txt

CSSSHB 54(HSS): "An Act providing an end-of-life option for terminally ill individuals; and providing for an effective date."

00            CS FOR SPONSOR SUBSTITUTE FOR HOUSE BILL NO. 54(HSS)                                                         
01 "An Act providing an end-of-life option for terminally ill individuals; and providing for                               
02 an effective date."                                                                                                     
03 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA:                                                                
04    * Section 1. AS 11.41.115 is amended by adding a new subsection to read:                                           
05            (g)  In a prosecution under AS 11.41.100(a)(1) or 11.41.110(a)(1) or (2), it is a                            
06       defense that the defendant was performing an action allowed under AS 13.56.                                       
07    * Sec. 2. AS 11.41.120 is amended by adding a new subsection to read:                                              
08            (c)  In a prosecution under this section, it is a defense that the defendant was                             
09       performing an action allowed under AS 13.56.                                                                      
10    * Sec. 3. AS 13 is amended by adding a new chapter to read:                                                        
11                    Chapter 56. Voluntary Ending of Life.                                                              
12            Sec. 13.56.010. Individuals allowed to end life. (a) As provided in this                                   
13       chapter, a qualified individual may use medicine obtained from the qualified                                      
14       individual's attending physician to end the qualified individual's life.                                          
01            (b)  To be a qualified individual under (a) of this section, an individual must                              
02                 (1)  be a resident of this state;                                                                       
03                 (2)  be 18 years of age or older;                                                                       
04                 (3)  have been determined to be capable;                                                                
05                 (4)  have been determined to be suffering from a terminal disease; and                                  
06                 (5)  have voluntarily expressed the wish to die.                                                        
07            (c)  An individual does not qualify under (b) of this section solely because of                              
08       the individual's age or disability.                                                                               
09            Sec. 13.56.020. Attending physician and pharmacist authority. If a                                         
10 qualified individual's attending physician complies with this chapter, the attending                                    
11       physician may                                                                                                     
12 (1)  dispense medication directly to the qualified individual, including                                                
13 ancillary medications intended to facilitate the desired effect or minimize the qualified                               
14       individual's discomfort; or                                                                                       
15 (2)  write a prescription for the medication for the qualified individual                                               
16 and in person, by mail, or by electronic transmission deliver the prescription for the                                  
17 medication to a pharmacist, who may dispense the medication to the qualified                                            
18 individual, the attending physician, or an expressly identified agent of the qualified                                  
19       individual.                                                                                                       
20 Sec. 13.56.030. Requests for medication. (a) To receive medication under this                                         
21 chapter, a qualified individual shall make an oral request and a written request to the                                 
22 qualified individual's attending physician. The qualified individual shall repeat the oral                              
23 request to the qualified individual's attending physician not sooner than 15 days after                                 
24       making the initial oral request.                                                                                  
25 (b)  Notwithstanding (a) of this section, if a qualified individual is not                                              
26 physically able to speak, a qualified individual may make an oral request by whatever                                   
27 means the qualified individual can use to make the request, including electronic                                        
28       means, as long as the request is made in person.                                                                  
29 (c)  Notwithstanding (a) of this section, if a qualified individual is not                                              
30 physically able to sign a written request, the qualified individual may direct another                                  
31       individual to sign for the qualified individual.                                                                  
01 Sec. 13.56.040. Right to rescind request. When a qualified individual makes                                           
02 the second oral request under AS 13.56.030, the attending physician shall offer the                                     
03 qualified individual an opportunity to rescind the initial oral request and the written                                 
04 request. A qualified individual may rescind a request at any time and in any manner                                     
05 without regard to the qualified individual's mental state. An attending physician may                                   
06 not dispense or prescribe medication under this chapter unless the attending physician                                  
07       offers the qualified individual an opportunity to rescind the request.                                            
08 Sec. 13.56.050. Written request requirements. (a) A written request for                                               
09 medication under this chapter must be in substantially the form described in                                            
10 AS 13.56.060, signed and dated by the qualified individual, and witnessed by at least                                   
11 two other individuals. The attending physician may not witness the request. The                                         
12 witnesses shall, in the presence of the qualified individual, attest that, to the best of                               
13 their knowledge and belief, the qualified individual is capable, acting voluntarily, and                                
14       not under undue influence to sign the request.                                                                    
15            (b) Only one witness may be                                                                                  
16 (1) a relative of the qualified individual by blood, marriage, or                                                       
17       adoption;                                                                                                         
18 (2) an individual who, at the time the qualified individual signs the                                                   
19 request, would be entitled to a portion of the estate of the qualified individual at death                              
20       under a will or by operation of law; or                                                                           
21 (3) an owner, operator, or employee of a health care facility where the                                                 
22       qualified individual is receiving medical treatment or is a resident.                                             
23 (c) If the qualified individual is an inpatient in a long-term care facility when                                       
24 the qualified individual signs the request, one of the witnesses shall be an individual                                 
25 designated by the facility who has the qualifications established by the department by                                  
26 regulation. In this subsection, "long-term care facility" includes an assisted living                                   
27       home as defined in AS 47.32.900 and a nursing facility as defined in AS 47.32.900.                                
28 Sec. 13.56.060. Form for written request. A request for a medication under                                            
29       this chapter must be in substantially the following form:                                                         
30                  REQUEST FOR MEDICATION TO END MY LIFE                                                                  
31            I, _________________, am an adult of sound mind.                                                             
01            I am suffering from _______________, which my attending physician                                            
02       has determined is a terminal disease and which has been medically confirmed                                       
03       by a consulting physician.                                                                                        
04 I have been fully informed of my diagnosis, prognosis, the nature of the                                                
05 medication to be prescribed and potential associated risks, the expected result,                                        
06 and the feasible alternatives, including comfort care, hospice care, and pain                                           
07       control.                                                                                                          
08            I request that my attending physician prescribe medication that will end                                     
09       my life in a humane and dignified manner.                                                                         
10            INITIAL ONE OF THE FOLLOWING:                                                                                
11 _____ I have informed my family of my decision and taken their                                                          
12       opinions into consideration.                                                                                      
13            _____ I have decided not to inform my family of my decision.                                                 
14            _____ I have no family to inform of my decision.                                                             
15            I understand that I have the right to rescind this request at any time.                                      
16 I understand the full import of this request, and I expect to die when I                                                
17 take the medication to be prescribed. I further understand that, although most                                          
18 deaths occur within three hours, my death may take longer, and my attending                                             
19       physician has counseled me about this possibility.                                                                
20 I make this request voluntarily and without reservation, and I accept                                                   
21       full moral responsibility for my actions.                                                                         
22            Signed: _____________________                                                                                
23            Dated: ______________________                                                                                
24                        DECLARATION OF WITNESSES                                                                         
25            We declare that the person signing this request                                                              
26 (1) is personally known to us or has provided proof of                                                                  
27            identity;                                                                                                    
28 (2) in our presence signed or directed another person to                                                                
29            sign this request;                                                                                           
30 (3) is not an individual for whom either of us is the                                                                   
31            attending physician; and                                                                                     
01                      (4) to the best of our knowledge and belief,                                                       
02                           (A) has the ability to make and communicate                                                   
03                 health care decisions to health care providers; and                                                     
04                           (B) is acting voluntarily and not under undue                                                 
05                 influence.                                                                                              
06            _______________________ Witness 1 Date: _____                                                                
07            _______________________ Witness 2 Date: _____                                                                
08            NOTE: One witness may not be a relative (by blood, marriage, or adoption) of                                 
09       the individual signing this request, may not be entitled to a portion of the individual's                         
10 estate on death, and may not own, operate, or be employed at a health care facility                                     
11 where the person is an individual or resident. If the individual is an inpatient at a                                   
12 health care facility, one of the witnesses shall be an individual designated by the                                     
13       facility.                                                                                                         
14 Sec. 13.56.070. Attending physician duties and authority. (a) The attending                                           
15       physician shall                                                                                                   
16 (1)  make the initial determination of whether an individual has a                                                      
17       terminal disease, is capable, and has made the request for medication voluntarily;                                
18 (2)  request that the individual demonstrate that the individual is a                                                   
19       resident of this state;                                                                                           
20                 (3)  inform the individual of the                                                                       
21                      (A)  individual's medical diagnosis;                                                               
22                      (B)  individual's prognosis;                                                                       
23                      (C)  potential risks associated with taking the medication;                                        
24                      (D)  probable result of taking the medication; and                                                 
25 (E)  feasible alternatives, including comfort care, hospice care,                                                       
26            and pain control;                                                                                            
27 (4)  refer the individual to a consulting physician for medical                                                         
28 confirmation of the diagnosis and for a determination that the individual is capable and                                
29       acting voluntarily;                                                                                               
30 (5)  refer the individual for counseling if appropriate under                                                           
31       AS 13.56.090;                                                                                                     
01                 (6)  recommend that the individual notify the individual's next of kin;                                 
02                 (7)  counsel the individual about the importance of having another                                      
03       person present when the individual takes the medication prescribed under this chapter                             
04       and of not taking the medication in a public place;                                                               
05 (8)  inform the individual that the individual has an opportunity to                                                    
06 rescind the request at any time and in any manner and offer the individual an                                           
07 opportunity to rescind the request at the end of the 15-day waiting period under                                        
08       AS 13.56.030;                                                                                                     
09                 (9)  immediately before dispensing or prescribing medication under this                                 
10       chapter, verify that the individual is making an informed decision;                                               
11 (10)  fulfill the requirements of AS 13.56.130 for medical record                                                       
12       documentation;                                                                                                    
13 (11)  ensure that all appropriate steps are carried out under this chapter                                              
14 before dispensing or prescribing medication to enable a qualified individual to end the                                 
15       qualified individual's life under this chapter; and                                                               
16 (12)  if the attending physician has a current federal Drug Enforcement                                                 
17 Administration registration number and complies with applicable regulations, dispense                                   
18 medication directly, including ancillary medications intended to facilitate the desired                                 
19 effect or minimize the qualified individual's discomfort, or, with the qualified                                        
20       individual's consent,                                                                                             
21 (A)  contact a pharmacist and inform the pharmacist of a                                                                
22            prescription for the medication; and                                                                         
23 (B)  deliver the written prescription in person, by mail, or by                                                         
24 electronic transmission to the pharmacist who will dispense the medication to                                           
25 the qualified individual, the attending physician, or an agent of the qualified                                         
26            individual who is expressly identified as an agent by the qualified individual.                              
27 (b)  Notwithstanding any other provision of law to the contrary, the attending                                          
28       physician may sign the qualified individual's death certificate.                                                  
29 Sec. 13.56.080. Confirmation by consulting physician. Before an individual                                            
30 becomes a qualified individual under this chapter, a consulting physician shall                                         
31 examine the individual and the individual's relevant medical records, confirm in                                        
01 writing the attending physician's diagnosis that the individual is suffering from a                                     
02 terminal disease, and verify that the individual is capable, is acting voluntarily, and                                 
03       has made an informed decision.                                                                                    
04 Sec. 13.56.090. Counseling referral. If the attending physician or the                                                
05 consulting physician determines that an individual may be suffering from a psychiatric                                  
06 or psychological disorder or depression causing impaired judgment, either physician                                     
07 shall refer the individual for counseling, and the attending physician may not dispense                                 
08 or prescribe medication until the person performing the counseling determines that the                                  
09 individual is not suffering from depression or a psychiatric or psychological disorder                                  
10       causing impaired judgment.                                                                                        
11 Sec. 13.56.100. Informed decision. An attending physician may not dispense                                            
12 or prescribe medication unless the qualified individual has made an informed decision.                                  
13 Immediately before dispensing or prescribing medication under this chapter, the                                         
14 attending physician shall verify that the qualified individual is making an informed                                    
15       decision.                                                                                                         
16 Sec. 13.56.110. Family notification. The attending physician may not deny a                                           
17 qualified individual's request for medication if the qualified individual declines or is                                
18       unable to notify the qualified individual's next of kin.                                                          
19 Sec. 13.56.120. Waiting periods. An attending physician may not dispense                                              
20 medication or write a prescription for medication for a qualified individual unless at                                  
21 least 15 days have elapsed between the qualified individual's initial oral request and                                  
22 the writing of the prescription and more than 48 hours have elapsed between the                                         
23       qualified individual's written request and the writing of the prescription.                                       
24 Sec. 13.56.130. Medical record documentation requirements. Before a                                                   
25 qualified individual receives medication under this chapter, the medical record of the                                  
26       qualified individual must contain                                                                                 
27 (1)  a record of all oral requests by a qualified individual for medication                                             
28       under this chapter;                                                                                               
29 (2)  all written requests by a qualified individual for medication under                                                
30       this chapter;                                                                                                     
31 (3)  the attending physician's diagnosis, prognosis, and determination                                                  
01       that the individual is capable, is acting voluntarily, and has made an informed                                   
02       decision;                                                                                                         
03                 (4)  the consulting physician's diagnosis, prognosis, and verification                                  
04       that the individual is capable, is acting voluntarily, and has made an informed                                   
05       decision;                                                                                                         
06                 (5)  if counseling is performed, a report of the determinations made                                    
07       during counseling and the outcome;                                                                                
08                 (6)  a record of the attending physician's offer to the qualified                                       
09       individual to rescind the qualified individual's request at the time of the qualified                             
10       individual's second oral request under AS 13.56.030;                                                              
11 (7)  a note by the attending physician indicating that all requirements                                                 
12 under this chapter have been met and indicating the steps taken to carry out the                                        
13       request, including a statement describing the medication prescribed.                                              
14 Sec. 13.56.140. Effect on construction of wills and contracts. A provision in                                         
15 a will or a contract, whether written or oral, is not valid to the extent that the provision                            
16 requires, prohibits, imposes a condition on, or otherwise addresses whether an                                          
17       individual may make or rescind a request for medication under this chapter.                                       
18 Sec. 13.56.150. Immunity; effect of action on status of individuals. (a) A                                            
19 person is not subject to civil or criminal liability or professional disciplinary action,                               
20 including disciplinary action by a licensing authority, for participating or otherwise                                  
21 acting in good faith compliance with this chapter, including being present when a                                       
22 qualified individual takes the prescribed medication to end the qualified individual's                                  
23       life under this chapter.                                                                                          
24 (b)  A professional organization or association or health care provider may not                                         
25 subject a person to censure, discipline, suspension, loss of license, loss of privileges,                               
26 loss of membership, or other penalty for participating in or refusing to participate in                                 
27       good faith compliance with this chapter.                                                                          
28 (c)  A request by an individual for, or provision by an attending physician of,                                         
29 medication in good faith compliance with this chapter does not provide the sole basis                                   
30       for the appointment of a guardian or conservator of the individual.                                               
31 Sec. 13.56.160. No duty to participate. A health care provider is not under a                                         
01 duty, whether by contract, statute, or other legal requirement, to dispense medication,                                 
02 prescribe medication, or otherwise participate in the provision of medication to a                                      
03 qualified individual under this chapter. If a health care provider is unable or unwilling                               
04 to carry out a qualified individual's request under AS 13.56.030 and the qualified                                      
05 individual transfers the qualified individual's care to another health care provider, the                               
06 transferring health care provider shall provide to the other health care provider, at the                               
07 qualified individual's request, a copy of the qualified individual's relevant medical                                   
08       records.                                                                                                          
09 Sec. 13.56.170. Prohibitions. Notwithstanding another provision of law to the                                         
10 contrary, a health care provider may not prohibit another health care provider,                                         
11 including an employee, contractor, or lessee of the prohibiting health care provider,                                   
12 from participating in this chapter. However, a health care provider may prohibit                                        
13 another health care provider, including an employee, contractor, or lessee of the                                       
14 prohibiting health care provider, from allowing a patient of the prohibited health care                                 
15 provider to administer medication on the premises of the prohibiting health care                                        
16       provider if the medication was obtained under this chapter.                                                       
17 Sec. 13.56.180. Prohibition notice. To prohibit another health care provider                                          
18 from allowing a patient to administer medication on the premises of the prohibiting                                     
19 health care provider, the prohibiting health care provider shall notify the prohibited                                  
20       health care provider in writing about the prohibition.                                                            
21 Sec. 13.56.190. Sanctions. (a) Notwithstanding AS 13.56.150 and 13.56.160,                                            
22 if a health care provider violates a prohibition allowed under AS 13.56.170 after                                       
23 receiving a written notice under AS 13.56.180, the prohibiting health care provider                                     
24       may impose the following sanctions on the prohibited health care provider:                                        
25 (1)  loss of privileges, loss of membership, or other sanction provided                                                 
26 under the bylaws, policies, or procedures of the prohibiting health care provider if the                                
27 prohibited health care provider is a member of the prohibiting health care provider's                                   
28       medical staff;                                                                                                    
29 (2)  termination of a lease or another contract between the prohibiting                                                 
30 health care provider and the prohibited health care provider, or an imposition of                                       
31 nonmonetary remedies provided by the lease or other contract; in this paragraph,                                        
01       "remedies" does not include the loss or restriction of medical staff privileges or                                
02       exclusion from a medical care provider panel.                                                                     
03            (b)  A prohibiting health care provider who imposes sanctions under (a) of this                              
04       section shall follow all procedures that are provided under an applicable contract, the                           
05       applicable terms of employment, or law for imposing the sanctions.                                                
06            (c)  Suspension or termination of staff membership or privileges under (a) of                                
07       this section is not reportable under AS 08.64.336.                                                                
08            Sec. 13.56.200. Criminal penalties. (a) A person commits the crime of abuse                                
09       of life-ending process if the person, with the intent to cause the individual's death or                          
10       knowing that the death of the individual is substantially certain to result,                                      
11 (1)  without the authorization of the individual, falsely makes,                                                        
12 completes, or alters a request for medication or conceals or destroys a rescission of the                               
13       individual's request; or                                                                                          
14 (2)  exerts undue influence on an individual to request medication for                                                  
15 the purpose of ending the individual's life or to destroy a rescission of the individual's                              
16 request; in this paragraph, "undue influence" means the control of an individual by a                                   
17 person who stands in a position of trust or confidence to exploit wrongfully the trust,                                 
18 dependency, or fear of the individual to gain control over the decision making of the                                   
19       individual.                                                                                                       
20 (b)  Abuse of life-ending process is a class A felony and may be punished as                                            
21       provided in AS 12.55.                                                                                             
22 (c)  This chapter does not prevent the imposition of criminal penalties that                                            
23       apply under another law for conduct that is inconsistent with this chapter.                                       
24 Sec. 13.56.210. Civil penalties. This chapter does not limit liability for civil                                      
25       damages resulting from a person's negligent conduct or intentional misconduct.                                    
26 Sec. 13.56.220. Claims for costs incurred. A governmental entity that incurs                                          
27 expenses that result from a qualified individual's ending the qualified individual's life                               
28 under this chapter in a public place may file a claim against the estate of the individual                              
29       to recover the costs and attorney fees related to enforcing the claim.                                            
30 Sec. 13.56.230. Duties of department. (a) The department shall annually                                               
31       review a sample of records maintained under this chapter.                                                         
01 (b)  After dispensing medication under this chapter, a health care provider shall                                       
02       file with the department a copy of the record of dispensing the medication.                                       
03 (c)  The department shall adopt regulations under AS 44.62 (Administrative                                              
04 Procedure Act) to facilitate the collection of information about compliance with this                                   
05 chapter. The information collected is not a public record under AS 40.25.110, and the                                   
06       department may not make the information available for inspection by the public.                                   
07 (d)  The department shall generate and make available to the public an annual                                           
08 statistical report of the information collected under (c) of this section. The statistical                              
09 report may not disclose information that is confidential under (c) of this section, but                                 
10 shall present the information in a manner that prevents the identification of particular                                
11       persons.                                                                                                          
12 (e)  In this section, "department" means the Department of Health and Social                                            
13       Services.                                                                                                         
14 Sec. 13.56.240. Attending physician qualifications. (a) To qualify as an                                              
15       attending physician under this chapter, a physician must                                                          
16                 (1)  have primary responsibility for the patient's health care;                                         
17 (2)  have primary responsibility for the treatment of the patient's                                                     
18       terminal illness; and                                                                                             
19 (3)  routinely provide medical care to patients with advanced and                                                       
20       terminal illnesses in the normal course of the physician's practice.                                              
21 (b)  Notwithstanding (a)(3) of this section, an attending physician's practice                                          
22 may not be primarily or solely made up of individuals requesting medication under                                       
23       this chapter.                                                                                                     
24 Sec. 13.56.250. Construction of chapter. (a) This chapter may not be                                                  
25 construed to authorize or require a health care provider to provide health care contrary                                
26       to generally accepted health care standards applicable to the health care provider.                               
27 (b)  This chapter may not be construed to authorize a physician or another                                              
28 person to end an individual's life by lethal injection, mercy killing, or active                                        
29 euthanasia. An action allowed by this chapter is an affirmative defense to a criminal                                   
30 charge of homicide, murder, manslaughter, criminally negligent homicide, suicide,                                       
31       assisted suicide, mercy killing, or euthanasia under the law of this state.                                       
01 Sec. 13.56.260. Insurance or annuity policies; contracts. Notwithstanding                                             
02 AS 21.45.250 or another provision of law to the contrary, a person may not condition                                    
03 the sale, procurement, issuance, rate, delivery, issuance for delivery, or other aspect of                              
04 a life insurance policy, health insurance policy, accident insurance policy, or annuity                                 
05 policy, or another contract on the making or rescission of a request by a qualified                                     
06       individual for medication under this chapter.                                                                     
07 Sec. 13.56.270. Coordination with other law. A request for medication under                                           
08 this chapter is not an advance health care directive under AS 13.52, and AS 13.52 does                                  
09       not apply to an activity allowed by this chapter.                                                                 
10 Sec. 13.56.290. Definitions. In this chapter, unless the context indicates                                            
11       otherwise,                                                                                                        
12 (1)  "attending physician" means a physician who qualifies under                                                        
13       AS 13.56.240 as an attending physician;                                                                           
14 (2)  "capable" means that an individual has the ability to make and                                                     
15 communicate health care decisions to health care providers; in this paragraph,                                          
16 "communicate" includes communication through a person familiar with the                                                 
17       individual's manner of communicating if the person is available;                                                  
18 (3)  "consulting physician" means a physician who is qualified by                                                       
19 specialty or experience to make a professional diagnosis and prognosis about the                                        
20       individual's disease;                                                                                             
21 (4)  "counseling" means consultation as necessary between a                                                             
22 psychiatrist or psychologist and an individual to determine whether the individual is                                   
23 capable and not suffering from a psychiatric or psychological disorder or depression                                    
24       causing impaired judgment;                                                                                        
25 (5)  "health care provider" means a person or health care facility                                                      
26 licensed, certified, or otherwise authorized or permitted by the law of this state to                                   
27 administer health care or dispense medication in the ordinary course of business or                                     
28 practice of a profession; in this paragraph, "health care facility" means a private,                                    
29 municipal, or state hospital; independent diagnostic testing facility; primary care                                     
30 outpatient facility; skilled nursing facility; kidney disease treatment center, including                               
31 freestanding hemodialysis units; intermediate care facility; ambulatory surgical                                        
01 facility; Alaska Pioneers' Home or Alaska Veterans' Home administered by the                                            
02 department under AS 47.55; state correctional facility as defined in AS 33.30.901;                                      
03 private, municipal, or state facility employing one or more public health nurses; and                                   
04       long-term care facility;                                                                                          
05                 (6)  "informed decision" means a decision that is based on an                                           
06       appreciation of the relevant facts and that is made after the attending physician fully                           
07       informs an individual of the                                                                                      
08                      (A)  individual's medical diagnosis;                                                               
09                      (B)  individual's prognosis;                                                                       
10 (C)  potential risks associated with taking the medication to be                                                        
11            prescribed;                                                                                                  
12 (D)  probable result of taking the medication to be prescribed;                                                         
13            and                                                                                                          
14 (E)  feasible alternatives, including comfort care, hospice care,                                                       
15            and pain control;                                                                                            
16 (7)  "medication" means medication to end a qualified individual's life                                                 
17       under this chapter;                                                                                               
18 (8)  "physician" means a doctor of medicine or osteopathy who is                                                        
19       licensed under AS 08.64 to practice medicine or osteopathy;                                                       
20 (9)  "prescription" means a prescription for medication to end a                                                        
21       qualified individual's life under this chapter;                                                                   
22 (10)  "prohibited health care provider" means a health care provider                                                    
23       that is prohibited by another health care provider under AS 13.56.170;                                            
24 (11)  "prohibiting health care provider" means a health care provider                                                   
25       that prohibits another health care provider under AS 13.56.170;                                                   
26 (12)  "qualified individual" means an individual who is qualified under                                                 
27       AS 13.56.010(b);                                                                                                  
28                 (13)  "request" means a request under AS 13.56.030;                                                     
29 (14)  "terminal disease" means an incurable and irreversible disease                                                    
30 that has been medically confirmed and that will, within reasonable medical judgment,                                    
31 produce death within six months; in this paragraph, "medically confirmed" means that                                    
01       a consulting physician who has examined the individual's relevant medical records has                             
02       confirmed the medical opinion of the attending physician.                                                         
03    * Sec. 4. The uncodified law of the State of Alaska is amended by adding a new section to                          
04 read:                                                                                                                   
05       APPLICABILITY. AS 13.56, enacted by sec. 3 of this Act, applies to a contract, will,                              
06 or life, health, or accident insurance or annuity policy if the contract, will, or policy is                            
07 delivered or issued for delivery on or after the effective date of sec. 3 of this Act.                                  
08    * Sec. 5. The uncodified law of the State of Alaska is amended by adding a new section to                          
09 read:                                                                                                                   
10       TRANSITION: REGULATIONS. The Department of Health and Social Services may                                         
11 adopt regulations authorized by AS 13.56, enacted by sec. 3 of this Act. The regulations take                           
12 effect under AS 44.62 (Administrative Procedure Act), but not before January 1, 2019.                                   
13    * Sec. 6. Section 5 of this Act takes effect immediately under AS 01.10.070(c).                                    
14    * Sec. 7. Except as provided in sec. 6 of this Act, this Act takes effect January 1, 2019.