Archive for Financial & Legal

New Indiana Law Requires POST Documentation

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New Indiana Law Requires POST Documentation
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There is always confusion about DNRs, and who should, or shouldn’t be resuscitated. Each doctor’s office, or hospital, now require a separate copy of your wishes, signed by a multitude of people, with extra hoops to jump through. In fact, this process is getting closer and closer to being as difficult as taxes are, and dealing with the IRS. For someone who simply wants to make sure that their own wishes are followed at their end of life, State’s sure do not make the process an easy one. Depending on your State will depend on which forms you need, and where to submit them to. In our experience, every place that your loved one MAY be seen needs to have their DNR on file, POA, and if in Indiana, the POST form. Below you’ll find information about the newly adopted POST form laws.
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As of July 2013, Indiana’s Physician Orders for Scope of Treatment (POST) legislation was signed in, and took effect. While POST is not a living will, this form does allow each individual to make specific decisions and interventions about their medical care. Being signed by both the patient and the doctor, this document helps make one’s wishes actionable.
POST is not for everyone, or otherwise healthy people. This form is for patients who are chronically ill, with progressive frailty, those with terminal conditions caused by injury, disease or illness from which there can be no real recovery, or death will occur at some near future point. Those patients with conditions where resuscitation may be unsuccessful, where cardiac or pulmonary failure is present; or those patients with a life expectancy of six months or less.
These forms do have different parts, and don’t be afraid to ask your doctor’s office to help you fill them out. If any patient is unable to make their own decisions, or sign for themselves, a legal representative must sign. This form IS NOT complete until it HAS BEEN SIGNED by the PHYSICIAN.

Downloadable/Printable POST form for INDIANA residents

For more information, or list of the complete laws surrounding the POST forms and law, please visit the in.gov website, and follow their links!

Resources Used: Indiana State web site (linked above)

Doomed Retirement??

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Doomed Retirement??

With this “new deal” passed, things are definitely shifting throughout our country, and our world. This article covers the differences in retirement years ago, to what will be (and won’t be) happening with peoples retirement in the future. Here are some points from the article:

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“The Great Recession and the weak recovery darkened the retirement picture for significant numbers of Americans. And the full extent of the damage is only now being grasped by experts and policymakers” (theday.com).

“Advocates for older Americans are calling on the federal government to bolster Social Security benefits or to create a new layer of retirement help for future retirees. Others want employers and the government to do more to encourage retirement savings and to discourage workers from using the money for non-retirement purposes” (theday.com).

“The economic downturn exacerbated long-term factors that were already eroding the financial standing of aging Americans: an inexorable rise in health care costs, growing debt among older Americans and a shift in responsibility from employers to workers to plan for retirement.
The consequence is that the nation is facing a huge retirement savings deficit – as much as $6.6 trillion, or about $57,000 per household, according to a U.S. Senate report” (theday.com).

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To read the full article, click here! (Resources Used:)
http://www.theday.com/article/20130218/NWS13/302189950/1069/rss

Fiscal Cliffs, Medicare, and Should I Care?

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Fiscal Cliffs, Medicare, and Should I Care?

At the beginning of this year, the government was still knee deep figuring out what the fiscal cliff will be, and just what each of the cuts will affect. There is still confusion as to what will be dropped from Medicare, and what will be kept. The news on this topic seems to change daily, as it will until the cliff is officially “passed” at whatever amount they come to. The articles below will give you some insight as to who will be affected by the changes, and who will benefit.~

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-This article, Who Won, Who lost in “Fiscal Cliff” Deal covers those who will be positively affected, and those who will be negatively affected.

http://www.foxbusiness.com/personal-finance/2013/01/08/who-won-who-lost-from-fiscal-cliff-deal/

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-Although it’s from where it’s from….it still has a few points of real, truthful information.
http://en.wikipedia.org/wiki/United_States_fiscal_cliff

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-Most of the Medicare “parts” of the approved fiscal cliff deal shows that Medicare may have been saved….for the most part. Not every aspect, but some.
http://www.medpagetoday.com/Washington-Watch/Washington-Watch/36726

Resources Used:
Fox news.com
Wikipedia.com
Medpagetoday.com

Automatic Payments: Convenience, or Money Drain??

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Automatic Payments: Convenience, or Money Drain??

Automatic payments can be a God send, making the bill payer’s life much easier, and less to worry about—right?? In most cases, absolutely! Many of us use this method of payment for our bills through our online banking program. Tracking these payments through our banking system allows us to ensure that each payment was made, and when. However, many insurance companies that deal with the elderly offer these payments, and they are being taken out more than once, sometimes late, or not at all–thusly resulting in the cancellation of whatever policy the payments were for. This is a growing problem as technology programs and bill pay systems grow, but are not always up to par. In this post, you’ll find information on this topic, as well as stories from others that similar issues have happened to.~

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Why is this a problem?
When automatic payments go crazy, many things can be affected. Bank accounts are normally first to be affected, and where people notice first. Elderly folks who are not good at balancing their checkbooks, can get themselves into sticky situations if these double, and triple taken payments are not quickly noticed. This can cause bounced checks, and other important household bills to go unpaid, and thusly turned off.

In other companies, such as insurance companies, where automatic payments are taken monthly to ensure that medical coverage remains current, if those automatic payments are interrupted for any reason, coverage can be lost with no notice. Granted, most reputable companies would NEVER cancel someone’s insurance without notice, but note to self–it happens more than you think!

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What can be done to prevent multiple automatic payments, or cancellations from automatic payments?
If you’re a care giver, or relative of an elderly person who uses this automatic payment feature, make sure you discuss this problem that many are having with these types of payments. There is really no way to prevent this from happening, but for paying bills monthly through your bank’s bill pay system, or by sending a paper check to them each month.

Other’s that were affected by similar situations:
(Below are personal accounts of situations dealing with the authors of these quotes paragraphs below. I know none of these people, only sharing their story as another example of awry auto payments, and insurance issues.)

-Terry S., Dayton, OH August 2012
“In March 2011, before my parents’ policy was due to be renewed, my mother called to cancel the policy. The rates kept going up so my parents changed insurance companies. In May 2011, they received a bill for a renewal. I called them and told them to cancel the policy. They wanted proof of other insurance. I called their current insurance company and the insurance company called AARP. I thought the matter was closed. Today August 2012, my parents received a bill for auto insurance of $1,236.00, with a payment schedule for Sept 2012 through April 2013. I again called AARP and my dad also requested that they cancel the policy. They have not made a payment since February 2011.
I don’t understand why they are still carrying the policy. Other insurance companies cancel your policy as soon as you stop making payments. My dad is now 85 years old and I feel like AARP is trying to take advantage of him. I pay all his bills. AARP is trying to bill him for $155.76 each month. His current insurance company only charges him a little more than $50 a month for auto insurance. Please help. This policy with AARP needs to be cancelled immediately. My dad should not have to fax them proof of other insurance. This is still a free country and he still has a choice in which insurance company he wants to use. Now that I am over the age of 50, I will never join AARP. It’s a ripoff out to cheat senior citizens.”

-John of Selbyville, 2012
“My insurance has increased with no substantial reason (clean record). I have since cancelled and I am waiting for a premium refund. AARP Hartford Auto is definitely a rip off of senior citizens and I believe AARP is aware of this injustice. The Hartford Group should be investigated by the State Attorney General and the Better Business association.”

-Paul, Glen Ellyn, 2012
“They have been advertising on TV a no drop policy. This is false advertisement. As of 11/7/11, they dropped me, my wife and family. My youngest son had an accident, in which he totaled the car. Since then, he has his own car and insurance and is not on our policy. AARP would not renew our policy, even though the above individual is not on it.”

-IB Pete, 2011
“Due to a broken phone/update I had to pay my account in full before any action could be taken. I paid the account in full, the problem was that I had also scheduled a online payment to be taken out in the next couple days.When the account was paid in full at the Verizon store called Verizon financial services to stop that payment.. Financial Services stated,” Done, no payment will be taken out.” Well.Payment WAS taken out the next day. Asking for a refund on that payment from Verizon is like nothing that I would wish on anyone. First I was told that it could be refunded in 72 hours after my giving some information to financial services..which was done via the Verizon store. After the 72 hours and no refund they are now telling me it will take up to 10 – 15 days… After I fax a copy of my bank statement. How odd is it that a payment came be taken in a day or less but a refund takes weeks or longer. What a fight, and nothing can be done but to wait. This is a case of “NO Service” Support from Verizon as with other big companies.”

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Other Sources:
This website also offers information about which bills should, and should not go on to automatic bill pay systems. Check it out for more info!
http://financialsoft.about.com/od/onlinesoftware/a/Bills-You-Shouldnt-Put-on-Autopay.htm

 

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Other things to watch for with Automatic Payments and Insurance Deals:

*Beware of the bait!! Many who are affected by insurance issues fail to read the “fine print,” and go with whatever the agent, or friendly phone person tells them. Although it would be wonderful to be able to trust insurance representatives, let’s be honest—they’re in that business for money, and nothing else. Always read that fine print, because the deal that they have presented to you in the beginning may not be the same deal you end up with three months in!!

*Most utility companies, including mobile carriers, let you set up an option on your account to get bills via email or text before automatic payments go through. Use this setting to keep an eye on account balances before they are paid.

*Give all bills, whether you receive them electronically or on paper, a high priority. It’s easy to overlook email and text notices, and paper bills that are stashed aside when you are busy.

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How did this affect me?
For two of my grandparents, this was a huge issue. One used a major “senior” insurance company for their secondary insurance, and prescription coverage. This company started off fine, took the automatic payments on the same day each month. And then suddenly, she was calling me to tell me she had overdrawn her account, and couldn’t figure out how this had happened. After much investigating, it turned out that this company had been taking multiple payments for three months in a row! Even worse, when I called to have that money refunded—they “couldn’t” do it immediately. They stated that it needed to be investigated, as my grandma may have “accidentally” done it. After a few more weeks, and cancelling her policy with this “great senior insurance” company, and moving her to a different company….suddenly a refund check, and apology letter came in the mail.

For my other grandparent, their issues came with an insurance policy company. She had this policy for YEARS, decades even….so when they suddenly cancelled her policy, she was upset, and confused. Once she called, she was told that “the monthly amount due had gone up, so we cancelled it.” After a phone fight, they reinstated the policy at the higher rate. Years later (this year), they did the same thing again! Apparently, when this company’s rates go up–rather than just letting the customer know, and adjusting their automatic payment amount, they cancel you without notice. So, for months, my grandma had no insurance! Same thing happened this time, as the last! More run around, not a lot of answers, and to make matters even worse, they told her she needed to pay hundreds more to reinstate the policy!!! TERRIBLE CUSTOMER and BUSNIESS SERVICE!!! Of course, she should not be made to pay anything extra, as this was obviously an error within the company.

Resources Used:
consumer affairs.com
financial soft.advice.com
Verizon wireless community discussions

Tips & Pointers on Taking Over the Bills

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Tips & Pointers on Taking over the Bills

When my Grandpa died, the bill payer did, too. This left my Grandma trying to do something that she wasn’t comfortable with. She called me one day, and explained the situation asking for my help. I didn’t mind, as having had my own accounts & bills for years, and working at a phone bank helped my knowledge. The first day I went, she handed me a pile of folders. She had separated each bill in each pocket, and had about ten different places she was keeping track of each bill. I was lost, and even worse, so was she. It was too much, and her “system” wasn’t working.

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Here are a few things that I did, first- to try to help her understand her own bills; second-what I did when she couldn’t/didn’t want to/didn’t try to take care of her accounts; third- what happens when one “takes over” the bills.~

Number 1: Steps to Re-Teach Banking and Bills
*Online Bill Pay
This was one of the first things that I set up for my Grandma. She handed me the pile of bills, which included her bank statements. Luckily, most all big banks, credit unions, or what have you all offer this feature for free. I signed her up, and added all her bills. We sat and went over each bill, typed in the amount, and paid it. She liked how it showed her the available balance after each bill was taken out. We talked about how to mark the bills paid (which for her ended up being a large black sharpie’d X), and how we would get together on the 3rd, and 6th of the months to pay all the bills at once, for the month.

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*Practice Basic Addition and Subtraction

The basic math skills of addition and subtraction will be needed, too. The nice thing about online banking is that it will do that “math” for you. This was such a help to her. Basic practice of adding dollar amounts will also help keep their brain’s sharp on the skill. In the beginning, she would sit with me, and work basic money problems. But towards the end, she could’ve cared less….which showed in her math skills in the checkbook.
There came a point where she wasn’t even trying to keep the log….and the bills weren’t even being opened. She was saving it all for me. At this time, there were also some events that ended up her moving into a few different residences.

Number 2: Steps to Ensure a Responsible Party on the Utilities & Banking
*Adding a Responsible Party for Utilities
This was something I didn’t find out about, right away. At each place she moved, we’d have to go through the new phone lines, cable for the television, internet service, bills, change of addresses & phone numbers–everything. It was always a pain in the arse, especially since it was all in my Grandma’s name. So, each company always wanted to talk to her…and she would’ve rather talked about what she was doing later, or sing a silly song. Finally, one of the assisted living complexes suggested that I simply add my name as an authorized contact on her accounts. Hello, ease! After I did this with each place, finally things were a bit easier. I could call with questions on a bill, and get them answered–easily. No more twenty five thousand questions, no more hassle… Simplicity in any care giver situation is a must. An absolute must. So, this is one of those really easy things that can be done, and it makes all of the moving and reconnecting processes easier on everyone.

*Splitting the Accounts
There was a specific point where she couldn’t keep track of anything. Running it all by my Dad, it was decided to give her her own, lower dollar checking account. This account was only for her grocery trips, or incidentals. The main account was kept for the bills, insurance, and Social Security deposits. For awhile, this worked great. She had her “own” money still, and this allowed us to track her spending, and make sure she wasn’t funding anything questionable.
I was added to her bank account as a secondary, allowing me to pay the bills for her legally. This made it simple to ensure that each month, she had her money, and all the bills were paid.
Many financial institutions now offer free checking accounts, and these types of accounts are perfect for the basic account for a situation like this.

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Number 3: Steps in Completely Taking Over the Bills Correctly
*DO IT LEGALLY! There were immediate situations with prescriptions, medical bills, and taxes that came up quickly. I didn’t want to “be in charge” of these things without the full backing of the courts, and my Grandma. You might not think taking on someone’s “bills” is much, but it completely makes you responsible for everything they do!! Sort of similar to a co-signer. It’s indeed a heavy responsibility, and one that needs to be taken very seriously. So, if you’ll be dealing with the banking, the taxes, the medicines, or any of the well being of your relative….please seek out an attorney, and become their Power of Attorney, OR be listed as an authorized representative for the person in writing.

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We used an attorney for this purpose, and my Grandma went along with us to be present. I would suggest that your family members also be present for any meetings with an attorney, until they are COMPLETELY unable to think, walk, or talk.

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*Is it all really necessary? Not always, no. It absolutely depends on your situation. In my situation, I was signing tax forms, housing paperwork, medical things, etc., and the lawyer thought it best, too. I didn’t want to be signing my name on things, stepping up to be responsible for something, and then get hit in the face with something odd. And believe me, they (the IRS) know when they’re not doing their own thing. Even if it’s not fraud…even if you’re just helping. Always best to be upfront with information like this!!!

i understand her wishes….do you?

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This picture speaks volumes to me right now. This woman was ensuring that her wishes were clear, and she thought this was the only way to be sure of this, and save her family any turmoil. She tattoo’ed “Do Not Resuscitate” onto her chest. Is this really what the world, what our nursing home “laws” make our elderly do?? Because their DNR forms, living wills, special forms and other just are not good enough for these facilities to accept, understand, and FOLLOW??

Did you know that DNR forms are no longer good enough to state you want no heroics?? Now one apparently has to specify specific treatments or procedures that they would, or would not allow. Such as not wanting CPR, IV fluids, cardiac assistance, or feeding tubes; but will accept a smack in the face. To many states now, a DNR simply means no CPR. And many elderly people, and those taking care of the elderly, do not know of these changes. So, here they are…thinking they are going peacefully. And suddenly, brought right back into reality….but not as themselves. As half vegetables, in pain, uncomfortable, and angry. 🙁 Shouldn’t nursing home facilities be upfront with any updates needed to these DNR or living will forms?? Or are they hushed to avoid SITUATIONS happening??

There is no thought as to quality of life, or ability of one’s self after a debilitating illness. Being trapped in a bed, with no control of any body function, being fed, washed, turned–all when you’re ready to go….does that sound like something you’re interested in doing for a few weeks?? or a few months, while you wait for the end??

Who makes the final judgement call then? Who declares who is comfortable, uncomfortable, suffering or not?? If a person’s word and wishes mean nothing, and their wants are ignored….then what the hell is the point?? If the people they appointed to speak for them when they can’t, also don’t matter…..then what the hell is the point??

signed,
Disgruntled POA/bestfriend/granddaughter….

DNR Orders: To honor, or not honor thy wishes…

     When you hear the abbreviation “DNR,” at first you may think that this means the Department of Natural Resources. Well, it does. However, it also stands for ‘Do Not Resuscitate,’ and many people across the country have a DNR order in place once their health starts to deteriorate. This is a simple form that a person fills out when they wish no heroics, and no elaborate or medical measures be done to save their life. It is a very personal decision that someone must make while still in their right mind, so that family and friends can be made aware of the decision that the person has made.
     Some would say that a lawyer should be seen to file this order, but that is not a necessary step for this. Roughly half a million people hold a DNR order in their personal file, and many will run into trouble having their wishes honored as they wanted. This is a sad fact in America currently. There are many other aspects to DNR’s, and other forms that can be filled out to help and assist the DNR form, which will be posted about later. Below is our story of dealing with the DNR order process.
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     This was my case. My grandma had a DNR order in place, and a living will done by an attorney. (We’ll cover Living Wills on a different post, as well as how they are the same and different.) The family knew of her wishes, and planned to abide by them. Who knew then how difficult this would prove to be. Once we signed her into the nursing home in the summer of 2011, and filled out all the proper paperwork and documentation, we thought we were set. The establishment had all the copies of living wills, DNR orders, wishes, wants, dislikes & likes, etc. We were satisfied that there, someone would be with her 24 hours a day, 7 days a week. We thought her wishes would be honored, as everyone loved her there.
     Grandma’s got some health issues, including congestive heart failure. This is what was taking her from us at this very moment…slowly, and uncomfortably. 🙁 So, one night in September 2012 she had some heartburn, and the staff called 911. When an ambulance responds, they have to treat…especially when the copy of the DNR isn’t made available, or “good enough” for their standards. So, off to the hospital she went. They declared there some acid reflux, plus anxiety….plus the downhill effects from the congestive heart failure. She refused all other treatment, and was taken back to the nursing home. A care plan meeting was held soon after, where my Dad and I firmly stated, and restated her wishes. We verified that they had all copies needed–they did. We also learned, for the first time, that a DNR order copy must reside at every and any place where the person, in this case grandma, may end up for care. They suggested leaving a copy at each hospital, with each relative, in every car, every wallet or purse…well, you probably get the drift. 🙁 It was hard to understand how the place that was responsible for her care, wasn’t responsible for providing the documents that the ambulance needed to begin with. In the meantime, we contacted an attorney friend. However, nothing happens immediately, so we were too late.
      Fast forward a few months, Grandma starts to fall apart a bit. Becomes more wheel chair dependant, and her body starts “acting out” against her. Gets pretty weak in December 2012, but still peppy, and ornery as ever. Then it happens. New Year’s Morning, bright and early. The phones started blowing up, and the biggest disaster of 2013 began…
     Through miscommunications, mistruths, Nurse’s trying to be Jesus, and complete confusion…she was rushed to the ER, and was non-responsive. For you medical folks, her oxygen levels were lowering, and were down to 66. She was laying in bed while this was happening, falling asleep peacefully. Nurse Jesus knew of her DNR order, because she rubbed it in my face days later. She chose to send her to the ER, where once there and awake, she refused all treatment immediately. She was also informed that she would most likely die very soon without treatment, to which she replied, “if that’s how it is, then that’s how it is.” Well, if that’s not stating that you understand your chances, I’m not sure what is.
     In days to follow, while Grandma rolls around in bed, drugged out of her gourd, at times miserable….it’s hard to not ask yourself why Nurse J had to make that decision. At the next care meeting, we brought up these issues. And needed to know why her DNR was again, not followed. Circles of swirling paperwork, apologies all around, protocol’s broken, grievance’s filed…..and the knowledge we gained from this, is that a DNR order won’t matter. It truly depends on who finds you in your troubled state, and if they know, and ACCEPT your wishes. Because the minute 911 is called, or intervention is taken, it has to be followed through with. At least until you are conscious, and can make that decision yourself. We wish we would’ve known some of these simple things BEFORE all this happened….

*File the DNR at each hospital, doctor’s office, and literally everywhere an ambulance could deliver your ailing family member,
*Each family member responsible for the person should have a copy,
Just because a lawyer has made it official with the courts, doesn’t make it any more legal. Truth be told, you do NOT need a lawyer to have a DNR order!!

*DNR forms that are torn, dingy, or dirty may not be accepted. Same for vagueness. But again that is up to the establishment, or whoever has come to assess the family member.

*Have your doctor sign the form, and acknowledge and communicate your wishes to your doctor as well.

*Trust only close family with your wishes. Know that many nursing home establishments mean well, but often will not honor wishes.

     Below you will find the Indiana Law on DNR Orders and related information.

IC 16-36-5
Chapter 5. Out of Hospital Do Not Resuscitate Declarations

IC 16-36-5-1
“Cardiopulmonary resuscitation” or “CPR” defined
Sec. 1. As used in this chapter, “cardiopulmonary resuscitation” or “CPR” means cardiopulmonary resuscitation or a component of cardiopulmonary resuscitation, including:
(1) cardiac compression;
(2) endotracheal intubation and other advanced airway management;
(3) artificial ventilation;
(4) defibrillation;
(5) administration of cardiac resuscitation medications; and
(6) related procedures.
The term does not include the Heimlich maneuver or a similar procedure used to expel an obstruction from the throat.
As added by P.L.148-1999, SEC.12.
IC 16-36-5-2
“Competent witness” defined
Sec. 2. As used in this chapter, “competent witness” means a person at least eighteen (18) years of age who is not:
(1) the person who signed an out of hospital DNR declaration on behalf of and at the direction of the declarant;
(2) a parent, spouse, or child of the declarant;
(3) entitled to any part of the declarant’s estate; or
(4) directly financially responsible for the declarant’s medical care.
For purposes of subdivision (3), a person is not considered to be entitled to any part of the declarant’s estate solely by virtue of being nominated as a personal representative or as the attorney for the estate in the declarant’s will.
As added by P.L.148-1999, SEC.12.
IC 16-36-5-3
“Declarant” defined
Sec. 3. As used in this chapter, “declarant” means a person:
(1) who has executed an out of hospital DNR declaration under section 11(a) of this chapter; or
(2) for whom a representative has executed an out of hospital DNR declaration under section 11(b) of this chapter;
and for whom an out of hospital DNR order has been written under section 12 of this chapter.
As added by P.L.148-1999, SEC.12.
IC 16-36-5-4
“DNR” defined
Sec. 4. As used in this chapter, “DNR” means do not resuscitate.
As added by P.L.148-1999, SEC.12.

IC 16-36-5-5
“Out of hospital” defined
Sec. 5. As used in this chapter, “out of hospital” refers to a location other than:
(1) an acute care hospital licensed under IC 16-21-2; or
(2) a health facility licensed under IC 16-28.
As added by P.L.148-1999, SEC.12.
IC 16-36-5-6
“Out of hospital DNR declaration and order” defined
Sec. 6. As used in this chapter, “out of hospital DNR declaration and order” means a document executed under sections 11 and 12 of this chapter.
As added by P.L.148-1999, SEC.12.
IC 16-36-5-7
“Out of hospital DNR identification device” defined
Sec. 7. As used in this chapter, “out of hospital DNR identification device” means a device developed by the emergency medical services commission under section 17 of this chapter.
As added by P.L.148-1999, SEC.12.
IC 16-36-5-8
“Qualified person” defined
Sec. 8. As used in this chapter, “qualified person” means an individual certified as a qualified person under section 10 of this chapter.
As added by P.L.148-1999, SEC.12.
IC 16-36-5-9
“Representative” defined
Sec. 9. As used in this chapter, “representative” means a person’s:
(1) legal guardian or other court appointed representative responsible for making health care decisions for the person;
(2) health care representative under IC 16-36-1; or
(3) attorney in fact for health care appointed under IC 30-5-5-16.
As added by P.L.148-1999, SEC.12.
IC 16-36-5-10
Certification as qualified person
Sec. 10. An attending physician may certify that a patient is a qualified person if the attending physician determines, in accordance with reasonable medical standards, that one (1) of the following conditions is met:
(1) The person has a terminal condition (as defined in IC 16-36-4-5).
(2) The person has a medical condition such that, if the person were to suffer cardiac or pulmonary failure, resuscitation would be unsuccessful or within a short period the person would
experience repeated cardiac or pulmonary failure resulting in death.
As added by P.L.148-1999, SEC.12.
IC 16-36-5-11
Execution of declaration
Sec. 11. (a) A person who is of sound mind and at least eighteen (18) years of age may execute an out of hospital DNR declaration.
(b) A person’s representative may execute an out of hospital DNR declaration for the person under this chapter only if the person is:
(1) at least eighteen (18) years of age; and
(2) incompetent.
(c) An out of hospital DNR declaration must meet the following conditions:
(1) Be voluntary.
(2) Be in writing.
(3) Be signed by the person making the declaration or by another person in the declarant’s presence and at the declarant’s express direction.
(4) Be dated.
(5) Be signed in the presence of at least two (2) competent witnesses.
(d) An out of hospital DNR declaration must be issued on the form specified in section 15 of this chapter.
As added by P.L.148-1999, SEC.12.

IC 16-36-5-12
Issuance of DNR order
Sec. 12. An out of hospital DNR order:
(1) may be issued only by the declarant’s attending physician; and
(2) may be issued only if both of the following apply:
(A) The attending physician has determined the patient is a qualified person.
(B) The patient has executed an out of hospital DNR declaration under section 11 of this chapter.
As added by P.L.148-1999, SEC.12.
IC 16-36-5-13
Transfer of patient to another physician
Sec. 13. (a) An attending physician who does not issue an out of hospital DNR order for a patient who is a qualified person may transfer the patient to another physician, who may issue an out of hospital DNR order, unless:
(1) the attending physician has reason to believe the patient’s declaration was not validly executed, or there is evidence the patient no longer intends the declaration to be enforced; and
(2) the patient is unable to validate the declaration.
(b) Notwithstanding section 10 of this chapter, if an attending physician, after reasonable investigation, does not find any other
physician willing to honor the patient’s out of hospital DNR declaration and issue an out of hospital DNR order, the attending physician may refuse to issue an out of hospital DNR order.
(c) If the attending physician does not transfer a patient under subsection (a), the attending physician may attempt to ascertain the patient’s intent and attempt to determine the validity of the declaration by consulting with any of the following individuals who are reasonably available, willing, and competent to act:
(1) A court appointed guardian of the patient, if one has been appointed. This subdivision does not require the appointment of a guardian so that a treatment decision may be made under this section.
(2) A person designated by the patient in writing to make a treatment decision.
(3) The patient’s spouse.
(4) An adult child of the patient or a majority of any adult children of the patient who are reasonably available for consultation.
(5) An adult sibling of the patient or a majority of any adult siblings of the patient who are reasonably available for consultation.
(6) The patient’s clergy.
(7) Another person who has firsthand knowledge of the patient’s intent.
(d) The individuals described in subsection (c)(1) through (c)(7) shall act in the best interest of the patient and shall follow the patient’s express or implied intent, if known.
(e) The attending physician acting under subsection (c) shall list the names of the individuals described in subsection (c) who were consulted and include the information received in the patient’s medical file.
(f) If the attending physician determines from the information received under subsection (c) that the patient intended to execute a valid out of hospital DNR declaration, the attending physician may:
(1) issue an out of hospital DNR order, with the concurrence of at least one (1) physician documented in the patient’s medical file; or
(2) request a court to appoint a guardian for the patient to make the consent decision on behalf of the patient.
(g) An out of hospital DNR order must be issued on the form specified in section 15 of this chapter.
As added by P.L.148-1999, SEC.12.
IC 16-36-5-14
Effect of declaration during pregnancy
Sec. 14. An out of hospital DNR declaration and order of a declarant known to be pregnant has no effect during the declarant’s pregnancy.
As added by P.L.148-1999, SEC.12.

IC 16-36-5-15
Form
Sec. 15. An out of hospital DNR declaration and order must be in substantially the following form:
OUT OF HOSPITAL DO NOT RESUSCITATE DECLARATIONAND ORDER
This declaration and order is effective on the date of execution and remains in effect until the death of the declarant or revocation.
OUT OF HOSPITAL DO NOT RESUSCITATE DECLARATION
Declaration made this ____ day of __________. I, _____________, being of sound mind and at least eighteen (18) years of age, willfully and voluntarily make known my desires that my dying shall not be artificially prolonged under the circumstances set forth below. I declare:
My attending physician has certified that I am a qualified person, meaning that I have a terminal condition or a medical condition such that, if I suffer cardiac or pulmonary failure, resuscitation would be unsuccessful or within a short period I would experience repeated cardiac or pulmonary failure resulting in death.
I direct that, if I experience cardiac or pulmonary failure in a location other than an acute care hospital or a health facility, cardiopulmonary resuscitation procedures be withheld or withdrawn and that I be permitted to die naturally. My medical care may include any medical procedure necessary to provide me with comfort care or to alleviate pain.
I understand that I may revoke this out of hospital DNR declaration at any time by a signed and dated writing, by destroying or canceling this document, or by communicating to health care providers at the scene the desire to revoke this declaration.
I understand the full import of this declaration.
Signed___________________________________
Printed name______________________________
_________________________________________
City and State of Residence___________________
The declarant is personally known to me, and I believe the declarant to be of sound mind. I did not sign the declarant’s signature above, for, or at the direction of, the declarant. I am not a parent, spouse, or child of the declarant. I am not entitled to any part of the declarant’s estate or directly financially responsible for the declarant’s medical care. I am competent and at least eighteen (18) years of age.
Witness____________Printed name___________Date__________
Witness____________Printed name___________Date__________
OUT OF HOSPITAL DO NOT RESUSCITATE ORDER
I,___________________, the attending physician of _________________, have certified the declarant as a qualified person to make an out of hospital DNR declaration, and I order health care providers having actual notice of this out of hospital DNR declaration and order not to initiate or continue cardiopulmonary resuscitation procedures on behalf of the declarant,
unless the out of hospital DNR declaration is revoked.
Signed_____________________Date__________
Printed name______________________________
Medical license number_____________________
As added by P.L.148-1999, SEC.12.
IC 16-36-5-16
Copies of declaration and order
Sec. 16. Copies of the out of hospital DNR declaration and order must be kept:
(1) by the declarant’s attending physician in the declarant’s medical file; and
(2) by the declarant or the declarant’s representative.
As added by P.L.148-1999, SEC.12.
IC 16-36-5-17
Identification devices
Sec. 17. (a) The emergency medical services commission shall develop an out of hospital DNR identification device that must be:
(1) a necklace or bracelet; and
(2) inscribed with:
(A) the declarant’s name;
(B) the declarant’s date of birth; and
(C) the words “Do Not Resuscitate”.
(b) An out of hospital DNR identification device may be created for a declarant only after an out of hospital DNR declaration and order has been executed by a declarant and an attending physician.
(c) The device developed under subsection (a) is not a substitute for the out of hospital DNR declaration and order.
As added by P.L.148-1999, SEC.12.
IC 16-36-5-18
Revocation
Sec. 18. (a) A declarant may at any time revoke an out of hospital DNR declaration and order by any of the following:
(1) A signed, dated writing.
(2) Physical cancellation or destruction of the declaration and order by the declarant or another in the declarant’s presence and at the declarant’s direction.
(3) An oral expression by the declarant of intent to revoke.
(b) A declarant’s representative may revoke an out of hospital DNR declaration and order under this chapter only if the declarant is incompetent.
(c) A revocation is effective upon communication to a health care provider.
(d) A health care provider to whom the revocation of an out of hospital DNR declaration and order is communicated shall immediately notify the declarant’s attending physician, if known, of the revocation.
(e) An attending physician notified of the revocation of an out of
hospital DNR declaration and order shall immediately:
(1) add the revocation to the declarant’s medical file, noting the time, date, and place of revocation, if known, and the time, date, and place that the physician was notified;
(2) cancel the out of hospital DNR declaration and order by entering the word “VOID” on each page of the out of hospital DNR declaration and order in the declarant’s medical file; and
(3) notify any health care facility staff responsible for the declarant’s care of the revocation.
As added by P.L.148-1999, SEC.12.
IC 16-36-5-19
Health care provider duties
Sec. 19. (a) A health care provider shall withhold or discontinue CPR to a patient in an out of hospital location if the health care provider has actual knowledge of:
(1) an original or a copy of a signed out of hospital DNR declaration and order executed by the patient; or
(2) an out of hospital DNR identification device worn by the patient or in the patient’s possession.
(b) A health care provider shall disregard an out of hospital DNR declaration and order and perform CPR if:
(1) the declarant is conscious and states a desire for resuscitative measures;
(2) the health care provider believes in good faith that the out of hospital DNR declaration and order has been revoked;
(3) the health care provider is ordered by the attending physician to disregard the out of hospital DNR declaration and order; or
(4) the health care provider believes in good faith that the out of hospital DNR declaration and order must be disregarded to avoid verbal or physical confrontation at the scene.
(c) A health care provider transporting a declarant shall document on the transport form:
(1) the presence of an out of hospital DNR declaration and order;
(2) the attending physician’s name; and
(3) the date the out of hospital DNR declaration and order was signed.
(d) An out of hospital DNR identification device must accompany a declarant whenever the declarant is transported.
As added by P.L.148-1999, SEC.12.
IC 16-36-5-20
Health care provider liability
Sec. 20. A health care provider who in good faith and in accordance with reasonable medical standards:
(1) participates in the withholding or withdrawal of CPR from a declarant:
(A) by whom an out of hospital DNR declaration and order
has been executed under this chapter; or
(B) who has revoked an out of hospital DNR declaration and order when the health care provider has no notice of the revocation; or
(2) provides CPR to a declarant:
(A) when the health care provider has no notice of the out of hospital DNR declaration and order; or
(B) after a revocation of an out of hospital DNR declaration and order;
is not subject to criminal or civil liability and may not be found to have committed an act of unprofessional conduct.
As added by P.L.148-1999, SEC.12.
IC 16-36-5-21
Presumption of validity
Sec. 21. (a) If a declarant is incompetent at the time of the decision to withhold or withdraw CPR, an out of hospital DNR declaration and order executed under this chapter is presumed to be valid.
(b) For purposes of this chapter, a health care provider may presume in the absence of actual notice to the contrary that the declarant was of sound mind when the out of hospital DNR declaration and order was executed.
(c) The fact that a declarant executed an out of hospital declaration may not be considered as an indication of the declarant’s mental incompetency.
As added by P.L.148-1999, SEC.12.
IC 16-36-5-22
Petition for review
Sec. 22. (a) A person may challenge the validity of an out of hospital DNR declaration and order by filing a petition for review in a court in the county in which the declarant resides.
(b) A petition filed under subsection (a) must include the name and address of the declarant’s attending physician.
(c) A court in which a petition is filed under subsection (a) may declare an out of hospital DNR declaration and order void if the court finds that the out of hospital DNR declaration and order was executed:
(1) when the declarant was incapacitated due to insanity, mental illness, mental deficiency, duress, undue influence, fraud, excessive use of drugs, confinement, or other disability;
(2) contrary to the declarant’s wishes; or
(3) when the declarant was not a qualified person.
(d) If a court finds that the out of hospital DNR declaration and order is void, the court shall cause notice of the finding to be sent to the declarant’s attending physician.
(e) Upon notice under subsection (d), the declarant’s attending physician shall follow the procedures under section 18(e) of this chapter.

As added by P.L.148-1999, SEC.12.
IC 16-36-5-23
Effect upon life insurance policies
Sec. 23. (a) A death caused by the withholding or withdrawal of CPR under this chapter does not constitute a suicide.
(b) The execution of an out of hospital DNR declaration and order under this chapter does not affect the sale, issuance, or terms of a life insurance policy.
(c) A policy of life insurance is not legally impaired or invalidated by the execution of an out of hospital DNR declaration and order or by the withholding or withdrawal of CPR from an insured declarant, notwithstanding any term of the policy to the contrary.
(d) An out of hospital DNR declaration and order may not be considered in the establishment of insurance premiums for a declarant.
(e) A person may not require another person to execute an out of hospital DNR declaration and order as a condition for being insured for or receiving health care services.
(f) This chapter does not impair or supersede any legal right or legal responsibility that a person may have to effect the withholding or withdrawal of CPR in a lawful manner.
As added by P.L.148-1999, SEC.12.
IC 16-36-5-24
Intent of person without declaration not presumed
Sec. 24. This chapter does not create any presumption concerning the intent of a person who has not executed an out of hospital DNR declaration and order to consent to the withholding or withdrawal of CPR if a terminal condition exists, or if a medical condition exists such that the outcome of performing CPR would have the results specified in section 10(2) of this chapter.
As added by P.L.148-1999, SEC.12.
IC 16-36-5-25
Euthanasia not authorized
Sec. 25. This chapter does not authorize euthanasia or any affirmative or deliberate act or omission to end life other than to permit the natural process of dying.
As added by P.L.148-1999, SEC.12.
IC 16-36-5-26
Effect upon chain of proximate cause
Sec. 26. The act of withholding or withdrawing CPR, when done under:
(1) an out of hospital DNR declaration and order issued under this chapter;
(2) a court order or decision of a court appointed guardian; or
(3) a good faith medical decision by the attending physician that the patient has a terminal illness;

is not an intervening force and does not affect the chain of proximate cause between the conduct of a person that placed the patient in a terminal condition and the patient’s death.
As added by P.L.148-1999, SEC.12.
IC 16-36-5-27
Destruction of declaration; forgery of revocation
Sec. 27. A person who knowingly or intentionally:
(1) physically cancels or destroys an out of hospital DNR declaration and order without the declarant’s consent;
(2) physically cancels or destroys an out of hospital DNR declaration and order without the declarant’s representative’s consent if the declarant is incompetent; or
(3) falsifies or forges a revocation of another person’s out of hospital DNR declaration and order;
commits a Class B misdemeanor.
As added by P.L.148-1999, SEC.12.
IC 16-36-5-28
Deception with intent to cause withholding of CPR
Sec. 28. (a) A person who knowingly or intentionally:
(1) falsifies or forges the out of hospital DNR declaration and order of another person with intent to cause the withholding or withdrawal of CPR; or
(2) conceals or withholds personal knowledge of the revocation of an out of hospital DNR declaration and order with intent to cause the withholding or withdrawal of CPR;
commits a Class C felony.
(b) A person who commits an offense described in this section is subject to IC 29-1-2-12.1.
As added by P.L.148-1999, SEC.12.