Effective - 28 Aug 2007
190.600. Citation of act — definitions. — 1. Sections 190.600 to 190.621 shall be known and may be cited as the "Outside the Hospital Do-Not-Resuscitate Act".
2. As used in sections 190.600 to 190.621, unless the context clearly requires otherwise, the following terms shall mean:
(1) "Attending physician":
(a) A physician licensed under chapter 334 selected by or assigned to a patient who has primary responsibility for treatment and care of the patient; or
(b) If more than one physician shares responsibility for the treatment and care of a patient, one such physician who has been designated the attending physician by the patient or the patient's representative shall serve as the attending physician;
(2) "Cardiopulmonary resuscitation" or "CPR", emergency medical treatment administered to a patient in the event of the patient's cardiac or respiratory arrest, and shall include cardiac compression, endotracheal intubation and other advanced airway management, artificial ventilation, defibrillation, administration of cardiac resuscitation medications, and related procedures;
(3) "Department", the department of health and senior services;
(4) "Emergency medical services personnel", paid or volunteer firefighters, law enforcement officers, first responders, emergency medical technicians, or other emergency service personnel acting within the ordinary course and scope of their professions, but excluding physicians;
(5) "Health care facility", any institution, building, or agency or portion thereof, private or public, excluding federal facilities and hospitals, whether organized for profit or not, used, operated, or designed to provide health services, medical treatment, or nursing, rehabilitative, or preventive care to any person or persons. Health care facility includes but is not limited to ambulatory surgical facilities, health maintenance organizations, home health agencies, hospices, infirmaries, renal dialysis centers, long-term care facilities licensed under sections 198.003 to 198.186, medical assistance facilities, mental health centers, outpatient facilities, public health centers, rehabilitation facilities, and residential treatment facilities;
(6) "Hospital", a place devoted primarily to the maintenance and operation of facilities for the diagnosis, treatment, or care for not less than twenty-four consecutive hours in any week of three or more nonrelated individuals suffering from illness, disease, injury, deformity, or other abnormal physical conditions; or a place devoted primarily to provide for not less than twenty-four consecutive hours in any week medical or nursing care for three or more nonrelated individuals. Hospital does not include any long-term care facility licensed under sections 198.003 to 198.186;
(7) "Outside the hospital do-not-resuscitate identification" or "outside the hospital DNR identification", a standardized identification card, bracelet, or necklace of a single color, form, and design as described by rule of the department that signifies that the patient's attending physician has issued an outside the hospital do-not-resuscitate order for the patient and has documented the grounds for the order in the patient's medical file;
(8) "Outside the hospital do-not-resuscitate order" or "outside the hospital DNR order", a written physician's order signed by the patient and the attending physician, or the patient's representative and the attending physician, in a form promulgated by rule of the department which authorizes emergency medical services personnel to withhold or withdraw cardiopulmonary resuscitation from the patient in the event of cardiac or respiratory arrest;
(9) "Outside the hospital do-not-resuscitate protocol" or "outside the hospital DNR protocol", a standardized method or procedure promulgated by rule of the department for the withholding or withdrawal of cardiopulmonary resuscitation by emergency medical services personnel from a patient in the event of cardiac or respiratory arrest;
(10) "Patient", a person eighteen years of age or older who is not incapacitated, as defined in section 475.010, and who is otherwise competent to give informed consent to an outside the hospital do-not-resuscitate order at the time such order is issued, and who, with his or her attending physician, has executed an outside the hospital do-not-resuscitate order under sections 190.600 to 190.621. A person who has a patient's representative shall also be a patient for the purposes of sections 190.600 to 190.621, if the person or the person's patient's representative has executed an outside the hospital do-not-resuscitate order under sections 190.600 to 190.621;
(11) "Patient's representative":
(a) An attorney in fact designated in a durable power of attorney for health care for a patient determined to be incapacitated under sections 404.800 to 404.872; or
(b) A guardian or limited guardian appointed under chapter 475 to have responsibility for an incapacitated patient.
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(L. 2007 H.B. 182)
Structure Missouri Revised Statutes
Title XII - Public Health and Welfare
Chapter 190 - Emergency Services
Section 190.020 - Public hearing, notice — costs, how paid.
Section 190.025 - Petitions — consolidation, when — amended, how.
Section 190.030 - Sufficiency of petition, county commission to determine.
Section 190.035 - Notice of election, contents.
Section 190.040 - Form of ballot — effect of passage on tax rate — fund created — refunds, when.
Section 190.041 - Tax levy for central dispatching service, when, amount — funds kept separate.
Section 190.043 - Increase in tax rate without voter approval, when, amount.
Section 190.045 - Returns of election, where filed — effect of.
Section 190.051 - Change in number of board members, when — ballot language.
Section 190.052 - Board member must live in his district — vacancies, how filled.
Section 190.053 - Educational training required for board of directors — failure to attend.
Section 190.056 - Recall of directors, procedure.
Section 190.060 - Powers of district.
Section 190.065 - Bonds, issuance of — election, form of ballot.
Section 190.070 - Annexation, petition for — hearing — election, form of ballot.
Section 190.074 - Collection of taxes — levy — procedure.
Section 190.075 - Records, what and how kept.
Section 190.080 - Donated property — title, how taken.
Section 190.085 - Failure to approve bonds, effect of — dissolution — funds, how rebated.
Section 190.094 - Minimum ambulance staffing — volunteer defined.
Section 190.100 - Definitions.
Section 190.102 - Regional EMS advisory committees.
Section 190.104 - Pediatric emergency medical services system.
Section 190.107 - Contracts for mutual aid services.
Section 190.108 - Air ambulance licenses — sale or transfer of ownership, notice required.
Section 190.109 - Ground ambulance license.
Section 190.111 - Inspection limitation — effect of sale or transfer on a license.
Section 190.120 - Insurance, what coverage required — policy provisions required — term of policy.
Section 190.131 - Certification of training entities.
Section 190.133 - Emergency medical response agency license.
Section 190.134 - Dispatch agency, requirements.
Section 190.142 - Emergency medical technician license — rules.
Section 190.144 - Immunity from liability, when.
Section 190.146 - Lapse of license, request to return to active status, procedure.
Section 190.160 - Renewals of licenses, requirements.
Section 190.165 - Suspension or revocation of licenses, grounds for — procedure.
Section 190.171 - Aggrieved party may seek review by administrative hearing commission.
Section 190.173 - Confidentiality of information.
Section 190.175 - Records to be maintained by licensee.
Section 190.176 - Data collection system.
Section 190.180 - Penalty for violation.
Section 190.185 - Rules and regulations, department to adopt — procedure.
Section 190.190 - Time to comply granted existing equipment and personnel.
Section 190.200 - Public information and education.
Section 190.205 - Insurers' duties.
Section 190.243 - Transportation to trauma, STEMI, or stroke centers or hospitals, how authorized.
Section 190.248 - Investigations of allegations of violations, completed when — access to records.
Section 190.255 - Naloxone, first responder may administer, when — definition.
Section 190.265 - Helipads, hospitals not required to have fencing or barriers.
Section 190.270 - Citation of law.
Section 190.275 - Definitions.
Section 190.286 - Inapplicability to certain out-of-state businesses.
Section 190.290 - Definitions.
Section 190.300 - Definitions.
Section 190.306 - Dissolution of emergency telephone service not required, when (Christian County).
Section 190.315 - Contract for service authorized.
Section 190.320 - Election — ballot form.
Section 190.328 - Election of board, Christian and Scott counties, when — terms.
Section 190.329 - Election of board, exceptions, when — terms.
Section 190.334 - Performance and fiscal audits authorized.
Section 190.336 - Recall, board members subject to — procedure.
Section 190.340 - Emergency services board, officers duties, rules and regulations.
Section 190.355 - Use of existing resources required.
Section 190.400 - Definitions — interoperability service agreements, what agencies.
Section 190.420 - Fund established.
Section 190.470 - Alternate consolidation — petition, election — board appointed, requirements.
Section 190.475 - Centralized database to be maintained, updates.
Section 190.500 - Temporary license — qualified health care professions — declared emergency.
Section 190.525 - Definitions.
Section 190.534 - Violations, penalty — attorney general to have concurrent jurisdiction.
Section 190.537 - Rulemaking authority.
Section 190.550 - Schedule of fees established, rules — collection and deposit.
Section 190.600 - Citation of act — definitions.
Section 190.606 - Immunity from liability, what persons and entities.
Section 190.609 - Order effective, when — limitations of order.
Section 190.618 - Rules — rulemaking authority.
Section 190.621 - Penalty for concealing or falsifying an order.
Section 190.800 - Imposition of tax — definitions.
Section 190.803 - Formula for tax based on gross receipts — challenge of validity of rules.
Section 190.806 - Record-keeping requirements, confidentiality.
Section 190.812 - Determination of tax final, when — timely protest permitted.
Section 190.815 - Rulemaking authority.
Section 190.818 - Remittance of tax — fund created, use of moneys.
Section 190.821 - Tax period — failure to pay, delinquency, enforcement procedures.
Section 190.824 - Tax-exempt status of ambulance service not affected.
Section 190.827 - Payments to ambulance services, when.
Section 190.830 - Federal financial participation required.
Section 190.833 - No tax imposed prior to effective date.
Section 190.836 - Rules requirements, authority.
Section 190.839 - Expiration date.
Section 190.840 - Nonseverability clause.
Section 190.900 - REPLICA enacted — definitions.
Section 190.903 - Home state licensure.
Section 190.906 - Compact privilege to practice.
Section 190.909 - Conditions of practice in a remote state.
Section 190.912 - Relationship to emergency management assistance compact.
Section 190.915 - Veterans, service members separating from active duty military, and their spouses.
Section 190.918 - Adverse actions.
Section 190.921 - Additional powers invested in a member state's EMS authority.
Section 190.924 - Establishment of the interstate commission for EMS personnel practice.
Section 190.927 - Coordinated database.
Section 190.933 - Oversight, dispute resolution, and enforcement.