Page:United States Statutes at Large Volume 104 Part 2.djvu/613

 .J'^s^l?*'^-""•,. PUBLIC LAW 101-508 —NOV. 5, 1990 104 STAT. 1388-205 "(A) in the case of a hospital, at the time of the individual's admission as an inpatient, "(B) in the case of a nursing facility, at the time of the individual's admission as a resident, "(C) in the case of a provider of home health care or personal care services, in advance of the individual coming under the care of the provider, "(D) in the case of a hospice program, at the time of initial receipt of hospice care by the individual from the program, and "(E) in the case of a health maintenance organization, at the time of enrollment of the individual with the organization. "(3) Nothing in this section shall be construed to prohibit the application of a State law which allows for an objection on the basis of conscience for any health care provider or any agent of such provider which as a matter of conscience cannot implement an advance directive.". ^^ "(4) In this subsection, the term 'advance directive' means a written instruction, such as a living will or durable power of attorney for health care, recognized under State law (whether statutory or as recognized by the courts of the State) and relating to the provision of such care when the individual is incapacitated. ^^ (b) CONFORMING AMENDMENTS.— (1) Section 1903(m)(l)(A) (42 U.S.C. 1396b(m)(l)(A)) is amended— (A) by inserting "meets the requirement of section 1902(w)' after "which" the first place it appears, and (B) by inserting "meets the requirement of section 1902(a) and" after "which" the second place it appears. (2) Section 1919(c)(2) of such Act (42 U.S.C. 1396r(c)(2)) is amended by adding at the end the following new subparagraph: "(E) INFORMATION RESPECTING ADVANCE DIRECTIVES. —A nursing facility must comply with the requirement of section 1902(w) (relating to maintaining written policies and procedures respecting advance directives).". (c) EFFECTIVE DATE.—The amendments made by this section shall apply with respect to services furnished on or after the first day of the first month beginning more than 1 year after the date of the enactment of this Act. (d) PuBuc EDUCATION CAMPAIGN.— (1) IN GENERAL.— The Secretary, no later than 6 months after the date of enactment of this section, shall develop and implement a national campaign to inform the public of the option to execute advance directives and of a patient's right to participate and direct health care decisions. (2) DEVELOPMENT AND DISTRIBUTION OF INFORMATION. —The Secretary shall develop or approve nationwide informational materials that would be distributed by providers under the requirements of this section, to inform the public and the medical and legal profession of each person's right to make decisions concerning medical care, including the right to accept or refuse medical or surgical treatment, and the existence of advance directives. (3) PROVIDING ASSISTANCE TO STATES. —The Secretary shall assist appropriate State agencies, associations, or other private entities in developing the State-specific documents that would be distributed by providers under the requirements of this section. The Secretary shall further assist appropriate State 42 USC 1396a note. 42 USC 1396a note.
 * ' So in original. Probably should be "directive.".
 * So in original. Probably should be "incapacitated.".".

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