2nd Engrossment - 80th Legislature (1997 - 1998) Posted on 12/15/2009 12:00am
Engrossments | ||
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Introduction | Posted on 01/22/1998 | |
1st Engrossment | Posted on 01/30/1998 | |
2nd Engrossment | Posted on 03/20/1998 |
1.1 A bill for an act 1.2 relating to health; modifying provisions governing 1.3 advance health care directives; combining laws 1.4 governing living wills and durable power of attorney 1.5 for health care; amending Minnesota Statutes 1996, 1.6 sections 144.335, subdivision 1; 145C.01, subdivisions 1.7 2, 3, 4, 8, and by adding subdivisions; 145C.02; 1.8 145C.03; 145C.04; 145C.05, subdivisions 1 and 2; 1.9 145C.06; 145C.07; 145C.08; 145C.09; 145C.10; 145C.11; 1.10 145C.12; 145C.13, subdivision 1; 145C.15; 525.55, 1.11 subdivisions 1 and 2; 525.551, subdivisions 1 and 5; 1.12 525.9212; and 609.215, subdivision 3; Minnesota 1.13 Statutes 1997 Supplement, sections 149A.80, 1.14 subdivision 2; 253B.04, subdivision 1a; 253B.07, 1.15 subdivision 1; and 253B.092, subdivisions 2 and 6; 1.16 proposing coding for new law in Minnesota Statutes, 1.17 chapters 145B; and 145C. 1.18 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 1.19 Section 1. Minnesota Statutes 1996, section 144.335, 1.20 subdivision 1, is amended to read: 1.21 Subdivision 1. [DEFINITIONS.] For the purposes of this 1.22 section, the following terms have the meanings given them: 1.23 (a) "Patient" means a natural person who has received 1.24 health care services from a provider for treatment or 1.25 examination of a medical, psychiatric, or mental condition, the 1.26 surviving spouse and parents of a deceased patient, or a person 1.27 the patientdesignatesappoints in writing as a representative, 1.28 including a health care agent acting pursuant to chapter 145C, 1.29 unless the authority of the agent has been limited by the 1.30 principal in the principal's health care directive. Except for 1.31 minors who have received health care services pursuant to 2.1 sections 144.341 to 144.347, in the case of a minor, patient 2.2 includes a parent or guardian, or a person acting as a parent or 2.3 guardian in the absence of a parent or guardian. 2.4 (b) "Provider" means (1) any person who furnishes health 2.5 care services and is licensed to furnish the services pursuant 2.6 to chapter 147, 148, 148B, 150A, 151, or 153; (2) a home care 2.7 provider licensed under section 144A.46; (3) a health care 2.8 facility licensed pursuant to this chapter or chapter 144A; (4) 2.9 a physician assistant registered under chapter 147A; and (5) an 2.10 unlicensed mental health practitioner regulated pursuant to 2.11 sections 148B.60 to 148B.71. 2.12 (c) "Individually identifiable form" means a form in which 2.13 the patient is or can be identified as the subject of the health 2.14 records. 2.15 Sec. 2. [145B.011] [APPLICATION OF CHAPTER.] 2.16 This chapter applies only to living wills executed before 2.17 August 1, 1998. If a document purporting to be a living will is 2.18 executed on or after August 1, 1998, its legal sufficiency, 2.19 interpretation, and enforcement must be determined under the 2.20 provisions of chapter 145C in effect on the date of its 2.21 execution. 2.22 Sec. 3. Minnesota Statutes 1996, section 145C.01, is 2.23 amended by adding a subdivision to read: 2.24 Subd. 1a. [ACT IN GOOD FAITH.] "Act in good faith" means 2.25 to act consistently with a legally sufficient health care 2.26 directive of the principal, a living will executed under chapter 2.27 145B, a declaration regarding intrusive mental health treatment 2.28 executed under section 253B.03, subdivision 6d, or information 2.29 otherwise made known by the principal, unless the actor has 2.30 actual knowledge of the modification or revocation of the 2.31 information expressed. If these sources of information do not 2.32 provide adequate guidance to the actor, "act in good faith" 2.33 means acting in the best interests of the principal, considering 2.34 the principal's overall general health condition and prognosis 2.35 and the principal's personal values to the extent known. 2.36 Notwithstanding any instruction of the principal, a health care 3.1 agent, health care provider, or any other person is not acting 3.2 in good faith if the person violates the provisions of section 3.3 609.215 prohibiting assisted suicide. 3.4 Sec. 4. Minnesota Statutes 1996, section 145C.01, is 3.5 amended by adding a subdivision to read: 3.6 Subd. 1b. [DECISION-MAKING CAPACITY.] "Decision-making 3.7 capacity" means the ability to understand the significant 3.8 benefits, risks, and alternatives to proposed health care and to 3.9 make and communicate a health care decision. 3.10 Sec. 5. Minnesota Statutes 1996, section 145C.01, 3.11 subdivision 2, is amended to read: 3.12 Subd. 2. [HEALTH CARE AGENT.] "Health care agent" means an 3.13 individual age 18 or older who isdesignatedappointed by a 3.14 principal in adurablehealth care power of attorneyfor health3.15careto make health care decisions on behalf ofathe principal 3.16and has consented to act in that capacity.An agent"Health 3.17 care agent" may also be referred to as "attorney in factagent." 3.18 Sec. 6. Minnesota Statutes 1996, section 145C.01, 3.19 subdivision 3, is amended to read: 3.20 Subd. 3. [DURABLEHEALTH CARE POWER OF ATTORNEYFOR HEALTH3.21CARE.] "DurableHealth care power of attorneyfor health care" 3.22 means an instrumentauthorizing an agentappointing one or more 3.23 health care agents to make health care decisions for the 3.24 principalif the principal is unable, in the judgment of the3.25attending physician, to make or communicate health care3.26decisions. 3.27 Sec. 7. Minnesota Statutes 1996, section 145C.01, 3.28 subdivision 4, is amended to read: 3.29 Subd. 4. [HEALTH CARE.] "Health care" means any care, 3.30 treatment, service, or procedure to maintain, diagnose, ortreat3.31 otherwise affect a person's physical or mental condition. 3.32 "Health care" includes the provision of nutrition or hydration 3.33 parenterally or through intubation but does not include any 3.34 treatment, service, or procedure that violates the provisions of 3.35 section 609.215 prohibiting assisted suicide. "Health 3.36 care"does not include intrusive mental health treatment as4.1defined in section 253B.03, subdivision 6b, unless the durable4.2power of attorney for health care specifically applies to4.3decisions relating to intrusive mental health treatmentalso 4.4 includes the establishment of a person's abode within or without 4.5 the state and personal security safeguards for a person, to the 4.6 extent decisions on these matters relate to the health care 4.7 needs of the person. 4.8 Sec. 8. Minnesota Statutes 1996, section 145C.01, is 4.9 amended by adding a subdivision to read: 4.10 Subd. 5a. [HEALTH CARE DIRECTIVE.] "Health care directive" 4.11 means a written instrument that complies with section 145C.03 4.12 and includes one or more health care instructions, a health care 4.13 power of attorney, or both; or a durable power of attorney for 4.14 health care executed under this chapter before August 1, 1998. 4.15 Sec. 9. Minnesota Statutes 1996, section 145C.01, is 4.16 amended by adding a subdivision to read: 4.17 Subd. 7a. [HEALTH CARE INSTRUCTION.] "Health care 4.18 instruction" means a written statement of the principal's 4.19 values, preferences, guidelines, or directions regarding health 4.20 care. 4.21 Sec. 10. Minnesota Statutes 1996, section 145C.01, 4.22 subdivision 8, is amended to read: 4.23 Subd. 8. [PRINCIPAL.] "Principal" means an individual age 4.24 18 or older who has executed adurable power of attorney for4.25 health care directive. 4.26 Sec. 11. Minnesota Statutes 1996, section 145C.01, is 4.27 amended by adding a subdivision to read: 4.28 Subd. 9. [REASONABLY AVAILABLE.] "Reasonably available" 4.29 means readily able to be contacted without undue effort and 4.30 willing and able to act in a timely manner considering the 4.31 urgency of the principal's health care needs. 4.32 Sec. 12. Minnesota Statutes 1996, section 145C.02, is 4.33 amended to read: 4.34 145C.02 [DURABLE POWER OF ATTORNEY FORHEALTH CARE 4.35 DIRECTIVE.] 4.36A durable power of attorney for health care under this5.1chapter authorizes the agent to make health care decisions for5.2the principal when the principal is unable, in the judgment of5.3the principal's attending physician, to make or communicate5.4health care decisions. The durable power of attorney for health5.5care must substantially comply with the requirements of this5.6chapter. An instrument executed prior to August 1, 1993,5.7purporting to create a durable power of attorney for health care5.8is valid if the document specifically authorizes the agent to5.9make health care decisions and is executed in compliance with5.10section 145C.03.A principal with the capacity to do so may 5.11 execute a health care directive. A health care directive may 5.12 include one or more health care instructions to direct health 5.13 care providers, others assisting with health care, family 5.14 members, and a health care agent. A health care directive may 5.15 include a health care power of attorney to appoint a health care 5.16 agent to make health care decisions for the principal when the 5.17 principal, in the judgment of the principal's attending 5.18 physician, lacks decision-making capacity, unless otherwise 5.19 specified in the health care directive. 5.20 Sec. 13. Minnesota Statutes 1996, section 145C.03, is 5.21 amended to read: 5.22 145C.03 [REQUIREMENTS.] 5.23 Subdivision 1. [EXECUTIONLEGAL SUFFICIENCY.]A durable5.24power of attorney for health care must be signed by the5.25principal or in the principal's name by some other individual5.26acting in the principal's presence and by the principal's5.27direction. A durable power of attorney for health care must5.28contain the date of its execution and must be witnessed or5.29acknowledged by one of the following methods:5.30(1) signed by at least two individuals age 18 or older each5.31of whom witnessed either the signing of the instrument by the5.32principal or the principal's acknowledgment of the signature; or5.33(2) acknowledged by the principal before a notary public5.34who is not the agent.To be legally sufficient in this state, a 5.35 health care directive must: 5.36 (1) be in writing; 6.1 (2) be dated; 6.2 (3) state the principal's name; 6.3 (4) be executed by a principal with capacity to do so with 6.4 the signature of the principal or with the signature of another 6.5 person authorized by the principal to sign on behalf of the 6.6 principal; 6.7 (5) contain verification of the principal's signature or 6.8 the signature of the person authorized by the principal to sign 6.9 on behalf of the principal, either by a notary public or by 6.10 witnesses as provided under this chapter; and 6.11 (6) include a health care instruction, a health care power 6.12 of attorney, or both. 6.13 Subd. 2. [INDIVIDUALS INELIGIBLE TO ACT AS HEALTH CARE 6.14 AGENT.] (a) An individual appointed by the principal under 6.15 section 145C.05, subdivision 2, paragraph (b), to make the 6.16 determination of the principal's decision-making capacity is not 6.17 eligible to act as the health care agent. 6.18 (b) The following individuals are not eligible to act as 6.19 the health care agentin a durable power of attorney for health6.20care, unless the individualdesignatedappointed is related to 6.21 the principal by blood, marriage, registered domestic 6.22 partnership, or adoption, or unless the principal has otherwise 6.23 specified in the health care directive: 6.24 (1) a health care provider attending the principal on the 6.25 date of execution of the health care directive or on the date 6.26 the health care agent must make decisions for the principal; or 6.27 (2) an employee of a health care provider attending the 6.28 principal on the date of execution of the health care directive 6.29 or on the date the health care agent must make decisions for the 6.30 principal. 6.31 Subd. 3. [INDIVIDUALS INELIGIBLE TO ACT AS WITNESSES OR 6.32 NOTARY PUBLIC.]The(a) A health care agentdesignatedor 6.33 alternate health care agent appointed inthe durable power of6.34attorney fora health care power of attorney may not act as a 6.35 witness or notary public for the execution of thedurable power6.36of attorney forhealth care directive that includes the health 7.1 care power of attorney. 7.2 (b) At least one witness to the execution of thedurable7.3power of attorney forhealth care directive must not be a health 7.4 care provider providing direct care to the principal or an 7.5 employee of a health care provider providing direct care to the 7.6 principal on the date of execution. A person notarizing a 7.7 health care directive may be an employee of a health care 7.8 provider providing direct care to the principal. 7.9 Sec. 14. Minnesota Statutes 1996, section 145C.04, is 7.10 amended to read: 7.11 145C.04 [EXECUTED IN ANOTHER STATE.] 7.12 (a) Adurable power of attorney for health care or similar7.13document executed in another state or jurisdiction in compliance7.14with the law of that state or jurisdiction is valid and7.15enforceable in this state, to the extent the document is7.16consistent with the laws of this statehealth care directive or 7.17 similar document executed in another state or jurisdiction is 7.18 legally sufficient under this chapter if it: 7.19 (1) complies with the law of the state or jurisdiction in 7.20 which it was executed; or 7.21 (2) complies with section 145C.03. 7.22 (b) Nothing in this section shall be interpreted to 7.23 authorize a directive or similar document to override the 7.24 provisions of section 609.215 prohibiting assisted suicide. 7.25 Sec. 15. Minnesota Statutes 1996, section 145C.05, 7.26 subdivision 1, is amended to read: 7.27 Subdivision 1. [CONTENT.] Adurable power of attorney for7.28 health care directive executed pursuant to this chapter may, but 7.29 need not, be in thefollowingform:7.30"I appoint .......... as my agent (my attorney in fact) to7.31make any health care decision for me when, in the judgment of my7.32attending physician, I am unable to make or communicate the7.33decision myself and my agent consents to make or communicate the7.34decision on my behalf.7.35My agent has the power to make any health care decision for7.36me. This power includes the power to give consent, to refuse8.1consent, or to withdraw consent to any care, treatment, service,8.2or procedure to maintain, diagnose, or treat my physical or8.3mental condition, including giving me food or water by8.4artificial means. My agent has the power, where consistent with8.5the laws of this state, to make a health care decision to8.6withhold or stop health care necessary to keep me alive. It is8.7my intention that my agent or any alternative agent has a8.8personal obligation to me to make health care decisions for me8.9consistent with my expressed wishes. I understand, however,8.10that my agent or any alternative agent has no legal duty to act.8.11My agent and any alternative agents have consented to act8.12as my agent. My agent and any alternative agents have been8.13notified that they will be nominated as a guardian or8.14conservator for me.8.15My agent must act consistently with my desires as stated in8.16this document or as otherwise made known by me to my agent.8.17My agent has the same right as I would have to receive,8.18review, and obtain copies of my medical records and to consent8.19to disclosure of those records."contained in section 145C.16. 8.20 Sec. 16. Minnesota Statutes 1996, section 145C.05, 8.21 subdivision 2, is amended to read: 8.22 Subd. 2. [ADDITIONALPROVISIONS THAT MAY BE INCLUDED.]The8.23durable power of attorney for(a) A health care directive may 8.24 includeadditionalprovisions consistent with this chapter, 8.25 including, but not limited to: 8.26 (1) the designation of one or morealternativealternate 8.27 health care agents to act if the named health care agent is 8.28unable, unavailable, or unwillingnot reasonably available to 8.29 serve; 8.30 (2)specific instructions to the agent or any alternative8.31agentsdirections to joint health care agents regarding the 8.32 process or standards by which the health care agents are to 8.33 reach a health care decision for the principal, and a statement 8.34 whether joint health care agents may act independently of one 8.35 another; 8.36 (3) limitations, if any, on the right of the health care 9.1 agent or anyalternativealternate health care agents to 9.2 receive, review, obtain copies of, and consent to the disclosure 9.3 of the principal's medical records; 9.4 (4) limitations, if any, on the nomination of the health 9.5 care agent as guardian or conservator of the person for purposes 9.6 of section 525.544;and9.7 (5) a document of gift for the purpose of making an 9.8 anatomical gift, as set forth in sections 525.921 to 525.9224, 9.9 or an amendment to, revocation of, or refusal to make an 9.10 anatomical gift.; 9.11 (6) a declaration regarding intrusive mental health 9.12 treatment under section 253B.03, subdivision 6d, or a statement 9.13 that the health care agent is authorized to give consent for the 9.14 principal under section 253B.04, subdivision 1a; 9.15 (7) a funeral directive as provided in section 149A.80, 9.16 subdivision 2; 9.17 (8) limitations, if any, to the effect of dissolution or 9.18 annulment of marriage or termination of domestic partnership on 9.19 the appointment of a health care agent under section 145C.09, 9.20 subdivision 2; 9.21 (9) specific reasons why a principal wants a health care 9.22 provider or an employee of a health care provider attending the 9.23 principal to be eligible to act as the principal's health care 9.24 agent; 9.25 (10) health care instructions by a woman of child bearing 9.26 age regarding how she would like her pregnancy, if any, to 9.27 affect health care decisions made on her behalf; and 9.28 (11) health care instructions regarding artificially 9.29 administered nutrition or hydration. 9.30 (b) A health care directive may include a statement of the 9.31 circumstances under which the directive becomes effective other 9.32 than upon the judgment of the principal's attending physician in 9.33 the following situations: 9.34 (1) a principal who in good faith generally selects and 9.35 depends upon spiritual means or prayer for the treatment or care 9.36 of disease or remedial care and does not have an attending 10.1 physician, may include a statement appointing an individual who 10.2 may determine the principal's decision-making capacity; and 10.3 (2) a principal who in good faith does not generally select 10.4 a physician or a health care facility for the principal's health 10.5 care needs may include a statement appointing an individual who 10.6 may determine the principal's decision-making capacity, provided 10.7 that if the need to determine the principal's capacity arises 10.8 when the principal is receiving care under the direction of an 10.9 attending physician in a health care facility, the determination 10.10 must be made by an attending physician after consultation with 10.11 the appointed individual. 10.12 If a person appointed under clause (1) or (2) is not 10.13 reasonably available and the principal is receiving care under 10.14 the direction of an attending physician in a health care 10.15 facility, an attending physician shall determine the principal's 10.16 decision-making capacity. 10.17 (c) A health care directive may authorize a health care 10.18 agent to make health care decisions for a principal even though 10.19 the principal retains decision-making capacity. 10.20 Sec. 17. Minnesota Statutes 1996, section 145C.06, is 10.21 amended to read: 10.22 145C.06 [WHEN EFFECTIVE.] 10.23(a) Except as provided in paragraph (b), a durable power of10.24attorney forA health care directive is effective for a health 10.25 care decision when: 10.26 (1) ithas been executed in accordance withmeets the 10.27 requirements of section 145C.03, subdivision 1; and 10.28 (2) the principalis unable, in the determination of the 10.29 attending physician of the principal,to make or communicate10.30that health care decision and the agent consents to make or10.31communicate the decisionlacks decision-making capacity to make 10.32 the health care decision; or if other conditions for 10.33 effectiveness otherwise specified by the principal have been met. 10.34 A health care directive is not effective for a health care 10.35 decision when the principal, in the determination of the 10.36 attending physician of the principal, recovers decision-making 11.1 capacity; or if other conditions for effectiveness otherwise 11.2 specified by the principal have been met. 11.3(b) If the principal states in the durable power of11.4attorney that the principal does not have an attending physician11.5because the principal in good faith generally selects and11.6depends upon spiritual means or prayer for the treatment or care11.7of disease or remedial care, the principal may designate an11.8individual in the durable power of attorney for health care who11.9may certify in a writing acknowledged before a notary public11.10that the principal is unable to make or communicate a health11.11care decision. The requirements of section 145C.03,11.12subdivisions 2 and 3, relating to the eligibility of a health11.13care provider attending the principal or the provider's employee11.14to act as an agent or witness apply to an individual designated11.15under this paragraph.11.16 Sec. 18. Minnesota Statutes 1996, section 145C.07, is 11.17 amended to read: 11.18 145C.07 [AUTHORITY AND DUTIES OF HEALTH CARE AGENT.] 11.19 Subdivision 1. [AUTHORITY.] The health care agent has 11.20 authority to make any particular health care decision only if 11.21 the principalis unablelacks decision-making capacity, in the 11.22 determination of the attending physician, to make or communicate 11.23 that health care decision; or if other conditions for 11.24 effectiveness otherwise specified by the principal have been 11.25 met.The agent does not have authority to consent to a11.26voluntary commitment under chapter 253B.The physician or other 11.27 health care provider shall continue to obtain the principal's 11.28 informed consent to all health care decisions for which the 11.29 principalis capable of informed consenthas decision-making 11.30 capacity, unless other conditions for effectiveness otherwise 11.31 specified by the principal have been met. An alternate health 11.32 care agent has authority to act if the primary health care agent 11.33 is not reasonably available to act. 11.34 Subd. 2. [HEALTH CARE AGENT AS GUARDIAN.]Except as11.35otherwise provided in the durable power of attorney for health11.36careUnless the principal has otherwise specified in the health 12.1 care directive, the appointment of the health care agent in a 12.2durable power of attorney forhealth care directive is 12.3 considered a nomination of a guardian or conservator of the 12.4 person for purposes of section 525.544. 12.5 Subd. 3. [DUTIES.] In exercisingtheauthority underthe12.6durable power of attorney fora health care directive,thea 12.7 health care agent has a duty to act inaccordance with the12.8desires of the principal as expressed in the durable power of12.9attorney for health care, as expressed in a living will under12.10chapter 145B or in a declaration regarding intrusive mental12.11health treatment under section 253B.03, subdivision 6d, or as12.12otherwise made known by the principal to the agent at any time.12.13If the principal's desires are not known or cannot be determined12.14from information known to the agent, the agent has a duty to act12.15in the best interests of the principal taking into account the12.16principal's overall medical condition and prognosisgood faith. 12.17AnA health care agent or anyalternativealternate health care 12.18 agent has a personal obligation to the principal to make health 12.19 care decisions authorized by thedurablehealth care power of 12.20 attorneyfor health care, but this obligation does not 12.21 constitute a legal duty to act. 12.22 Subd. 4. [INCONSISTENCIES AMONG DOCUMENTS.] In the event 12.23 of inconsistency between thedesignationappointment of a proxy 12.24 under chapter 145B or section 253B.03, subdivision 6d, or ofan12.25 a health care agent under this chapter, the most 12.26 recentdesignationappointment takes precedence. In the event 12.27 of other inconsistencies among documents executed under this 12.28 chapter, under chapter 145B, or under section 253B.03, 12.29 subdivision 6d, or 525.544, or other legally sufficient 12.30 documents, the provisions of the most recently executed document 12.31 take precedence only to the extent of the inconsistency. 12.32 Sec. 19. Minnesota Statutes 1996, section 145C.08, is 12.33 amended to read: 12.34 145C.08 [AUTHORITY TO REVIEW MEDICAL RECORDS.] 12.35AnA health care agent acting pursuant to adurable power12.36of attorney forhealth care directive has the same right as the 13.1 principal to receive, review, and obtain copies of medical 13.2 records of the principal, and to consent to the disclosure of 13.3 medical records of the principal, unless thedurable power of13.4attorney for health care expressly provides otherwiseprincipal 13.5 has otherwise specified in the health care directive. 13.6 Sec. 20. Minnesota Statutes 1996, section 145C.09, is 13.7 amended to read: 13.8 145C.09 [REVOCATION OFDURABLE POWER OF ATTORNEYHEALTH 13.9 CARE DIRECTIVE.] 13.10 Subdivision 1. [REVOCATION.]TheA principal with the 13.11 capacity to do so may revoke adurable power of attorney for13.12 health care directive in whole or in part at any time by doing 13.13 any of the following: 13.14 (1) canceling, defacing, obliterating, burning, tearing, or 13.15 otherwise destroying thedurable power of attorney forhealth 13.16 care directive instrument or directing another in the presence 13.17 of the principal to destroy thedurable power of attorney for13.18 health care directive instrument, with the intent to revoke the 13.19 health care directive in whole or in part; 13.20 (2) executing a statement, in writing and dated, expressing 13.21 the principal's intent to revoke thedurable power of attorney13.22forhealth care directive in whole or in part; 13.23 (3) verbally expressing the principal's intent to revoke 13.24 thedurable power of attorney forhealth care directive in whole 13.25 or in part in the presence of two witnesses who do not have to 13.26 be present at the same time; or 13.27 (4) executing a subsequentdurable power of attorney for13.28 health careinstrumentdirective, to the extent the subsequent 13.29 instrument is inconsistent with any prior instrument. 13.30 Subd. 2. [EFFECT OF DISSOLUTION OR ANNULMENT OF MARRIAGE 13.31 OR TERMINATION OF DOMESTIC PARTNERSHIP ON APPOINTMENT OF HEALTH 13.32 CARE AGENT.] Unless thedurable power of attorney for health13.33care expressly provides otherwiseprincipal has otherwise 13.34 specified in the health care directive, the appointment by the 13.35 principal of the principal's spouse or registered domestic 13.36 partner as health care agent under adurablehealth care power 14.1 of attorneyfor health careis revoked by the commencement of 14.2 proceedings for dissolution, annulment, or termination of the 14.3 principal's marriage or commencement of proceedings for 14.4 termination of the principal's registered domestic partnership. 14.5 Sec. 21. Minnesota Statutes 1996, section 145C.10, is 14.6 amended to read: 14.7 145C.10 [PRESUMPTIONS.] 14.8 (a) The principal is presumed to have the capacity to 14.9appoint an agent to makeexecute a health caredecisions14.10 directive and to revoke adurable power of attorney forhealth 14.11 care directive, absent clear and convincing evidence to the 14.12 contrary. 14.13 (b) A health care provider or health care agent may presume 14.14 that adurable power of attorney forhealth care directive is 14.15validlegally sufficient absent actual knowledge to the contrary. 14.16 A health care directive is presumed to be properly executed, 14.17 absent clear and convincing evidence to the contrary. 14.18It is presumed that an(c) A health care agent, and a 14.19 health care provider acting pursuant to the direction ofana 14.20 health care agent, are presumed to be acting in good faithand14.21in the best interests of the principal, absent clear and 14.22 convincing evidence to the contrary. 14.23 (d) A health care directive is presumed to remain in effect 14.24 until the principal modifies or revokes it, absent clear and 14.25 convincing evidence to the contrary. 14.26 (e) This chapter does not create a presumption concerning 14.27 the intention of an individual who has not executed adurable14.28power of attorney forhealth care directive and does not impair 14.29 or supersede any right or responsibility of an individual to 14.30 consent, refuse to consent, or withdraw consent to health care 14.31 on behalf of another in the absence of adurable power of14.32attorney forhealth care directive. 14.33 (f) A copy of a health care directive is presumed to be a 14.34 true and accurate copy of the executed original, absent clear 14.35 and convincing evidence to the contrary, and must be given the 14.36 same effect as an original. 15.1For purposes of this chapter, acting in good faith means15.2acting consistently with the desires of the principal as15.3expressed in the durable power of attorney for health care, as15.4expressed in a living will under chapter 145B or in a15.5declaration regarding intrusive mental health treatment under15.6section 253B.03, subdivision 6d, or otherwise made known by the15.7principal to the agent. If the principal's desires are not15.8known or cannot be determined from information known to the15.9agent, acting in good faith means acting in the best interests15.10of the principal, taking into account the principal's overall15.11medical condition and prognosis.15.12 (g) When a patient who lacks decision-making capacity is 15.13 pregnant, and in reasonable medical judgment there is a real 15.14 possibility that if health care to sustain her life and the life 15.15 of the fetus is provided the fetus could survive to the point of 15.16 live birth, it is presumed that such health care should be 15.17 provided, even if the withholding or withdrawal of such health 15.18 care would be authorized were she not pregnant. This 15.19 presumption is negated by health care directive provisions 15.20 described in section 145C.05, subdivision 2, paragraph (a), 15.21 clause (10), that are to the contrary, or, in the absence of 15.22 such provisions, by clear and convincing evidence that the 15.23 patient's wishes, while competent, were to the contrary. 15.24 Sec. 22. Minnesota Statutes 1996, section 145C.11, is 15.25 amended to read: 15.26 145C.11 [IMMUNITIES.] 15.27 Subdivision 1. [HEALTH CARE AGENT.]AnA health care agent 15.28 is not subject to criminal prosecution or civil liabilityfor15.29any health care decision made in good faith pursuant to a15.30durable power of attorney for health care, unless the agent has15.31actual knowledge of the revocation of the durable power of15.32attorney for health careif the health care agent acts in good 15.33 faith. 15.34 Subd. 2. [HEALTH CARE PROVIDER.] (a) A health care 15.35 provider is not subject to criminal prosecution, civil 15.36 liability, or professional disciplinary action if the health 16.1 care provider acts in good faith. 16.2 (b) A health care provider is not subject to criminal 16.3 prosecution, civil liability, or professional disciplinary 16.4 action if the health care provider relies on a health care 16.5 decision made by the health care agent and the following 16.6 requirements are satisfied: 16.7 (1) the health care provider believes in good faith that 16.8 the decision was made byana health care agentauthorized16.9 appointed to make the decision and has no actual knowledge that 16.10 thedurable power of attorney forhealth care directive has been 16.11 revoked; and 16.12 (2) the health care provider believes in good faith that 16.13 thedecision is consistent with the desires of the principal as16.14expressed in the durable power of attorney for health care or16.15otherwise made known by the principal to thehealth care agent 16.16 is acting in good faith. 16.17(b)(c) A health care provider who administers health care 16.18 necessary to keep the principal alive, despite a health care 16.19 decision of the health care agent to withhold or withdraw that 16.20 treatment, is not subject to criminal prosecution, civil 16.21 liability, or professional disciplinary action if that health 16.22 care provider promptly took all reasonable steps to: 16.23 (1) notify the health care agent of the health care 16.24 provider's unwillingness to comply; 16.25 (2) document the notification in the principal's medical 16.26 record; and 16.27 (3) permit the health care agent to arrange to transfer 16.28 care of the principal to another health care provider willing to 16.29 comply with the decision of the health care agent. 16.30 Sec. 23. Minnesota Statutes 1996, section 145C.12, is 16.31 amended to read: 16.32 145C.12 [PROHIBITED PRACTICES.] 16.33 Subdivision 1. [HEALTH CARE PROVIDER.] A health care 16.34 provider, health care service plan, insurer, self-insured 16.35 employee welfare benefit plan, or nonprofit hospital plan may 16.36 not condition admission to a facility, or the providing of 17.1 treatment or insurance, on the requirement that an individual 17.2 execute adurable power of attorney forhealth care directive. 17.3 Subd. 2. [INSURANCE.] A policy of life insurance is not 17.4 legally impaired or invalidated in any manner by the withholding 17.5 or withdrawing of health care pursuant to the direction ofana 17.6 health care agent appointed pursuant to this chapter, or 17.7 pursuant to the implementation of health care instructions under 17.8 this chapter. 17.9 Sec. 24. [145C.16] [SUGGESTED FORM.] 17.10 The following is a suggested form of a health care 17.11 directive and is not a required form. 17.12 HEALTH CARE DIRECTIVE 17.13 I, ..........................., understand this document 17.14 allows me to do ONE OR BOTH of the following: 17.15 PART I: Name another person (called the health care agent) 17.16 to make health care decisions for me if I am unable to decide or 17.17 speak for myself. My health care agent must make health care 17.18 decisions for me based on the instructions I provide in this 17.19 document (Part II), if any, the wishes I have made known to him 17.20 or her, or must act in my best interest if I have not made my 17.21 health care wishes known. 17.22 AND/OR 17.23 PART II: Give health care instructions to guide others 17.24 making health care decisions for me. If I have named a health 17.25 care agent, these instructions are to be used by the agent. 17.26 These instructions may also be used by my health care providers, 17.27 others assisting with my health care and my family, in the event 17.28 I cannot make decisions for myself. 17.29 PART I: APPOINTMENT OF HEALTH CARE AGENT 17.30 THIS IS WHO I WANT TO MAKE HEALTH CARE DECISIONS 17.31 FOR ME IF I AM UNABLE TO DECIDE OR SPEAK FOR MYSELF 17.32 (I know I can change my agent or alternate agent at any 17.33 time and I know I do not have to appoint an agent or an 17.34 alternate agent) 17.35 NOTE: If you appoint an agent, you should discuss this health 17.36 care directive with your agent and give your agent a copy. If 18.1 you do not wish to appoint an agent, you may leave Part I blank 18.2 and go to Part II. 18.3 When I am unable to decide or speak for myself, I trust and 18.4 appoint .......................... to make health care decisions 18.5 for me. This person is called my health care agent. 18.6 Relationship of my health care agent to me: ......... 18.7 ............................................................... 18.8 Telephone number of my health care agent: ........... 18.9 ............................................................... 18.10 Address of my health care agent: .................... 18.11 .............................................................. 18.12 (OPTIONAL) APPOINTMENT OF ALTERNATE HEALTH CARE AGENT: If 18.13 my health care agent is not reasonably available, I trust and 18.14 appoint .................... to be my health care agent instead. 18.15 Relationship of my alternate health care agent to me: 18.16 ............................................................... 18.17 Telephone number of my alternate health care agent: 18.18 ............................................................... 18.19 Address of my alternate health care agent: ......... 18.20 ............................................................... 18.21 THIS IS WHAT I WANT MY HEALTH CARE AGENT TO BE ABLE TO 18.22 DO IF I AM UNABLE TO DECIDE OR SPEAK FOR MYSELF 18.23 (I know I can change these choices) 18.24 My health care agent is automatically given the powers 18.25 listed below in (A) through (D). My health care agent must 18.26 follow my health care instructions in this document or any other 18.27 instructions I have given to my agent. If I have not given 18.28 health care instructions, then my agent must act in my best 18.29 interest. 18.30 Whenever I am unable to decide or speak for myself, my 18.31 health care agent has the power to: 18.32 (A) Make any health care decision for me. This includes 18.33 the power to give, refuse, or withdraw consent to any care, 18.34 treatment, service, or procedures. This includes deciding 18.35 whether to stop or not start health care that is keeping me or 18.36 might keep me alive, and deciding about intrusive mental health 19.1 treatment. 19.2 (B) Choose my health care providers. 19.3 (C) Choose where I live and receive care and support when 19.4 those choices relate to my health care needs. 19.5 (D) Review my medical records and have the same rights that 19.6 I would have to give my medical records to other people. 19.7 If I DO NOT want my health care agent to have a power 19.8 listed above in (A) through (D) OR if I want to LIMIT any power 19.9 in (A) through (D), I MUST say that here: 19.10 .............................................................. 19.11 ............................................................... 19.12 ............................................................... 19.13 My health care agent is NOT automatically given the powers 19.14 listed below in (1) and (2). If I WANT my agent to have any of 19.15 the powers in (1) and (2), I must INITIAL the line in front of 19.16 the power; then my agent WILL HAVE that power. 19.17 ... (1) To decide whether to donate my organs when I die. 19.18 ... (2) To decide what will happen with my body when I die 19.19 (burial, cremation). 19.20 If I want to say anything more about my health care agent's 19.21 powers or limits on the powers, I can say it here: 19.22 ................................................................. 19.23 ................................................................. 19.24 ................................................................. 19.25 PART II: HEALTH CARE INSTRUCTIONS 19.26 NOTE: Complete this Part II if you wish to give health care 19.27 instructions. If you appointed an agent in Part I, completing 19.28 this Part II is optional but would be very helpful to your 19.29 agent. However, if you chose not to appoint an agent in Part I, 19.30 you MUST complete some or all of this Part II if you wish to 19.31 make a valid health care directive. 19.32 These are instructions for my health care when I am unable 19.33 to decide or speak for myself. These instructions must be 19.34 followed (so long as they address my needs). 19.35 THESE ARE MY BELIEFS AND VALUES ABOUT MY HEALTH CARE 19.36 (I know I can change these choices or leave any of them 20.1 blank) 20.2 I want you to know these things about me to help you make 20.3 decisions about my health care: 20.4 My goals for my health care: .............................. 20.5 ................................................................. 20.6 ................................................................. 20.7 My fears about my health care: ............................ 20.8 ................................................................. 20.9 ................................................................. 20.10 My spiritual or religious beliefs and traditions: ......... 20.11 ................................................................. 20.12 ................................................................. 20.13 My beliefs about when life would be no longer worth 20.14 living: ........................................................ 20.15 ................................................................. 20.16 ................................................................. 20.17 My thoughts about how my medical condition might affect my 20.18 family: ........................................................ 20.19 ................................................................. 20.20 ................................................................. 20.21 THIS IS WHAT I WANT AND DO NOT WANT FOR MY HEALTH CARE 20.22 (I know I can change these choices or leave any of them 20.23 blank) 20.24 Many medical treatments may be used to try to improve my 20.25 medical condition or to prolong my life. Examples include 20.26 artificial breathing by a machine connected to a tube in the 20.27 lungs, artificial feeding or fluids through tubes, attempts to 20.28 start a stopped heart, surgeries, dialysis, antibiotics, and 20.29 blood transfusions. Most medical treatments can be tried for a 20.30 while and then stopped if they do not help. 20.31 I have these views about my health care in these situations: 20.32 (Note: You can discuss general feelings, specific 20.33 treatments, or leave any of them blank) 20.34 If I had a reasonable chance of recovery, and were 20.35 temporarily unable to decide or speak for myself, I would want: 20.36 ................................................................. 21.1 ................................................................. 21.2 ................................................................. 21.3 If I were dying and unable to decide or speak for myself, I 21.4 would want: .................................................... 21.5 ................................................................. 21.6 ................................................................. 21.7 If I were permanently unconscious and unable to decide or 21.8 speak for myself, I would want: ................................ 21.9 ................................................................. 21.10 ................................................................. 21.11 If I were completely dependent on others for my care and 21.12 unable to decide or speak for myself, I would want: ............ 21.13 ................................................................. 21.14 ................................................................. 21.15 In all circumstances, my doctors will try to keep me 21.16 comfortable and reduce my pain. This is how I feel about pain 21.17 relief if it would affect my alertness or if it could shorten my 21.18 life: .......................................................... 21.19 ................................................................. 21.20 ................................................................. 21.21 There are other things that I want or do not want for my 21.22 health care, if possible: 21.23 Who I would like to be my doctor: ......................... 21.24 ................................................................. 21.25 ................................................................. 21.26 Where I would like to live to receive health care: 21.27 ................................................................. 21.28 ................................................................. 21.29 ................................................................. 21.30 Where I would like to die and other wishes I have about 21.31 dying: ......................................................... 21.32 ................................................................. 21.33 ................................................................. 21.34 My wishes about donating parts of my body when I die: ..... 21.35 ................................................................. 21.36 ................................................................. 22.1 My wishes about what happens to my body when I die 22.2 (cremation, burial): ........................................... 22.3 ................................................................. 22.4 ................................................................. 22.5 Any other things: ......................................... 22.6 ................................................................. 22.7 ................................................................. 22.8 PART III: MAKING THE DOCUMENT LEGAL 22.9 This document must be signed by me. It also must either be 22.10 verified by a notary public (Option 1) OR witnessed by two 22.11 witnesses (Option 2). It must be dated when it is verified or 22.12 witnessed. 22.13 I am thinking clearly, I agree with everything that is 22.14 written in this document, and I have made this document 22.15 willingly. 22.16 .......................................... 22.17 My Signature 22.18 Date signed: ..................... 22.19 Date of birth: ..................... 22.20 Address: ................................... 22.21 ................................... 22.22 If I cannot sign my name, I can ask someone to sign this 22.23 document for me. 22.24 .......................................... 22.25 Signature of the person who I asked to sign this document for me. 22.26 .......................................... 22.27 Printed name of the person who I asked to sign this document for 22.28 me. 22.29 Option 1: Notary Public 22.30 In my presence on .................... (date), 22.31 ....................... (name) acknowledged his/her signature on 22.32 this document or acknowledged that he/she authorized the person 22.33 signing this document to sign on his/her behalf. I am not named 22.34 as a health care agent or alternate health care agent in this 22.35 document. 22.36 .............................. 23.1 (Signature of Notary) (Notary Stamp) 23.2 Option 2: Two Witnesses 23.3 Two witnesses must sign. Only one of the two witnesses can 23.4 be a health care provider or an employee of a health care 23.5 provider giving direct care to me on the day I sign this 23.6 document. 23.7 Witness One: 23.8 (i) In my presence on ............... (date), 23.9 ............... (name) acknowledged his/her signature on this 23.10 document or acknowledged that he/she authorized the person 23.11 signing this document to sign on his/her behalf. 23.12 (ii) I am at least 18 years of age. 23.13 (iii) I am not named as a health care agent or an alternate 23.14 health care agent in this document. 23.15 (iv) If I am a health care provider or an employee of a 23.16 health care provider giving direct care to the person listed 23.17 above in (A), I must initial this box: [ ] 23.18 I certify that the information in (i) through (iv) is true 23.19 and correct. 23.20 ...................................... 23.21 (Signature of Witness One) 23.22 Address: .......................................... 23.23 .......................................... 23.24 Witness Two: 23.25 (i) In my presence on .............. (date), 23.26 ................. (name) acknowledged his/her signature on this 23.27 document or acknowledged that he/she authorized the person 23.28 signing this document to sign on his/her behalf. 23.29 (ii) I am at least 18 years of age. 23.30 (iii) I am not named as a health care agent or an alternate 23.31 health care agent in this document. 23.32 (iv) If I am a health care provider or an employee of a 23.33 health care provider giving direct care to the person listed 23.34 above in (A), I must initial this box: [ ] 23.35 I certify that the information in (i) through (iv) is true 23.36 and correct. 24.1 .................................... 24.2 (Signature of Witness Two) 24.3 Address: ......................................... 24.4 ......................................... 24.5 REMINDER: Keep this document with your personal papers in a 24.6 safe place (not in a safe deposit box). Give signed copies to 24.7 your doctors, family, close friends, health care agent, and 24.8 alternate health care agent. Make sure your doctor is willing 24.9 to follow your wishes. This document should be part of your 24.10 medical record at your physician's office and at the hospital, 24.11 home care agency, hospice, or nursing facility where you receive 24.12 your care. 24.13 Sec. 25. Minnesota Statutes 1996, section 145C.13, 24.14 subdivision 1, is amended to read: 24.15 Subdivision 1. [GROSS MISDEMEANOR OFFENSES.] Whoever 24.16 commits any of the following acts is guilty of a gross 24.17 misdemeanor: 24.18 (1) willfully conceals, cancels, defaces, or obliterates a 24.19durable power of attorney forhealth care directive of a 24.20 principal without the consent of the principal; 24.21 (2) willfully conceals or withholds personal knowledge of a 24.22 revocation of adurable power of attorney forhealth care 24.23 directive; 24.24 (3) falsifies or forges adurable power of attorney for24.25 health care directive or a revocation of the instrument; 24.26 (4) coerces or fraudulently induces another to execute a 24.27durable power of attorney forhealth care directive; or 24.28 (5) requires or prohibits the execution of adurable power24.29of attorney forhealth care directive as a condition for being 24.30 insured for or receiving all or some health care services. 24.31 Sec. 26. Minnesota Statutes 1996, section 145C.15, is 24.32 amended to read: 24.33 145C.15 [DUTIES OF HEALTH CARE PROVIDERS TO PROVIDE 24.34 LIFE-SUSTAINING HEALTH CARE.] 24.35 (a) If a proxy acting under chapter 145B orana health 24.36 care agent acting under this chapter directs the provision of 25.1 health care, nutrition, or hydration that, in reasonable medical 25.2 judgment, has a significant possibility of sustaining the life 25.3 of the principal or declarant, a health care provider shall take 25.4 all reasonable steps to ensure the provision of the directed 25.5 health care, nutrition, or hydration if the provider has the 25.6 legal and actual capability of providing the health care either 25.7 itself or by transferring the principal or declarant to a health 25.8 care provider who has that capability. Any transfer of a 25.9 principal or declarant under this paragraph must be done 25.10 promptly and, if necessary to preserve the life of the principal 25.11 or declarant, by emergency means. This paragraph does not apply 25.12 if a living will under chapter 145B or adurable power of25.13attorney forhealth care directive indicates an intention to the 25.14 contrary. 25.15 (b) A health care provider who is unwilling to provide 25.16 directed health care under paragraph (a) that the provider has 25.17 the legal and actual capability of providing may transfer the 25.18 principal or declarant to another health care provider willing 25.19 to provide the directed health care but the provider shall take 25.20 all reasonable steps to ensure provision of the directed health 25.21 care until the principal or declarant is transferred. 25.22 (c) Nothing in this section alters any legal obligation or 25.23 lack of legal obligation of a health care provider to provide 25.24 health care to a principal or declarant who refuses, has 25.25 refused, or is unable to pay for the health care. 25.26 Sec. 27. Minnesota Statutes 1997 Supplement, section 25.27 149A.80, subdivision 2, is amended to read: 25.28 Subd. 2. [DETERMINATION OF RIGHT TO CONTROL AND DUTY OF 25.29 DISPOSITION.] The right to control the disposition of the 25.30 remains of a deceased person, including the location and 25.31 conditions of final disposition, unless other directions have 25.32 been given by the decedent pursuant to subdivision 1, vests in, 25.33 and the duty of final disposition of the body devolves upon, the 25.34 following in the order named: 25.35 (1) the persondesignatedappointed in a dated written 25.36 instrument signed by the decedent. Written instrument includes, 26.1 but is not limited to, a health care directive executed under 26.2 chapter 145C. Written instrument does not include a durable or 26.3 nondurable power of attorney which terminates on the death of 26.4 the principal pursuant to sections 523.08 and 523.09; 26.5 (2) the surviving, legally recognized spouse; 26.6 (3) the surviving biological or adopted child or children 26.7 of the decedent over the age of majority, provided that, in the 26.8 absence of actual knowledge to the contrary, a funeral director 26.9 or mortician may rely on instructions given by the child or 26.10 children who represent that they are the sole surviving child, 26.11 or that they constitute a majority of the surviving children; 26.12 (4) the surviving parent or parents of the decedent; 26.13 (5) the surviving biological or adopted sibling or siblings 26.14 of the decedent over the age of majority, provided that, in the 26.15 absence of actual knowledge to the contrary, a funeral director 26.16 or mortician may rely on instructions given by the sibling or 26.17 siblings who represent that they are the sole surviving sibling, 26.18 or that they constitute a majority of the surviving siblings; 26.19 (6) the person or persons respectively in the next degree 26.20 of kinship in the order named by law to inherit the estate of 26.21 the decedent; and 26.22 (7) the appropriate public or court authority, as required 26.23 by law. 26.24 For purposes of this subdivision, the appropriate public or 26.25 court authority includes the county board of the county in which 26.26 the death occurred if the person dies without apparent financial 26.27 means to provide for final disposition or the district court in 26.28 the county in which the death occurred. 26.29 Sec. 28. Minnesota Statutes 1997 Supplement, section 26.30 253B.04, subdivision 1a, is amended to read: 26.31 Subd. 1a. [VOLUNTARY TREATMENT OR ADMISSION FOR PERSONS 26.32 WITH MENTAL ILLNESS.] (a) A person with a mental illness may 26.33 seek or voluntarily agree to accept treatment or admission to a 26.34 facility. If the mental health provider determines that the 26.35 person lacks the capacity to give informed consent for the 26.36 treatment or admission, and in the absence of adurable power of27.1attorney forhealth care power of attorney that authorizes 27.2 consent, the designated agency or its designee may give informed 27.3 consent for mental health treatment or admission to a treatment 27.4 facility on behalf of the person. 27.5 (b) The designated agency shall apply the following 27.6 criteria in determining the person's ability to give informed 27.7 consent: 27.8 (1) whether the person demonstrates an awareness of the 27.9 person's illness, and the reasons for treatment, its risks, 27.10 benefits and alternatives, and the possible consequences of 27.11 refusing treatment; and 27.12 (2) whether the person communicates verbally or nonverbally 27.13 a clear choice concerning treatment that is a reasoned one, not 27.14 based on delusion, even though it may not be in the person's 27.15 best interests. 27.16 (c) The basis for the designated agency's decision that the 27.17 person lacks the capacity to give informed consent for treatment 27.18 or admission, and that the patient has voluntarily accepted 27.19 treatment or admission, must be documented in writing. 27.20 (d) A mental health provider that provides treatment in 27.21 reliance on the written consent given by the designated agency 27.22 under this subdivision is not civilly or criminally liable for 27.23 performing treatment without consent. This paragraph does not 27.24 affect any other liability that may result from the manner in 27.25 which the treatment is performed. 27.26 (e) A person who receives treatment or is admitted to a 27.27 facility under this subdivision has the right to refuse 27.28 treatment at any time or to be released from a facility as 27.29 provided under subdivision 2. The person or any interested 27.30 person acting on the person's behalf may seek court review 27.31 within five days for a determination of whether the person's 27.32 agreement to accept treatment or admission is voluntary. At the 27.33 time a person agrees to treatment or admission to a facility 27.34 under this subdivision, the designated agency or its designee 27.35 shall inform the person in writing of the person's rights under 27.36 this paragraph. 28.1 (f) This subdivision does not authorize the administration 28.2 of neuroleptic medications. Neuroleptic medications may be 28.3 administered only as provided in section 253B.092. 28.4 Sec. 29. Minnesota Statutes 1997 Supplement, section 28.5 253B.07, subdivision 1, is amended to read: 28.6 Subdivision 1. [PREPETITION SCREENING.] (a) Prior to 28.7 filing a petition for commitment of or early intervention for a 28.8 proposed patient, an interested person shall apply to the 28.9 designated agency in the county of the proposed patient's 28.10 residence or presence for conduct of a preliminary 28.11 investigation, except when the proposed patient has been 28.12 acquitted of a crime under section 611.026 and the county 28.13 attorney is required to file a petition for commitment. The 28.14 designated agency shall appoint a screening team to conduct an 28.15 investigation which shall include: 28.16 (i) a personal interview with the proposed patient and 28.17 other individuals who appear to have knowledge of the condition 28.18 of the proposed patient. If the proposed patient is not 28.19 interviewed, reasons must be documented; 28.20 (ii) identification and investigation of specific alleged 28.21 conduct which is the basis for application; 28.22 (iii) identification, exploration, and listing of the 28.23 reasons for rejecting or recommending alternatives to 28.24 involuntary placement; and 28.25 (iv) in the case of a commitment based on mental illness, 28.26 the following information, if it is known or available: 28.27 information that may be relevant to the administration of 28.28 neuroleptic medications, if necessary, including the existence 28.29 of a declaration under section 253B.03, subdivision 6d, or a 28.30durable power of attorney forhealth care directive under 28.31 chapter 145C or a guardian, conservator, proxy, 28.32 orattorney-in-factagent with authority to make health care 28.33 decisions for the proposed patient; information regarding the 28.34 capacity of the proposed patient to make decisions regarding 28.35 administration of neuroleptic medication; and whether the 28.36 proposed patient is likely to consent or refuse consent to 29.1 administration of the medication. 29.2 (b) In conducting the investigation required by this 29.3 subdivision, the screening team shall have access to all 29.4 relevant medical records of proposed patients currently in 29.5 treatment facilities. Data collected pursuant to this clause 29.6 shall be considered private data on individuals. The 29.7 prepetition screening report is not admissible in any court 29.8 proceedings unrelated to the commitment proceedings. 29.9 (c) When the prepetition screening team recommends 29.10 commitment, a written report shall be sent to the county 29.11 attorney for the county in which the petition is to be filed. 29.12 (d) The prepetition screening team shall refuse to support 29.13 a petition if the investigation does not disclose evidence 29.14 sufficient to support commitment. Notice of the prepetition 29.15 screening team's decision shall be provided to the prospective 29.16 petitioner. 29.17 (e) If the interested person wishes to proceed with a 29.18 petition contrary to the recommendation of the prepetition 29.19 screening team, application may be made directly to the county 29.20 attorney, who may determine whether or not to proceed with the 29.21 petition. Notice of the county attorney's determination shall 29.22 be provided to the interested party. 29.23 (f) If the proposed patient has been acquitted of a crime 29.24 under section 611.026, the county attorney shall apply to the 29.25 designated county agency in the county in which the acquittal 29.26 took place for a preliminary investigation unless substantially 29.27 the same information relevant to the proposed patient's current 29.28 mental condition, as could be obtained by a preliminary 29.29 investigation, is part of the court record in the criminal 29.30 proceeding or is contained in the report of a mental examination 29.31 conducted in connection with the criminal proceeding. If a 29.32 court petitions for commitment pursuant to the rules of criminal 29.33 or juvenile procedure or a county attorney petitions pursuant to 29.34 acquittal of a criminal charge under section 611.026, the 29.35 prepetition investigation, if required by this section, shall be 29.36 completed within seven days after the filing of the petition. 30.1 Sec. 30. Minnesota Statutes 1997 Supplement, section 30.2 253B.092, subdivision 2, is amended to read: 30.3 Subd. 2. [ADMINISTRATION WITHOUT JUDICIAL REVIEW.] 30.4 Neuroleptic medications may be administered without judicial 30.5 review in the following circumstances: 30.6 (1) the patient has the capacity to make an informed 30.7 decision under subdivision 4; 30.8 (2) the patient does not have the present capacity to 30.9 consent to the administration of neuroleptic medication, but 30.10 prepared adurable power of attorney forhealth care directive 30.11 under chapter 145C or a declaration under section 253B.03, 30.12 subdivision 6d, requesting treatment or authorizing an agent or 30.13 proxy to request treatment, and the agent or proxy has requested 30.14 the treatment; 30.15 (3) a substitute decision-maker appointed by the court 30.16 consents to the administration of the neuroleptic medication and 30.17 the patient does not refuse administration of the medication; or 30.18 (4) the substitute decision-maker does not consent or the 30.19 patient is refusing medication, and the patient is in an 30.20 emergency situation. 30.21 Sec. 31. Minnesota Statutes 1997 Supplement, section 30.22 253B.092, subdivision 6, is amended to read: 30.23 Subd. 6. [PATIENTS WITHOUT CAPACITY TO MAKE INFORMED 30.24 DECISION; SUBSTITUTE DECISION-MAKER.] (a) Upon request of any 30.25 person, and upon a showing that administration of neuroleptic 30.26 medications may be recommended and that the person may lack 30.27 capacity to make decisions regarding the administration of 30.28 neuroleptic medication, the court shall appoint a substitute 30.29 decision-maker with authority to consent to the administration 30.30 of neuroleptic medication as provided in this section. The 30.31 substitute decision-maker must be an individual or a community 30.32 or institutional multidisciplinary panel designated by the local 30.33 mental health authority. In appointing a substitute 30.34 decision-maker, the court shall give preference to a guardian or 30.35 conservator, proxy, orattorney-in-facthealth care agent with 30.36 authority to make health care decisions for the patient. The 31.1 court may provide for the payment of a reasonable fee to the 31.2 substitute decision-maker for services under this section or may 31.3 appoint a volunteer. 31.4 (b) If the person's treating physician recommends treatment 31.5 with neuroleptic medication, the substitute decision-maker may 31.6 give or withhold consent to the administration of the 31.7 medication, based on the standards under subdivision 7. If the 31.8 substitute decision-maker gives informed consent to the 31.9 treatment and the person does not refuse, the substitute 31.10 decision-maker shall provide written consent to the treating 31.11 physician and the medication may be administered. The 31.12 substitute decision-maker shall also notify the court that 31.13 consent has been given. If the substitute decision-maker 31.14 refuses or withdraws consent or the person refuses the 31.15 medication, neuroleptic medication may not be administered to 31.16 the person without a court order or in an emergency. 31.17 (c) A substitute decision-maker appointed under this 31.18 section has access to the pertinent sections of the patient's 31.19 health records on the past or present administration of 31.20 medication. The designated agency or a person involved in the 31.21 patient's physical or mental health care may disclose 31.22 information to the substitute decision-maker for the sole 31.23 purpose of performing the responsibilities under this section. 31.24 (d) At a hearing under section 253B.08, the petitioner has 31.25 the burden of proving incapacity by a preponderance of the 31.26 evidence. If a substitute decision-maker has been appointed by 31.27 the court, the court shall make findings regarding the patient's 31.28 capacity to make decisions regarding the administration of 31.29 neuroleptic medications and affirm or reverse its appointment of 31.30 a substitute decision-maker. If the court affirms the 31.31 appointment of the substitute decision-maker, and if the 31.32 substitute decision-maker has consented to the administration of 31.33 the medication and the patient has not refused, the court shall 31.34 make findings that the substitute decision-maker has consented 31.35 and the treatment is authorized. If a substitute decision-maker 31.36 has not yet been appointed, upon request the court shall make 32.1 findings regarding the patient's capacity and appoint a 32.2 substitute decision-maker if appropriate. 32.3 (e) If an order for civil commitment or early intervention 32.4 did not provide for the appointment of a substitute 32.5 decision-maker or for the administration of neuroleptic 32.6 medication, the treatment facility may later request the 32.7 appointment of a substitute decision-maker upon a showing that 32.8 administration of neuroleptic medications is recommended and 32.9 that the person lacks capacity to make decisions regarding the 32.10 administration of neuroleptic medications. A hearing is not 32.11 required in order to administer the neuroleptic medication 32.12 unless requested under subdivision 10 or if the substitute 32.13 decision-maker withholds or refuses consent or the person 32.14 refuses the medication. 32.15 (f) The substitute decision-maker's authority to consent to 32.16 treatment lasts for the duration of the court's order of 32.17 appointment or until modified by the court. 32.18 If the substitute decision-maker withdraws consent or the 32.19 patient refuses consent, neuroleptic medication may not be 32.20 administered without a court order. 32.21 (g) If there is no hearing after the preliminary hearing, 32.22 then the court shall, upon the request of any interested party, 32.23 review the reasonableness of the substitute decision-maker's 32.24 decision based on the standards under subdivision 7. The court 32.25 shall enter an order upholding or reversing the decision within 32.26 seven days. 32.27 Sec. 32. Minnesota Statutes 1996, section 525.55, 32.28 subdivision 1, is amended to read: 32.29 Subdivision 1. [TIME OF NOTICE; TO WHOM GIVEN.] In all 32.30 cases, upon the filing of the petition the court shall fix the 32.31 time and place for the hearing and shall order that notice be 32.32 given of the hearing. At least 14 days prior to the hearing, 32.33 personal service of the notice shall be made upon the proposed 32.34 ward or conservatee. Notice by mail postmarked at least 14 days 32.35 before the hearing shall also be served on: 32.36 (1) the spouse, parents, adult children, brothers and 33.1 sisters,; 33.2 (2) a health care agent or proxy appointed pursuant to a 33.3 health care directive as defined in section 145C.01, a living 33.4 will under chapter 145B, or other similar document executed in 33.5 another state and enforceable under the laws of this state; and,33.6 (3) if none of those in clause (1) or (2) are alive or can 33.7 be located, on the nearest kindred as determined by the court, 33.8 and on any other persons the court may direct, by mail33.9postmarked at least 14 days prior to the hearing. 33.10 If the person is a patientor, resident, or client of any 33.11 hospital, nursing home, home care agency, or other institution, 33.12 notice by mail shall also be given to the administrative head of 33.13 the institution. If the person is a nonresident or if after 33.14 diligent search cannot be found in this state, notice shall be 33.15 given in the manner and to those persons as the court may 33.16 determine. 33.17 Sec. 33. Minnesota Statutes 1996, section 525.55, 33.18 subdivision 2, is amended to read: 33.19 Subd. 2. [FORM; SERVICE.] The notice shall be written in 33.20 language which can be easily understood. Included with the 33.21 notice shall be a copy of the petition. The notice shall 33.22 contain information regarding the nature, purpose and legal 33.23 effects of the guardianship or conservatorship proceedings on 33.24 the proposed ward or conservatee. The notice shall state that 33.25 the person may be adjudged incapable of self care for person or 33.26 property, and by reason thereof, a guardian or conservator may 33.27 be appointed, and that the adjudication may transfer to the 33.28 appointed guardian or conservator certain rights, including the 33.29 right to manage and control property, to enter into contracts 33.30 and to determine residence. The notice shall further contain 33.31 information regarding the rights of the proposed ward or 33.32 conservatee in the proceeding, including the right to attend the 33.33 hearing, to be represented by an attorney, to oppose the 33.34 proceeding, and to present evidence. The notice shall state 33.35 that if the proposed ward or conservatee wishes to exercise the 33.36 right to be represented by an attorney, that person must either 34.1 obtain counsel of choice, or ask the court to appoint an 34.2 attorney to represent that person, and that the county shall pay 34.3 a reasonable attorney's fee if that person is indigent. The 34.4 procedure for requesting a court appointed attorney shall be 34.5 described in the notice. If the proposed ward or conservatee is 34.6 a patient, resident, or client of any hospital, nursing home, 34.7 home care agency, or other institution, the notice must further 34.8 require the institution to advise the court of the existence, if 34.9 known, of a health care directive, as defined in section 34.10 145C.01, executed by the proposed ward or conservatee, a living 34.11 will executed under chapter 145B, or any other similar document 34.12 executed in another state and enforceable under the laws of this 34.13 state. 34.14 The process server shall inquire whether the proposed ward 34.15 or conservatee desires the notice and petition to be read to 34.16 that person, and shall read the notice and petition if requested 34.17 to do so. In place of a process server, the court may appoint a 34.18 visitor to deliver the notice and petition and explain them to 34.19 the proposed ward or conservatee. 34.20 Sec. 34. Minnesota Statutes 1996, section 525.551, 34.21 subdivision 1, is amended to read: 34.22 Subdivision 1. [ATTENDANCE AT HEARING.] If the proposed 34.23 ward or conservatee is within the state, that person shall be 34.24 present at the hearing unless in a meeting with a visitor that 34.25 person specifically waives the right to appear in person or is 34.26 not able to attend by reason of medical condition as evidenced 34.27 by a written statement from a licensed physician. The written 34.28 statement shall be evidence only of the proposed ward's or 34.29 conservatee's medical inability to attend the hearing, and shall 34.30 not be considered in determining the issue of incapacity. The 34.31 written statement must also inform the court of the physician's 34.32 knowledge, if any, of the existence of a health care directive, 34.33 as defined in section 145C.01, executed by the proposed ward or 34.34 conservatee, a living will executed under chapter 145B, or any 34.35 other similar document executed in another state and enforceable 34.36 under the laws of this state. In any instance in which a 35.1 proposed ward or conservatee is absent from the hearing, the 35.2 court shall specify in its findings of fact the reason for 35.3 nonattendance. 35.4 If a visitor delivered the notice and petition pursuant to 35.5 section 525.55 and the proposed ward or conservatee has waived 35.6 the right to attend the hearing, the visitor may testify as to 35.7 the notice and any waiver of the right to appear in person, and 35.8 as to other matters which may assist the court in determining 35.9 the need for a guardian or conservator and the extent of the 35.10 power to be granted. 35.11 Sec. 35. Minnesota Statutes 1996, section 525.551, 35.12 subdivision 5, is amended to read: 35.13 Subd. 5. [FINDINGS.] In all cases the court shall make 35.14 specific written findings of fact, state separately its 35.15 conclusions of law, and direct the entry of an appropriate 35.16 judgment or order. 35.17 If upon completion of the hearing and consideration of the 35.18 record the court finds: (a) that the requirements for the 35.19 voluntary appointment of a conservator or guardian have been 35.20 met, or (b)(1) that the proposed ward or conservatee is 35.21 incapacitated as defined in section 525.54; and (2) in need of 35.22 the supervision and protection of a guardian or conservator; and 35.23 (3) that no appropriate alternatives to the guardianship or 35.24 conservatorship exist which are less restrictive of the person's 35.25 civil rights and liberties, such as those set forth in section 35.26 525.54, subdivision 7, it shall enter its order or judgment 35.27 granting all of the powers set out in section 525.56, 35.28 subdivision 3, in the case of a guardian of the person, and 35.29 section 525.56, subdivision 4, in the case of a guardian of the 35.30 estate, or specifying the powers of the conservator pursuant to 35.31 section 525.56. The court shall make a finding that appointment 35.32 of the person chosen as guardian or conservator is in the best 35.33 interests of the ward or conservatee. Except as provided in 35.34 section 525.544, subdivision 1, if more than one person has 35.35 petitioned the court to serve as guardian or conservator, or if 35.36 the petition is contested, the court shall make a finding that 36.1 the person to be appointed as guardian or conservator is the 36.2 most suitable and best qualified person among those who are 36.3 available before making the appointment. The court's finding as 36.4 to the best available guardian must specifically address the 36.5 reasons for the court's determination that the appointment of 36.6 that person is in the best interests of the ward or 36.7 conservatee. The court must also clarify the respective legal 36.8 authorities of a guardian or conservator appointed under this 36.9 chapter and any existing health care agent or proxy appointed 36.10 under a health care directive as defined in section 145C.01, a 36.11 living will under chapter 145B, or other similar document 36.12 executed in another state and enforceable under the laws of this 36.13 state. 36.14 The court may enumerate in its findings which legal rights 36.15 the proposed ward or conservatee is incapable of exercising. 36.16 Sec. 36. Minnesota Statutes 1996, section 525.9212, is 36.17 amended to read: 36.18 525.9212 [MAKING, REVOKING, AND OBJECTING TO ANATOMICAL 36.19 GIFTS, BY OTHERS.] 36.20 (a) Any member of the following classes of persons, in the 36.21 order of priority listed, may make an anatomical gift of all or 36.22 a part of the decedent's body for an authorized purpose, unless 36.23 the decedent has made a refusal to make that anatomical gift 36.24 that is unrevoked at the time of death: 36.25 (1) the spouse of the decedent; 36.26 (2) an adult son or daughter of the decedent; 36.27 (3) either parent of the decedent; 36.28 (4) an adult brother or sister of the decedent; 36.29 (5) a grandparent of the decedent; and 36.30 (6) a guardian or conservator of the person of the decedent 36.31 at the time of death or a health care agent or proxy appointed 36.32 by the decedent under a health care directive as defined in 36.33 section 145C.01, a living will under chapter 145B, or other 36.34 similar document executed in another state and enforceable under 36.35 the laws of this state. 36.36 (b) An anatomical gift may not be made by a person listed 37.1 in paragraph (a) if: 37.2 (1) a person in a prior class is available at the time of 37.3 death to make an anatomical gift; 37.4 (2) the person proposing to make an anatomical gift knows 37.5 of a refusal or contrary indications by the decedent; or 37.6 (3) the person proposing to make an anatomical gift knows 37.7 of an objection to making an anatomical gift by a member of the 37.8 person's class or a prior class. 37.9 (c) An anatomical gift by a person authorized under 37.10 paragraph (a) must be made by (i) a document of gift signed by 37.11 the person, or (ii) the person's telegraphic, recorded 37.12 telephonic, or other recorded message, or other form of 37.13 communication from the person that is contemporaneously reduced 37.14 to writing and signed by the recipient. 37.15 (d) An anatomical gift by a person authorized under 37.16 paragraph (a) may be revoked by any member of the same or a 37.17 prior class if, before procedures have begun for the removal of 37.18 a part from the body of the decedent, the physician, surgeon, 37.19 technician, or enucleator removing the part knows of the 37.20 revocation. 37.21 (e) A failure to make a decision as to an anatomical gift 37.22 under paragraph (a) is not an objection to the making of an 37.23 anatomical gift. 37.24 Sec. 37. Minnesota Statutes 1996, section 609.215, 37.25 subdivision 3, is amended to read: 37.26 Subd. 3. [ACTS OR OMISSIONS NOT CONSIDERED AIDING SUICIDE 37.27 OR AIDING ATTEMPTED SUICIDE.] (a) A health care provider, as 37.28 defined in section 145B.02, subdivision 6, who administers, 37.29 prescribes, or dispenses medications or procedures to relieve 37.30 another person's pain or discomfort, even if the medication or 37.31 procedure may hasten or increase the risk of death, does not 37.32 violate this section unless the medications or procedures are 37.33 knowingly administered, prescribed, or dispensed to cause death. 37.34 (b) A health care provider, as defined in section 145B.02, 37.35 subdivision 6, who withholds or withdraws a life-sustaining 37.36 procedure in compliance with chapter 145B or 145C or in 38.1 accordance with reasonable medical practice does not violate 38.2 this section. 38.3 Sec. 38. [EFFECT OF AMENDMENTS.] 38.4 A document executed prior to August 1, 1998, that purports 38.5 to be a living will under Minnesota Statutes, chapter 145B, a 38.6 durable power of attorney for health care under Minnesota 38.7 Statutes, chapter 145C, or a declaration regarding intrusive 38.8 mental health treatment under Minnesota Statutes, section 38.9 253B.03, subdivision 6a, is valid if the document: 38.10 (1) complied with the law in effect on the date it was 38.11 executed; or 38.12 (2) complies with the requirements of Minnesota Statutes, 38.13 section 145C.03. 38.14 If the document complied with the law in effect on the date 38.15 it was executed but does not also comply with the requirements 38.16 of Minnesota Statutes, section 145C.03, it shall be given effect 38.17 in accordance with the laws in effect on the date it was 38.18 executed, unless the document provides otherwise. 38.19 Nothing in sections 1 to 38 impairs the evidentiary effect 38.20 under common law or reasonable medical practice with respect to 38.21 other written or oral expressions of an individual's desires 38.22 regarding health care. 38.23 Sec. 39. [EFFECTIVE DATE.] 38.24 Sections 1 to 38 are effective August 1, 1998.