1| STATE OF OKLAHOMA | | | 2| 1st Session of the 60th Legislature (2025) | | | 3|SENATE BILL 937 By: Howard | | | 4| | | | 5| | | | 6| AS INTRODUCED | | | 7| An Act relating to health care; creating the Uniform | | Health Care Decisions Act of 2025; providing short | 8| title; specifying conditions for capacity for certain | | purpose; stipulating extent of certain right; | 9| providing for certain presumptions of capacity; | | providing for rebuttal of certain capacity; | 10| prohibiting certain individuals from making specified | | findings; authorizing creation of certain health care | 11| instruction; requiring certain documentation; | | providing for revocation of health care instruction | 12| under certain condition; authorizing creation of | | certain power of attorney; providing for | 13| disqualification of agency under certain conditions; | | specifying effect of health care decision; | 14| stipulating requirements for adult witness; defining | | presence of witness; allowing certain power of | 15| attorney to include health care instruction; | | providing for codification; and providing an | 16| effective date. | | | 17| | | | 18| | | | 19|BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA: | | | 20| SECTION 1. NEW LAW A new section of law to be codified | | | 21|in the Oklahoma Statutes as Section 3105A.1 of Title 63, unless | | | 22|there is created a duplication in numbering, reads as follows: | | | 23| This act shall be known and may be cited as the "Uniform Health | | | 24|Care Decisions Act of 2025". | | | Req. No. 329 Page 1 ___________________________________________________________________________
1| SECTION 2. NEW LAW A new section of law to be codified | | | 2|in the Oklahoma Statutes as Section 3105A.2 of Title 63, unless | | | 3|there is created a duplication in numbering, reads as follows: | | | 4| A. An individual has capacity for the purpose of this act if | | | 5|the individual: | | | 6| 1. Is willing and able to communicate a decision independently | | | 7|or with appropriate services, technological assistance, supported | | | 8|decision-making, or other reasonable accommodation; and | | | 9| 2. In making or revoking: | | | 10| a. a health care decision, understands the nature and | | | 11| consequences of the decision, including the primary | | | 12| risks and benefits of the decision, | | | 13| b. a health care instruction, understands the nature and | | | 14| consequences of the instruction, including the primary | | | 15| risks and benefits of the choices expressed in the | | | 16| instruction, and | | | 17| c. an appointment of an agent under a health care power | | | 18| of attorney or identification of a default surrogate, | | | 19| recognizes the identity of the individual being | | | 20| appointed or identified and understands the general | | | 21| nature of the relationship of the individual making | | | 22| the appointment or identification with the individual | | | 23| being appointed or identified. | | | 24| | | | Req. No. 329 Page 2 ___________________________________________________________________________
1| B. The right of an individual who has capacity to make a | | | 2|decision about the individual's health care is not affected by | | | 3|whether the individual creates or revokes an advance health care | | | 4|directive. | | | 5| SECTION 3. NEW LAW A new section of law to be codified | | | 6|in the Oklahoma Statutes as Section 3105A.3 of Title 63, unless | | | 7|there is created a duplication in numbering, reads as follows: | | | 8| A. An individual is presumed to have capacity to make or revoke | | | 9|a health care decision, health care instruction, and power of | | | 10|attorney for health care unless: | | | 11| 1. A court has found the individual lacks capacity to do so; or | | | 12| 2. The presumption is rebutted under subsection B of this | | | 13|section. | | | 14| B. Subject to the provisions of this act, a presumption under | | | 15|subsection A of this section may be rebutted by a finding that the | | | 16|individual lacks capacity: | | | 17| 1. Subject to subsection C of this section, made on the basis | | | 18|of a contemporaneous examination by any of the following: | | | 19| a. a physician, | | | 20| b. a psychologist licensed or otherwise authorized to | | | 21| practice in this state, | | | 22| c. an individual with training and expertise in the | | | 23| finding of lack of capacity who is licensed or | | | 24| otherwise authorized to practice in this state as: | | | Req. No. 329 Page 3 ___________________________________________________________________________
1| (1) a physician assistant, | | | 2| (2) an Advanced Practice Registered Nurse, or | | | 3| (3) a social worker, or | | | 4| d. a responsible health care professional not described | | | 5| in subparagraph a, b, or c of this paragraph if: | | | 6| (1) the individual about whom the finding is to be | | | 7| made is experiencing a health condition requiring | | | 8| a decision regarding health care treatment to be | | | 9| made promptly to avoid loss of life or serious | | | 10| harm to the health of the individual, and | | | 11| (2) an individual listed in subparagraph a, b, or c | | | 12| of this paragraph is not reasonably available; | | | 13| 2. Made in accordance with accepted standards of the profession | | | 14|and the scope of practice of the individual making the finding and | | | 15|to a reasonable degree of certainty; and | | | 16| 3. Documented in a record signed by the individual making the | | | 17|finding that includes an opinion of the cause, nature, extent, and | | | 18|probable duration of the lack of capacity. | | | 19| C. The finding under subsection B of this section may not be | | | 20|made by: | | | 21| 1. A family member of the individual presumed to have capacity; | | | 22| 2. The cohabitant of the individual or a descendant of the | | | 23|cohabitant; or | | | 24| | | | Req. No. 329 Page 4 ___________________________________________________________________________
1| 3. The individual's surrogate, a family member of the | | | 2|surrogate, or a descendant of the surrogate. | | | 3| D. If the finding under subsection B of this section was based | | | 4|on a condition the individual no longer has, or a responsible health | | | 5|care professional subsequently has good cause to believe the | | | 6|individual has capacity, the individual is presumed to have capacity | | | 7|unless a court finds the individual lacks capacity or the | | | 8|presumption is rebutted under subsection B of this section. | | | 9| SECTION 4. NEW LAW A new section of law to be codified | | | 10|in the Oklahoma Statutes as Section 3105A.4 of Title 63, unless | | | 11|there is created a duplication in numbering, reads as follows: | | | 12| A. An individual may create a health care instruction that | | | 13|expresses the individual's preferences for future health care, | | | 14|including preferences regarding: | | | 15| 1. Health care professionals or health care institutions; | | | 16| 2. How a health care decision will be made and communicated; | | | 17| 3. Persons that should or should not be consulted regarding a | | | 18|health care decision; | | | 19| 4. A person to serve as guardian for the individual if one is | | | 20|appointed; and | | | 21| 5. An individual to serve as a default surrogate. | | | 22| B. A health care professional to whom an individual | | | 23|communicates or provides an instruction under subsection A of this | | | 24|section shall document the instruction and the date of the | | | Req. No. 329 Page 5 ___________________________________________________________________________
1|instruction in the individual's medical record or communicate the | | | 2|instruction and date of the instruction to an administrator with | | | 3|responsibility for medical records of the health care institution | | | 4|providing health care to the individual, who shall document the | | | 5|instruction and the date of the instruction in the individual's | | | 6|medical record. | | | 7| C. A health care instruction made by an individual that | | | 8|conflicts with an earlier health care instruction made by the | | | 9|individual, including an instruction documented in a medical order, | | | 10|revokes the earlier instruction to the extent of the conflict. | | | 11| D. A health care instruction may be in the same record as a | | | 12|power of attorney for health care. | | | 13| SECTION 5. NEW LAW A new section of law to be codified | | | 14|in the Oklahoma Statutes as Section 3105A.5 of Title 63, unless | | | 15|there is created a duplication in numbering, reads as follows: | | | 16| A. An individual may create a power of attorney for health care | | | 17|to appoint an agent to make health care decisions for the | | | 18|individual. | | | 19| B. An individual is disqualified from acting as agent for an | | | 20|individual who lacks capacity to make health care decisions if: | | | 21| 1. A court finds that the potential agent poses a danger to the | | | 22|individual's well-being, even if the court does not issue a | | | 23|restraining order against the potential agent; or | | | 24| | | | Req. No. 329 Page 6 ___________________________________________________________________________
1| 2. The potential agent is an owner, operator, employee, or | | | 2|contractor of a nursing home or other residential care facility in | | | 3|which the individual resides or is receiving care, unless the owner, | | | 4|operator, employee, or contractor is a family member of the | | | 5|individual, the cohabitant of the individual, or a descendant of the | | | 6|cohabitant. | | | 7| C. A health care decision made by an agent is effective without | | | 8|judicial approval. | | | 9| D. A power of attorney for health care must be in a record, | | | 10|signed by the individual creating the power, and signed by an adult | | | 11|witness who: | | | 12| 1. Reasonably believes the act of the individual to create the | | | 13|power of attorney is voluntary and knowing; | | | 14| 2. Is not: | | | 15| a. the agent appointed by the individual, | | | 16| b. the agent's spouse, domestic partner, or cohabitant, | | | 17| or | | | 18| c. if the individual resides or is receiving care in a | | | 19| nursing home or other residential care facility, the | | | 20| owner, operator, employee, or contractor of the | | | 21| nursing home or other residential care facility; and | | | 22| 3. Is present when the individual signs the power of attorney | | | 23|or when the individual represents that the power of attorney | | | 24|reflects the individual's wishes. | | | Req. No. 329 Page 7 ___________________________________________________________________________
1| E. A witness under subsection D of this section is considered | | | 2|present if the witness and the individual are: | | | 3| 1. Physically present in the same location; | | | 4| 2. Using electronic means that allow for real-time audio and | | | 5|visual transmission and communication in real time to the same | | | 6|extent as if the witness and the individual were physically present | | | 7|in the same location; or | | | 8| 3. Able to speak to and hear each other in real time through | | | 9|audio connection if: | | | 10| a. the identity of the individual is personally known to | | | 11| the witness, or | | | 12| b. the witness is able to authenticate the identity of | | | 13| the individual by receiving accurate answers from the | | | 14| individual that enable the authentication. | | | 15| F. A power of attorney for health care may include a health | | | 16|care instruction. | | | 17| SECTION 6. This act shall become effective November 1, 2025. | | | 18| | | | 19| 60-1-329 DC 1/16/2025 1:14:00 PM | | | 20| | | | 21| | | | 22| | | | 23| | | | 24| | | | Req. No. 329 Page 8