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SB 410

Relating to transportation; prescribing an effective date.

2025 Regular Session Introduced by Fred Girod

Hospitals may petition a county court to discharge incapacitated adults when no authorized decision-maker agrees, after two physicians concur; court rules within 5 business days.

In committee upon adjournment.
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Bill Summary · SB 410

Summary — SB 410: Hospital Petition/Discharge Incapable Adults

Status: Introduced (1st reading). Effective date in bill: October 1, 2025.
Statutory location added: Part 4 of Article 5, Chapter 131E — new G.S. 131E‑90.5.

Main purpose

Allow a hospital to ask a court to authorize discharge of an adult patient who lacks capacity to make health‑care decisions when no person authorized under G.S. 90‑21.13(c) is willing to consent to discharge. The bill creates a short, expedited court process to resolve these impasses so hospitals can lawfully discharge patients when clinically appropriate.

Key provisions / required steps

  • New statute (G.S. 131E‑90.5) authorizes the hospital providing care to petition the county superior court for an order authorizing discharge when:
    • The patient lacks capacity to make or communicate health‑care decisions, and
    • No person authorized under G.S. 90‑21.13(c) is willing to make health‑care decisions or consent to discharge on the patient’s behalf.
  • Preconditions before filing:
    • The attending physician must have the written concurrence of a second physician licensed in North Carolina regarding the discharge decision.
    • The hospital may not file the petition sooner than five business days after receiving that written concurrence.
  • Filing and court process:
    • The hospital may petition the superior court with or without legal counsel.
    • The court must issue an order granting or denying the petition within five business days after receiving it.
    • The court order, if granted, authorizes discharge “as ordered by the attending physician” (i.e., the discharge plan supported by the two physicians).
  • Scope limitation:
    • Applies only to adult patients (age 18 or older).

Who is affected

  • Hospitals and their legal/administrative teams (can initiate petitions).
  • Attending physicians and consulting physicians (must document concurrence).
  • Incapacitated adult patients who have no willing or available authorized decision‑maker.
  • Families, potential surrogates or guardians (may be bypassed if unwilling to act).
  • County superior courts (will receive and rule on petitions under an expedited timeline).

Procedural/timeline highlights

  • Hospital must wait ≥5 business days after second‑physician concurrence before filing.
  • Court must rule within 5 business days of petition receipt — expedited adjudication.
  • The bill becomes effective October 1, 2025 (per bill text).

Potential impacts and considerations

  • Intended benefits:
    • Reduce prolonged hospital stays caused by inability to obtain discharge consent.
    • Improve patient flow, reduce costs, and allow medically appropriate transitions of care.
  • Potential concerns:
    • Due process and patient protections: expedited schedule may limit opportunity for interested parties to contest discharge.
    • Risk management and post‑discharge supports are not detailed in the bill (responsibility for placement, follow‑up care, or safety conditions after discharge may rely on existing law/practice).
    • Increased short‑deadline caseload for superior courts.
  • Interaction with existing law:
    • Operates where G.S. 90‑21.13(c) (the statute defining who may make health‑care decisions for incapacitated patients) yields no willing decision‑maker; does not replace guardianship or other long‑term decision regimes.

If you’d like, I can:
- Draft a one‑page checklist hospitals could use to comply with the bill’s procedural requirements, or
- Identify specific statutory or case‑law issues (due process, guardianship interplay) for further legal review.

Compiled from official sources — confirm details with the bill’s official record.

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