HB3093/SB783, An Act Improving Medical Decision Making

Joint Committee on the Judiciary

The Massachusetts Hospital Association (MHA), on behalf of its member hospitals and health systems, appreciate this opportunity to offer its strong support for HB3093/SB783, “An Act Improving Medical Decision Making.” This bill would improve medical decision-making processes by establishing guidelines for healthcare providers to discuss medical treatment with an appropriate and legally valid surrogate when a patient is incapacitated and lacks a health care proxy.

Currently, when a patient is incapacitated, hospitals and healthcare providers work with patients to secure a legally valid health care proxy or the appointment of a legal guardian, as appropriate, to assist with full medical decision-making. However, in situations when a valid health care proxy has not been executed for an incapacitated patient, providers are forced to go through lengthy, cumbersome, and expensive court processes to identify and appoint a valid legal guardian. As a result, patients are often prevented from accessing necessary post-acute levels care while they remain boarded in hospital emergency departments or inpatient units until courts proceedings are completed and a ruling is issued..

The vast majority of states across the country (44 states to date) have successfully addressed this troubling bureaucratic delay by establishing a priority list of surrogates for incapacitated patients without health care proxies. HB3093/SB783 would align Massachusetts with the rest of the nation by creating a legally valid standard under which a treating health care provider could appoint a surrogate decision-maker – following the family hierarchy set forth in the bill - for non-extraordinary medical decisions for a patient who lacks a health care proxy. It is important to note that this hierarchy is the same list that the Department of Public Health has adopted for hospitals and clinics to use in obtaining consent for autopsies and laboratory testing. Appropriately accelerating the same medical decision-making process under HB3093/SB783 to all levels of care will enhance safe and timely care for these patients.

For all of these reasons, MHA respectfully requests that the committee issue HB3093/SB783 an expedited favorable report. Thank you for your time and your consideration of this matter. If you have any questions or need further information, please do not hesitate to contact Michael Sroczynski, MHA’s Vice President of Government Advocacy at (781) 262-6055 or msroczynski@mhalink.org.