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California Powers of Attorney and Health Care Directives

Serve your clients better—understand all aspects of using California powers of attorney for financial management planning and health care decision planning for persons who lose capacity, including successfully drafting forms and enforcing their terms.

“ ...an invaluable resource to any attorney tasked with executing a DPOA or AHCD that will effectively meet the needs of their client, gain acceptance by third parties, and survive judicial challenges.”
Alameda County Law Library

Serve your clients better—understand all aspects of using California powers of attorney for financial management planning and health care decision planning for persons who lose capacity, including successfully drafting forms and enforcing their terms.

  • Assisting clients with medical decisions, including do-not-resuscitate orders, organ donation, and end-of-life decisions
  • HIPAA and CMIA, and medical marijuana
  • Understanding the new California End of Life Option legislation
  • Using power of attorney for estate planning decisions when the principal loses capacity
  • Alternatives to using power of attorney and advanced health care directives, and ethical obligations of the attorney in drafting documents and enforcing their terms, including judicial proceedings

 

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“ ...an invaluable resource to any attorney tasked with executing a DPOA or AHCD that will effectively meet the needs of their client, gain acceptance by third parties, and survive judicial challenges.”
Alameda County Law Library

Serve your clients better—understand all aspects of using California powers of attorney for financial management planning and health care decision planning for persons who lose capacity, including successfully drafting forms and enforcing their terms.

  • Assisting clients with medical decisions, including do-not-resuscitate orders, organ donation, and end-of-life decisions
  • HIPAA and CMIA, and medical marijuana
  • Understanding the new California End of Life Option legislation
  • Using power of attorney for estate planning decisions when the principal loses capacity
  • Alternatives to using power of attorney and advanced health care directives, and ethical obligations of the attorney in drafting documents and enforcing their terms, including judicial proceedings

 

Selected Developments

October 2018 Update

On May 10, 2018, the California Supreme Court issued an order approving new Rules of Professional Conduct, which go into effect November 1, 2018, including a renumbering of the rules. The new rules are summarized in chap 3, §11.13.

A “dependent adult” is “any person between the ages of 18 and 64 years, ‘regardless of whether the person lives independently,’ who resides in this state and who has physical or mental limitations that restrict his or her ability to carry out normal activities or to protect his or her rights, including, but not limited to, persons who have physical or developmental disabilities, or whose physical or mental abilities have diminished because of age.” Welf & I C §15610.23(a). The statue was amended by Stats 2018, chap 70, §5 to include adults living by themselves. See §4.47.

Welf & I C §15630.1 was amended in 2017 (Stats 2017, chap 408 (AB 611)) and provides that a mandated reporter is authorized to not honor a power of attorney, as to an attorney-in-fact, about whom he or she made a report of suspected financial abuse of an elder or dependent adult to an adult protective services agency or a local law enforcement agency of any state. See §4.78.

The United States Supreme Court has prescribed official forms for use in representing creditors in bankruptcy proceedings. An agent may represent the creditor, but the agent must first present a properly completed and executed power of attorney in a prescribed form. These forms have been superseded by updated forms. See §5.48.

The Tax Cuts and Jobs Act (Pub L 115–97, 131 Stat 2054), signed into law on December 22, 2017, has sweeping changes relating to income taxes, but it only affects the estate, gift, and GST by an increase in the applicable exclusion amount to approximately $11.2 million for 2018 (subject to adjustment for inflation through 2025). See §§6.3–6.6, 6.8, 6.27.

Under the Tax Cut and Jobs Act (Pub L 115–97, 131 Stat 2054), the annual exclusion amount for estates is $11.18 million per individual, with portability for individuals and their spouses. See Rev Proc 2018–18, 2018–10 Int Rev Bull 392. For tax year 2018, the exemption for annual exclusion gifts stays $14,000. See §§6.2, 6.5, 6.27.

The End of Life Option Act (Health & S C §§443–443.22) was suspended pending the resolution of Ahn v Hestrin (2018) (Sup Ct, Case No. RIC 1607135). However, the court of appeals has reinstated the Act until all legal challenges to the Act have been decided. See §§7.46, 9.31–9.34.

Effective January 1, 2018, “dementia” has been replaced by “major neurocognitive disorder” in sections of the Health and Safety Code and the Probate Code. See Stats 2017, ch 122; Health & S C §1569.698; and Prob C §2356.5. See §§7.44, 8.39.

In chapter 8, these preprinted forms have been revised: the VA Advance Directive Durable Power of Attorney for Health Care and Living Will (see §8.2 for link), the CMA Advance Health Care Directive, Wallet Identification Card & Instructions (see §§8.4–8.5), the California Hospital Association (CHA) form (see §8.6), the Easily Understood Advance Healthcare Directive (Institute for Healthcare Advancement) (see §8.7), and the Physician Orders for Life-Sustaining Treatment (POLST) form (see §8.43).

A great need for organs currently exists in the United States. As of July 10, 2017, there were 117,216 individuals on the national organ transplantation waiting list. The Gift of Life Donation Initiative (launched in 2001 by the U.S. Department of Health and Human Services (HHS)) includes such features as the implementation of a model donor card, donor education as part of driver education curriculum, the establishment of a national forum on donor registry options and guidelines, and a Gift of Life medal program for donor families (http://organdonor.gov). For extensive organ donation information, see §§9.44–9.64.

Many attorney-drafted and standard AHCDs and DPOAs and related documents have been revised. See §§3.40 5.48, 8.11.

In 2016, California voters approved Proposition 64, or the Control, Regulate and Tax Adult Use of Marijuana Act (AUMA), which legalized the nonmedical use of marijuana by persons 21 years of age and up and cultivation of up to six marijuana plants per residence for personal use. See a new section on the topic at §9.76B.

CALIFORNIA POWERS OF ATTORNEY AND HEALTH CARE DIRECTIVES

(1st Edition)

October 2018

TABLE OF CONTENTS

 

File Name

Book Section

Title

CH01

Chapter 1

Powers of Attorney and Health Care Directives: Overview and International Considerations

01-039

§1.39

Provision for International Health Care Instruction

CH02

Chapter 2

Alternatives to Powers of Attorney and Advance Health Care Directives

02-035

§2.35

Authorization for Care Provider to Consent to Medical or Dental Treatment of Minor (Fam C §6910)

02-037

§2.37

Caregiver’s Authorization Affidavit (Fam C §6552)

02-039

§2.39

Application by Minor for Consent to Medical or Dental Care

02-040

§2.40

Order Granting Consent for Medical or Dental Care of Minor

CH03

Chapter 3

Ethical Considerations When Drafting Powers of Attorney and Advance Health Care Directives

03-039

§3.39

Declaration Regarding Mental Functions

CH04

Chapter 4

Durable Powers of Attorney for Financial Management: The Fundamentals

04-003

§4.3

Power of Attorney Is Durable

04-006

§4.6

Limited Durable Power of Attorney for Management and Disposition of Specific Real Property

04-007

§4.7

Introductory Clause if Power of Attorney Limited to Specific Time Period

04-009

§4.9

Power of Attorney Immediately Effective and Durable, and Principal Understands Instrument

04-015

§4.15

Springing DPOA

04-016

§4.16

Termination of Springing DPOA on Principal’s Restoration to Capacity

04-017

§4.17

Springing DPOA and Termination of Springing DPOA on Principal’s Restoration to Capacity—Incapacity Panel

04-022

§4.22

Warning Statement Required for Preprinted Forms Sold or Distributed

04-031

§4.31

Acceptance by Agent

04-052

§4.52

Joint Agency—Joint Action Required

04-053

§4.53

Joint Agency—Either Agent Authorized to Act Alone

04-054

§4.54

Settlement of Disputes Between Joint Agents

04-055

§4.55

Joint Agent Unable to Act

04-060

§4.60

Appointment of Successor Agent

04-061

§4.61

Successor Agent’s Liability for Prior Agent’s Acts

04-066

§4.66

Warning to Agent

04-080

§4.80

Requirement That Agent Post Bond

04-082

§4.82

Compensation of Agent—Reasonable Compensation

04-083

§4.83

Compensation of Agent—Hourly Rate

04-084

§4.84

Compensation of Agent—Percentage of Net Assets

04-085

§4.85

Compensation of Agent—Joint Agents Serving

04-087

§4.87

Revocation of DPOA

04-103

§4.103

Authorization to Use Photocopies

CH05

Chapter 5

Durable Powers of Attorney for Financial Management: Specific Clauses and Complete Forms

05-003

§5.3

Authority Regarding Real Property

05-004

§5.4

Authority Regarding Real Property That May Have Environmental Hazards

05-006

§5.6

Authority to Invest and Reinvest

05-008

§5.8

Authority to Transact Business Regarding Accounts

05-009

§5.9

Authority to Transact Business Regarding Accounts (Prob C §5204)

05-010

§5.10

Authorization to Maintain, Have Access to, and Remove Property From Safe Deposit Boxes

05-011

§5.11

Authority to Use and Cancel Credit Cards

05-011A

§5.11A

Authority Over Digital Devices, Assets, and Accounts

05-014

§5.14

General Self-Dealing Authorized

05-015

§5.15

Limited Self-Dealing Authorized

05-016

§5.16

General Commingling of Principal and Agent’s Assets Authorized

05-017

§5.17

Commingling of Specific Bank Account of Principal and Agent Authorized

05-019

§5.19

Authority to Assert Attorney-Client Privilege

05-020

§5.20

Authority to Collect Assets, Compromise Claims, and Litigate

05-022

§5.22

Authority Regarding Government Benefits (Short Form)

05-023

§5.23

Authority Regarding Public Benefits (Long Form)

05-026

§5.26

Sample Request for Acknowledgment of Receipt and Acceptance of DPOA by Benefit Administrator

05-029

§5.29

Authority to Deal With Employee, Retirement, and Other Benefits

05-031

§5.31

Authority Regarding Principal’s Business (Short Form)

05-032

§5.32

Authority Regarding Principal’s Business (Long Form)

05-034

§5.34

Authority to Deal With Partnership Interests

05-035

§5.35

Authority to Exercise Stock Options

05-037

§5.37

Powers Specifically Not Granted

05-039

§5.39

Authority Over Insurance

05-041

§5.41

Authority Over Annuity Contracts

05-043

§5.43

Providing Support for Others

05-045

§5.45

Nomination of Conservator of Person and Estate

05-047

§5.47

Authority to Appear for Military, Charitable, or Religious Person or Spouse in Adoption Proceeding

05-049

§5.49

General Administrative Authority

05-051

§5.51

Revocation and Amendment

05-053

§5.53

Certifying Power of Attorney

05-055

§5.55

Attorney Certificate Regarding Limitation on Authority to Petition

05-056

§5.56

Limitation on Authority to Petition for Court Enforcement of Agent’s Duties

05-058

§5.58

Duty to Prepare Annual Financial Reports

05-059

§5.59

Duty to Report

05-061

§5.61

Authority to Employ Professional Advisers

05-063

§5.63

Springing Durable Power of Attorney for Personal Care (Separate Document)

05-064

§5.64

Personal Care Provisions as Part of DPOA

05-065

§5.65

Principal’s Intention to Remain in Own Home

05-066

§5.66

Restriction on Sale of Home Until All Other Assets Are Depleted

05-067

§5.67

Restriction on Sale or Encumbrance of Principal’s Residence

05-068

§5.68

Authority to Dispose of Personal Effects

05-069

§5.69

General and Immediately Effective Durable Power of Attorney

05-070

§5.70

General Springing Durable Power of Attorney

05-071

§5.71

Uniform Statutory Form Power of Attorney (Prob C §4401)

05-072

§5.72

Cover Letter to Principal to Accompany DPOA Draft

CH06

Chapter 6

Estate and Tax Planning Using Powers of Attorney

06-021

§6.21

Broad Authority to Exercise Estate Planning Powers

06-030

§6.30

Authority to Make Annual Gifts up to Annual Gift Tax Exclusion Amount

06-031

§6.31

Authority to Make Gifts Beyond Annual Gift Tax Exclusion Amount

06-032

§6.32

Powers Relating to Gifts (Long Form)

06-034

§6.34

Authority to Create Special Needs Trust

06-036

§6.36

Authority to Transfer Assets to and Remove Assets From Revocable Living Trust

06-038

§6.38

Authority to Fund Trusts Not Created by Principal

06-040

§6.40

Authority to Exercise Powers of Appointment

06-042

§6.42

Authority to Prepay or Postpone Taxes and to Borrow and Grant Security Interests

06-044

§6.44

Authority to Exercise Annual Withdrawal Rights

06-048

§6.48

Authority to Execute Disclaimers

06-050

§6.50

Authority to Make Elections and File Consents to Special-Use Valuation

06-054

§6.54

Authority to Qualify for Installment Payment of Federal Estate Taxes

06-056

§6.56

Conversion of Joint Tenancy Property to Community Property

06-058

§6.58

Entering Into Aggregate Property Agreement

06-060

§6.60

Authority to Consent to Split Gifts With Spouse

06-062

§6.62

Authority to Pay Third Party Tuition and Medical Expenses

06-072

§6.72

Authority to Represent Principal on Tax Matters and Sign Tax Returns

CH07

Chapter 7

Advance Health Care Directives: The Fundamentals

07-009A

§7.9A

Physician’s Certificate of Incapacity

07-021

§7.21

Ombudsman as Witness

07-025

§7.25

Co-Agent Decision-Maker if Dispute

07-027

§7.27

Provision for Advisory Committee

07-029

§7.29

Excluding Unwanted Outsider Involvement

07-031

§7.31

Resignation as Agent

07-032

§7.32

Temporary Resignation as Agent

07-035

§7.35

Revocation of PAHC

07-075

§7.75

Limitation on Authority to Petition for Court Enforcement of Agent’s Duties

CH08

Chapter 8

Advance Health Care Directives: Complete Forms and Related Documents

08-003

§8.3

Statutory Form Advance Health Care Directive (Prob C §4701)

08-009

§§8.9-8.47

Designation of Agent and Successor Agents

 

§8.10

Nomination of Conservator of Person and Estate

 

§8.11

General Statement of Agent’s Authority

 

§8.12

When Agent’s Authority Becomes Effective

 

§8.13

Health Care Instruction—Prolong Life or Not Prolong Life

 

§8.14

Inspection and Disclosure of Confidential Medical Information

 

§8.15

Agent’s Authority to Sign Documents, Waivers, and Releases

 

§8.16

Agent’s and Others’ Visitation Rights

 

§8.17

Organ Donation

 

§8.18

Disposition of Remains

 

§8.19

Autopsy Authorization

 

§8.20

Administrative Provisions

 

§8.21

Withholding and Withdrawing Life-Sustaining Treatment

 

§8.22

Treatment for Alzheimer’s Disease

 

§8.23

Participation in Medical Research

 

§8.24

Agent’s Authority to Act if Provider Fails to Honor Wishes of Principal

 

§8.25

Negative Designation of Agent

 

§8.26

No Premature Withdrawal of Treatment

 

§8.28

Medical Directive and Release for Jehovah’s Witness Principal

 

§8.29

Medical Directive for Christian Scientist Principal

 

§8.30

Medical Directive for Orthodox Jewish Principal

 

§8.31

Medical Directive for Catholic Principal

 

§8.32

Agent’s Acceptance and Consent to Act

 

§8.33

Physician’s Acknowledgment

 

§8.33A

Complete Attorney-Drafted AHCD

 

§8.35

Authorization to Release Health Information by Settlor, Principal, or Others

 

§8.36

Authorization to Release Health Information by Trustees, Co-Trustees, Successor Trustees, and Agents

 

§8.37

Requirement to Have Agent Under Power of Attorney Execute HIPAA and CMIA Release

 

§8.38

Authorization to Release Health Information to Health Care Agent

 

§8.42

Agent Authorized to Direct or Consent to DNR Orders

 

§8.47

Anatomical Gifts

CH10

Chapter 10

Third Party Acceptance of Powers of Attorney and Health Care Directives

10-012

§10.12

Affidavit (Prob C §4305)

10-013

§10.13

Third Parties Directed to Accept Agent’s Signature and Acts

10-014

§10.14

Enforcement and Damages for Noncompliance

10-015

§10.15

Release of Information to Agent Authorized and Privilege Waived

10-016

§10.16

Third Parties Held Harmless

10-017

§10.17

Sample Letter From Principal’s Attorney to Third Party

10-025

§10.25

Letter to Doctor Concerning AHCD

10-026

§10.26

Letter to Nursing Home Administrator Concerning AHCD

10-027

§10.27

Letter to Residential Care Facility for Elderly (RCFE) Concerning AHCD

CH11

Chapter 11

Judicial Proceedings

11-044

§11.44

Sample Petition to Compel Third Party to Honor Agent’s Authority to Arrange for Disposal of Principal’s Remains as Authorized in Advance Health Care Directive

11-045

§11.45

Sample Order to Compel Third Party to Honor Agent’s Authority to Arrange for Disposal of Principal’s Remains as Authorized in Advance Health Care Directive

11-056

§11.56

Sample Petition to Compel Third Party to Honor Agent’s Authority and for Attorney Fees and Costs

11-057

§11.57

Sample Petition to Compel Accounting by Attorney-in-Fact, Award Attorney Fees, Remove Attorney-in-Fact, and Recognize Successor

11-058

§11.58

Sample Order to Compel Accounting by Attorney-in-Fact, Award Attorney Fees, Remove Attorney-in-Fact, and Recognize Successor

 

1

Powers of Attorney and Health Care Directives: Overview and International Considerations

Alexandra Gadzo

Max K. Riederer von Paar

  • I.  PRELIMINARY CONSIDERATIONS
    • A.  Introduction  1.1
    • B.  Scope of Book  1.2
    • C.  Definitions
      • 1.  Common Terms Used in Durable Powers of Attorney for Financial Management  1.3
      • 2.  Common Terms Used in Advance Health Care Directives and Powers of Attorney for Health Care  1.4
    • D.  Legal Authority
      • 1.  History and Background  1.5
      • 2.  Statutory Source of Power of Attorney Law and Health Care Decisions Law  1.6
      • 3.  Relation to General Law of Agency  1.7
    • E.  Capacity  1.8
    • F.  Coordination of Durable Powers of Attorney and Advance Health Care Directives  1.9
  • II.  OVERVIEW OF DURABLE POWERS OF ATTORNEY FOR FINANCIAL MANAGEMENT
    • A.  Power of Attorney Requirements  1.10
    • B.  Validity of Prior Documents  1.11
    • C.  The Agent
      • 1.  Multiple and Successor Agents  1.12
      • 2.  Standard of Care  1.13
      • 3.  Rights and Duties  1.14
        • a.  General Powers and Rights  1.15
        • b.  Powers That Must Be Specifically Granted  1.16
        • c.  Duties  1.17
    • D.  Modification and Revocation  1.18
    • E.  Relationship With Third Party  1.19
    • F.  Judicial Proceedings; Permission to Disobey Principal  1.20
    • G.  Use in Other States  1.21
  • III.  OVERVIEW OF ADVANCE HEALTH CARE DIRECTIVES  1.22
    • A.  Requirements for Execution  1.23
    • B.  Duration of Validity  1.24
    • C.  Validity of Documents Drafted Before July 1, 2000  1.25
    • D.  The Agent  1.26
      • 1.  Agent’s Authority  1.27
      • 2.  Limitations on Agent’s Authority  1.28
      • 3.  Agent’s Liability  1.29
    • E.  Revocation  1.30
    • F.  Relationship With Third Parties  1.31
    • G.  Judicial Proceedings  1.32
    • H.  Out-of-State Documents  1.33
  • IV.  OVERVIEW OF POWERS OF ATTORNEY FOR PERSONAL CARE  1.34
  • V.  INTERNATIONAL CONSIDERATIONS  1.35
    • A.  Recognition by United States of Powers of Attorney Drafted in Other Countries  1.36
    • B.  Recognition by Foreign Jurisdictions of Powers of Attorney Drafted in United States  1.37
    • C.  Practical Considerations When Drafting Powers of Attorney for International Clients  1.38
    • D.  Form: Provision for International Health Care Instruction  1.39
  • VI.  SAFEKEEPING AND TRANSFER OF DOCUMENTS
    • A.  Where Client Should Keep Originals and Copies  1.40
    • B.  Documents Deposited With Attorney  1.41

2

Alternatives to Powers of Attorney and Advance Health Care Directives

Andrea Starrett

Amir Atashi Rang

  • I.  INTRODUCTION  2.1
  • II.  ADVANTAGES AND DISADVANTAGES OF DURABLE POWER OF ATTORNEY FOR FINANCIAL MANAGEMENT (DPOA) AND ADVANCE HEALTH CARE DIRECTIVE (AHCD)
    • A.  DPOA Advantages and Disadvantages
      • 1.  DPOA Advantages  2.2
      • 2.  DPOA Disadvantages  2.3
    • B.  AHCD and Power of Attorney for Health Care (PAHC) Advantages and Disadvantages  2.4
      • 1.  AHCD and PAHC Advantages  2.5
      • 2.  AHCD and PAHC Disadvantages  2.6
  • III.  WHEN DPOA OR AHCD IS NOT REASONABLE OR LEGAL OPTION  2.7
  • IV.  ALTERNATIVES TO DPOA AND AHCD
    • A.  Alternative Devices to DPOA  2.8
      • 1.  Revocable Living Trusts  2.9
        • a.  Compared With DPOA  2.10
        • b.  Coordinating DPOA With Revocable Living Trust  2.11
      • 2.  Conservatorship of the Estate  2.12
        • a.  Compared With DPOA  2.13
        • b.  Interaction of Conservator and Agent
          • (1)  Agent Accountable to Conservator  2.14
          • (2)  Avoiding Potential Conflicts Between Agent and Conservator  2.15
          • (3)  Personal Care Decisions  2.16
      • 3.  Joint Tenancy  2.17
        • a.  Compared With DPOA  2.18
        • b.  Problems With Joint Tenancy  2.19
      • 4.  Community Property Management
        • a.  Spouse or Domestic Partner and Agent Compared  2.20
        • b.  Coordination of DPOA, Community Property, and Conservatorship  2.21
      • 5.  Bank Accounts, Safe Deposit Boxes, and Similar Services  2.22
    • B.  Alternative Devices to AHCD
      • 1.  Conservatorship of the Person  2.23
        • a.  Medical Treatment Under Conservatorship
          • (1)  Conservatee’s Capacity for Informed Consent  2.24
          • (2)  Conservatee’s Lack of Capacity  2.25
          • (3)  Conservatee’s Belief in Prayer for Healing  2.26
          • (4)  Conservator’s Limited Authority  2.27
        • b.  Disadvantages of Conservatorship  2.28
        • c.  Interaction Between Conservator and Agent  2.29
      • 2.  Court-Ordered Health Care Decisions for Adult Without Conservator  2.30
      • 3.  Ability of Spouse to Make Health Care Decisions  2.31
      • 4.  Surrogate Designation  2.32
      • 5.  Physician Orders for Life-Sustaining Treatment (POLST)  2.32A
  • V.  HEALTH CARE AND PERSONAL CARE DECISIONS FOR MINORS  2.33
    • A.  Parent’s or Legal Guardian’s Authority to Delegate Decisions for Medical or Dental Care  2.34
    • B.  Form: Authorization for Care Provider to Consent to Medical or Dental Treatment of Minor (Fam C §6910)  2.35
    • C.  Voluntary Caregiver’s Authority to Enroll Minor in School and Authorize Medical Care  2.36
    • D.  Form: Caregiver’s Authorization Affidavit (Fam C §6552)  2.37
    • E.  Application by Minor for Court Consent to Medical or Dental Care  2.38
      • 1.  Form: Application by Minor for Consent to Medical or Dental Care  2.39
      • 2.  Form: Order Granting Consent for Medical or Dental Care of Minor  2.40
    • F.  Instances in Which Minor’s Consent Alone Is Sufficient
      • 1.  Minor of Certain Age and for Certain Treatments  2.41
      • 2.  Emancipated Minor  2.42

3

Ethical Considerations When Drafting Powers of Attorney and Advance Health Care Directives

Sarah A. Kirland

  • I.  OVERVIEW  3.1
  • II.  RULES OF PROFESSIONAL CONDUCT
    • A.  Sources of Authority  3.2
    • B.  Consequences of Violating Rules
      • 1.  Discipline by State Bar  3.3
      • 2.  Civil Liability for Malpractice  3.4
  • III.  ATTORNEY-CLIENT RELATIONSHIP
    • A.  Identifying Client  3.5
    • B.  Creation of Attorney-Client Relationship  3.6
    • C.  Written Representation Agreement  3.7
    • D.  Joint Representation  3.8
    • E.  Representing Principal  3.9
      • 1.  Advising Agent That He or She Is Not Client  3.10
      • 2.  Payment of Attorney Fees  3.11
  • IV.  DUTIES AND LIMITATIONS
    • A.  Duties to Client  3.12
      • 1.  Duty of Loyalty  3.13
      • 2.  Duty to Keep Client Confidences  3.14
      • 3.  Duty to Avoid Conflicts of Interest
        • a.  Avoiding Representation of Adverse Interests Generally  3.15
        • b.  Concurrent Representation of Multiple Parties  3.16
        • c.  Distinguishing Potential and Actual Conflict  3.17
        • d.  Informed Written Consent Required  3.18
        • e.  Representing Client With Interests Adverse to Former Client  3.19
      • 4.  Duty to Act Competently  3.20
    • B.  Duty to Client With Limited Mental Capacity  3.21
      • 1.  California Law  3.22
        • a.  Estate Planning Documents  3.23
        • b.  Protecting Client From Abuse, Undue Influence, or Fraud  3.24
        • c.  California State Bar Formal Opinion No. 89–112  3.25
      • 2.  ABA Model Rules  3.26
    • C.  Duty to Maintain Documents  3.27
  • V.  DETERMINING MENTAL CAPACITY OF CLIENTS  3.28
    • A.  Lawyer’s Obligation to Determine Client’s Capacity  3.29
    • B.  Standards and Tests for Legal Capacity
      • 1.  Due Process in Competence Determinations Act  3.30
        • a.  Evidence to Support Finding of Unsound Mind or Incapacity  3.31
        • b.  Ability to Communicate Decision and Understand Its Consequences  3.32
      • 2.  Specific Statutes Regarding Capacity  3.33
        • a.  Capacity to Contract, Convey, or Make Agency Appointments  3.34
        • b.  Capacity to Manage Personal and Financial Affairs and to Make Medical Decisions  3.35
    • C.  Attorney Assessment of Client Capacity  3.36
      • 1.  Evaluation Under Statutory Standards  3.37
      • 2.  Mental Status Assessment  3.38
    • D.  Form: Declaration Regarding Mental Functions  3.39
    • E.  Form: Capacity Declaration—Conservatorship (Judicial Council Form GC-335)  3.40

4

Durable Powers of Attorney for Financial Management: The Fundamentals

W. Vito Lanuti

Susan A. Katzen

  • I.  INTRODUCTION  4.1
  • II.  TYPES OF POWERS OF ATTORNEY FOR FINANCIAL MANAGEMENT
    • A.  Durable Versus Nondurable Powers of Attorney
      • 1.  Discussion  4.2
      • 2.  Form: Power of Attorney Is Durable  4.3
    • B.  General Versus Limited Powers of Attorney
      • 1.  General Power of Attorney  4.4
      • 2.  Limited (or Special) Power of Attorney  4.5
      • 3.  Limited Power of Attorney Forms
        • a.  Form: Limited Durable Power of Attorney for Management and Disposition of Specific Real Property  4.6
        • b.  Form: Introductory Clause if Power of Attorney Limited to Specific Time Period  4.7
    • C.  Immediately Effective Versus Springing DPOA
      • 1.  Immediately Effective DPOA
        • a.  Discussion  4.8
        • b.  Form: Power of Attorney Immediately Effective and Durable, and Principal Understands Instrument  4.9
      • 2.  Springing (Contingent, Standby, or Conditional) DPOA  4.10
        • a.  Triggering Event  4.11
          • (1)  Physician Statement  4.12
          • (2)  Third Person or Incapacity Panel  4.13
        • b.  Practical Problems  4.14
        • c.  Form: Springing DPOA  4.15
        • d.  Form: Termination of Springing DPOA on Principal’s Restoration to Capacity  4.16
        • e.  Form: Springing DPOA and Termination of Springing DPOA on Principal’s Restoration to Capacity—Incapacity Panel  4.17
    • D.  Statutory, Printed, and Attorney-Drafted DPOAs  4.18
      • 1.  California Statutory Form DPOA  4.19
      • 2.  Preprinted DPOA Forms  4.20
      • 3.  Practical Problems in Using Statutory Form or Preprinted Forms  4.21
      • 4.  Form: Warning Statement Required for Preprinted Forms Sold or Distributed  4.22
  • III.  REQUIREMENTS FOR EXECUTION
    • A.  Execution of DPOA Generally  4.23
      • 1.  Notary or Witness Requirements  4.24
      • 2.  Recordable Format  4.25
    • B.  Execution Requirements if Power to Petition Is Limited  4.26
    • C.  Requirements for Execution of California Uniform Statutory Form DPOA  4.27
    • D.  Execution of Joint DPOA  4.28
    • E.  Review and Execution of New DPOA by Principal  4.29
    • F.  Execution of Documents by Agent
      • 1.  Acceptance by Agent  4.30
      • 2.  Form: Acceptance by Agent  4.31
      • 3.  Signing as Agent  4.32
  • IV.  THE PRINCIPAL
    • A.  Eligibility of Principal to Execute DPOA
      • 1.  Individuals  4.33
      • 2.  Fiduciaries  4.34
      • 3.  Agent’s Delegation to Secondary Agents  4.35
    • B.  Establishing Capacity of Principal at Execution of DPOA to Prevent Later Challenge  4.36
  • V.  THE AGENT
    • A.  Eligibility to Serve as Agent  4.37
    • B.  Selection of Agent  4.38
      • 1.  Spouse or Domestic Partner  4.39
      • 2.  Adult Children  4.40
      • 3.  Friend  4.41
      • 4.  Professional Adviser  4.42
      • 5.  Corporate Agent  4.43
      • 6.  Private Professional Fiduciary  4.44
      • 7.  Nonresident Agent  4.45
      • 8.  Problem of Prohibited Transferees as Agents  4.46
        • a.  Care Custodian as Prohibited Transferee  4.47
        • b.  Exceptions to Prohibited Transferee Rule  4.48
      • 9.  Multiple Agents  4.49
        • a.  Authority to Act  4.50
        • b.  Disagreement, Incapacity, or Death  4.51
        • c.  Form: Joint Agency—Joint Action Required  4.52
        • d.  Form: Joint Agency—Either Agent Authorized to Act Alone  4.53
        • e.  Form: Settlement of Disputes Between Joint Agents  4.54
        • f.  Form: Joint Agent Unable to Act  4.55
      • 10.  Different Agents for Different Tasks  4.56
      • 11.  Successor Agents  4.57
        • a.  Agent May Appoint Successor Agent  4.58
        • b.  Exculpating Clause  4.59
        • c.  Form: Appointment of Successor Agent  4.60
        • d.  Form: Successor Agent’s Liability for Prior Agent’s Acts  4.61
    • C.  Duty and Standard of Care; Authority to Act
      • 1.  Educating and Protecting Agent  4.62
      • 2.  Agent’s Authority
        • a.  Standard of Care  4.63
        • b.  Duty to Act  4.64
        • c.  Right to Resign  4.65
      • 3.  Form: Warning to Agent  4.66
      • 4.  Explicit Duties of Agent  4.67
      • 5.  Specific Prohibitions for Agents  4.68
      • 6.  Duty to Third Persons  4.69
      • 7.  Practical Considerations Related to Agent’s Standard of Conduct
        • a.  Limiting Agent’s Liability  4.70
        • b.  Specific Provisions Clarifying Agent’s Duties  4.71
      • 8.  Authorizing Specific Acts
        • a.  Acts That Must Be Expressly Authorized  4.72
        • b.  Acts That Should Be Expressly Authorized  4.73
          • (1)  Self-Dealing  4.74
          • (2)  Commingling  4.75
      • 9.  Authority to Obtain Confidential Information  4.76
      • 10.  Civil Actions for Financial Abuse of Elderly: Remedies Under Elder Abuse and Dependent Adult Civil Protection Act (EADACPA)  4.77
      • 11.  Reporting Financial Abuse of Elderly Under EADACPA  4.78
    • D.  Bond  4.79
    • E.  Form: Requirement That Agent Post Bond  4.80
    • F.  Reasonable Compensation  4.81
      • 1.  Form: Compensation of Agent—Reasonable Compensation  4.82
      • 2.  Form: Compensation of Agent—Hourly Rate  4.83
      • 3.  Form: Compensation of Agent—Percentage of Net Assets  4.84
      • 4.  Form: Compensation of Agent—Joint Agents Serving  4.85
  • VI.  TERMINATION OF DPOA
    • A.  Methods of Termination
      • 1.  Revocation by Principal  4.86
      • 2.  Form: Revocation of DPOA  4.87
      • 3.  Expiration of Agent’s Term or Extinction of Subject of Instrument  4.88
      • 4.  Agent’s Death  4.89
      • 5.  Agent’s Resignation  4.90
      • 6.  Agent’s Incapacity to Act  4.91
      • 7.  Dissolution or Annulment; Effect of Legal Separation or Termination of Domestic Partnership  4.92
      • 8.  Principal’s Incapacity to Contract Terminates Nondurable Power of Attorney  4.93
      • 9.  Restoration to Capacity and the Springing DPOA  4.94
      • 10.  Principal’s Death  4.95
      • 11.  Revocation by Court Order  4.96
    • B.  Practical Problems Related to Termination of DPOA
      • 1.  Capacity to Revoke  4.97
      • 2.  Loss of Instrument  4.98
      • 3.  Duties of Terminated Agent  4.99
      • 4.  Protection of Agent Who Acts in Good Faith Reliance on Terminated DPOA  4.100
  • VII.  USE OF DPOA
    • A.  Availability of Documents  4.101
    • B.  Use of Photocopies  4.102
    • C.  Form: Authorization to Use Photocopies  4.103
    • D.  Timely Recording of DPOA  4.104
    • E.  Multistate Considerations  4.105

5

Durable Powers of Attorney for Financial Management: Specific Clauses and Complete Forms

W. Vito Lanuti

Susan A. Katzen

  • I.  INTRODUCTION  5.1
  • II.  DRAFTING CLAUSES FOR SPECIFIC ASSETS AND ISSUES
    • A.  Real Property
      • 1.  Discussion  5.2
      • 2.  Form: Authority Regarding Real Property  5.3
      • 3.  Form: Authority Regarding Real Property That May Have Environmental Hazards  5.4
    • B.  Investments
      • 1.  Authority to Invest and Reinvest  5.5
      • 2.  Form: Authority to Invest and Reinvest  5.6
    • C.  Accounts, Safe Deposit Boxes, and Credit Cards
      • 1.  Authority to Make Transactions Regarding Accounts, Safe Deposit Boxes, and Credit Cards  5.7
      • 2.  Authority Over Digital Devices, Assets, and Accounts  5.7A
      • 3.  Form: Authority to Transact Business Regarding Accounts  5.8
      • 4.  Form: Authority to Transact Business Regarding Accounts (Prob C §5204)  5.9
      • 5.  Form: Authorization to Maintain, Have Access to, and Remove Property From Safe Deposit Boxes  5.10
      • 6.  Form: Authority to Use and Cancel Credit Cards  5.11
      • 7.  Form: Authority Over Digital Devices, Assets, and Accounts  5.11A
    • D.  Specific Agent Issues
      • 1.  Property Previously Belonging to Agent  5.12
      • 2.  Self-Dealing and Commingling  5.13
        • a.  Form: General Self-Dealing Authorized  5.14
        • b.  Form: Limited Self-Dealing Authorized  5.15
        • c.  Form: General Commingling of Principal and Agent’s Assets Authorized  5.16
        • d.  Form: Commingling of Specific Bank Account of Principal and Agent Authorized  5.17
    • E.  Litigation Authority
      • 1.  Authority to Assert Attorney-Client Privilege  5.18
      • 2.  Form: Authority to Assert Attorney-Client Privilege  5.19
      • 3.  Form: Authority to Collect Assets, Compromise Claims, and Litigate  5.20
    • F.  Government Benefits
      • 1.  Qualification for Public Medical Benefits  5.21
      • 2.  Form: Authority Regarding Government Benefits (Short Form)  5.22
      • 3.  Form: Authority Regarding Public Benefits (Long Form)  5.23
    • G.  Employee and Retirement Benefits
      • 1.  Authority to Deal With Employee, Retirement, and Other Benefits  5.24
      • 2.  Effective Use of Power  5.25
      • 3.  Form: Sample Request for Acknowledgment of Receipt and Acceptance of DPOA by Benefit Administrator  5.26
      • 4.  Institution-Provided DPOA  5.27
      • 5.  Cautions in Using Pre-2012 Statutory Form Power of Attorney  5.28
      • 6.  Form: Authority to Deal With Employee, Retirement, and Other Benefits  5.29
    • H.  Business, Partnership, and Stock Interests
      • 1.  Operation of Principal’s Business  5.30
      • 2.  Form: Authority Regarding Principal’s Business (Short Form)  5.31
      • 3.  Form: Authority Regarding Principal’s Business (Long Form)  5.32
      • 4.  Authority to Represent Partner  5.33
      • 5.  Form: Authority to Deal With Partnership Interests  5.34
      • 6.  Form: Authority to Exercise Stock Options  5.35
    • I.  Insurance and Annuities
      • 1.  Life Insurance Policies  5.36
      • 2.  Form: Powers Specifically Not Granted  5.37
      • 3.  Other Types of Insurance  5.38
      • 4.  Form: Authority Over Insurance  5.39
      • 5.  Annuities  5.40
      • 6.  Form: Authority Over Annuity Contracts  5.41
    • J.  Support for Persons Dependent on Principal
      • 1.  Providing Support for Others  5.42
      • 2.  Form: Providing Support for Others  5.43
    • K.  Nomination of Conservator of Person or Estate
      • 1.  Nominating Conservator of Person and Estate  5.44
      • 2.  Form: Nomination of Conservator of Person and Estate  5.45
    • L.  Appearance for Military, Charitable, or Religious Person in Adoption Proceedings
      • 1.  Discussion  5.46
      • 2.  Form: Authority to Appear for Military, Charitable, or Religious Person or Spouse in Adoption Proceeding  5.47
    • M.  Representation of Creditor in Bankruptcy Proceedings  5.48
  • III.  ADMINISTRATIVE PROVISIONS
    • A.  Form: General Administrative Authority  5.49
    • B.  Revocation and Amendment
      • 1.  Provision for Revocation and Amendment  5.50
      • 2.  Form: Revocation and Amendment  5.51
    • C.  Certifying Power of Attorney
      • 1.  Certification  5.52
      • 2.  Form: Certifying Power of Attorney  5.53
    • D.  Limiting Authority to Petition Court  5.54
      • 1.  Form: Attorney Certificate Regarding Limitation on Authority to Petition  5.55
      • 2.  Form: Limitation on Authority to Petition for Court Enforcement of Agent’s Duties  5.56
    • E.  Reports  5.57
      • 1.  Form: Duty to Prepare Annual Financial Reports  5.58
      • 2.  Form: Duty to Report  5.59
    • F.  Hiring Professional Advisers
      • 1.  Employing Professional Advisers  5.60
      • 2.  Form: Authority to Employ Professional Advisers  5.61
  • IV.  PROVISIONS REGARDING PRINCIPAL’S PERSONAL CARE AND RESIDENCE
    • A.  Personal Care Decisions and Durable Powers of Attorney  5.62
    • B.  Form: Springing Durable Power of Attorney for Personal Care (Separate Document)  5.63
    • C.  Individual Personal Care Provisions
      • 1.  Form: Personal Care Provisions as Part of DPOA  5.64
      • 2.  Form: Principal’s Intention to Remain in Own Home  5.65
      • 3.  Form: Restriction on Sale of Home Until All Other Assets Are Depleted  5.66
      • 4.  Form: Restriction on Sale or Encumbrance of Principal’s Residence  5.67
      • 5.  Form: Authority to Dispose of Personal Effects  5.68
  • V.  SAMPLES OF COMPLETE FORMS
    • A.  Form: General and Immediately Effective Durable Power of Attorney  5.69
    • B.  Form: General Springing Durable Power of Attorney  5.70
    • C.  Form: Uniform Statutory Form Power of Attorney (Prob C §4401)  5.71
    • D.  Form: Cover Letter to Principal to Accompany DPOA Draft  5.72

6

Estate and Tax Planning Using Powers of Attorney

Peter S. Myers

  • I.  CONSIDERATIONS IN USING DURABLE POWER OF ATTORNEY (DPOA) FOR ESTATE PLANNING
    • A.  Introduction  6.1
    • B.  Need for Increased Planning Flexibility  6.2
      • 1.  Estate and Gift Tax  6.3
        • a.  Estate Tax  6.4
        • b.  Gift Tax  6.5
      • 2.  Generation-Skipping Transfer Tax  6.6
      • 3.  Income Tax Basis  6.7
    • C.  Cost Constraints  6.8
    • D.  Safety  6.9
    • E.  Drafting Protections: Scope of Agent’s Authority  6.10
    • F.  Coordinating DPOA With Other Estate Planning Documents  6.11
      • 1.  Will  6.12
      • 2.  Revocable Trust  6.13
      • 3.  Gifting Authority
        • a.  DPOA or Revocable Living Trust  6.14
        • b.  Survivor’s Trust  6.15
      • 4.  Power of Attorney for Health Care  6.16
      • 5.  Conservatorship  6.17
  • II.  ESTATE AND TAX PLANNING THROUGH USE OF DPOA
    • A.  California Statutory Limitations for Estate Planning Powers
      • 1.  Express Authorization  6.18
      • 2.  Using Separate DPOA for Estate and Tax Planning  6.19
      • 3.  Estate Planning Powers in DPOAs Executed Before January 1, 1995  6.20
      • 4.  Form: Broad Authority to Exercise Estate Planning Powers  6.21
    • B.  Potential Tax and Creditor Problems in Creation and Use of DPOA  6.22
      • 1.  Principal Liable for Capital Gains and Gift Tax  6.23
      • 2.  Agent’s Potential Liability
        • a.  Agent as Holder of General Power of Appointment  6.24
        • b.  Power to Amend Trust: Agent’s Possible Tax Consequences  6.25
        • c.  Avoiding Tax and Creditor Consequences to Agent  6.26
  • III.  SPECIFIC GIFT AND ESTATE TAX PLANNING POWERS OF AGENT
    • A.  Gifts  6.27
      • 1.  Qualifying Cash Gifts for Annual Gift Tax Exclusion  6.28
      • 2.  Noncash Gifts, Gifts Over Annual Exclusion Amount, and Charitable Gifts  6.29
      • 3.  Form: Authority to Make Annual Gifts up to Annual Gift Tax Exclusion Amount  6.30
      • 4.  Form: Authority to Make Gifts Beyond Annual Gift Tax Exclusion Amount  6.31
      • 5.  Form: Powers Relating to Gifts (Long Form)  6.32
    • B.  Special Needs Trusts
      • 1.  Amending Trust to Create Special Needs Trust  6.33
      • 2.  Form: Authority to Create Special Needs Trust  6.34
    • C.  Moving Assets to or From Trusts
      • 1.  Authority to Transfer Assets to or Remove Assets From Trusts  6.35
      • 2.  Form: Authority to Transfer Assets to and Remove Assets From Revocable Living Trust  6.36
    • D.  Funding Trust Not Created by Principal
      • 1.  Authority to Fund Trusts Not Created by Principal  6.37
      • 2.  Form: Authority to Fund Trusts Not Created by Principal  6.38
    • E.  Powers of Appointment
      • 1.  Exercise of Powers of Appointment  6.39
      • 2.  Form: Authority to Exercise Powers of Appointment  6.40
    • F.  Miscellaneous Tax Provision
      • 1.  Authority to Prepay or Postpone Taxes and to Borrow for Purposes of Tax Planning  6.41
      • 2.  Form: Authority to Prepay or Postpone Taxes and to Borrow and Grant Security Interests  6.42
    • G.  Withdrawal Rights From Trusts
      • 1.  Authority to Exercise Annual “5 or 5” Power  6.43
      • 2.  Form: Authority to Exercise Annual Withdrawal Rights  6.44
    • H.  Disclaimers
      • 1.  Use of Disclaimers  6.45
      • 2.  Legal Requirements for Disclaimer
        • a.  Federal Requirements for Qualified Disclaimer  6.46
        • b.  California Requirements  6.47
      • 3.  Form: Authority to Execute Disclaimers  6.48
    • I.  Farm and Business Interests
      • 1.  Qualification for Special-Use Valuation of Farm and Business Interests  6.49
      • 2.  Form: Authority to Make Elections and File Consents to Special-Use Valuation  6.50
    • J.  Family-Owned Businesses
      • 1.  Family-Owned Business Deduction [Deleted]  6.51
      • 2.  Form: Authority to Take Family-Owned Business Deduction [Deleted]  6.52
    • K.  Installment Payment of Federal Estate Taxes
      • 1.  Qualification for Installment Payment of Federal Estate Taxes  6.53
      • 2.  Form: Authority to Qualify for Installment Payment of Federal Estate Taxes  6.54
    • L.  Transmutation
      • 1.  Conversion of Separate Property to Community Property  6.55
      • 2.  Form: Conversion of Joint Tenancy Property to Community Property  6.56
    • M.  Aggregate Property Agreements
      • 1.  Entering Into Aggregate Property Agreement  6.57
      • 2.  Form: Entering Into Aggregate Property Agreement  6.58
    • N.  Splitting Gifts With Spouse
      • 1.  Consent to Split Gifts With Spouse  6.59
      • 2.  Form: Authority to Consent to Split Gifts With Spouse  6.60
    • O.  Tuition and Medical Expenses
      • 1.  Payment of Tuition and Medical Expenses  6.61
      • 2.  Form: Authority to Pay Third Party Tuition and Medical Expenses  6.62
    • P.  Execution of Tax Returns and Representation on Other Tax Matters
      • 1.  Authority to Sign Tax Returns  6.63
      • 2.  Other Tax Matters Requiring Power of Attorney  6.64
      • 3.  Tax Matters Not Requiring Power of Attorney  6.65
      • 4.  IRS Power of Attorney Procedures
        • a.  Types of Documents IRS Accepts and Other Required Procedures  6.66
        • b.  IRS Form 2848  6.67
        • c.  Power of Attorney Other Than IRS Form 2848  6.68
        • d.  Filing Forms With IRS  6.69
        • e.  Resubmission of Power of Attorney Forms After 3 Years  6.70
        • f.  Substitution, Delegation, or Revocation of Power  6.71
      • 5.  Form: Authority to Represent Principal on Tax Matters and Sign Tax Returns  6.72

7

Advance Health Care Directives: The Fundamentals

Fay Blix

  • I.  INTRODUCTION
    • A.  Preliminary Considerations  7.1
    • B.  California’s Natural Death Act  7.2
    • C.  Definitions of Common Health Care Planning Terms  7.3
    • D.  Attorney’s Role
      • 1.  Defining Client’s Wishes on Health Care Issues  7.4
      • 2.  Advising Client After Execution of Health Care Documents  7.5
    • E.  Distinguishing Between an Advance Health Care Directive (AHCD) and a Power of Attorney for Health Care (PAHC)  7.6
    • F.  Types of Advance Health Care Directives  7.7
    • G.  AHCD Agent’s Relationship With Agent Under DPOA  7.8
    • H.  Capacity for Health Care Decision Making
      • 1.  “Capacity” Defined  7.9
      • 2.  Form: Physician’s Certificate of Incapacity  7.9A
      • 3.  Principal’s Rights  7.10
      • 4.  Agent’s Rights  7.11
    • I.  Federal Protection of Right to Execute Advance Directive for Health Care  7.12
  • II.  CONTENTS AND PROCEDURES
    • A.  Basic Considerations  7.13
    • B.  HIPAA Concerns  7.14
    • C.  Contents and Execution Requirements  7.15
      • 1.  Witnessing
        • a.  Statutory Requirements  7.16
        • b.  Oral Acknowledgment May Be Permissible  7.17
      • 2.  Notarization  7.18
    • D.  Witnesses
      • 1.  Proper Witnesses  7.19
      • 2.  Ombudsman as Witness  7.20
      • 3.  Form: Ombudsman as Witness  7.21
    • E.  The Agent
      • 1.  Who May Serve  7.22
      • 2.  Selection  7.23
      • 3.  Multiple Agents and Decision-Makers
        • a.  Multiple Agents  7.24
        • b.  Form: Co-Agent Decision-Maker if Dispute  7.25
        • c.  Single Agent With Advisers  7.26
        • d.  Form: Provision for Advisory Committee  7.27
        • e.  Excluding Involvement of Outside Organizations or Government Officials  7.28
        • f.  Form: Excluding Unwanted Outsider Involvement  7.29
      • 4.  Resignation
        • a.  Procedures  7.30
        • b.  Form: Resignation as Agent  7.31
        • c.  Form: Temporary Resignation as Agent  7.32
    • F.  Expiration  7.33
    • G.  Revocation
      • 1.  Procedures and Effect  7.34
      • 2.  Form: Revocation of PAHC  7.35
    • H.  Execution in Another State  7.36
  • III.  AGENT’S AUTHORITY
    • A.  General Principles  7.37
      • 1.  Right to Receive Information  7.38
      • 2.  Right to Receive Compensation  7.39
      • 3.  Health Care Decisions by Surrogate  7.40
    • B.  Presumptive Validity of AHCD  7.41
    • C.  Limitations on Agent
      • 1.  Principal Has Capacity  7.42
      • 2.  Express Limitations in Document  7.43
        • a.  Limitation on Placing Principal in a Facility and on Authorizing Convulsive Treatment, Psychosurgery, Sterilization, or Abortion  7.44
        • b.  Specific Limitations on Execution and Use of PAHC  7.45
        • c.  Prohibitions Against Mercy Killing, Assisted Suicide, and Euthanasia  7.46
    • D.  Relationship to Conservator of the Person  7.47
    • E.  Relationship to Surrogate  7.48
    • F.  Medical Experimentation  7.49
    • G.  Withholding or Withdrawing Medical Treatment
      • 1.  In General  7.50
      • 2.  Use of Detailed Forms  7.51
      • 3.  Artificially Administered Nutrition and Hydration  7.52
    • H.  Postmortem Authority  7.53
      • 1.  Disposition of Remains  7.54
        • a.  Agent Not Responsible for Funeral Expenses  7.55
        • b.  Principal’s Killer Loses Rights Over Disposition of Remains  7.56
      • 2.  Authorize Autopsy  7.57
      • 3.  Anatomical Gifts  7.58
        • a.  Agent’s Authorization to Make Anatomical Gift  7.59
        • b.  Making Anatomical Gift  7.60
        • c.  Revoking or Amending Anatomical Gift
          • (1)  By Donor or by Agent Under Power of Attorney  7.61
          • (2)  By Other Third Parties  7.62
        • d.  Written Refusal to Make Anatomical Gift  7.63
      • 4.  Duty to Inform Individuals of Principal’s Death  7.63A
  • IV.  RIGHTS AND LIABILITIES OF HEALTH CARE PROVIDERS  7.64
    • A.  Law Limits Health Care Professional’s Liability  7.65
    • B.  Physician Orders for Life-Sustaining Treatment  7.66
    • C.  Form: Physician Orders for Life-Sustaining Treatment (POLST) [Deleted]  7.67
    • D.  Health Care Providers’ Penalties for Violating Health Care Decisions Act  7.68
  • V.  DOCUMENT REGISTRATION
    • A.  State Registry System  7.69
    • B.  Form: Registration of Written Advance Health Care Directive (Secretary of State Form SFL-461)  7.70
    • C.  Alternate Registry Services
      • 1.  DocuBank  7.71
      • 2.  Legal Directives, LLC  7.72
  • VI.  LIMITING COURT ENFORCEMENT
    • A.  Limiting Power to Petition  7.73
    • B.  Practical Considerations  7.74
    • C.  Form: Limitation on Authority to Petition for Court Enforcement of Agent’s Duties  7.75
  • VII.  SUMMARY OF HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996 (HIPAA) AND CALIFORNIA’S CONFIDENTIALITY OF MEDICAL INFORMATION ACT (CMIA)  7.76
    • A.  Some Basic Terms and Requirements
      • 1.  Covered Entities  7.77
      • 2.  Protected Health Information  7.78
      • 3.  Written Authorization for Use or Disclosure  7.79
      • 4.  Disclosure Limited to “Minimum Necessary”  7.80
      • 5.  Required Notice to Patient  7.81
      • 6.  Privacy Official  7.82
    • B.  HIPAA and Health Care Agents
      • 1.  Agents’ Problems Under HIPAA  7.83
      • 2.  Practical Suggestions  7.84
    • C.  Resources   7.85

8

Advance Health Care Directives: Complete Forms and Related Documents

Fay Blix

Ruth A. Phelps

  • I.  OVERVIEW  8.1
  • II.  INTRODUCTION TO FILL-IN-THE-BLANK ADVANCE HEALTH CARE DIRECTIVES  8.2
    • A.  Form: Statutory Form Advance Health Care Directive (Prob C §4701)  8.3
    • B.  Form: Advance Health Care Directive (California Medical Association)  8.4
    • C.  Form: California Medical Association Wallet Identification Card  8.5
    • D.  Form: Advance Health Care Directive (California Hospital Association)  8.6
    • E.  Form: Easily Understood Advance Health Care Directive (Institute for Healthcare Advancement)  8.7
    • F.  Form: Advance Health Care Directive for Persons With Developmental Disabilities (Coalition for Compassionate Care)   8.7A
    • G.  Psychiatric Advance Health Care Directive
      • 1.  Use of Psychiatric Advance Health Care Directive  8.7B
      • 2.  Form: Psychiatric Advance Health Care Directive  8.7C
  • III.  ATTORNEY-DRAFTED FORM  8.8
    • A.  Form: Designation of Agent and Successor Agents  8.9
    • B.  Form: Nomination of Conservator of Person and Estate  8.10
    • C.  Form: General Statement of Agent’s Authority  8.11
    • D.  Form: When Agent’s Authority Becomes Effective  8.12
    • E.  Form: Health Care Instruction—Prolong Life or Not Prolong Life  8.13
    • F.  Form: Inspection and Disclosure of Confidential Medical Information  8.14
    • G.  Form: Agent’s Authority to Sign Documents, Waivers, and Releases  8.15
    • H.  Form: Agent’s and Others’ Visitation Rights  8.16
    • I.  Form: Organ Donation  8.17
    • J.  Form: Disposition of Remains  8.18
    • K.  Form: Autopsy Authorization  8.19
    • L.  Form: Administrative Provisions  8.20
    • M.  Additional or Alternative Statements of Desires
      • 1.  Form: Withholding and Withdrawing Life-Sustaining Treatment  8.21
      • 2.  Form: Treatment for Alzheimer’s Disease  8.22
      • 3.  Form: Participation in Medical Research  8.23
      • 4.  Form: Agent’s Authority to Act if Provider Fails to Honor Wishes of Principal  8.24
      • 5.  Form: Negative Designation of Agent  8.25
      • 6.  Form: No Premature Withdrawal of Treatment  8.26
      • 7.  Medical Directives Based on Religious Beliefs
        • a.  The Issue  8.27
        • b.  Form: Medical Directive and Release for Jehovah’s Witness Principal  8.28
        • c.  Form: Medical Directive for Christian Scientist Principal  8.29
        • d.  Form: Medical Directive for Orthodox Jewish Principal  8.30
        • e.  Form: Medical Directive for Catholic Principal  8.31
    • N.  Form: Agent’s Acceptance and Consent to Act  8.32
    • O.  Form: Physician’s Acknowledgment  8.33
    • P.  Form: Complete Attorney-Drafted AHCD  8.33A
    • Q.  Form: One-Page Attorney-Drafted AHCD  8.33B
  • IV.  RELATED DOCUMENTS
    • A.  Introduction to Health Insurance Portability and Accountability Act (HIPAA) and Confidentiality of Medical Information Act (CMIA) Release Forms  8.34
      • 1.  Form: Authorization to Release Health Information by Settlor, Principal, or Others  8.35
      • 2.  Form: Authorization to Release Health Information by Trustees, Co-Trustees, Successor Trustees, and Agents  8.36
      • 3.  Form: Requirement to Have Agent Under Power of Attorney Execute HIPAA and CMIA Release  8.37
      • 4.  Form: Authorization to Release Health Information to Health Care Agent  8.38
    • B.  Request Regarding Resuscitative Measures
      • 1.  Statutory Authority  8.39
      • 2.  Physician Orders for Life-Sustaining Treatment (POLST)  8.39A
      • 3.  Reliance by Health Care Providers  8.40
      • 4.  Practical Issues  8.41
      • 5.  Form: Agent Authorized to Direct or Consent to DNR Orders  8.42
      • 6.  Form: Physician Orders for Life-Sustaining Treatment (POLST)  8.43
    • C.  Anatomical Gifts
      • 1.  Issues to Discuss With Clients  8.44
      • 2.  Relevant Statutory Provisions  8.45
      • 3.  California Anatomical Gift Donor Registration (The Living Bank)  8.46
      • 4.  Form: Anatomical Gifts  8.47
    • D.  Living Will  8.48

9

Health Care Decisions: The Legal and Medical Environments

Fay Blix

  • I.  OVERVIEW
    • A.  Introduction  9.1
    • B.  Problems Presented by Medical Technology  9.2
    • C.  Role of Attorneys  9.3
  • II.  LEGAL ENVIRONMENT
    • A.  Right to Refuse Medical Treatment  9.4
      • 1.  Cruzan, First Supreme Court Case  9.5
      • 2.  Federal Law  9.6
      • 3.  Common Law Rights  9.7
      • 4.  Health Care Decisions Law  9.8
      • 5.  California Constitution  9.9
    • B.  Right of Competent Persons to Refuse Medical Treatment  9.10
      • 1.  Right to Refuse Treatment; Informed Consent  9.11
      • 2.  Right to Refuse Mechanical Respiration  9.12
      • 3.  Right to Refuse Artificial Nutrition and Hydration  9.13
    • C.  Right of Incompetent Persons to Refuse Medical Treatment  9.14
      • 1.  Proportionate-Treatment Test  9.15
      • 2.  Surrogate Decision-Maker’s Rights  9.16
      • 3.  Conservator’s Broad Discretion
        • a.  Conservatee in Persistent Vegetative State
          • (1)  California Law  9.17
          • (2)  Limitations on Broad Discretion and Practice Considerations for California Attorneys  9.18
          • (3)  Terri Schiavo Case  9.19
            • (a)  Litigation  9.20
            • (b)  Legislation and Further Litigation  9.21
            • (c)  Lesson of Schiavo Case  9.22
        • b.  Conservatee Conscious but Unable to Understand or Speak  9.23
      • 4.  Independent Counsel for Proposed Conservatee  9.24
      • 5.  Protection Under Health Care Decisions Law  9.25
    • D.  Right to Demand Medical Treatment  9.26
    • E.  Protection From Criminal or Civil Liability of Health Care Providers  9.27
      • 1.  Case Law
        • a.  Liability for Following Direction Regarding Care  9.28
        • b.  Liability for Failing to Follow Direction Regarding Care  9.29
      • 2.  Statutes  9.30
    • F.  Assisted Suicide  9.31
      • 1.  California Cases  9.32
      • 2.  Federal Cases  9.33
      • 3.  California Statutes and the End of Life Option Act  9.34
      • 4.  Laws of Other States  9.35
        • a.  Oregon Law  9.36
        • b.  Oregon’s Experience Under the Law  9.37
        • c.  Washington’s Law  9.37A
        • d.  Montana’s Law  9.37B
        • e.  Vermont’s Law  9.37C
        • f.  New Mexico’s Morris v Brandenburg  9.37D
      • 5.  Federal Legislation  9.38
      • 6.  Laws of Other Countries  9.39
      • 7.  Physician-Assisted Suicide  9.40
      • 8.  Federal Directive to Pursue Disciplinary Action Against Physicians Who Act Under Oregon’s Assisted Suicide Law  9.41
  • III.  MEDICAL ENVIRONMENT
    • A.  Introduction  9.42
    • B.  Problem Areas
      • 1.  Brain Death  9.43
      • 2.  Organ Donation  9.44
        • a.  Uniform Anatomical Gift Act  9.45
        • b.  California’s Passage of Anatomical Gift Act  9.46
        • c.  Definition of Anatomical Gift  9.47
        • d.  Persons Authorized to Make Anatomical Gift
          • (1)  During Lifetime  9.48
          • (2)  After Death  9.49
        • e.  Making Anatomical Gift  9.50
        • f.  Donor Registries  9.51
        • g.  Where Gifts Can Be Made  9.52
        • h.  Revoking or Amending Anatomical Gift
          • (1)  By Donor or Agent Under Power of Attorney  9.53
          • (2)  By Donor Alone  9.54
          • (3)  By Other Third Parties  9.55
        • i.  Refusing to Make Anatomical Gift  9.56
          • (1)  Making Refusal  9.57
          • (2)  Amending or Revoking Refusal  9.58
        • j.  Preclusive Effect of Anatomical Gift  9.59
        • k.  Emergency Personnel Must Reasonably Search for Documents Concerning Anatomical Gift  9.60
        • l.  Authorized Examination by Agents or Others  9.61
        • m.  Medical Viability and Other Concerns With UAGA  9.62
        • n.  Case Highlighting Concerns With Anatomical Gifting  9.63
        • o.  Attorney Considerations in Advising Clients About Organ Donation  9.64
      • 3.  Persistent Vegetative State (Irreversible Coma)  9.65
      • 4.  Cardiopulmonary Resuscitation (CPR)  9.66
        • a.  Do Not Resuscitate (DNR) Policy During and After Surgery  9.67
        • b.  Do Not Resuscitate (DNR) Policy in Residential Care Facilities  9.68
      • 5.  Do-Not-Transfer and Do-Not-Hospitalize Orders  9.69
      • 6.  Mechanically Assisted Respiration  9.70
      • 7.  Artificial Nutritional Support
        • a.  Types of Artificial Nutritional Support  9.71
        • b.  Decision to Withdraw Artificial Nutritional Support  9.72
      • 8.  Maintenance Dialysis  9.73
      • 9.  Medicalization of Marijuana  9.74
        • a.  Medical Necessity Defense and Controlled Substances Act  9.75
        • b.  Constitutional Rights and Controlled Substances Act  9.76
        • c.  Rohrabacher-Farr Medical Marijuana Amendment  9.76A
        • d.  Recreationalization of Marijuana in California  9.76B
  • IV.  DUTY TO EDUCATE  9.77

10

Third Party Acceptance of Powers of Attorney and Health Care Directives

Robert S. Kosloff

  • I.  INTRODUCTION  10.1
  • II.  THIRD PARTY ACCEPTANCE OF DURABLE POWER OF ATTORNEY FOR FINANCIAL MANAGEMENT (DPOA)
    • A.  Legal Duty  10.2
    • B.  Aids to Acceptance by Third Parties  10.3
      • 1.  General Suggestions  10.4
      • 2.  Better Communication  10.5
      • 3.  Drafting Solutions  10.6
    • C.  Particularly Troublesome Third Parties
      • 1.  Banks  10.7
        • a.  Bank Accounts  10.8
        • b.  Safe Deposit Boxes  10.9
        • c.  Online Banking  10.9A
      • 2.  Title Companies  10.10
      • 3.  Brokerage Firm or Stock Transfer Agents  10.11
    • D.  Attorney-Drafted Forms to Aid DPOA Acceptance by Third Parties
      • 1.  Form: Affidavit (Prob C §4305)  10.12
      • 2.  Form: Third Parties Directed to Accept Agent’s Signature and Acts  10.13
      • 3.  Form: Enforcement and Damages for Noncompliance  10.14
      • 4.  Form: Release of Information to Agent Authorized and Privilege Waived  10.15
      • 5.  Form: Third Parties Held Harmless  10.16
      • 6.  Form: Sample Letter From Principal’s Attorney to Third Party  10.17
    • E.  Last Straw: Legal Proceeding to Enforce Power of Attorney  10.18
  • III.  THIRD PARTY ACCEPTANCE OF ADVANCE HEALTH CARE DIRECTIVE
    • A.  Introduction  10.19
    • B.  Types of Health Care Documents  10.20
    • C.  Third Party’s Legal Duty
      • 1.  Third Parties May Not Legitimately Refuse to Honor AHCD  10.21
      • 2.  Limitation of Liability  10.22
      • 3.  Patient’s Protected Health Information (PHI); HIPAA and CMIA Considerations  10.22A
    • D.  Aids to Acceptance of AHCD  10.23
    • E.  Legal Proceedings to Enforce AHCD  10.24
    • F.  Letters to Various Entities
      • 1.  Form: Letter to Doctor Concerning AHCD  10.25
      • 2.  Form: Letter to Nursing Home Administrator Concerning AHCD  10.26
      • 3.  Form: Letter to Residential Care Facility for Elderly (RCFE) Concerning AHCD  10.27

11

Judicial Proceedings

Don Edward Green

  • I.  INTRODUCTION: GENERAL CONCEPTS  11.1
    • A.  Probate Court Is Court of General Jurisdiction  11.2
    • B.  Powers of Attorney Versus Non-Health-Care Issues  11.3
  • II.  PRELIMINARY CONSIDERATIONS
    • A.  Avoiding Conflicts  11.4
    • B.  Whether to File  11.5
    • C.  Choice of Court and Proceeding  11.6
      • 1.  Appointment of Conservator With Power to Revoke or Amend  11.7
      • 2.  Challenge to Agent’s Amendment of Trust  11.8
      • 3.  Civil Action for Damages for Agent’s Wrongdoing  11.9
      • 4.  Injunction  11.10
      • 5.  Jury Trial  11.11
      • 6.  Agent’s Authority to Bind Principal to Arbitration  11.12
    • D.  Ethics, Duty, and Privilege  11.13
      • 1.  Attorney-Client Privilege  11.14
      • 2.  Conflict of Interest  11.15
    • E.  Evidentiary Issues  11.16
    • F.  Issues Regarding Incapacity  11.17
      • 1.  Proving Deficits and Incapacity Under DPCDA  11.18
      • 2.  Presumptions Under DPCDA Affecting Capacity to Contract  11.19
      • 3.  Proving Incapacity Under the Health Care Decisions Law  11.20
  • III.  PROCEDURAL CONSIDERATIONS
    • A.  Applicable Law  11.21
    • B.  Jurisdiction
      • 1.  Subject Matter Jurisdiction  11.22
      • 2.  Personal Jurisdiction  11.23
    • C.  Nondurable Powers  11.24
    • D.  Venue  11.25
    • E.  Standing  11.26
    • F.  Notice
      • 1.  Statutory Notice Requirements  11.27
      • 2.  Notice Under California Rules of Court  11.28
    • G.  Miscellaneous Procedural Provisions  11.29
    • H.  Guardian Ad Litem  11.30
    • I.  Contents of Petition  11.31
    • J.  Discovery, Law and Motion, and Trials  11.32
    • K.  Obtaining Medical Information Under HIPAA and CMIA  11.33
    • L.  Expenses and Attorney Fees  11.34
      • 1.  Reimbursement for Expenses and Attorney Fees  11.35
      • 2.  Award of Attorney Fees  11.36
    • M.  Costs  11.37
    • N.  Appeals  11.38
    • O.  Representation by Counsel  11.39
  • IV.  ADVANCE HEALTH CARE DIRECTIVES
    • A.  Temporary Orders  11.40
    • B.  Petition Regarding Advance Health Care Directives  11.41
    • C.  No Direct Authority to Compel Recognition  11.42
    • D.  Terminating Life Support  11.43
    • E.  Form: Sample Petition to Compel Third Party to Honor Agent’s Authority to Arrange for Disposal of Principal’s Remains as Authorized in Advance Health Care Directive  11.44
    • F.  Form: Sample Order to Compel Third Party to Honor Agent’s Authority to Arrange for Disposal of Principal’s Remains as Authorized in Advance Health Care Directive  11.45
  • V.  FINANCIAL MANAGEMENT AND PERSONAL CARE POWERS
    • A.  General Provisions
      • 1.  Temporary Orders  11.46
      • 2.  Petitions Under Prob C §4541  11.47
        • a.  Determining Whether Power Is in Effect or Has Terminated  11.48
        • b.  Passing on Prior or Proposed Acts of Agent  11.49
        • c.  Compelling Agent to Submit Accounts or Reports  11.50
        • d.  Revoking Agent’s Authority  11.51
        • e.  Approving Agent’s Resignation  11.52
      • 3.  Lack of Express Remedies Section  11.53
    • B.  Types of Petitions Challenging Agent’s Actions  11.54
    • C.  Refusal to Recognize Financial Management and Personal Care Powers  11.55
  • VI.  SAMPLE PETITIONS AND ORDER
    • A.  Form: Sample Petition to Compel Third Party to Honor Agent’s Authority and for Attorney Fees and Costs  11.56
    • B.  Form: Sample Petition to Compel Accounting by Attorney-in-Fact, Award Attorney Fees, Remove Attorney-in-Fact, and Recognize Successor  11.57
    • C.  Form: Sample Order to Compel Accounting by Attorney-in-Fact, Award Attorney Fees, Remove Attorney-in-Fact, and Recognize Successor  11.58
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