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Health Care Power of Attorney Toolkit 1




             Health Care Power of Attorney Toolkit
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Health Care Power of Attorney Toolkit 2



Step 1. Assign Health Care Agent(s). First, write in the mental health
treatmen...
Health Care Power of Attorney Toolkit 3


   E. Would the mental health treatment consumer like their Health Care Agent
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Health Care Power of Attorney Toolkit 4


A. Included are miscellaneous provisions from the HCPA statute, which the
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Health Care Power of Attorney Toolkit for Clinicians

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Transcript of "Health Care Power of Attorney Toolkit for Clinicians"

  1. 1. Health Care Power of Attorney Toolkit 1 Health Care Power of Attorney Toolkit For clinicians Drafting a Health Care Power of Attorney Document North Carolina has a way mental health treatment consumers can plan ahead for mental health treatment they might want to receive if they are in a crisis and are unable to communicate for themselves or make voluntary decisions of their own free will. There are two tools they can use to plan in case of and for a future crisis. One tool is called an Advance Directive for Mental Health Treatment. This document allows mental health treatment consumers to write down instructions to give their clinicians if they are in a crisis and cannot make their own mental health treatment decisions. The second tool is called a Health Care Power of Attorney (used to appoint a Health Care Agent.) A Health Care Agent is someone who the mental health treatment consumer trusts and someone they would like to make decisions for them during a mental health crisis. This toolkit will walk them through filling out Health Care Power of Attorney documents in six steps. What is a Health Care Agent? A Health Care Agent is someone who would be available to make decisions for a mental health treatment consumer in a crisis if they are not able to communicate or speak for themselves. This needs to be someone who they trust, even though they might give pretty specific instructions to this person about their care. It is important to recognize the mental health treatment consumer can also put limits on the types of decisions their HCA could make. Also, they may elect as many HCAs as they wish in the event someone is not available in the future. The Health Care Agent will be called if a physician or psychologist determines the mental health treatment consumer is in a crisis and cannot make decisions for him/herself. This is the moment when the HCA becomes responsible for the decisions the mental health treatment consumer wants them to make. How can a Health Care Power of Attorney documented be drafted? If the mental health treatment consumer is interested in completing a Health Care Power of Attorney Document, please print out a blank copy of the Health Care Power of Attorney Worksheet and walk through the following easy steps:
  2. 2. Health Care Power of Attorney Toolkit 2 Step 1. Assign Health Care Agent(s). First, write in the mental health treatment consumer’s name and assign at least one Health Care Agent, indicating their address and home and work phone numbers. Please be aware that the Health Care Agent cannot be the mental health treatment consumer’s doctor or other provider of their treatment. They may assign as many Health Care Agents as they wish. The second would be notified if the first was not available or willing to serve as Health Care Agent, the third would be notified if the first and second were not available or willing to serve, etc. Step 2. Designate Physicians for Crisis Evaluation. Next, the mental health treatment consumer can identify any physicians or psychologists that they would like to assess whether they are having a crisis in which they could no longer communicate treatment decisions. If this is something they would be interested in, the mental health treatment consumer would provide the name, clinic, and phone number of the doctor they would want to evaluate them. Please note that if the doctor is not available at the time, another doctor will have to assess the mental health treatment consumer. Step 3. Grant Authorities to Health Care Agent. The mental health treatment consumer simply places their initials in the boxes next to the powers they wish to grant the Health Care Agent. A. Would the mental health treatment consumer like their Health Care Agent to be able to request review/receive their mental health records? This would include any information about their health or mental health or health care, either written or verbal. This would also include being able to consent to disclose this information to other health care providers. Yes or no? B. Would the mental health treatment consumer like their Health Care Agent to be able to hire or fire anyone who is providing their health care? Yes or no? C. Would the mental health treatment consumer like their Health Care Agent to be able to consent to their admission to or discharge from a medical hospital or other medical facility (not including psychiatric hospitals)? Yes or no? D. Would the mental health treatment consumer like their Health Care Agent to be able to consent to a mental health admission or discharge? This is particularly important because the Health Care Agent in such a situation could help the mental health treatment consumer avoid being involuntarily committed. That is, the HCA could consent to admission for the mental health treatment consumer, even though at the time, they may not think hospitalization is needed. Yes or no?
  3. 3. Health Care Power of Attorney Toolkit 3 E. Would the mental health treatment consumer like their Health Care Agent to be able to consent to medications for their treatment and electroconvulsive treatment (ECT)? Yes or no? F. Would the mental health treatment consumer like their Health Care Agent to be able to consent or not consent (agree or not agree) to medical tests, X-rays, medications or surgery for medical conditions? Yes or no? G. Would the mental health treatment consumer like their Health Care Agent to be able to make decisions if they are physically sick or may die? Yes or no? H. Would the mental health treatment consumer like their Health Care Agent to make decisions about their body should the mental health treatment consumer die, such as donating the body or having an autopsy? Yes or no? I. Does the mental health treatment consumer want their Health Care Agent to have the authority to carry out these decisions even if they mean releasing the mental health treatment consumer’s medical providers from liability? Yes or no? Step 4. Make Any Special Provisions. Here, the mental health treatment consumer can limit the authorities granted to the Health Care Agent for either physical health care or mental health care. A. Physical Health. Here they may include any specific limitations they deem appropriate such as: their own definition of when life-sustaining treatment should be withheld or discontinued, or instructions to refuse any specific types of treatment that are inconsistent with their religious beliefs, or unacceptable to them for any other reason. B. Mental Health. Here they may include any specific limitations they deem appropriate such as: limiting the grant of authority to make only mental health treatment decisions, their own instructions regarding the administration or withholding of psychotropic medications and electroconvulsive treatment (ECT), instructions regarding their admission to and retention in a health care facility for mental health treatment, or instructions to refuse any specific types of treatment that are unacceptable to them): Step 5. Include Provision on Guardianship. If the mental health treatment consumer has a long period of illness, a court may wish to appoint a guardian to make decisions for them. If they would like to nominate their health care agent as a guardian, should the need arise, this can be done here as well. Is that something they wish to do? Yes or no? Step 6. Sign and Notarize. This last section contains necessary legal documentation for the HCPA forms.
  4. 4. Health Care Power of Attorney Toolkit 4 A. Included are miscellaneous provisions from the HCPA statute, which the mental health treatment consumer agrees to when they sign the document. B. As principal, they should read through the entire document to ensure it is accurate. They must have some identification I.D. to show the notary. C. Witnesses cannot be family members or anyone working at the mental health center; neighbors or friends are okay but they too must have I.D.. D. The notary fills out this section and stamps the document.

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