Appendix Health-care Power of Attorney and Combined Advance Directive Legislation

LibraryAlzheimer's and the Practice of Law: Counseling Clients with Dementia and Their Families (ABA) (2013 Ed.)

Appendix HEALTH-CARE POWER OF ATTORNEY AND COMBINED ADVANCE DIRECTIVE LEGISLATION

SELECTED FEATURES COMPARED: DECEMBER 2009

Explanation: The descriptors in the chart are generalizations of statutory language and not quotations, so the statutes must be consulted for precise meaning. All states limit appointed agent's from acting over the objection of the principal, unless otherwise noted in the column under Limits on Agent's Powers.

Abbreviations:

LW = Living Will

DPA = Durable Power of Attorney

UHCDA = Uniform Health Care Decisions Act.

POLST = Physician Order for Life sustaining Treatment, or similar protocol

STATE

TYPE

PROVIDES FORM

LIMITS ON AGENT'S POWERS

PROHIBITED AGENTS

1. alabama

Ala. Stat. §§ 22-8A-2 to -14 (West 2007).

Natural Death Act

Combined Advance Directive [Modeled on UHCDA]

YES Must be substantially followed

• Mental health facility admission and treatments

• Psycho-surgery

• Sterilization

• Abortion

• Indiv. Provider*

*Exception for relatives employed by the provider

See also Durable

Power of

Attorney Act,

§ 26-1-2

Separate LW Statute: NO

• Pregnancy limitation

• Nutrition & hydration—refusal permitted if expressly authorized

FORMALITIES OF EXECUTION

PROHIBITED WITNESSES

Note: "Provider" includes employees of provider

REGISTRY FOR ADVANCE DIRECTIVES

OUT-OF-STATE DIRECTIVES RECOGNIZED

POLST PROTOCOL STATEWIDE

• 2 or more witnesses age 19 or older

• Minor = 18

• Agent

• Proxy signor

• Relative/Spouse

• Heir/Beneficiary

• Person responsible for care costs

YES

STATE

TYPE

PROVIDES FORM

LIMITS ON AGENT'S POWERS

PROHIBITED AGENTS

2. alaska

Alaska Stat. §§ 13.52.010 to -.395 (West 2007).

Health Care Decisions Act

Separate LW Statute: NO

Combined Advance Directive [Modeled on UHCDA] plus incorporates mental health directive

yes

Optional

• Psycho-surgery*

• Sterilization*

• Abortion*

• Removal of bodily organs*

• Temporary admission to mental health facility*

• Electro-convulsive therapy*

• Psychotropic mediation*

• Life-sustaining procedures*

• Pregnancy limitation

*Consent/refusal permitted only if expressly authorized.

• Facility provider*

*Exception for relatives

3. arizona

Ariz. Rev. Stat. Ann. §§ 36-3201 to -3262 (West 2007).

Combined

Advance

Directive

yes

Optional

None specified

None specified

FORMALITIES OF EXECUTION

PROHIBITED WITNESSES

Note: "Provider" includes employees of provider

REGISTRY FOR ADVANCE DIRECTIVES

OUT-OF-STATE DIRECTIVES RECOGNIZED

POLST PROTOCOL STATEWIDE

• 2 witness or notarized

• Agent

• Facility provider

One may not be:

• Relative/Spouse

• Heir/Beneficiary

YES

• 1 witness or notarized

• Agent

• Provider If only one witness, person may not be:

• Relative/Spouse

• Heir/Beneficiary

YES

STATE

TYPE

PROVIDES FORM

LIMITS ON AGENT'S POWERS

PROHIBITED AGENTS

4. arkansas

Ark. Code Ann. § 20-13-104 (2007).

Durable Power of Attorney for Health Care Act

See also Ark. Code Ann. § 20-17-201 to -218 (proxy appointment in Living Will Declaration)

Special DPA

NO

(But proxy appointment in Living Will Declaration does have optional form)

• Life-sustaining treatment—unless the DPA incorporates a proxy authorization from the Living Will Declaration statute, § 20-17202

• Pregnancy limitation

None specified

5. california

Cal. Prob. Code §§ 4600-4948 806 (West 2007).

Separate LW Statute: NO

Combined

Advance

Directive

YES

Optional

• Civil commitment

• Electro-convulsive therapy

• Psycho-surgery

• Sterilization

• Abortion

• Supervising Indiv. Provider*

• Facility Provider*

• Conservator—unless conditions are met.

*Exception for relatives who are employees of.

FORMALITIES OF EXECUTION

PROHIBITED WITNESSES

Note: "Provider" includes employees of provider

REGISTRY FOR ADVANCE DIRECTIVES

OUT-OF-STATE DIRECTIVES RECOGNIZED

POLST PROTOCOL STATEWIDE

• 2 witnesses

None specified

YES, if part of a (living will) declaration

• 2 witnesses or notarized

• Special institutional requirements

• Agent

• Indiv. Provider

• Facility Provider

One may not be:

• Relative/Spouse

• Heir/Beneficiary

YES

§§ 4800-4802

YES

YES

Cal. Probate Code §§ 4780-4785 (8/4/08)

"Physician Order for Life-Sustaining Treatment"

STATE

TYPE

PROVIDES FORM

LIMITS ON AGENT'S POWERS

PROHIBITED AGENTS

6. colorado

Colo. Rev. Stat. §§ 15-14-503 to -509 (West 2007).

Colorado Patient Autonomy Act

See also §§ 15-14-501 to -502 and §§ 15-14-601 to -611 re DPA

Separate LW Statute: Colo. Rev. Stat. §§15-18-101 to -113.

Special DPA

NO

None specified

None specified

FORMALITIES OF EXECUTION

PROHIBITED WITNESSES

Note:

"Provider"

includes

employees of

provider

REGISTRY FOR ADVANCE DIRECTIVES

OUT-OF-STATE DIRECTIVES RECOGNIZED

POLST PROTOCOL STATEWIDE

None specified

N/A

YES

STATE

TYPE

PROVIDES FORM

LIMITS ON AGENT'S POWERS

PROHIBITED AGENTS

7. connecticut

Conn. Gen. Stat. §§ 19a-570 to -580d (West 2007).

See also §§ 1-43 et seq. (2007) (statutory short form DPA) and § 1-56r (designation of person for decision making).

Separate LW Statute: NO

Combined Advance Directive

yes

Optional

None specified (but authority is described as authority to "convey" principal's wishes, rather than to make decisions for principal.)

• Pregnancy limitation

• Facility Provider*

• Attending physician

• Administrator or employee of gov't agency financially responsible for care*

*Exception for relatives

8. delaware

Del. Code Ann. tit. 16, §§ 2501-2518 (2007).

Separate LW Statute: NO

Combined

Advance Directive [Modeled on UHCDA]

yes

Optional

• Pregnancy limitation

• Residential LTC Facility Provider*

*Exception for relatives

FORMALITIES OF EXECUTION

PROHIBITED WITNESSES

Note: "Provider" includes employees of provider

REGISTRY FOR ADVANCE DIRECTIVES

OUT-OF-STATE DIRECTIVES RECOGNIZED

POLST PROTOCOL STATEWIDE

• 2 witnesses

• Special

institutional

requirements

• Agent

Not Addressed

• 2 witnesses

• Special

institutional

requirements

• Facility provider

• Relative/Spouse

• Heir/Beneficiary

• Creditor

• Person responsible for care costs

YES

STATE

TYPE

PROVIDES FORM

LIMITS ON AGENT'S POWERS

PROHIBITED AGENTS

9. district of columbia

D.C. Code §§ 21-2201 to -2213 (2007).

Separate LW Statute: D.C. Code §§ 7-621 to -630 (2007).

Special DPA

yes

Optional

• Decision to

medicate defendant to render him/her competent to stand trial

• Indiv. Provider

• Facility Provider

10. florida

Fla. Stat. Ann.

§§ 765.101 to -.404 (West 2007).

Separate LW Statute: NO

Combined

Advance

Directive

yes

Optional

• Mental health

facility admission*

• Electro-convulsive therapy*

• Psycho-surgery*

• Sterilization*

• Abortion*

• Experimental treatments not approved by IRB*

• Life-sustaining procedures while pregnant*

• Pregnancy limitation*

*Consent/refusal permissible if expressly authorized

None specified

FORMALITIES OF EXECUTION

PROHIBITED WITNESSES

Note: "Provider" includes employees of provider

REGISTRY FOR ADVANCE DIRECTIVES

OUT-OF-STATE DIRECTIVES RECOGNIZED

POLST PROTOCOL STATEWIDE

• 2 witnesses

• Principal

• Individual Provider

• Facility Provider One may not be

• Relative/Spouse or Heir/Beneficiary

Not Addressed

• 2 witnesses

• Agent One may not be

• Relative/Spouse

YES

STATE

TYPE

PROVIDES FORM

LIMITS ON AGENT'S POWERS

PROHIBITED AGENTS

11. georgia

Ga. Code Ann. §§ 31-36-1 to -13 (West 2008).

Separate LW Statute: NO

Combined

Advance

Directive

YES

Optional

• Mental health facility admission or treatment (incl. mental retardation or addiction)

• Psycho-surgery

• Sterilization

• Pregnancy limitation

• Indiv. Provider directly or indirectly involved

12. hawaii

Haw. Rev. Stat. §§ 327E-1 to -16 (2007).

See also Haw. Rev. Stat. § 551D-2.5 re DPA for health care

Separate LW Statute: NO

Combined Advance Directive [Modeled on UHCDA]

YES

Optional

None specified

• Facility Provider*

*Exception for relatives

13. idaho

Idaho Code Ann. §§ 39-4501 to -4509 (West 2007), specifically § 39-4505.

Separate LW Statute: NO

Combined

Advance

Directive

YES

Optional

• Pregnancy limitation

• Indiv.

Provider*

• Community Care Facility Provider*

*Exception for relatives who are employees of.

FORMALITIES OF EXECUTION

PROHIBITED WITNESSES

Note: "Provider" includes employees of provider

REGISTRY FOR ADVANCE DIRECTIVES

OUT-OF-STATE DIRECTIVES RECOGNIZED

POLST PROTOCOL STATEWIDE

• 2 witnesses

• Special institutional requirements

• Agent

• Heir/Beneficiary

• Indiv. Provider One may not be

• Institutional provider

YES

• 2 witnesses or

notarized

• Indiv.

provider

• Facility

provider

• Agent

One may not be

• Relative/

Spouse

• Heir/

Beneficiary

YES

• 2 witnesses or notarized

• Agent

• Indiv. Provider

• Community Care

• Facility One may not be

• Relative/Spouse or Heir/Beneficiary

YES

§ 39-4515

Not Addressed

YES

STATE

TYPE

PROVIDES FORM

LIMITS ON AGENT'S POWERS

PROHIBITED AGENTS

14. illinois

755 ILL. Comp. Stat. 45/4-1 to 4-12 (West 2007).

Separate LW Statute: 755 Ill. Comp. Stat. 35/1 to 35/10.

Special DPA

yes

Optional

None specified

• Indiv. Provider

15. indiana

Ind. Code §§ 30-5-1-1 to 30-5-5-19 (2007), specifically §§ 30-5-5-16 and -17, and

Ind. Code §§ 16-36-1-1 to -19, specifically §§ 16-36-1-6 and -7.

Separate LW Statute: Ind. Code Ann. §§ 16-36-4-1 to -21

Ind. Code Ann. §§ 16-36-1-1 to -14 (West 2007).

General DPA with health powers.

Health Care Consent Statute including appointment of health care representative

NO

But mandatory language for authority re life-sustaining treatment (§ 30-5-5-17) NO

But mandatory language above is...

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