House 5447

WEST VIRGINIA LEGISLATURE

2026 REGULAR SESSION

Introduced

House Bill 5447

By Delegates Pritt and Worrell

[Introduced February 11, 2026; referred to the Committee on Health and Human Resources]

A BILL to amend and reenact §16-30C-3 and §16-30C-7 of the Code of West Virginia, 1931, as amended; and to amend said code by adding a new section designated §16-30C-7a, relating to the Do Not Resuscitate Act; adding definitions clarifying code status orders; compliance with do-not-resuscitate orders; and requiring hospitals and other health-care facilities to adopt or amend internal do-not-resuscitate order policy to reflect the availability of two-tier code status (DNR-CCA and DNR-CC).

Be it enacted by the Legislature of West Virginia:

ARTICLE 30C. DO NOT RESUSCITATE ACT.

§16-30C-3. Definitions.

As used in this article, unless the context clearly requires otherwise, the following definitions apply:

(a) "Attending physician" means the physician selected by or assigned to the person who has primary responsibility for treatment or care of the person and who is a licensed physician. If more than one physician shares that responsibility, any of those physicians may act as the attending physician under the provisions of this article.

(b) "Cardiopulmonary resuscitation" means those measures used to restore or support cardiac or respiratory function in the event of a cardiac or respiratory arrest.

"Do-not-resuscitate comfort care arrest (DNR-CCA)" means a code-status order indicating that the patient may receive all medically indicated or desired interventions — including diagnostics, therapies, mechanical ventilation, vasopressors, IV fluids, nutrition, and other disease-directed treatments — up until the moment of cardiopulmonary arrest; at that moment, CPR (chest compressions, defibrillation, ACLS, etc.) shall not be performed.

"Do-not-resuscitate comfort care (DNR-CC)" means a code-status order indicating that the patient wishes for comfort-focused care only, with the withholding or withdrawal of all life-prolonging therapies, including but not limited to CPR, mechanical ventilation, vasopressors, hemodialysis, artificial nutrition/hydration, antibiotics for life-prolonging purposes, and invasive diagnostics or surgeries — while ensuring adequate palliative and comfort measures (pain/symptom management, oxygen for comfort, psychosocial/spiritual support, hygiene, oral intake if tolerated).

(c) "Do-not-resuscitate identification" means a standardized identification necklace, bracelet, card or physician orders for scope of treatment form as set forth in this article that signifies that a do-not-resuscitate order has been issued for the possessor.

(d) "Do-not-resuscitate order" means an order issued by a licensed physician that cardiopulmonary resuscitation should not be administered to a particular person and shall be interpreted to include DNR-CCA and DNR-CC categories when properly specified on the DNR order form or POST form.

(e) "Emergency medical services personnel" means paid or volunteer firefighters, law-enforcement officers, emergency medical technicians, paramedics or other emergency services personnel, providers or entities acting within the usual course of their professions.

(f) "Health care decision" means a decision to give, withhold or withdraw informed consent to any type of health care, including, but not limited to, medical and surgical treatments, including life-prolonging interventions, nursing care, hospitalization, treatment in a nursing home or other extended care facility, home health care and the gift or donation of a body organ or tissue.

(g) "Health care facility" means a facility established to administer and provide health care services and which is commonly known by a wide variety of titles, including, but not limited to, hospitals, medical centers, ambulatory health care facilities, physicians' offices and clinics, extended care facilities operated in connection with hospitals, nursing homes and extended care facilities operated in connection with rehabilitation centers.

(h) "Health care provider" means any physician, dentist, nurse, paramedic, psychologist or other person providing medical, dental, nursing, psychological or other health care services of any kind.

(i) "Home" means any place of residence other than a health care facility and includes residential board and care homes and personal care homes.

(j) "Incapacity" or words of like import means the inability because of physical or mental impairment, to appreciate the nature and implications of a health care decision, to make an informed choice regarding the alternatives presented and to communicate that choice in an unambiguous manner.

(k) "Physician orders for scope of treatment (POST) form" means a standardized form containing orders by a qualified physician that details a person's life-sustaining wishes as provided by §16-30-25 of this code.

(l) "Qualified physician" means a physician licensed to practice medicine who has personally examined the person.

(m) "Representative" means a person designated by a principal to make health care decisions in accordance with §16-30A-1 et seq. of this code.

(n) "Surrogate decision maker" or "surrogate" means an individual eighteen years of age or older who is reasonably available, is willing to make health care decisions on behalf of an incapacitated person, possesses the capacity to make health care decisions and is identified or selected by the attending physician or advanced nurse practitioner in accordance with applicable provisions of §16-30-1 et seq. of this code as the person or persons who is to make decisions pursuant to this article: Provided, That a representative named in the incapacitated person's medical power of attorney, if such document has been completed, shall have priority over a surrogate decision maker.

(o) "Trauma" means blunt or penetrating bodily injuries from impact which occur in situations, including, but not limited to, motor vehicle collisions, mass casualty incidents and industrial accidents.

§16-30C-7. Compliance with a do-not-resuscitate order.

(a) Health care providers shall comply with the do-not-resuscitate order when presented with one of the following:

(1) A do-not-resuscitate order completed by a physician on a form as specified in §16-30C-6 this code;

(2) Do-not-resuscitate identification as set forth in §16-30C-6 this code;

(3) A do-not-resuscitate order for a person present or residing in a health care facility issued in accordance with the health care facility's policies and procedures; or

(4) A physician orders for scope of treatment form in which a qualified physician has documented a do-not-resuscitate order.

(b) Pursuant to this article, health care providers shall respect do-not-resuscitate orders for persons in health care facilities, ambulances, homes and communities within this state.

(c) Every in hospital do-not-resuscitate order shall include explicit specification of the code-status category (Full Code / DNR-CCA / DNR-CC).  The order form (or POST form where used) shall include checkboxes or fields for:

(1) When a DNR order is placed or changed, the attending physician (or qualified APRN/PA per as in §16-30C-6 of this code) must shall discuss with the patient (or surrogate) the full scope of interventions that will be withheld or permitted under the selected category, ensuring informed consent;

(2) Code-status category (Full Code / DNR-CCA / DNR-CC);

(3) Scope of permitted interventions (if DNR-CCA or DNR-CC) — including, but not limited to, mechanical ventilation, vasopressors, IV fluids, antibiotics, nutrition, and comfort measures;

(4) Name of ordering provider, credentials, date/time; and

(5) Capacity assessment (or surrogate identification), consent documentation, and revocation instructions consistent with §16-30C-8.

§16-30C-7a. Facility Policy Requirement.

Hospitals and other health-care facilities shall adopt internal policy (or amend existing do-not-resuscitate order policy) to reflect the availability of the two-tier code statuses (DNR-CCA and DNR-CC), provide staff training, and include standardized order sets or EHR templates that incorporate the new categories.

NOTE: The purpose of this bill is to add explicit recognition of Do-not-resuscitate -Comfort Care Arrest (DNR-CCA) and Do-not-resuscitate -Comfort Care (DNR-CC) that is feasible and legally coherent, promoting clearer and more patient-centered care.

Strike-throughs indicate language that would be stricken from a heading or the present law and underscoring indicates new language that would be added.