MEDICAL TREATMENT
This section explains your rights to make health care decisions and how you can plan what should be done when you cannot speak for yourself.
You have the right to be informed by CCHP of State law regarding advance directives, and to get information from CCHP regarding any changes to that law. The information will tell you about changes in State law for advance directives as soon as possible, but no later than ninety (90) calendar days after the effective date of change.
A federal law requires us to give you this information. We hope this information will help increase your control over your medical treatment.
How do I know what I want?
Your physician must tell you about your medical condition and about what different treatments can do for you. Many treatments have “side effects.” Your physician must offer you information about serious problems that the medical treatment is likely to cause you.
Often more than one treatment might help. People also have different ideas about which treatment is best. Your physician can tell you which treatments are available to you, but your doctor cannot choose for you. The choice depends on what is important to you.
What if I am too sick to decide?
If you cannot make treatment decisions your physician may ask your closest available relative or friends to help decide what is best for you. To ensure that decisions are what you want them to be, it is helpful if you say
in advance what you want to happen if you cannot speak for yourself.
There are several kinds of “Advance Directives” that you can use to say what you want and to designate someone to speak for you.
California law now provides that an Advance Directive means either an “individual health care instruction or a power of attorney for health care.” In July 2000, California enacted the Health Care Decisions Law that consolidated previous California advance directive laws to allow you to express in advance what you want to happen. A new advance directive called the Advance Health Care Directive (AHCD) replaces previous documents such as the “Living Will” and the Durable Power of Attorney for Health Care. The Advanced Health Care Directive allows you to:
x Create a Power of Attorney for Health Care, thereby designating an agent to make health care decisions for you, the principal.
x Provide instructions for future health care decisions including whether or not to prolong life or alleviate pain in certain circumstances.
Who can fill out this form?
You can if you are eighteen (18) years or older and of sound mind. You do not need a lawyer to fill it out. You must, however, comply with statutory requirements such as having the document dated, signed and acknowledged by a notary or witnessed by two (2) witnesses (one of which must not be either related by blood, marriage, adoption or entitled to any portion of your estate upon your death). Other requirements may apply if you are currently in a Skilled Nursing Facility. A detailed description of these requirements can be found in California Probate Code Sections 4670 et seq.
CONTRA COSTA HEALTH PLAN
Medi-Cal Evidence of Coverage & Disclosure Form
Who can I name to make medical
treatment decisions when I am unable to do so?
You can choose an adult relative or friend you trust as your “agent” to speak for you when you are too sick to make your own decisions. You would use the Advance Health Care Directive to appoint this person. Another way to name an adult relative or friend to make medical decision on your behalf is to designate a “surrogate” by personally informing the supervising health care provider. This oral designation must be promptly recorded in your health care record. It is only effective during the course of treatment or illness, or during the stay in the health care institution when the designation is made.
How does this person know what I would want?
After you choose someone, talk to that person about what you want. You can also write down in the Advance Health Care Directive when you would or would not want medical treatment. Talk to your physician about what you want and give your physician a copy of the form. Give another copy to the person named as your agent. Also, take a copy with you when you go into a hospital or other treatment facility.
Sometimes treatment decisions are hard to make and it helps your family and physicians if they know what you want. The Advance Health Care Directive also gives them legal protection when they follow your wishes.
What if I do not have anybody to make decisions for me?
You can still use the Advance Health Care Directive to indicate your instructions for health care treatment. Prior to the Health
Care Decisions Law, the now repealed California Natural Death Act provided for a “Living Will” called a declaration. This declaration is now a part of the Advance Health Care Directive. Under either the “Living Will” declaration or the provisions of the Advance Health Care Directive, you are telling your doctor that you do or do not want any treatment that would only prolong your dying. If you instruct it, all life- sustaining treatment would be stopped if you were terminally ill and your death was expected soon, or if you were permanently unconscious. However, you would still get treatment to keep you comfortable.
How do I issue an “individual health care instruction”?
An individual instruction means that you, as a patient can issue either a written or an oral direction concerning health care decisions for yourself. As indicated above, one way to issue a direction is to use the Advance Health Care Directive. You can also just write down your wishes on a piece of paper. Your physicians and family can use what you write in deciding about your treatment. Keep in mind, however, that oral instructions and written instructions other than those in the Advance Health Care Directive may not give as much legal protection for your wishes as well as a properly executed Advance Health Care Directive.
Once you communicate such a directive to your physician or other supervising health care provider, the provider who knows of the existence of an Advance Health Care Directive is required to record its existence in the patient’s health care record. If your directive is in writing, the provider is further required to request a copy to be kept with your medical records.
CONTRA COSTA HEALTH PLAN
Medi-Cal Evidence of Coverage & Disclosure Form
Rev. 08.21.14 EOC-54 Medi-Cal 2014-2015_EOC
Are Living Wills and Durable Powers of Attorneys created prior to the new law still valid?
Yes. If you completed an advance directive prior to July 2000, it will remain valid and it is unnecessary to use the new Advance Health Care Directive so long as the prior advance directive was valid under the law in existence prior to July 2000.
What if I change my mind?
You can change or revoke any of these documents at any time as long as you can communicate your wishes.