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HB 369 2026
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
A bill to be entitled 1
An act relating to patient-directed medical orders; 2
amending s. 765.101, F.S.; revising definitions and 3
defining the term "patient-directed medical order"; 4
amending s. 765.102, F.S.; revising legislative 5
findings and intent; creating s. 765.3041, F.S.; 6
authorizing the execution of a patient-directed 7
medical order for a specified purpose; providing 8
requirements for valid patient-directed medical 9
orders; authorizing the use of telehealth for a 10
specified purpose; requiring that certain health care 11
services be provided to the principal regardless of 12
the decision to withhold or withdraw life-prolonging 13
procedures; authorizing physicians, physician 14
assistants, and advanced practice registered nurses to 15
withhold or withdraw life-prolonging procedures under 16
certain circumstances without penalty; providing 17
construction; amending ss. 395.1041, 400.142, 400.487, 18
400.605, 400.6095, 400.611, 401.35, 401.45, 429.255, 19
429.73, 744.4431, 752.001, 765.110, 765.204, 765.205, 20
and 765.305, F.S.; conforming cross-references and 21
provisions to changes made by the act; requiring the 22
Agency for Health Care Administration to create and 23
update a database for the storage of patient-directed 24
medical orders; providing an effective date. 25
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Be It Enacted by the Legislature of the State of Florida: 27
28
Section 1. Present subsections (15) through (22) of 29
section 765.101, Florida Statutes, are redesignated as 30
subsections (16) through (23), respectively, a new subsection 31
(15) is added to that section, and subsections (1) and (7) of 32
that section are amended, to read: 33
765.101 Definitions.—As used in this chapter: 34
(1) "Advance directive" means a witnessed written document 35
or oral statement in which instructions are given by a principal 36
or in which the principal's desires are expressed concerning any 37
aspect of the principal's health care or health information, and 38
includes, but is not limited to, the designation of a health 39
care surrogate, a living will, or an anatomical gift made 40
pursuant to part V of this chapter. An advance directive may 41
also include a patient-directed medical order. 42
(7) "Health care facility" means a hospital, nursing home, 43
hospice, home health agency, or health maintenance organization 44
licensed in this state; a, or any facility subject to part I of 45
chapter 394; or an assisted living facility or adult family-care 46
home licensed under chapter 429. 47
(15) "Patient-directed medical order" means a medical 48
order created by the principal in collaboration with a 49
physician, a physician assistant, or an advanced practice 50
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registered nurse registered under s. 464.0123 which is portable 51
across health care settings and accessible in a voluntary online 52
registry. 53
Section 2. Subsection (6) of section 765.102, Florida 54
Statutes, is amended to read: 55
765.102 Legislative findings and intent.— 56
(6) For purposes of this chapter: 57
(a) Palliative care is the comprehensive management of the 58
physical, psychological, social, spiritual, and existential 59
needs of patients. Palliative care is especially suited to the 60
care of persons who have incurable or, progressive illnesses. 61
(b) Palliative care may must include: 62
1. An opportunity to discuss and plan for end-of-life 63
care. 64
2. Assurance that physical and mental suffering will be 65
carefully attended to. 66
3. Assurance that preferences for withholding and 67
withdrawing life-sustaining interventions will be honored. 68
4. Assurance that the personal goals of the dying person 69
will be addressed. 70
5. Assurance that the dignity of the dying person will be 71
a priority. 72
6. Assurance that health care providers will not abandon 73
the dying person. 74
7. Assurance that the burden to family and others will be 75
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addressed. 76
8. Assurance that advance directives for care, orders not 77
to resuscitate executed pursuant to s. 401.45, and patient-78
directed medical orders executed pursuant to s. 765.3041 will be 79
respected regardless of the location of care. 80
9. Assurance that organizational mechanisms are in place 81
to evaluate the availability and quality of end-of-life, 82
palliative, and hospice care services, including the evaluation 83
of administrative and regulatory barriers. 84
10. Assurance that necessary health care services will be 85
provided and that relevant reimbursement policies are available. 86
11. Assurance that the goals expressed in subparagraphs 87
1.-10. will be accomplished in a culturally appropriate manner. 88
Section 3. Section 765.3041, Florida Statutes, is created 89
to read: 90
765.3041 Patient-directed medical orders.— 91
(1) To facilitate a principal's instructions concerning 92
treatment preferences, a patient-directed medical order may be 93
executed in advance to direct the actions of health care 94
providers and health care facilities. 95
(2) A valid patient-directed medical order must: 96
(a) Be on a form adopted by rule of the Department of 97
Health and may be combined with an order not to resuscitate 98
executed pursuant to s. 401.45. The form must: 99
1. Address medical interventions to be withheld or 100
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withdrawn when the application of life-prolonging procedures 101
would serve only to prolong artificially the process of dying. 102
2. Be signed by the principal and the principal's 103
physician, physician assistant, or advanced practice registered 104
nurse registered under s. 464.0123. 105
a. If the principal is physically unable to sign the form, 106
the physician, physician assistant, or advanced practice 107
registered nurse present at the discussion as required by 108
subparagraph (b)1. may subscribe the principal's signature in 109
the principal's presence and at the principal's direction. If 110
telehealth is used, the physician, physician assistant, or 111
advanced practice registered nurse may be present at either 112
location where telehealth is being administered. 113
b. If the principal is incapacitated, the form may be 114
signed by the principal's health care surrogate or proxy, court-115
appointed guardian as provided in chapter 744, or attorney in 116
fact under a durable power of attorney as provided in chapter 117
709. The court-appointed guardian or attorney in fact must be 118
delegated authority to make health care decisions on behalf of 119
the principal. 120
c. All signatures may be electronic signatures. 121
(b) Clearly express the principal's preferences and 122
instructions for care, which may include all treatments 123
available, modified treatments that are not prolonged or 124
burdensome, or comfort measures that do not pursue or continue 125
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interventions. 126
1. The principal and a physician, a physician assistant, 127
or an advanced practice registered nurse registered under s. 128
464.0123 must discuss the principal's medical treatment wishes 129
relating to medical interventions to be withheld or withdrawn 130
based on the principal's values and preferences in the event the 131
principal becomes unable to make her or his own decisions. 132
2. The discussion must be in person and may be conducted 133
using telehealth. 134
(3) Regardless of the decision to withhold or withdraw 135
life-prolonging procedures, necessary health care services must 136
be provided for the care and comfort of the principal or to 137
alleviate pain. 138
(4) A physician, a physician assistant, or an advanced 139
practice registered nurse registered under s. 464.0123 may 140
withhold or withdraw cardiopulmonary resuscitation or other 141
life-prolonging procedures if presented with an order not to 142
resuscitate executed pursuant to s. 401.45 or a patient-directed 143
medical order executed pursuant to this section which contains 144
an order not to resuscitate or an order to withhold or withdraw 145
life-prolonging procedures. A physician, a physician assistant, 146
or an advanced practice registered nurse registered under s. 147
464.0123 is not subject to any disciplinary action under s. 148
456.072 or criminal prosecution or civil liability, or 149
considered to have engaged in negligent or unprofessional 150
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conduct, for withholding or withdrawing cardiopulmonary 151
resuscitation or other life-prolonging procedures pursuant to 152
such orders. The absence of an order not to resuscitate executed 153
pursuant to s. 401.45 or a patient-directed medical order 154
executed pursuant to this section does not preclude a physician, 155
a physician assistant, or an advanced practice registered nurse 156
registered under s. 464.0123 from withholding or withdrawing 157
cardiopulmonary resuscitation or other life-prolonging 158
procedures as otherwise authorized by law. 159
Section 4. Paragraph (l) of subsection (3) of section 160
395.1041, Florida Statutes, is amended to read: 161
395.1041 Access to and ensurance of emergency services; 162
transfers; patient rights; diversion programs; reports of 163
controlled substance overdoses.— 164
(3) EMERGENCY SERVICES; DISCRIMINATION; LIABILITY OF 165
FACILITY OR HEALTH CARE PERSONNEL.— 166
(l) Hospital personnel may withhold or withdraw 167
cardiopulmonary resuscitation or other life-prolonging 168
procedures if presented with an order not to resuscitate 169
executed pursuant to s. 401.45 or a patient-directed medical 170
order executed pursuant to s. 765.3041 which contains an order 171
not to resuscitate or an order to withhold or withdraw life-172
prolonging procedures. Facility staff and facilities are shall 173
not be subject to criminal prosecution or civil liability, or 174
nor be considered to have engaged in negligent or unprofessional 175
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conduct, for withholding or withdrawing cardiopulmonary 176
resuscitation or other life-prolonging procedures pursuant to 177
such orders an order. The absence of an order not to resuscitate 178
executed pursuant to s. 401.45 or a patient-directed medical 179
order executed pursuant to s. 765.3041 does not preclude a 180
physician from withholding or withdrawing cardiopulmonary 181
resuscitation or other life-prolonging procedures as otherwise 182
authorized permitted by law. 183
Section 5. Subsection (3) of section 400.142, Florida 184
Statutes, is amended to read: 185
400.142 Emergency medication kits; orders not to 186
resuscitate and patient-directed medical orders.— 187
(3) Facility staff may withhold or withdraw 188
cardiopulmonary resuscitation or other life-prolonging 189
procedures if presented with an order not to resuscitate 190
executed pursuant to s. 401.45 or a patient-directed medical 191
order executed pursuant to s. 765.3041 which contains an order 192
not to resuscitate or an order to withhold or withdraw life-193
prolonging procedures. Facility staff and facilities are not 194
subject to criminal prosecution or civil liability, or 195
considered to have engaged in negligent or unprofessional 196
conduct, for withholding or withdrawing cardiopulmonary 197
resuscitation or other life-prolonging procedures pursuant to 198
such orders order. The absence of an order not to resuscitate 199
executed pursuant to s. 401.45 or a patient-directed medical 200
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order executed pursuant to s. 765.3041 does not preclude a 201
physician from withholding or withdrawing cardiopulmonary 202
resuscitation or other life-prolonging procedures as otherwise 203
authorized permitted by law. 204
Section 6. Subsection (7) of section 400.487, Florida 205
Statutes, is amended to read: 206
400.487 Home health service agreements; physician's, 207
physician assistant's, and advanced practice registered nurse's 208
treatment orders; patient assessment; establishment and review 209
of plan of care; provision of services; orders not to 210
resuscitate and patient-directed medical orders.— 211
(7) Home health agency personnel may withhold or withdraw 212
cardiopulmonary resuscitation or other life-prolonging 213
procedures if presented with an order not to resuscitate 214
executed pursuant to s. 401.45 or a patient-directed medical 215
order executed pursuant to s. 765.3041 which contains an order 216
not to resuscitate or an order to withhold or withdraw life-217
prolonging procedures. The agency shall adopt rules providing 218
for the implementation of such orders. Home health personnel and 219
agencies are shall not be subject to criminal prosecution or 220
civil liability, or nor be considered to have engaged in 221
negligent or unprofessional conduct, for withholding or 222
withdrawing cardiopulmonary resuscitation or other life-223
prolonging procedures pursuant to such orders an order and rules 224
adopted by the agency. The absence of an order not to 225
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resuscitate executed pursuant to s. 401.45 or a patient-directed 226
medical order executed pursuant to s. 765.3041 does not preclude 227
a physician from withholding or withdrawing cardiopulmonary 228
resuscitation or other life-prolonging procedures as otherwise 229
authorized by law. 230
Section 7. Paragraph (e) of subsection (1) of section 231
400.605, Florida Statutes, is amended to read: 232
400.605 Administration; forms; fees; rules; inspections; 233
fines.— 234
(1) The agency shall by rule establish minimum standards 235
and procedures for a hospice pursuant to this part. The rules 236
must include: 237
(e) Procedures relating to the implementation of advance 238
advanced directives, patient-directed medical orders executed 239
pursuant to s. 765.3041, and do-not-resuscitate orders not to 240
resuscitate executed pursuant to s. 401.45. 241
Section 8. Subsection (8) of section 400.6095, Florida 242
Statutes, is amended to read: 243
400.6095 Patient admission; assessment; plan of care; 244
discharge; death.— 245
(8) The hospice care team may withhold or withdraw 246
cardiopulmonary resuscitation or other life-prolonging 247
procedures if presented with an order not to resuscitate 248
executed pursuant to s. 401.45 or a patient-directed medical 249
order executed pursuant to s. 765.3041 which contains an order 250
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not to resuscitate or an order to withhold or withdraw life-251
prolonging procedures. The agency shall adopt rules providing 252
for the implementation of such orders. Hospice staff are shall 253
not be subject to criminal prosecution or civil liability, or 254
nor be considered to have engaged in negligent or unprofessional 255
conduct, for withholding or withdrawing cardiopulmonary 256
resuscitation or other life-prolonging procedures pursuant to 257
such orders an order and applicable rules. The absence of an 258
order not to resuscitate executed pursuant to s. 401.45 or a 259
patient-directed medical order executed pursuant to s. 765.3041 260
does not preclude a physician from withholding or withdrawing 261
cardiopulmonary resuscitation or other life-prolonging 262
procedures as otherwise authorized permitted by law. 263
Section 9. Paragraph (b) of subsection (4) of section 264
400.611, Florida Statutes, is amended to read: 265
400.611 Interdisciplinary records of care; 266
confidentiality; release of records.— 267
(4) A hospice may not release a patient's 268
interdisciplinary record or any portion thereof, unless the 269
person requesting the information provides to the hospice: 270
(b) In the case of an incapacitated patient, a patient 271
authorization executed before prior to the patient's death by 272
the patient's then acting legal guardian, health care surrogate 273
as defined in s. 765.101 s. 765.101(21), health care proxy as 274
defined in s. 765.101 s. 765.101(19), or agent under power of 275
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attorney; 276
Section 10. Subsection (4) of section 401.35, Florida 277
Statutes, is amended to read: 278
401.35 Rules.—The department shall adopt rules, including 279
definitions of terms, necessary to carry out the purposes of 280
this part. 281
(4) The rules must establish circumstances and procedures 282
under which emergency medical technicians and paramedics may 283
honor orders not to resuscitate executed pursuant to s. 401.45 284
or patient-directed medical orders executed pursuant to s. 285
765.3041 which contain an order not to resuscitate or an order 286
to withhold or withdraw life-prolonging procedures by the 287
patient's physician, physician assistant, or advanced practice 288
registered nurse registered under s. 464.0123 not to resuscitate 289
and the documentation and reporting requirements for handling 290
such orders requests. 291
Section 11. Paragraphs (a) and (b) of subsection (3) of 292
section 401.45, Florida Statutes, are amended to read: 293
401.45 Denial of emergency treatment; civil liability.— 294
(3)(a) Resuscitation may be withheld or withdrawn from a 295
patient by An emergency medical technician or paramedic may 296
withhold or withdraw cardiopulmonary resuscitation or other 297
life-prolonging procedures if presented with evidence of an 298
order not to resuscitate executed pursuant to this subsection or 299
a patient-directed medical order executed pursuant to s. 300
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765.3041 which contains an order not to resuscitate or an order 301
to withhold or withdraw life-prolonging procedures by the 302
patient's physician or physician assistant is presented to the 303
emergency medical technician or paramedic. An order not to 304
resuscitate executed pursuant to this subsection or a patient-305
directed medical order executed pursuant to s. 765.3041 which 306
contains an order not to resuscitate or an order to withhold or 307
withdraw life-prolonging procedures, to be valid, must be on the 308
form adopted by rule of the department. The form must be signed 309
by the patient's physician, or physician assistant, or advanced 310
practice registered nurse registered under s. 464.0123 and by 311
the patient or, if the patient is incapacitated, the patient's 312
health care surrogate or proxy as provided in chapter 765, 313
court-appointed guardian as provided in chapter 744, or attorney 314
in fact under a durable power of attorney as provided in chapter 315
709. The court-appointed guardian or attorney in fact must have 316
been delegated authority to make health care decisions on behalf 317
of the patient. 318
(b) Any licensee, physician, medical director, or 319
emergency medical technician or paramedic who acts under the 320
direction of a medical director is not subject to criminal 321
prosecution or civil liability, and has not engaged in negligent 322
or unprofessional conduct, as a result of the withholding or 323
withdrawal of cardiopulmonary resuscitation or other life-324
prolonging procedures from a patient pursuant to this subsection 325
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and rules adopted by the department. 326
Section 12. Subsection (4) of section 429.255, Florida 327
Statutes, is amended to read: 328
429.255 Use of personnel; emergency care.— 329
(4) Facility staff may withhold or withdraw 330
cardiopulmonary resuscitation, or the use of an automated 331
external defibrillator, or other life-prolonging procedures if 332
presented with an order not to resuscitate executed pursuant to 333
s. 401.45 or a patient-directed medical order executed pursuant 334
to s. 765.3041 which contains an order not to resuscitate or an 335
order to withhold or withdraw life-prolonging procedures. The 336
agency shall adopt rules providing for the implementation of 337
such orders. Facility staff and facilities are may not be 338
subject to criminal prosecution or civil liability, or nor be 339
considered to have engaged in negligent or unprofessional 340
conduct, for withholding or withdrawing cardiopulmonary 341
resuscitation, the or use of an automated external 342
defibrillator, or other life-prolonging procedures pursuant to 343
such orders an order and rules adopted by the agency. The 344
absence of an order not to resuscitate executed pursuant to s. 345
401.45 or a patient-directed medical order executed pursuant to 346
s. 765.3041 does not preclude a physician from withholding or 347
withdrawing cardiopulmonary resuscitation, the or use of an 348
automated external defibrillator, or other life-prolonging 349
procedures as otherwise authorized permitted by law. 350
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Section 13. Subsection (3) of section 429.73, Florida 351
Statutes, is amended to read: 352
429.73 Rules and standards relating to adult family-care 353
homes.— 354
(3) The agency shall adopt rules providing for the 355
implementation of orders not to resuscitate and patient-directed 356
medical orders. The provider may withhold or withdraw 357
cardiopulmonary resuscitation or other life-prolonging 358
procedures if presented with an order not to resuscitate 359
executed pursuant to s. 401.45 or a patient-directed medical 360
order executed pursuant to s. 765.3041 which contains an order 361
not to resuscitate or an order to withhold or withdraw life-362
prolonging procedures. The provider is shall not be subject to 363
criminal prosecution or civil liability, or nor be considered to 364
have engaged in negligent or unprofessional conduct, for 365
withholding or withdrawing cardiopulmonary resuscitation or 366
other life-prolonging procedures pursuant to such orders an 367
order and applicable rules. The absence of an order not to 368
resuscitate executed pursuant to s. 401.45 or a patient-directed 369
medical order executed pursuant to s. 765.3041 does not preclude 370
a physician from withholding or withdrawing cardiopulmonary 371
resuscitation or other life-prolonging procedures as otherwise 372
authorized by law. 373
Section 14. Subsections (1), (7), and (8) of section 374
744.4431, Florida Statutes, are amended to read: 375
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744.4431 Guardianship power regarding life-prolonging 376
procedures.— 377
(1) Except as provided in this section, decisions by a 378
professional guardian, as defined in s. 744.102, to withhold or 379
withdraw life-prolonging procedures from, or to execute an order 380
not to resuscitate pursuant to s. 401.45 or a patient-directed 381
medical order pursuant to s. 765.3041 which contains an order 382
not to resuscitate or an order to withhold or withdraw life-383
prolonging procedures for, a ward must be approved by the court. 384
A professional guardian appointed to act on behalf of a ward's 385
person must petition the court pursuant to the Florida Probate 386
Rules for authority to consent to withhold or withdraw life-387
prolonging procedures or to execute an order not to resuscitate 388
pursuant to s. 401.45 or a patient-directed medical order 389
pursuant to s. 765.3041. Court approval must be obtained before 390
taking such action, except as provided in subsection (7). 391
(7) Court approval is not required for the following 392
decisions: 393
(a) A decision to withhold or withdraw life-prolonging 394
procedures made by a professional guardian to whom authority has 395
been granted by the court under s. 744.3115 to carry out the 396
instructions in or to take actions consistent with the ward's 397
advance directive, order not to resuscitate executed pursuant to 398
s. 401.45, or patient-directed medical order executed pursuant 399
to s. 765.3041 which contains an order not to resuscitate or an 400
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order to withhold or withdraw life-prolonging procedures, as 401
long as there are no known objections from the ward; the ward's 402
attorney; the ward's next of kin, if known; and any other 403
interested persons as the court may direct based on s. 404
765.105(1). 405
(b) A decision by a professional guardian who has been 406
delegated health care decisionmaking authority to execute an 407
order not to resuscitate pursuant to s. 401.45 or a patient-408
directed medical order pursuant to s. 765.3041, as described in 409
s. 401.45(3)(a), if the ward is in a hospital and the following 410
conditions are met: 411
1. The ward's primary treating physician and at least one 412
other consulting physician document in the ward's medical record 413
that: 414
a. There is no reasonable medical probability for recovery 415
from or a cure of the ward's underlying medical condition; 416
b. The ward is in an end-stage condition, a terminal 417
condition, or a persistent vegetative state as those terms are 418
defined in s. 765.101, and that the ward's death is imminent; 419
and 420
c. Resuscitation will cause the ward physical harm or 421
additional pain. 422
2. The professional guardian has notified the ward's next 423
of kin, if known, and any interested persons as the court may 424
direct and the decision is not contrary to the ward's expressed 425
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wishes and there are no known objections from the ward; the 426
ward's attorney; the ward's next of kin, if known; or any other 427
interested persons as the court may direct on the basis of s. 428
765.105(1). 429
(8) Within 2 business days after executing an order not to 430
resuscitate pursuant to s. 401.45 or a patient-directed medical 431
order pursuant to s. 765.3041 which contains an order not to 432
resuscitate or an order to withhold or withdraw life-prolonging 433
procedures under paragraph (7)(b), a professional guardian must 434
notify the court in writing of all of the following: 435
(a) The date the order not to resuscitate or patient-436
directed medical order was executed. 437
(b) The location of the ward when the order not to 438
resuscitate or patient-directed medical order was executed. 439
(c) The names of the physicians who documented the ward's 440
condition in the ward's medical record. 441
Section 15. Subsection (3) of section 752.001, Florida 442
Statutes, is amended to read: 443
752.001 Definitions.—As used in this chapter, the term: 444
(3) "Persistent vegetative state" has the same meaning as 445
provided in s. 765.101 s. 765.101(15). 446
Section 16. Subsections (1) and (4) of section 765.110, 447
Florida Statutes, are amended to read: 448
765.110 Health care facilities and providers; discipline.— 449
(1) A health care facility, pursuant to Pub. L. No. 101-450
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508, ss. 4206 and 4751, shall provide to each patient written 451
information concerning the individual's rights concerning 452
advance directives, orders not to resuscitate executed pursuant 453
to s. 401.45, or patient-directed medical orders executed 454
pursuant to s. 765.3041 which contain an order not to 455
resuscitate or an order to withhold or withdraw life-prolonging 456
procedures and the health care facility's policies respecting 457
the implementation of such rights, and shall document in the 458
patient's medical records whether or not the individual has 459
executed an advance directive, an order not to resuscitate 460
pursuant to s. 401.45, or a patient-directed medical order 461
pursuant to s. 765.3041 which contains an order not to 462
resuscitate or an order to withhold or withdraw life-prolonging 463
procedures. 464
(4) The Department of Health, in consultation with the 465
Department of Elderly Affairs, for health care providers; the 466
Agency for Health Care Administration for hospitals, hospices, 467
nursing homes, home health agencies, assisted living facilities, 468
adult family-care homes, and health maintenance organizations; 469
and the Department of Children and Families for facilities 470
subject to part I of chapter 394 shall adopt rules to implement 471
this section. 472
Section 17. Subsection (3) of section 765.204, Florida 473
Statutes, is amended to read: 474
765.204 Capacity of principal; procedure.— 475
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(3) The surrogate's authority commences either upon a 476
determination under subsection (2) that the principal lacks 477
capacity or upon a stipulation of such authority pursuant to s. 478
765.101 s. 765.101(21). Such authority remains in effect until a 479
determination that the principal has regained such capacity, if 480
the authority commenced as a result of incapacity, or until the 481
authority is revoked, if the authority commenced immediately 482
pursuant to s. 765.101 s. 765.101(21). Upon commencement of the 483
surrogate's authority, a surrogate who is not the principal's 484
spouse shall notify the principal's spouse or adult children of 485
the principal's designation of the surrogate. Except if the 486
principal provided immediately exercisable authority to the 487
surrogate pursuant to s. 765.101 s. 765.101(21), in the event 488
that the primary or attending physician determines that the 489
principal has regained capacity, the authority of the surrogate 490
shall cease, but recommences if the principal subsequently loses 491
capacity as determined pursuant to this section. A health care 492
provider is not liable for relying upon health care decisions 493
made by a surrogate while the principal lacks capacity. At any 494
time when a principal lacks capacity, a health care decision 495
made on the principal's behalf by a surrogate is effective to 496
the same extent as a decision made by the principal. If a 497
principal possesses capacity, health care decisions of the 498
principal take precedence over decisions made by the surrogate 499
that present a material conflict. 500
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Section 18. Paragraph (c) of subsection (1) of section 501
765.205, Florida Statutes, is amended to read: 502
765.205 Responsibility of the surrogate.— 503
(1) The surrogate, in accordance with the principal's 504
instructions, unless such authority has been expressly limited 505
by the principal, shall: 506
(c) Provide written consent using an appropriate form 507
whenever consent is required, including the execution of an a 508
physician's order not to resuscitate pursuant to s. 401.45 or a 509
patient-directed medical order pursuant to s. 765.3041 which 510
contains an order not to resuscitate or an order to withhold or 511
withdraw life-prolonging procedures. 512
Section 19. Subsection (2) of section 765.305, Florida 513
Statutes, is amended to read: 514
765.305 Procedure in absence of a living will.— 515
(2) Before exercising the incompetent patient's right to 516
forego treatment, including the execution of an order not to 517
resuscitate pursuant to s. 401.45 or a patient-directed medical 518
order pursuant to s. 765.3041 which contains an order not to 519
resuscitate or an order to withhold or withdraw life-prolonging 520
procedures, the surrogate must be satisfied that: 521
(a) The patient does not have a reasonable medical 522
probability of recovering capacity so that the right could be 523
exercised by the patient. 524
(b) The patient has an end-stage condition, the patient is 525
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in a persistent vegetative state, or the patient's physical 526
condition is terminal. 527
Section 20. The Agency for Health Care Administration 528
shall create and update a database for the storage of patient-529
directed medical orders, which shall be stored solely at the 530
option of the patient in electronic form by the agency. 531
Section 21. This act shall take effect July 1, 2026. 532