What Is It?
As a Southern California Edison employee, you have the right to decline medical treatment, even if you die as a result of your decision. Depending on your medical condition, your prognosis, and your views on the quality of life, you may wish to refuse lifesaving measures, such as cardiopulmonary resuscitation (CPR). Executing a do not resuscitate (DNR) order is one way of doing this. A DNR is a doctor's order that tells all other medical personnel not to perform CPR if you go into cardiac arrest. Cardiac arrest occurs when your heart stops beating, blood flow to your brain stops, and you stop breathing. If the blood flow is not quickly restored, permanent damage to the brain and other organs can occur. CPR simulates heartbeat and breathing, while attempting to restart these functions.
The term CPR actually encompasses a variety of separate procedures, including cardiac compression, endotracheal intubation, assisted ventilation, defibrillation, and cardiac medications. Most states recognize two types of DNRs. One is effective only while you are hospitalized. The other is used by people outside the hospital--for example, nursing home residents, hospice patients, and even those who are not receiving medical treatment.
Typically, terminally ill patients and elderly individuals execute DNRs to avoid prolonging their final illnesses. However, some states allow healthy adults to execute the orders, as well. Depending on the laws of your state, a DNR used outside the hospital may be called a 'pre-hospital DNR,' 'out-of-hospital DNR,' 'outpatient DNR,' 'DNR for EMS,' or 'CPR directive.' As a result of your request, your doctor generally notes an in-hospital DNR order on your chart. Out-of-hospital DNRs take various forms, depending on the laws of your state. ID bracelets, MedicAlert necklaces, and wallet cards are some methods of noting DNR status.
When Can It Be Used?
Availability of DNRs Is Determined By State Law
Not all states have DNR laws. For Southern California Edison employees, you may want to consider how your state's laws govern whether DNRs are permissible, who can execute a DNR, and what form the order must take. These laws may permit in-hospital DNRs, out-of-hospital DNRs, both of these, or neither of these. Some state laws allow any person of legal age to execute a DNR, while others permit DNRs only for individuals with terminally ill conditions. Some states allow children to participate in decisions regarding DNR in certain cases. Check the laws of your state and any other states where you spend a significant amount of time.
Strengths
Allows You to Exercise Choice In Medical Treatment
Cardiopulmonary resuscitation (CPR) has produced some miraculous results when used on normally healthy individuals in trauma situations. However, it can be a painful and even violent procedure. Its effectiveness is limited when used on terminally ill or hopelessly deteriorated patients. In some cases, CPR only delays the moment of death.
For example, CPR could restore your heartbeat, but if permanent brain or organ damage occurs during cardiac arrest, you may be dependent on life support machines. Executing a do not resuscitate (DNR) order allows you to choose a natural death.
Example(s): Hal is hospitalized with a terminally ill condition. He is on a respirator and knows he has only a short time to live. Hal consults his doctor and learns that the laws of his state permit in-hospital DNRs. This will allow him to forego CPR if his heart fails. Hal asks his doctor to execute a DNR as soon as possible. The following week, Hal's heart stops. Because of Hal's DNR, hospital personnel do not attempt CPR.
Specifically Intended for an Emergency Situation
If you go into cardiopulmonary arrest, your DNR lets medical personnel know that you don't want CPR. Because of the emergency nature of this situation, other types of advanced directives are usually not timely enough to accomplish this goal.
Tradeoffs
Extremely Limited Usefulness
Although a do not resuscitate (DNR) order is a very powerful instrument, it is only effective under specific conditions. Generally, a DNR comes into play only if you go into cardiac arrest, and it frequently only allows you to refuse cardiopulmonary resuscitation (CPR), although in some states it may allow you to decline other drastic medical treatment as well. A living will or durable power of attorney for health care may be needed to convey other medical treatment instructions, such as your wishes regarding life support and intravenous feeding.
Out-of-Hospital DNR May Not Be Effective In Other States
As a Southern California Edison employee, it is beneficial to understand how an out-of-hospital DNR that is valid in your state may not be valid in other states. Therefore, if you spend a significant amount of time in another state, you should find out whether that state's laws recognize DNRs, whether you are eligible to have a DNR in that state, and what restrictions are placed on the form of the DNR.
Doctors May Be Hesitant to Broach This Topic or Reluctant to Write a DNR
If you are hospitalized with a serious illness, your doctor may not bring up the option of executing a DNR. If you don't want to be resuscitated, you should initiate this discussion with your doctor. Also, studies indicate that many doctors are slow to write DNRs, even when they are aware of their patients' preferences, although the reasons for this vary. If you are a Southern California Edison employee and want to ensure your wishes are followed, you should touch base with your doctor to make sure the DNR is placed on your chart.
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How to Do It
Research Your State's Laws Regarding Dnrs
Not all states provide for these orders. Each state has its own eligibility requirements, particularly for out-of-hospital DNRs.
Discuss Your Wishes With Your Doctor
Your doctor should be able to provide information on your prognosis and counsel you on your options. If you are a Southern California Edison employee, your doctor's signature will most likely be required on any DNR you execute.
Execute Your Out-of-Hospital DNR Properly And Keep It With You
If you are a Southern California Edison employee interested in DNR, you must consider how if your state allows out-of-hospital DNRs, there is probably a required format for the order. Examples of state-required DNR formats include ID bracelets, necklaces, wallet cards, and letter-size forms. If your DNR is not in the required form, it may not be honored. If medical personnel can't find your DNR order, they are obligated to give full and immediate care. Thus, it is extremely important to execute your DNR order properly and keep it with you (or in an appropriate place) at all times.
Example(s): Hal is a resident of an assisted-living facility. Hal is 89 years old and feels he has lived a good life. He does not want to die in a hospital or be dependent on machines for his survival. Hal discusses his feelings with his doctor. Hal's doctor suggests executing an out-of-hospital DNR, which will instruct medical personnel not to perform cardiopulmonary resuscitation (CPR) if Hal goes into cardiac or respiratory arrest. Hal agrees and receives an ID bracelet noting his DNR status. Hal wears his bracelet faithfully. Six years later, Hal's heart fails as he jogs in the park. Medical personnel arrive on the scene, but immediately notice Hal's DNR ID bracelet. CPR is not attempted.
Tell People About Your Decision
In general, other people cannot reverse your decision once you execute a DNR. As a Southern California Edison employee however, if your DNR is misplaced or for some reason is not followed, it would be important for your family and friends to understand your wishes. Although this topic may be difficult to discuss, those close to you are more likely to support and uphold your decision if they understand how you feel and why you feel that way. If you have appointed a representative in a durable power of attorney for health care (DPAHC) , it is especially important that this person be aware of your decision.
Coordinate All Advanced Directives
Since a DNR is so limited in scope, you may wish to establish a living will and/or DPAHC as well. If you do so, make sure your wishes are stated consistently throughout these documents. In some states, the most recent document will govern if there is a conflict, so you must make sure your wishes are clear.
Tax Considerations for Southern California Edison Employees
Income Tax
None
Gift And Estate Tax
None
Questions & Answers for Southern California Edison Employees
What If You Go Into a Coma Before Executing Your DNR, And You Can't Express Your Wishes?
Your healthcare representative, if you have appointed one, may be able to have a DNR executed on your behalf. As a Southern California Edison employee, there must be evidence that this is what you would want. You might include these instructions in your durable power of attorney for health care , especially if the laws of your state do not allow out-of-hospital DNRs. Be aware, however, that this method of instruction is useless in an emergency if your representative is not present. In some states, with your family's consent, your doctor may be able to execute a DNR on your behalf. Again, it would be unwise to rely on this course of action in an emergency.
Can You Change Your Mind?
Yes, it is possible to revoke a DNR order. If you have an out-of-hospital DNR, you may be able to revoke it by simply removing the bracelet or the wallet card. However, some states also have a database of DNR patients. If this is true in your state, you may need to take additional steps to revoke your DNR. When your doctor writes the DNR, ask what steps are necessary to revoke the order.
Additionally, medical personnel must give emergency care to anyone who requests it. For example, Emergency Medical Service guidelines in Wisconsin instruct personnel to perform cardiopulmonary resuscitation (CPR) if a person rips off his or her DNR bracelet or asks for CPR during cardiac arrest.
How does SoCalGas determine its pension contribution levels for 2024, and what factors influence the funding strategies to maintain financial stability? In preparing for the Test Year (TY) 2024, SoCalGas employs a detailed actuarial process to ascertain the necessary pension contributions. The actuarial valuation includes an assessment of the company's Projected Benefit Obligation (PBO) under Generally Accepted Accounting Principles (GAAP). These calculations incorporate variables such as current employee demographics, expected retirement ages, and market conditions. Additionally, SoCalGas must navigate external economic factors, including interest rates and economic forecasts, which can impact the funded status of its pension plans and the associated financial obligations.
SoCalGas determines its pension contribution levels using a detailed actuarial process that evaluates the Projected Benefit Obligation (PBO) under Generally Accepted Accounting Principles (GAAP). The contribution is influenced by variables such as employee demographics, retirement age expectations, market conditions, and external economic factors like interest rates and economic forecasts. SoCalGas maintains financial stability by adjusting funding strategies based on market returns and required amortization periods(Southern_California_Gas…).
What specific changes to SoCalGas's pension plan are being proposed for the upcoming fiscal year, and how will these changes impact existing employees and retirees? The proposals for the TY 2024 incorporate adjustments to the existing pension funding mechanisms, including the continuation of the two-way balancing account to account for fluctuations in pension costs. This measure is designed to stabilize funding while meeting both the service cost and the annual minimum contributions required under regulatory standards. Existing employees and retirees may see changes in their benefits as adjustments are made to align with these funding strategies, which may include modifications to expected payouts or contributions required from retirees depending on their service years and retirement age.
For the 2024 Test Year, SoCalGas is proposing to adjust its pension funding policy by shortening the amortization period for the PBO shortfall from fourteen to seven years. This change aims to fully fund the pension plan more quickly, improving long-term financial health while reducing intergenerational ratepayer burden. Existing employees and retirees may experience greater financial stability in the pension plan due to these proactive funding strategies(Southern_California_Gas…).
In what ways does SoCalGas's health care cost escalation projections for postretirement benefits compare with national trends, and what strategies are in place to manage these costs? The health care cost escalations required for the Postretirement Health and Welfare Benefits Other than Pension (PBOP) at SoCalGas have been developed in alignment with industry trends, which show consistent increases in health care expenses across the nation. Strategies implemented by SoCalGas involve negotiation with health care providers for favorable rates, introduction of health reimbursement accounts (HRAs), and ongoing assessments of utilization rates among retirees to identify potential savings. These measures aim to contain costs while ensuring that retirees maintain access to necessary healthcare services without a significant financial burden.
SoCalGas's healthcare cost projections for its Postretirement Benefits Other than Pensions (PBOP) align with national trends of increasing healthcare expenses. To manage these costs, SoCalGas employs strategies like negotiating favorable rates with providers, utilizing health reimbursement accounts (HRAs), and regularly assessing healthcare utilization. These efforts aim to control healthcare costs while ensuring that retirees receive necessary care(Southern_California_Gas…).
What resources are available to SoCalGas employees to help them understand their benefits and the changes that may occur in 2024? SoCalGas provides various resources to employees to clarify their benefits and upcoming changes, including dedicated HR representatives, comprehensive guides on benefits options, web-based portals, and informational seminars. Employees can access personalized accounts to view their specific benefits, contributions, and projections. Additionally, the company offers regular training sessions covering changes in benefits and how to navigate the retirement process effectively, empowering employees to make informed decisions regarding their retirement planning.
SoCalGas provides employees with various resources, including HR representatives, benefit guides, and web-based portals to help them understand their benefits. Employees also have access to personalized retirement accounts and training sessions that cover benefit changes and retirement planning, helping them make informed decisions regarding their future(Southern_California_Gas…).
How does the PBOP plan impact SoCalGas’s overall compensation strategy for attracting talent? The PBOP plan is a critical component of SoCalGas’s total compensation strategy, designed to attract and retain high-caliber talent in an increasingly competitive market. SoCalGas recognizes that comprehensive postretirement benefits enhance their appeal as an employer. The direct correlation between competitive benefits packages, including the PBOP plan's provisions for health care coverage and financial support during retirement, plays a significant role in talent acquisition and retention by providing peace of mind for employees about their long-term financial security.
SoCalGas's PBOP plan plays a crucial role in its overall compensation strategy by offering competitive postretirement health benefits that enhance the attractiveness of the company's total compensation package. This helps SoCalGas attract and retain a high-performing workforce, as comprehensive retirement and healthcare benefits are important factors for employees when choosing an employer(Southern_California_Gas…).
What are the anticipated trends in the pension and postretirement cost estimates for SoCalGas from 2024 through 2031, and what implications do these trends hold for financial planning? Anticipated trends in pension and postretirement cost estimates are projected to indicate gradual increases in these costs due to changing demographics, increasing life expectancies, and inflation impacting healthcare costs. Financial planning at SoCalGas thus necessitates a proactive approach to ensure adequate funding mechanisms are in place. This involves forecasting contributions that will remain in line with the projected obligations while also navigating regulatory requirements to avoid potential funding shortfalls or impacts on corporate finances.
SoCalGas anticipates gradual increases in pension and postretirement costs from 2024 to 2031 due to changing demographics, increased life expectancies, and rising healthcare costs. This trend implies that SoCalGas will need to implement robust financial planning strategies, including forecasting contributions and aligning funding mechanisms with regulatory requirements to avoid potential shortfalls(Southern_California_Gas…).
How do SoCalGas's pension plans compare with those offered by other utility companies in California in terms of competitiveness and sustainability? When evaluating SoCalGas's pension plans compared to other California utility companies, it becomes evident that SoCalGas's offerings emphasize not only competitive benefits but also a sustainable framework for its pension obligations. This comparative analysis includes studying funding ratios, benefit structures, and employee satisfaction levels. SoCalGas aims to maintain a robust pension plan that not only meets current employee needs but is also sustainable in the long term, adapting to changing economic conditions and workforce requirements while remaining compliant with state regulations.
SoCalGas's pension plans are competitive with those of other utility companies in California, with a focus on both benefit structure and long-term sustainability. SoCalGas emphasizes maintaining a robust pension plan that is adaptable to changing market conditions, regulatory requirements, and workforce needs. This allows the company to remain an attractive employer while ensuring the sustainability of its pension commitments(Southern_California_Gas…).
How can SoCalGas employees reach out for support regarding their pension and retirement benefits, and what types of inquiries can they make? Employees can contact SoCalGas’s Human Resources Benefits Department through dedicated communication channels such as the company’s HR support line, email, or scheduled one-on-one consultations. The HR team is trained to address a variety of inquiries related to pension benefits, eligibility requirements, plan options, and retirement planning strategies. Moreover, employees can request personalized benefits statements and assistance with understanding their entitlements and the implications of any regulatory changes affecting their plans.
SoCalGas employees can reach out to the company's HR Benefits Department through a dedicated support line, email, or consultations. They can inquire about pension benefits, eligibility, plan options, and retirement strategies. Employees may also request personalized benefits statements and clarification on regulatory changes that may affect their plans(Southern_California_Gas…).
What role does market volatility and economic conditions play in shaping the funding strategy of SoCalGas's pension plans? Market volatility and economic conditions play a significant role in shaping SoCalGas's pension funding strategy, influencing both asset returns and liabilities. Fluctuations in interest rates, market performance of invested pension assets, and changes in demographic factors directly affect the PBO calculation, requiring SoCalGas to adjust its funding strategy responsively. This involved the use of sophisticated financial modeling and scenario analysis to ensure that the pension plans remain adequately funded and financially viable despite adverse economic conditions, thereby protecting the interests of current and future beneficiaries.
Market volatility and economic conditions significantly impact SoCalGas's pension funding strategy, affecting both asset returns and liabilities. Factors like interest rates, market performance of pension assets, and demographic shifts influence the PBO calculation, prompting SoCalGas to adjust its funding strategy to ensure adequate pension funding and long-term plan viability(Southern_California_Gas…).
What steps have SoCalGas and SDG&E proposed to recover costs related to pension and PBOP to alleviate financial pressure on ratepayers? SoCalGas and SDG&E proposed implementing a two-way balancing account mechanism designed to smoothly recover the costs associated with their pension and PBOP plans. This initiative aims to ensure that any variances between projected and actual contributions are adjusted in a timely manner, thereby reducing the financial burden on ratepayers. By utilizing this approach, the Companies seek to maintain stable rates while ensuring that all pension obligations can be met without compromising operational integrity or service delivery to their customers. These questions reflect complex issues relevant to SoCalGas employees preparing for retirement and navigating the nuances of their benefits.
SoCalGas and SDG&E have proposed utilizing a two-way balancing account mechanism to recover pension and PBOP-related costs. This mechanism helps adjust for variances between projected and actual contributions, ensuring that costs are managed effectively and do not overly burden ratepayers. This approach aims to maintain stable rates while fulfilling pension obligations(Southern_California_Gas…).