SENATE AMENDED
PRIOR PRINTER'S NOS. 81, 1073, 1483 PRINTER'S NO. 2022
No. 96 Session of 2001
INTRODUCED BY FLEAGLE, NICKOL, MUNDY, CLARK, MANDERINO, VANCE,
L. I. COHEN, BELFANTI, T. STEVENSON, BEBKO-JONES, MARSICO,
FRANKEL, B. SMITH, BELARDI, RUBLEY, MAITLAND, DALEY, HERSHEY,
CAPPABIANCA, GEIST, HALUSKA, M. BAKER, STERN, CORRIGAN,
TIGUE, SCRIMENTI, SHANER, MAYERNIK, BARRAR, BASTIAN,
BENNINGHOFF, CLYMER, DAILEY, FAIRCHILD, HENNESSEY, JADLOWIEC,
R. MILLER, S. MILLER, NAILOR, PHILLIPS, SATHER, SOLOBAY,
STABACK, WILT, ZUG, BROWNE, SEMMEL, STEELMAN, McCALL AND
BOYES, JANUARY 23, 2001
SENATOR MOWERY, PUBLIC HEALTH AND WELFARE, IN SENATE, AS
AMENDED, MAY 22, 2001
AN ACT
1 Amending Title 20 (Decedents, Estates and Fiduciaries) of the
2 Pennsylvania Consolidated Statutes, further providing for the <--
3 family exemptions and for advance directives for health care, <--
4 FOR definitions and FOR emergency medical services; and <--
5 providing for out-of-hospital nonresuscitation.
6 The General Assembly of the Commonwealth of Pennsylvania
7 hereby enacts as follows:
8 Section 1. Section 3121 of Title 20 of the Pennsylvania <--
9 Consolidated Statutes is amended to read:
10 § 3121. When allowable.
11 (a) General rule.--The spouse of any decedent dying
12 domiciled in the Commonwealth, and if there be no spouse, or if
13 he has forfeited his rights, then such children as are members
14 of the same household as the decedent, and in the event there
15 are no such children, then the parent or parents of the decedent
1 who are members of the same household as the decedent, may
2 retain or claim as an exemption either real or personal
3 property, or both, not theretofore sold by the personal
4 representative, to the value of $3,500: Provided, That property
5 specifically devised or bequeathed by the decedent, or otherwise
6 specifically disposed of by him, may not be so retained or
7 claimed if other assets are available for the exemption. The
8 surviving husband or wife shall be a competent witness as to all
9 matters pertinent to the issue of forfeiture of the right to
10 exemption.
11 (b) Additional exemption amount.--In addition to the family
12 exemption amount provided for in subsection (a), there shall be
13 an exemption of $2,000 if the decedent executed an anatomical
14 gift of all or part of his or her body.
15 Section 1.1. The definition of "declarant" in section 5403
16 of Title 20 is amended to read:
17 SECTION 1. THE DEFINITION OF "DECLARANT" IN SECTION 5403 OF <--
18 TITLE 20 OF THE PENNSYLVANIA CONSOLIDATED STATUTES IS AMENDED TO
19 READ:
20 § 5403. Definitions.
21 The following words and phrases when used in this chapter
22 shall have the meanings given to them in this section unless the
23 context clearly indicates otherwise:
24 * * *
25 "Declarant." A person who makes a declaration in accordance
26 with this chapter. The term includes an emancipated minor.
27 * * *
28 Section 2. Section 5413 of Title 20 is amended to read:
29 § 5413. Emergency medical services.
30 [(a) Care given prior to declaration taking effect.--Nothing
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1 in this chapter shall be construed to make the provisions of a
2 declaration apply to care given to a patient by emergency
3 medical services personnel prior to the declaration's becoming
4 operative under sections 5405 (relating to when declaration
5 becomes operative) and 5408 (relating to duty of physician to
6 confirm terminal condition).
7 (b) Care given after declaration takes effect.--The
8 provisions of a declaration shall apply to care given to a
9 patient by emergency medical services personnel after the
10 declaration becomes operative under sections 5405 and 5408 only
11 if:
12 (1) an original declaration, signed by the declarant or
13 other authorized person, is presented to the emergency
14 medical services personnel. The emergency medical services
15 personnel must immediately notify the medical command
16 physician of the presence of the declaration; or
17 (2) the medical command physician, based on prior
18 notification by the attending physician or other health care
19 provider that a valid and operative declaration exists,
20 directs the emergency medical service personnel according to
21 the provisions of the declaration.
22 (c) Uncertainty regarding validity of declaration.--
23 Emergency medical services personnel confronted with any
24 conflicting information regarding the patient's wishes for life-
25 sustaining treatment shall act according to the accepted
26 treatment protocols and standards appropriate to their level of
27 certification.]
28 (a) General rule.--An emergency medical services provider
29 shall, in the course of providing care to a declarant, at all
30 times comply with the instructions of an authorized medical
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1 command physician to withhold or discontinue cardiopulmonary
2 resuscitation FOR A DECLARANT WHOSE ADVANCE DIRECTIVE HAS BECOME <--
3 OPERATIVE UNDER SECTION 5405 (RELATING TO WHEN DECLARATION
4 BECOMES OPERATIVE).
5 (b) Applicability.--This section is applicable only in those
6 instances where an out-of-hospital DNR order is not in effect
7 under section 5404-A(a) (relating to orders, bracelets and
8 necklaces).
9 Section 3. Title 20 is amended by adding a chapter to read:
10 CHAPTER 54-A
11 OUT-OF-HOSPITAL NONRESUSCITATION
12 Sec.
13 5401-A. Short title of chapter.
14 5402-A. Legislative findings and intent.
15 5403-A. Definitions.
16 5404-A. Orders, bracelets and necklaces.
17 5405-A. Revocation.
18 5406-A. Liability.
19 5407-A. Effect on suicide and life insurance.
20 5408-A. Order optional.
21 5409-A. Preservation of existing rights.
22 5410-A. Emergency medical services.
23 5411-A. Pregnancy.
24 5412-A. Penalties.
25 5413-A. Severability.
26 § 5401-A. Short title of chapter.
27 This chapter shall be known and may be cited as the Do-Not-
28 Resuscitate Act.
29 § 5402-A. Legislative findings and intent.
30 The General Assembly finds and declares as follows:
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1 (1) Although cardiopulmonary resuscitation has saved the
2 lives of individuals about to experience sudden, unexpected
3 death, present medical data indicates that cardiopulmonary
4 resuscitation rarely leads to prolonged survival in
5 individuals with terminal illnesses in whom death is
6 expected.
7 (2) In many circumstances, the performance of
8 cardiopulmonary resuscitation may cause infliction of
9 unwanted and unnecessary pain and suffering.
10 (3) Existing emergency medical services protocols may
11 require emergency medical services personnel to proceed to
12 cardiopulmonary resuscitation when an individual is found in
13 a cardiac or respiratory arrest even if the individual has
14 completed a living will or advance directive indicating that
15 the individual does not wish to receive cardiopulmonary
16 resuscitation.
17 (4) The administration of cardiopulmonary resuscitation
18 by emergency medical services personnel to an individual with
19 an out-of-hospital do-not-resuscitate order offends the
20 dignity of the individual and conflicts with standards of
21 accepted medical practice.
22 (5) This chapter provides clear direction to emergency
23 medical services personnel and other health care providers in
24 regard to the performance of cardiopulmonary resuscitation.
25 (6) Nothing in this chapter is intended to condone,
26 authorize or approve mercy killing, euthanasia or aided
27 suicide or to permit any affirmative or deliberate act or
28 omission to end life other than as defined in this chapter.
29 § 5403-A. Definitions.
30 The following words and phrases when used in this chapter
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1 shall have the meanings given to them in this section unless the
2 context clearly indicates otherwise:
3 "Attending physician." The physician who has primary
4 responsibility for the treatment and care of the patient.
5 "Bracelet." An out-of-hospital do-not-resuscitate bracelet.
6 "Cardiopulmonary resuscitation." Cardiac compression,
7 invasive airway techniques, artificial ventilation,
8 defibrillation and other related procedures.
9 "Declarant." As defined in section 5403 (relating to
10 definitions).
11 "Declaration." As defined in section 5403 (relating to
12 definitions).
13 "Department." The Department of Health of the Commonwealth.
14 "DNR." Do not resuscitate.
15 "Emergency medical services provider." A health care
16 provider recognized under the act of July 3, 1985 (P.L.164,
17 No.45), known as the Emergency Medical Services Act. The term
18 includes those individuals recognized under 42 Pa.C.S. § 8331.2
19 (relating to good Samaritan civil immunity for use of automated
20 external defibrillator).
21 "EMS." Emergency medical services.
22 "Health care provider." A person who is licensed or
23 certified by the laws of this Commonwealth to administer health
24 care in the ordinary course of business or practice of a
25 profession. The term includes personnel recognized under the act
26 of July 3, 1985 (P.L.164, No.45), known as the Emergency Medical
27 Services Act. The term includes those individuals recognized
28 under 42 Pa.C.S. § 8331.2 (relating to good Samaritan civil
29 immunity for use of automated external defibrillator).
30 "Incompetent." The lack of sufficient capacity for a person
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1 to make or communicate decisions concerning himself.
2 "Invasive airway technique." Any advanced airway technique,
3 including endotracheal intubation.
4 "Life-sustaining treatment." Any medical procedure or
5 intervention that, when administered to a patient, will serve
6 only to prolong the process of dying or to maintain the patient
7 in a state of permanent unconsciousness. Life-sustaining
8 treatment shall include nutrition and hydration administered by
9 gastric tube or intravenously or any other artificial or
10 invasive means if the order of the patient so specifically
11 provides.
12 "Medical command physician." A licensed physician who is
13 authorized to give medical command under the act of July 3, 1985
14 (P.L.164, No.45), known as the Emergency Medical Services Act.
15 "Necklace." An out-of-hospital do-not-resuscitate necklace.
16 "Order." An out-of-hospital do-not-resuscitate order.
17 "Out-of-hospital do-not-resuscitate bracelet." A bracelet in
18 the standard format set forth in section 5404-A (relating to
19 orders, bracelets and necklaces), supplied by the department and
20 issued by the attending physician, which may be worn, at the
21 patient's option, to notify emergency medical services providers
22 of the presence of an order.
23 "Out-of-hospital do-not-resuscitate necklace." A necklace in
24 the standard format set forth in section 5404-A (relating to
25 orders, bracelets and necklaces), supplied by the department and
26 issued by the attending physician, which may be worn, at the
27 patient's option, to notify emergency medical services providers
28 of the presence of an order.
29 "Out-of-hospital do-not-resuscitate order." An order in the
30 standard format set forth in section 5404-A (relating to orders,
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1 bracelets and necklaces), supplied by the department and issued
2 by the attending physician, directing emergency medical services
3 providers to withhold cardiopulmonary resuscitation from the
4 patient in the event of respiratory or cardiac arrest.
5 "Out-of-hospital do-not-resuscitate patient." Any of the
6 following:
7 (1) An individual:
8 (i) who is in a terminal condition; and
9 (ii) who, pursuant to section 5404-A(a) (relating to
10 orders, bracelets and necklaces), possesses and in any
11 manner displays or causes to be displayed for emergency
12 medical services providers an apparently valid order,
13 bracelet or necklace.
14 (2) A declarant:
15 (i) whose declaration has become operative under
16 section 5405(2) (relating to when declaration becomes
17 operative); and
18 (ii) who, pursuant to section 5404-A(a), possesses
19 and in any manner displays or causes to be displayed for
20 emergency medical services providers an apparently valid
21 order, bracelet or necklace.
22 "Patient." An out-of-hospital do-not-resuscitate patient.
23 "Permanently unconscious." A medical condition that has been
24 diagnosed in accordance with currently accepted medical
25 standards and with reasonable medical certainty as total and
26 irreversible loss of consciousness and capacity for interaction
27 with the environment. The term includes, without limitation, a
28 persistent vegetative state or irreversible coma.
29 "Person." An individual, corporation, partnership,
30 association or Federal, State or local government or
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1 governmental agency.
2 "Terminal condition." An incurable and irreversible medical
3 condition in an advanced state caused by injury, disease or
4 physical illness which will, in the opinion of the attending
5 physician, to a reasonable degree of medical certainty, result
6 in death regardless of the continued application of life-
7 sustaining treatment.
8 § 5404-A. Orders, bracelets and necklaces.
9 (a) Issuance.--An attending physician, upon the request of
10 an individual who is at least 18 years of age, has graduated
11 from high school or has married, or the individual's surrogate
12 if the surrogate is so authorized, shall issue to the individual
13 an order, and may issue at the request of the patient or the
14 patient's surrogate a bracelet or necklace supplied by the
15 department. The patient may, at the patient's option, wear the
16 bracelet or display the order or necklace to notify emergency
17 medical services providers of the patient's do-not-resuscitate
18 status.
19 (b) Format of order.--The department shall, with the advice
20 of the Pennsylvania Emergency Health Services Council and with
21 the assistance of the regional emergency medical services
22 councils, make available within 180 days of the effective date
23 of this subsection standard orders for issuance to patients by
24 attending physicians of this Commonwealth. The form of the order
25 shall contain, but not be limited to, the following:
26 PENNSYLVANIA OUT-OF-HOSPITAL
27 DO-NOT-RESUSCITATE ORDER
28 Patient's full legal name:
29 I, the undersigned, state that I am the attending
30 physician of the patient named above. The above-named
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1 patient has requested this order and I have made the
2 determination that this patient is in a terminal
3 condition and eligible for an order.
4 I direct any and all emergency medical services
5 personnel, commencing on the effective date of this
6 order, to withhold cardiopulmonary resuscitation (cardiac
7 compression, invasive airway techniques, artificial
8 ventilation, defibrillation and other related procedures)
9 from the patient in the event of the patient's
10 respiratory or cardiac arrest. I further direct such
11 personnel to provide to the patient other medical
12 interventions, such as intravenous fluids, oxygen or
13 other therapies necessary to provide comfort care or to
14 alleviate pain, unless directed otherwise by the patient
15 or the emergency medical services provider's authorized
16 medical command physician.
17 Signature of attending physician:
18 Printed name of attending physician:
19 Dated:
20 Attending physician's emergency telephone number:
21 Signature of patient (if capable of making informed
22 decisions):
23 I, the undersigned, hereby direct that in the event
24 of my cardiac and/or respiratory arrest, efforts at
25 cardiopulmonary resuscitation not be initiated. I
26 understand that I may revoke these directions at any time
27 by giving verbal instructions to the emergency medical
28 services providers, by physical cancellation or
29 destruction of this form or my bracelet or necklace, or
30 by simply not displaying this form or the bracelet or
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1 necklace for my EMS caregivers.
2 Signature of surrogate (if patient is incapable of
3 making informed decisions):
4 I, the undersigned, hereby certify that I am
5 authorized to execute this order on the patient's behalf
6 by virtue of having been designated as the patient's
7 surrogate and/or by virtue of my relationship to the
8 patient (specify relationship: _________________). I
9 hereby direct that in the event of the patient's cardiac
10 and/or respiratory arrest, efforts at cardiopulmonary
11 resuscitation not be initiated.
12 (c) Format of bracelet.--The department shall, with the
13 advice of the Pennsylvania Emergency Health Services Council and
14 with the assistance of the regional emergency medical services
15 councils, make available within 180 days of the effective date
16 of this subsection standard bracelets for issuance to patients
17 by attending physicians. The bracelets shall be uniform in
18 design and shall, at a minimum, on the face clearly indicate
19 OUT-OF-HOSPITAL DNR and the name of the patient and attending
20 physician, as well as the dated signature of the attending
21 physician.
22 (d) Format of necklace.--The department shall, with the
23 advice of the Pennsylvania Emergency Health Services Council and
24 with the assistance of the regional emergency medical services
25 councils, make available within 180 days of the effective date
26 of this subsection standard necklaces for issuance to patients
27 by attending physicians. The necklaces shall be uniform in
28 design and shall, at a minimum, on the face clearly indicate
29 OUT-OF-HOSPITAL DNR and the name of the patient and attending
30 physician, as well as the dated signature of the attending
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1 physician.
2 § 5405-A. Revocation.
3 (a) Patient.--If a patient has obtained an order, only the
4 patient may revoke the patient's DNR status.
5 (b) Surrogate.--If a surrogate has obtained an order, the
6 patient or the surrogate may revoke the patient's status.
7 (c) Manner.--Revocation under this section may be done at
8 any time without regard to the patient's physical or mental
9 condition and in any manner, including verbally or by destroying
10 or not displaying the order, bracelet or necklace.
11 § 5406-A. Liability.
12 (a) General rule.--No physician, emergency medical services
13 provider or other health care provider who, consistent with this
14 chapter, causes or participates in the initiating, continuing,
15 withholding or withdrawal of life-sustaining treatment or
16 cardiopulmonary resuscitation from a patient shall, as a result
17 of such action, be subject to criminal or civil liability or be
18 found to have committed an act of unprofessional conduct if the
19 attending physician, health care provider or emergency medical
20 services provider has followed the patient's expressed wishes in
21 the form of a declaration, order or revocation, executed
22 pursuant to this chapter.
23 (b) Absence of order, bracelet or necklace.--The absence of
24 an order, bracelet or necklace by a patient shall not give rise
25 to any presumption as to the intent of the patient to consent to
26 or to refuse the initiation, continuation or termination of
27 life-sustaining treatment.
28 § 5407-A. Effect on suicide and life insurance.
29 (a) Criminal effect.--The withholding or withdrawal of life-
30 sustaining treatment from a patient in accordance with the
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1 provisions of this chapter shall not, for any purpose,
2 constitute suicide or homicide.
3 (b) Life insurance.--The making of or failure to make an
4 order in accordance with this chapter shall not affect in any
5 manner the sale, procurement or issuance of any policy of life
6 insurance nor shall it be deemed to modify the terms of an
7 existing policy of life insurance. No policy of life insurance
8 shall be legally impaired or invalidated in any manner by the
9 withholding or withdrawal of life-sustaining treatment from an
10 insured patient, notwithstanding any term of the policy to the
11 contrary.
12 § 5408-A. Order optional.
13 No physician or other health care provider and no health care
14 service plan, health maintenance organization, insurer issuing
15 disability insurance, self-insured employee welfare benefit
16 plan, nonprofit hospital plan or Federal, State or local
17 government sponsored or operated program may:
18 (1) require any person to execute an order as a
19 condition for being insured for or receiving health care
20 services; or
21 (2) charge any person a different rate or fee whether or
22 not the person executes or has executed an order.
23 § 5409-A. Preservation of existing rights.
24 The provisions of this chapter shall not impair or supersede
25 any existing rights or responsibilities not addressed in this
26 chapter.
27 § 5410-A. Emergency medical services.
28 (a) Medical command instructions.--Notwithstanding the
29 absence of an order, bracelet or necklace pursuant to this
30 section, emergency medical services providers shall at all times
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1 comply with the instructions of an authorized medical command
2 physician to withhold or discontinue resuscitation.
3 (b) Effect of order, bracelet or necklace.--
4 (1) Emergency medical services providers are authorized
5 to, and shall, comply with an order if made aware of the
6 order by examining a bracelet, a necklace or the order
7 itself.
8 (2) Emergency medical services providers shall provide
9 other medical interventions necessary and appropriate to
10 provide comfort and alleviate pain, including intravenous
11 fluids, medications, oxygen and any other intervention
12 appropriate to the level of the certification of the
13 provider, unless otherwise directed by the patient or the
14 emergency medical services provider's authorized medical
15 command physician.
16 (3) As used in this subsection, the term "comply" means:
17 (i) to withhold cardiopulmonary resuscitation from
18 the patient in the event of respiratory or cardiac
19 arrest; or
20 (ii) to discontinue and cease cardiopulmonary
21 resuscitation in the event the emergency medical services
22 provider is presented with an order or discovers a
23 necklace or bracelet after initiating cardiopulmonary
24 resuscitation.
25 (c) Uncertainty regarding validity or applicability of
26 order, bracelet or necklace.--
27 (1) Emergency medical services providers who in good
28 faith are uncertain about the validity or applicability of an
29 order, bracelet or necklace shall render care in accordance
30 with their level of certification.
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1 (2) Emergency medical services providers who act under
2 paragraph (1) shall not be subject to civil or criminal
3 liability or administrative sanction for failure to comply
4 with an order under this section.
5 (d) Recognition of other states' orders.--Emergency medical
6 services or out-of-hospital DNR orders, bracelets or necklaces
7 valid in states other than this Commonwealth shall be recognized
8 in this Commonwealth to the extent that these orders, bracelets
9 or necklaces are consistent with the laws of this Commonwealth.
10 Emergency medical services providers shall act in accordance
11 with the provisions of this section when encountering a patient
12 with an apparently valid EMS or out-of-hospital DNR form,
13 bracelet or necklace issued by another state. Emergency medical
14 services providers acting in good faith under this section shall
15 be entitled to the same immunities and protections that would
16 otherwise be applicable.
17 § 5411-A. Pregnancy.
18 (a) General rule.--Notwithstanding the existence of an order
19 or direction to the contrary, life-sustaining treatment,
20 cardiopulmonary resuscitation, nutrition and hydration must be
21 provided to a pregnant patient unless, to a reasonable degree of
22 medical certainty as certified on the patient's medical record
23 by the attending physician and an obstetrician who has examined
24 the patient, life-sustaining treatment, nutrition and hydration:
25 (1) will not maintain the pregnant patient in such a way
26 as to permit the continuing development and live birth of the
27 unborn child;
28 (2) will be physically harmful to the pregnant patient;
29 or
30 (3) would cause pain to the pregnant patient which
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1 cannot be alleviated by medication.
2 (b) Pregnancy test.--Nothing in this section shall require a
3 physician to perform a pregnancy test unless the physician has
4 reason to believe that the patient may be pregnant.
5 (c) Payment of expenses by Commonwealth.--
6 (1) In the event that treatment, cardiopulmonary
7 resuscitation, nutrition or hydration are provided to a
8 pregnant patient, notwithstanding the existence of an order
9 or direction to the contrary, the Commonwealth shall pay all
10 usual, customary and reasonable expenses directly and
11 indirectly incurred by the pregnant patient to whom such
12 treatment, nutrition and hydration are provided.
13 (2) The Commonwealth shall have the right of subrogation
14 against all moneys paid by any third-party health insurer on
15 behalf of the pregnant patient.
16 (3) The expenditures incurred on behalf of the pregnant
17 patient shall constitute a grant and no lien shall be placed
18 upon the property of the pregnant patient, her estate or her
19 heirs.
20 § 5412-A. Penalties.
21 Any person who intentionally conceals, cancels, defaces,
22 obliterates or damages the order, bracelet or necklace of
23 another without the consent of the patient commits a felony of
24 the third degree. Any person who falsifies or forges the order,
25 bracelet or necklace of another, or conceals or withholds
26 personal knowledge of a revocation as provided in section 5405-A
27 (relating to revocation), with the intent to cause a withholding
28 or withdrawal of life-sustaining treatment contrary to the
29 wishes of the patient and, because of such an act, directly
30 causes life-sustaining treatment to be withheld or withdrawn and
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1 death to be hastened shall be subject to prosecution for
2 criminal homicide as provided in 18 Pa.C.S. Ch. 25 (relating to
3 criminal homicide). Any person who intentionally, by undue
4 influence, fraud or duress, causes a person to execute an order
5 pursuant to this chapter commits a felony of the third degree.
6 § 5413-A. Severability.
7 The provisions of this chapter are severable, and, if any
8 word, phrase, clause, sentence, section or provision of this
9 chapter is for any reason held to be unconstitutional, the
10 decision of the court shall not affect or impair any of the
11 remaining provisions of this chapter. It is hereby declared as
12 the legislative intent that this chapter would have been adopted
13 had such unconstitutional word, phrase, clause, sentence,
14 section or provision thereof not been included herein.
15 Section 4. The Department of Health shall, with the advice
16 of the Pennsylvania Emergency Health Services Council and with
17 the assistance of the regional emergency medical services
18 councils, develop and make available to health care providers
19 recognized under the act of July 3, 1985 (P.L.164, No.45), known
20 as the Emergency Medical Services Act, including those
21 individuals recognized under 42 Pa.C.S. § 8331.2, within 180
22 days of the effective date of this act, educational materials
23 relating to the implementation of the provisions of this act.
24 The department shall also cause the requirements of this act to
25 be included as part of the curricula for health care providers
26 recognized under the Emergency Medical Services Act.
27 Section 5. The Department of Health may contract with any
28 public or private entity to facilitate all or part of its
29 responsibilities under 20 Pa.C.S. Ch. 54 or 54-A.
30 Section 6. The Department of Health, upon the conclusion of
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1 at least one public hearing, shall publish interim regulations
2 in the Pennsylvania Bulletin within 120 days of the effective
3 date of this act. The interim regulations shall not be subject
4 to the act of July 31, 1968 (P.L.769, No.240), referred to as
5 the Commonwealth Documents Law, or to the act of June 25, 1982
6 (P.L.633, No.181), known as the Regulatory Review Act. The
7 interim regulations shall be effective until final regulations
8 are promulgated by the department. Final regulations shall be
9 promulgated no later than 18 months following the effective date
10 of this act.
11 Section 7. This act shall take effect in 60 days.
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