanation by the practitioner of the
20 continuum of end-of-life services and supports avail
21 able, including palliative care and hospice, and bene
22 fits for such services and supports that are available
23 under this title.
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•HR 3200 IH
1 ‘‘(F)(i) Subject to clause (ii), an explanation of
2 orders regarding life sustaining treatment or similar
3 orders, which shall include—
4 ‘‘(I) the reasons why the development of
5 such an order is beneficial to the individual and
6 the individual’s family and the reasons why
7 such an order should be updated periodically as
8 the health of the individual changes;
9 ‘‘(II) the information needed for an indi10
vidual or legal surrogate to make informed deci11
sions regarding the completion of such an
12 order; and
13 ‘‘(III) the identification of resources that
14 an individual may use to determine the require15
ments of the State in which such individual re16
sides so that the treatment wishes of that indi17
vidual will be carried out if the individual is un18
able to communicate those wishes, including re19
quirements regarding the designation of a sur20
rogate decisionmaker (also known as a health
21 care proxy).
22 ‘‘(ii) The Secretary shall limit the requirement
23 for explanations under clause (i) to consultations
24 furnished in a State—
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•HR 3200 IH
1 ‘‘(I) in which all legal barriers have been
2 addressed for enabling orders for life sustaining
3 treatment to constitute a set of medical orders
4 respected across all care settings; and
5 ‘‘(II) that has in effect a program for or6
ders for life sustaining treatment described in
7 clause (iii).
8 ‘‘(iii) A program for orders for life sustaining
9 treatment for a States described in this clause is a
10 program that—
11 ‘‘(I) ensures such orders are standardized
12 and uniquely identifiable throughout the State;
13 ‘‘(II) distributes or makes accessible such
14 orders to physicians and other health profes15
sionals that (acting within the scope of the pro16
fessional’s authority under State law) may sign
17 orders for life sustaining treatment;
18 ‘‘(III) provides training for health care
19 professionals across the continuum of care
20 about the goals and use of orders for life sus21
taining treatment; and
22 ‘‘(IV) is guided by a coalition of stake23
holders includes representatives from emergency
24 medical services, emergency department physi25
cians or nurses, state long-term care associa-
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•HR 3200 IH
1 tion, state medical association, state surveyors,
2 agency responsible for senior services, state de3
partment of health, state hospital association,
4 home health association, state bar association,
5 and state hospice association.
6 ‘‘(2) A practitioner described in this paragraph is—
7 ‘‘(A) a physician (as defined in subsection
8 (r)(1)); and
9 ‘‘(B) a nurse practitioner or physician’s assist10
ant who has the authority under State law to sign
11 orders for life sustaining treatments.
12 ‘‘(3)(A) An initial preventive physical examination
13 under subsection (WW), including any related discussion
14 during such examination, shall not be considered an ad15
vance care planning consultation for purposes of applying
16 the 5-year limitation under paragraph (1).
17 ‘‘(B) An advance care planning consultation with re18
spect to an individual may be conducted more frequently
19 than provided under paragraph (1) if there is a significant
20 change in the health condition of the individual, including
21 diagnosis of a chronic, progressive, life-limiting disease, a
22 life-threatening or terminal diagnosis or life-threatening
23 injury, or upon admission to a skilled nursing facility, a
24 long-term care facility (as defined by the Secretary), or
25 a hospice program.
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•HR 3200 IH
1 ‘‘(4) A consultation under this subsection may in2
clude the formulation of an order regarding life sustaining
3 treatment or a similar order.
4 ‘‘(5)(A) For purposes of this section, the term ‘order
5 regarding life sustaining treatment’ means, with respect
6 to an individual, an actionable medical order relating to
7 the treatment of that individual that—
8 ‘‘(i) is signed and dated by a physician (as de9
fined in subsection (r)(1)) or another health care
10 professional (as specified by the Secretary and who
11 is acting within the scope of the professional’s au12
thority under State law in signing such an order, in13
cluding a nurse practitioner or physician assistant)
14 and is in a form that permits it to stay with the in15
dividual and be followed by health care professionals
16 and providers across the continuum of care;
17 ‘‘(ii) effectively communicates the individual’s
18 preferences regarding life sustaining treatment, in19
cluding an indication of the treatment and care de20
sired by the individual;
21 ‘‘(iii) is uniquely identifiable and standardized
22 within a given locality, region, or State (as identified
23 by the Secretary); and
_____________________________
Telling me to take Midol wont help your butthurt.
RIP, my demon-child 5-16-11
Duchess of Dissent 1
Dont judge me because I sin differently than you.
If you want it sugar coated, dont ask me what i think! It would violate TOS.
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Scary facts about health care reform bill - 
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