|
|
|
A BILL TO BE ENTITLED
|
|
AN ACT
|
|
relating to the form and revocation of medical powers of attorney. |
|
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
|
SECTION 1. The heading to Section 166.155, Health and |
|
Safety Code, is amended to read as follows: |
|
Sec. 166.155. REVOCATION; EFFECT OF TERMINATION OF |
|
MARRIAGE. |
|
SECTION 2. Section 166.155, Health and Safety Code, is |
|
amended by amending Subsection (a) and adding Subsection (a-1) to |
|
read as follows: |
|
(a) A medical power of attorney is revoked by: |
|
(1) oral or written notification at any time by the |
|
principal to the agent or a licensed or certified health or |
|
residential care provider or by any other act evidencing a specific |
|
intent to revoke the power, without regard to whether the principal |
|
is competent or the principal's mental state; or |
|
(2) execution by the principal of a subsequent medical |
|
power of attorney. [; or] |
|
(a-1) An agent's authority under a medical power of attorney |
|
is revoked if the agent's marriage to [(3) the divorce of] the |
|
principal is dissolved, annulled, or declared void [and spouse, if
|
|
the spouse is the principal's agent,] unless the medical power of |
|
attorney provides otherwise. |
|
SECTION 3. Section 166.164, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 166.164. FORM OF MEDICAL POWER OF ATTORNEY. The |
|
medical power of attorney may [must] be in [substantially] the |
|
following form: |
|
MEDICAL POWER OF ATTORNEY DESIGNATION OF HEALTH CARE AGENT. |
|
I, __________ (insert your name) appoint: |
|
Name:___________________________________________________________ |
|
Address:________________________________________________________ |
|
Phone___________________________________________________________ |
|
as my agent to make any and all health care decisions for me, |
|
except to the extent I state otherwise in this document. This |
|
medical power of attorney takes effect if I become unable to make my |
|
own health care decisions and this fact is certified in writing by |
|
my physician. |
|
LIMITATIONS ON THE DECISION-MAKING AUTHORITY OF MY AGENT ARE |
|
AS FOLLOWS:_____________________________________________________ |
|
________________________________________________________________ |
|
DESIGNATION OF ALTERNATE AGENT. |
|
(You are not required to designate an alternate agent but you |
|
may do so. An alternate agent may make the same health care |
|
decisions as the designated agent if the designated agent is unable |
|
or unwilling to act as your agent. If the agent designated is your |
|
spouse, the designation is automatically revoked by law if your |
|
marriage is dissolved, annulled, or declared void unless this |
|
document provides otherwise.) |
|
If the person designated as my agent is unable or unwilling to |
|
make health care decisions for me, I designate the following |
|
persons to serve as my agent to make health care decisions for me as |
|
authorized by this document, who serve in the following order: |
|
A. First Alternate Agent |
|
Name:________________________________________________ |
|
Address:_____________________________________________ |
|
Phone __________________________________________ |
|
B. Second Alternate Agent |
|
Name:________________________________________________ |
|
Address:_____________________________________________ |
|
Phone __________________________________________ |
|
The original of this document is kept at: |
|
_____________________________________________________ |
|
_____________________________________________________ |
|
_____________________________________________________ |
|
The following individuals or institutions have signed |
|
copies: |
|
Name:________________________________________________ |
|
Address:_____________________________________________ |
|
_____________________________________________________ |
|
Name:________________________________________________ |
|
Address:_____________________________________________ |
|
_____________________________________________________ |
|
DURATION. |
|
I understand that this power of attorney exists indefinitely |
|
from the date I execute this document unless I establish a shorter |
|
time or revoke the power of attorney. If I am unable to make health |
|
care decisions for myself when this power of attorney expires, the |
|
authority I have granted my agent continues to exist until the time |
|
I become able to make health care decisions for myself. |
|
(IF APPLICABLE) This power of attorney ends on the following |
|
date: __________ |
|
PRIOR DESIGNATIONS REVOKED. |
|
I revoke any prior medical power of attorney. |
|
[ACKNOWLEDGMENT OF] DISCLOSURE STATEMENT. |
|
THIS MEDICAL POWER OF ATTORNEY IS AN IMPORTANT LEGAL |
|
DOCUMENT. BEFORE SIGNING THIS DOCUMENT, YOU SHOULD KNOW THESE |
|
IMPORTANT FACTS: |
|
Except to the extent you state otherwise, this document gives |
|
the person you name as your agent the authority to make any and all |
|
health care decisions for you in accordance with your wishes, |
|
including your religious and moral beliefs, when you are unable to |
|
make the decisions for yourself. Because "health care" means any |
|
treatment, service, or procedure to maintain, diagnose, or treat |
|
your physical or mental condition, your agent has the power to make |
|
a broad range of health care decisions for you. Your agent may |
|
consent, refuse to consent, or withdraw consent to medical |
|
treatment and may make decisions about withdrawing or withholding |
|
life-sustaining treatment. Your agent may not consent to voluntary |
|
inpatient mental health services, convulsive treatment, |
|
psychosurgery, or abortion. A physician must comply with your |
|
agent's instructions or allow you to be transferred to another |
|
physician. |
|
Your agent's authority is effective when your doctor |
|
certifies that you lack the competence to make health care |
|
decisions. |
|
Your agent is obligated to follow your instructions when |
|
making decisions on your behalf. Unless you state otherwise, your |
|
agent has the same authority to make decisions about your health |
|
care as you would have if you were able to make health care |
|
decisions for yourself. |
|
It is important that you discuss this document with your |
|
physician or other health care provider before you sign the |
|
document to ensure that you understand the nature and range of |
|
decisions that may be made on your behalf. If you do not have a |
|
physician, you should talk with someone else who is knowledgeable |
|
about these issues and can answer your questions. You do not need a |
|
lawyer's assistance to complete this document, but if there is |
|
anything in this document that you do not understand, you should ask |
|
a lawyer to explain it to you. |
|
The person you appoint as agent should be someone you know and |
|
trust. The person must be 18 years of age or older or a person under |
|
18 years of age who has had the disabilities of minority removed. |
|
If you appoint your health or residential care provider (e.g., your |
|
physician or an employee of a home health agency, hospital, nursing |
|
facility, or residential care facility, other than a relative), |
|
that person has to choose between acting as your agent or as your |
|
health or residential care provider; the law does not allow a person |
|
to serve as both at the same time. |
|
You should inform the person you appoint that you want the |
|
person to be your health care agent. You should discuss this |
|
document with your agent and your physician and give each a signed |
|
copy. You should indicate on the document itself the people and |
|
institutions that you intend to have signed copies. Your agent is |
|
not liable for health care decisions made in good faith on your |
|
behalf. |
|
Once you have signed this document, you have the right to make |
|
health care decisions for yourself as long as you are competent, and |
|
treatment cannot be given to you or stopped over your objection. |
|
You have the right to revoke the authority granted to your agent by |
|
informing your agent or your health or residential care provider |
|
orally or in writing or by your execution of a subsequent medical |
|
power of attorney. Unless you state otherwise in this document, |
|
your appointment of a spouse is revoked if your marriage is |
|
dissolved, annulled, or declared void. |
|
This document may not be changed or modified. If you want to |
|
make changes in this document, you must execute a new medical power |
|
of attorney. |
|
You may wish to designate an alternate agent in the event that |
|
your agent is unwilling, unable, or ineligible to act as your agent. |
|
Any alternate agent you designate has the same authority as the |
|
agent to make health care decisions for you. |
|
THIS POWER OF ATTORNEY IS NOT VALID UNLESS: |
|
(1) YOU SIGN IT AND HAVE YOUR SIGNATURE ACKNOWLEDGED |
|
BEFORE A NOTARY PUBLIC; OR |
|
(2) YOU SIGN IT IN THE PRESENCE OF TWO COMPETENT ADULT |
|
WITNESSES. |
|
THE FOLLOWING PERSONS MAY NOT ACT AS ONE OF THE WITNESSES: |
|
(1) the person you have designated as your agent; |
|
(2) a person related to you by blood or marriage; |
|
(3) a person entitled to any part of your estate after |
|
your death under a will or codicil executed by you or by operation |
|
of law; |
|
(4) your attending physician; |
|
(5) an employee of your attending physician; |
|
(6) an employee of a health care facility in which you |
|
are a patient if the employee is providing direct patient care to |
|
you or is an officer, director, partner, or business office |
|
employee of the health care facility or of any parent organization |
|
of the health care facility; or |
|
(7) a person who, at the time this medical power of |
|
attorney is executed, has a claim against any part of your estate |
|
after your death. |
|
By signing below, I acknowledge that [I have been provided
|
|
with a disclosure statement explaining the effect of this
|
|
document.] I have read and understand the [that] information |
|
contained in the above disclosure statement. |
|
(YOU MUST DATE AND SIGN THIS POWER OF ATTORNEY. YOU MAY SIGN |
|
IT AND HAVE YOUR SIGNATURE ACKNOWLEDGED BEFORE A NOTARY PUBLIC OR |
|
YOU MAY SIGN IT IN THE PRESENCE OF TWO COMPETENT ADULT WITNESSES.) |
|
SIGNATURE ACKNOWLEDGED BEFORE NOTARY |
|
I sign my name to this medical power of attorney on __________ |
|
day of __________ (month, year) at |
|
_____________________________________________ |
|
(City and State) |
|
_____________________________________________ |
|
(Signature) |
|
_____________________________________________ |
|
(Print Name) |
|
State of Texas |
|
County of ________ |
|
This instrument was acknowledged before me on __________ (date) by |
|
________________ (name of person acknowledging). |
|
_____________________________ |
|
NOTARY PUBLIC, State of Texas |
|
Notary's printed name: |
|
_____________________________ |
|
My commission expires: |
|
_____________________________ |
|
OR |
|
SIGNATURE IN PRESENCE OF TWO COMPETENT ADULT WITNESSES |
|
I sign my name to this medical power of attorney on __________ |
|
day of __________ (month, year) at |
|
_____________________________________________ |
|
(City and State) |
|
_____________________________________________ |
|
(Signature) |
|
_____________________________________________ |
|
(Print Name) |
|
STATEMENT OF FIRST WITNESS. |
|
I am not the person appointed as agent by this document. I am |
|
not related to the principal by blood or marriage. I would not be |
|
entitled to any portion of the principal's estate on the principal's |
|
death. I am not the attending physician of the principal or an |
|
employee of the attending physician. I have no claim against any |
|
portion of the principal's estate on the principal's |
|
death. Furthermore, if I am an employee of a health care facility |
|
in which the principal is a patient, I am not involved in providing |
|
direct patient care to the principal and am not an officer, |
|
director, partner, or business office employee of the health care |
|
facility or of any parent organization of the health care facility. |
|
Signature:________________________________________________ |
|
Print Name:___________________________________ Date:______ |
|
Address:__________________________________________________ |
|
SIGNATURE OF SECOND WITNESS. |
|
Signature:________________________________________________ |
|
Print Name:___________________________________ Date:______ |
|
Address:__________________________________________________ |
|
SECTION 4. Sections 166.162 and 166.163, Health and Safety |
|
Code, are repealed. |
|
SECTION 5. Not later than March 1, 2018, the executive |
|
commissioner of the Health and Human Services Commission shall |
|
adopt all rules necessary to implement this Act. |
|
SECTION 6. This Act takes effect September 1, 2017. |