HF 2753

Introduction - 94th Legislature (2025 - 2026)

Posted on 03/24/2025 03:04 p.m.

A bill for an act
relating to civil law; creating default surrogate for health decisions and providing
a process to appoint default surrogate for health decisions; amending Minnesota
Statutes 2024, sections 145C.01, subdivision 2, by adding subdivisions; 145C.03,
by adding a subdivision; 145C.10; 145C.11; proposing coding for new law in
Minnesota Statutes, chapter 145C.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2024, section 145C.01, is amended by adding a subdivision
to read:

new text begin Subd. 1c. new text end

new text begin Default surrogate for health decisions. new text end

new text begin A physician, advanced practice
registered nurse, or physician assistant shall not recognize a default surrogate for health
decisions unless the individual for whom a health care decision is necessary is an
unrepresented individual as defined in subdivision 10. "Default surrogate for health decisions"
means either an individual or individuals age 18 or older, or an organization, so long as the
individual, individuals, or organization is one of the following:
new text end

new text begin (1) an individual or individuals included in the unrepresented individual's kinship system;
new text end

new text begin (2) a friend or more than one friend of the unrepresented individual;
new text end

new text begin (3) a health care agent appointed by the unrepresented individual in a health care directive
that does not include a designation of the power necessary to make the health care decision
for which the physician, advanced practice registered nurse, or physician assistant seeks
informed consent;
new text end

new text begin (4) other individual or individuals designated in writing or verbally by the unrepresented
individual or who are qualified or registered to assist the unrepresented individual in other
respects, including but not limited to:
new text end

new text begin (i) a designated representative pursuant to section 144G.08, subdivision 19;
new text end

new text begin (ii) a client representative pursuant to section 144A.43, subdivision 1e;
new text end

new text begin (iii) a hospice patient's family pursuant to section 144A.75, subdivision 7;
new text end

new text begin (iv) an individual under section 144.651, subdivision 10;
new text end

new text begin (v) a responsible party pursuant to section 144.6501, subdivision 1, paragraph (e);
new text end

new text begin (vi) an individual appointed by the unrepresented individual in a valid power of attorney
pursuant to chapter 523; and
new text end

new text begin (vii) a representative payee with respect to governmental benefits; or
new text end

new text begin (5) a professional or other individuals supportive of the unrepresented individual such
as:
new text end

new text begin (i) clergy and religious order members;
new text end

new text begin (ii) care managers;
new text end

new text begin (iii) professional advocates;
new text end

new text begin (iv) supporters consistent with the definition of supported decision making in section
524.5-102, subdivision 16a; and
new text end

new text begin (v) individuals associated with a health care agent organization.
new text end

Sec. 2.

Minnesota Statutes 2024, section 145C.01, is amended by adding a subdivision to
read:

new text begin Subd. 1d. new text end

new text begin Friends. new text end

new text begin "Friends" means adults who exhibit good faith concern for the
unrepresented individual and who are familiar with and supportive of the unrepresented
individual.
new text end

Sec. 3.

Minnesota Statutes 2024, section 145C.01, subdivision 2, is amended to read:

Subd. 2.

Health care agent.

"Health care agent" means an individual age 18 or older
deleted text begin who is deleted text end new text begin or a health care agent organization new text end appointed by a principal in a health care power
of attorney to make health care decisions on behalf of the principal. "Health care agent"
may also be referred to as "agent."

Sec. 4.

Minnesota Statutes 2024, section 145C.01, is amended by adding a subdivision to
read:

new text begin Subd. 2a. new text end

new text begin Health care agent organization. new text end

new text begin "Health care agent organization" means an
organization that maintains a group of individuals who are reasonably available to serve as
health care agents pursuant to this chapter.
new text end

Sec. 5.

Minnesota Statutes 2024, section 145C.01, is amended by adding a subdivision to
read:

new text begin Subd. 7b. new text end

new text begin Kinship system. new text end

new text begin "Kinship system" means a system of social relationships
connecting people in a community or culture who are, or are held to be, related, and which
defines and regulates the reciprocal obligations within the system, such as family members,
religious communities, and ethnic communities.
new text end

Sec. 6.

Minnesota Statutes 2024, section 145C.01, is amended by adding a subdivision to
read:

new text begin Subd. 10. new text end

new text begin Unrepresented individual. new text end

new text begin "Unrepresented individual" means an individual
age 18 or older who:
new text end

new text begin (1) has not previously executed a health care directive containing health care instructions
or appointing a health care agent;
new text end

new text begin (2) has previously executed a health care directive appointing a health care agent but
the individual has revoked the health care power of attorney under section 145C.09, or has
appointed a health care agent who is not reasonably available, or who has not given the
health care agent in the reasonable professional judgment of the physician, advanced practice
registered nurse, or physician assistant the powers that are necessary to make the health
care decision for which the physician, advanced practice registered nurse, or physician
assistant seeks informed consent;
new text end

new text begin (3) has previously executed a health care directive containing health care instructions
which did not appoint a health care agent but has revoked the health care directive under
section 145C.09, or has provided health care instructions insufficient in the reasonable
professional judgment of the physician, advanced practice registered nurse, or physician
assistant to permit the physician, advanced practice registered nurse, or physician assistant
to act; or
new text end

new text begin (4) is not currently subject to a guardianship in which the power to make health care
decisions has been granted pursuant to section 524.5-313, paragraph (c).
new text end

Sec. 7.

Minnesota Statutes 2024, section 145C.03, is amended by adding a subdivision to
read:

new text begin Subd. 4. new text end

new text begin Health care agent organization appointed as agent. new text end

new text begin If the principal executes
a health care power of attorney appointing a health care agent organization as the principal's
health care agent, the health care power of attorney shall include the name, address, telephone
number, and email address of the health care agent organization, and the name of at least
one individual associated with the health care agent organization designated by the principal
to act as agent on behalf of the health care agent organization. The health care agent
organization may designate a successor agent or agents if the initial agent is not reasonably
available at the time the health care power of attorney becomes effective pursuant to section
145C.06.
new text end

Sec. 8.

Minnesota Statutes 2024, section 145C.10, is amended to read:

145C.10 PRESUMPTIONS.

(a) The principal is presumed to have the capacity to execute a health care directive and
to revoke a health care directive, absent clear and convincing evidence to the contrary.

(b) A health care provider or health care agent may presume that a health care directive
is legally sufficient absent actual knowledge to the contrary. A health care directive is
presumed to be properly executed, absent clear and convincing evidence to the contrary.

(c) A health care agent new text begin or default surrogate for health decisions new text end , and a health care provider
acting pursuant to the direction of a health care agent new text begin or default surrogate for health decisions new text end ,
are presumed to be acting in good faith, absent clear and convincing evidence to the contrary.

(d) A health care directive is presumed to remain in effect until the principal modifies
or revokes it, absent clear and convincing evidence to the contrary.

(e) This chapter does not create a presumption concerning the intention of an individual
who has not executed a health care directive and, except as otherwise provided by section
145C.15, does not impair or supersede any right or responsibility of an individual to consent,
refuse to consent, or withdraw consent to health care on behalf of another in the absence of
a health care directive new text begin , including but not limited to a default surrogate for health decisions new text end .

(f) A copy of a health care directive is presumed to be a true and accurate copy of the
executed original, absent clear and convincing evidence to the contrary, and must be given
the same effect as an original.

(g) When a patient lacks decision-making capacity and is pregnant, and in reasonable
medical judgment there is a real possibility that if health care to sustain her life and the life
of the fetus is provided the fetus could survive to the point of live birth, the health care
provider shall presume that the patient would have wanted such health care to be provided,
even if the withholding or withdrawal of such health care would be authorized were she not
pregnant. This presumption is negated by health care directive provisions described in
section 145C.05, subdivision 2, paragraph (a), clause (10), that are to the contrary, or, in
the absence of such provisions, by clear and convincing evidence that the patient's wishes,
while competent, were to the contrary.

Sec. 9.

Minnesota Statutes 2024, section 145C.11, is amended to read:

145C.11 IMMUNITIES.

Subdivision 1.

Health care agent new text begin and default surrogate for health decisions new text end .

A health
care agent new text begin or default surrogate for health decisions new text end is not subject to criminal prosecution or
civil liability if the health care agent acts in good faith.

Subd. 2.

Health care provider.

(a) With respect to health care provided to a patient
with a health care directive, a health care provider is not subject to criminal prosecution,
civil liability, or professional disciplinary action if the health care provider acts in good
faith and in accordance with applicable standards of care.

(b) A health care provider is not subject to criminal prosecution, civil liability, or
professional disciplinary action if the health care provider relies on a health care decision
made by the health care agent and the following requirements are satisfied:

(1) the health care provider believes in good faith that the decision was made by a health
care agent appointed to make the decision and has no actual knowledge that the health care
directive has been revoked; and

(2) the health care provider believes in good faith that the health care agent is acting in
good faith.

(c) A health care provider who administers health care necessary to keep the principal
alive, despite a health care decision of the health care agent new text begin or default surrogate for health
decisions new text end to withhold or withdraw that treatment, is not subject to criminal prosecution,
civil liability, or professional disciplinary action if that health care provider promptly took
all reasonable steps to:

(1) notify the health care agent new text begin or default surrogate for health decisions new text end of the health
care provider's unwillingness to comply;

(2) document the notification in the principal's medical record; and

(3) permit the health care agent new text begin or default surrogate for health decisions new text end to arrange to
transfer care of the principal to another health care provider willing to comply with the
decision of the health care agent new text begin or default surrogate for health decisions new text end .

new text begin (d) A health care provider is not subject to criminal prosecution, civil liability, or
professional disciplinary action if the health care provider relies on a health care decision
made by a default surrogate for health decisions when the following requirements are
satisfied:
new text end

new text begin (1) the health care provider believes in good faith that the default surrogate for health
decisions meets the requirements in section 145C.18, subdivision 1, clause (3); and
new text end

new text begin (2) the health care provider believes in good faith that the default surrogate for health
decisions is acting in good faith.
new text end

Sec. 10.

new text begin [145C.18] HEALTH CARE DECISIONS FOR UNREPRESENTED
INDIVIDUALS.
new text end

new text begin Subdivision 1. new text end

new text begin Requirements to appoint. new text end

new text begin When a physician, advanced practice registered
nurse, or physician assistant needs to obtain a health care decision from or on behalf of an
individual, the physician, advanced practice registered nurse, or physician assistant may
obtain the health care decision from a default surrogate for health decisions subject to the
reasonable satisfaction, in the good faith and reasonable professional judgment of the
physician, advanced practice registered nurse, or physician assistant of all the following
conditions:
new text end

new text begin (1) the individual is an unrepresented individual pursuant to section 145C.01, subdivision
10;
new text end

new text begin (2) the unrepresented individual does not have decision-making capacity pursuant to
section 145C.01, subdivision 4, with respect to the health care decision and does not have
the capacity pursuant to section 145C.02 to execute a health care directive, or has the capacity
pursuant to section 145C.02 to execute a health care directive but declines to do so;
new text end

new text begin (3) each default surrogate for health decisions recognized by the physician, advanced
practice registered nurse, or physician assistant:
new text end

new text begin (i) has demonstrated or expressed the willingness and ability to demonstrate good faith
concern for the unrepresented individual;
new text end

new text begin (ii) is familiar with or is willing and able to become familiar with and supportive of the
unrepresented individual's current personal values and life choices;
new text end

new text begin (iii) would be reasonably available to make health care decisions;
new text end

new text begin (iv) would act in good faith;
new text end

new text begin (v) would be reasonably acceptable to the unrepresented individual given the
unrepresented individual's reasonably determinable personal values and life choices; and
new text end

new text begin (vi) would not be considered ineligible to serve as a health care agent consistent with
section 145C.03, subdivision 2; and
new text end

new text begin (4) the physician, advanced practice nurse, or physician assistant documents the process
undertaken to satisfy the foregoing conditions and the rationale for the recognition of each
default surrogate for health decisions.
new text end

new text begin Subd. 2. new text end

new text begin Other laws. new text end

new text begin Each default surrogate for health decisions recognized pursuant
to subdivision 1 shall be considered to have specific authorization in law, including but not
limited to section 144.293, subdivision 2, clause (2), and Code of Federal Regulations, title
45, sections 164.502 and 164.510, paragraph (b), with respect to access to patient records
relevant to the health care decision for which the default surrogate for health decisions is
recognized.
new text end