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| Public Act 102-0794 |
| HB5047 Enrolled | LRB102 23511 LNS 32691 b |
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AN ACT concerning civil law. |
Be it enacted by the People of the State of Illinois, |
represented in the General Assembly: |
Section 5. The Illinois Power of Attorney Act is amended |
by changing Sections 4-4.1, 4-7, and 4-10 as follows: |
(755 ILCS 45/4-4.1) |
Sec. 4-4.1. Format. Documents, writings, forms, and copies |
referred to in this Article may be in hard copy or electronic |
format. Nothing in this Article is intended to prevent the |
population of a written instrument of a health care agency, |
document, writing, or form with electronic data. An agent may |
present an electronic device displaying an electronic copy of |
an executed form as proof of the health care agency. |
(Source: P.A. 101-163, eff. 1-1-20.) |
(755 ILCS 45/4-7) (from Ch. 110 1/2, par. 804-7) |
Sec. 4-7. Duties of health care providers and others in |
relation to health care agencies. Each health care provider |
and each other person with whom an agent deals under a health |
care agency shall be subject to the following duties and |
responsibilities: |
(a) It is the responsibility of the agent or patient to |
notify the health care provider of the existence of the health |
care agency and any amendment or revocation thereof. An agent |
may present an electronic device displaying an electronic copy |
of an executed form as proof of the health care agency. A |
health care provider furnished with a copy of a health care |
agency shall make it a part of the patient's medical records |
and shall enter in the records any change in or termination of |
the health care agency by the principal that becomes known to |
the provider. Whenever a provider believes a patient may lack |
capacity to give informed consent to health care which the |
provider deems necessary, the provider shall consult with any |
available health care agent known to the provider who then has |
power to act for the patient under a health care agency. |
(b) A health care decision made by an agent in accordance |
with the terms of a health care agency shall be complied with |
by every health care provider to whom the decision is |
communicated, subject to the provider's right to administer |
treatment for the patient's comfort care or alleviation of |
pain; but if the provider is unwilling to comply with the |
agent's decision, the provider shall promptly inform the agent |
who shall then be responsible to make the necessary |
arrangements for the transfer of the patient to another |
provider. It is understood that a provider who is unwilling to |
comply with the agent's decision will continue to afford |
reasonably necessary consultation and care in connection with |
the transfer. |
(c) At the patient's expense and subject to reasonable |
rules of the health care provider to prevent disruption of the |
patient's health care, each health care provider shall give an |
agent authorized to receive such information under a health |
care agency the same right the principal has to examine and |
copy any part or all of the patient's medical records that the |
agent deems relevant to the exercise of the agent's powers, |
whether the records relate to mental health or any other |
medical condition and whether they are in the possession of or |
maintained by any physician, psychiatrist, psychologist, |
therapist, hospital, nursing home or other health care |
provider. |
(d) If and to the extent a health care agency empowers the |
agent to (1) make an anatomical gift on behalf of the principal |
under the Illinois Anatomical Gift Act, as now or hereafter |
amended, or (2) authorize an autopsy of the principal's body |
pursuant to Section 2 of "An Act in relation to autopsy of dead |
bodies", approved August 13, 1965, as now or hereafter |
amended, or (3) direct the disposition of the principal's |
remains, the decision by an authorized agent as to anatomical |
gift, autopsy approval or remains disposition shall be deemed |
the act of the principal and shall control over the decision of |
other persons who might otherwise have priority; and each |
person to whom a direction by the agent in accordance with the |
terms of the agency is communicated shall comply with such |
direction. |
(Source: P.A. 93-794, eff. 7-22-04.) |
(755 ILCS 45/4-10) (from Ch. 110 1/2, par. 804-10) |
Sec. 4-10. Statutory short form power of attorney for |
health care. |
(a) The form prescribed in this Section (sometimes also |
referred to in this Act as the "statutory health care power") |
may be used to grant an agent powers with respect to the |
principal's own health care; but the statutory health care |
power is not intended to be exclusive nor to cover delegation |
of a parent's power to control the health care of a minor |
child, and no provision of this Article shall be construed to |
invalidate or bar use by the principal of any other or |
different form of power of attorney for health care. |
Nonstatutory health care powers must be executed by the |
principal, designate the agent and the agent's powers, and |
comply with the limitations in Section 4-5 of this Article, |
but they need not be witnessed or conform in any other respect |
to the statutory health care power. |
No specific format is required for the statutory health |
care power of attorney other than the notice must precede the |
form. The statutory health care power may be included in or |
combined with any other form of power of attorney governing |
property or other matters. |
The signature and execution requirements set forth in this |
Article are satisfied by: (i) written signatures or initials; |
or (ii) electronic signatures or computer-generated signature |
codes. Electronic documents under this Act may be created, |
signed, or revoked electronically using a generic, |
technology-neutral system in which each user is assigned a |
unique identifier that is securely maintained and in a manner |
that meets the regulatory requirements for a digital or |
electronic signature. Compliance with the standards defined in |
the Uniform Electronic Transactions Act or the implementing |
rules of the Hospital Licensing Act for medical record entry |
authentication for author validation of the documentation, |
content accuracy, and completeness meets this standard. |
(b) The Illinois Statutory Short Form Power of Attorney |
for Health Care shall be substantially as follows: |
NOTICE TO THE INDIVIDUAL SIGNING |
THE POWER OF ATTORNEY FOR HEALTH CARE |
No one can predict when a serious illness or accident |
might occur. When it does, you may need someone else to speak |
or make health care decisions for you. If you plan now, you can |
increase the chances that the medical treatment you get will |
be the treatment you want. |
In Illinois, you can choose someone to be your "health |
care agent". Your agent is the person you trust to make health |
care decisions for you if you are unable or do not want to make |
them yourself. These decisions should be based on your |
personal values and wishes. |
It is important to put your choice of agent in writing. The |
written form is often called an "advance directive". You may |
use this form or another form, as long as it meets the legal |
requirements of Illinois. There are many written and online |
on-lineresources to guide you and your loved ones in having a |
conversation about these issues. You may find it helpful to |
look at these resources while thinking about and discussing |
your advance directive. |
WHAT ARE THE THINGS I WANT MY |
HEALTH CARE AGENT TO KNOW? |
The selection of your agent should be considered |
carefully, as your agent will have the ultimate |
decision-making authority once this document goes into effect, |
in most instances after you are no longer able to make your own |
decisions. While the goal is for your agent to make decisions |
in keeping with your preferences and in the majority of |
circumstances that is what happens, please know that the law |
does allow your agent to make decisions to direct or refuse |
health care interventions or withdraw treatment. Your agent |
will need to think about conversations you have had, your |
personality, and how you handled important health care issues |
in the past. Therefore, it is important to talk with your agent |
and your family about such things as: |
(i) What is most important to you in your life? |
(ii) How important is it to you to avoid pain and |
suffering? |
(iii) If you had to choose, is it more important to you |
to live as long as possible, or to avoid prolonged |
suffering or disability? |
(iv) Would you rather be at home or in a hospital for |
the last days or weeks of your life? |
(v) Do you have religious, spiritual, or cultural |
beliefs that you want your agent and others to consider? |
(vi) Do you wish to make a significant contribution to |
medical science after your death through organ or whole |
body donation? |
(vii) Do you have an existing advance directive, such |
as a living will, that contains your specific wishes about |
health care that is only delaying your death? If you have |
another advance directive, make sure to discuss with your |
agent the directive and the treatment decisions contained |
within that outline your preferences. Make sure that your |
agent agrees to honor the wishes expressed in your advance |
directive. |
WHAT KIND OF DECISIONS CAN MY AGENT MAKE? |
If there is ever a period of time when your physician |
determines that you cannot make your own health care |
decisions, or if you do not want to make your own decisions, |
some of the decisions your agent could make are to: |
(i) talk with physicians and other health care |
providers about your condition. |
(ii) see medical records and approve who else can see |
them. |
(iii) give permission for medical tests, medicines, |
surgery, or other treatments. |
(iv) choose where you receive care and which |
physicians and others provide it. |
(v) decide to accept, withdraw, or decline treatments |
designed to keep you alive if you are near death or not |
likely to recover. You may choose to include guidelines |
and/or restrictions to your agent's authority. |
(vi) agree or decline to donate your organs or your |
whole body if you have not already made this decision |
yourself. This could include donation for transplant, |
research, and/or education. You should let your agent know |
whether you are registered as a donor in the First Person |
Consent registry maintained by the Illinois Secretary of |
State or whether you have agreed to donate your whole body |
for medical research and/or education. |
(vii) decide what to do with your remains after you |
have died, if you have not already made plans. |
(viii) talk with your other loved ones to help come to |
a decision (but your designated agent will have the final |
say over your other loved ones). |
Your agent is not automatically responsible for your |
health care expenses. |
WHOM SHOULD I CHOOSE TO BE MY HEALTH CARE AGENT? |
You can pick a family member, but you do not have to. Your |
agent will have the responsibility to make medical treatment |
decisions, even if other people close to you might urge a |
different decision. The selection of your agent should be done |
carefully, as he or she will have ultimate decision-making |
authority for your treatment decisions once you are no longer |
able to voice your preferences. Choose a family member, |
friend, or other person who: |
(i) is at least 18 years old; |
(ii) knows you well; |
(iii) you trust to do what is best for you and is |
willing to carry out your wishes, even if he or she may not |
agree with your wishes; |
(iv) would be comfortable talking with and questioning |
your physicians and other health care providers; |
(v) would not be too upset to carry out your wishes if |
you became very sick; and |
(vi) can be there for you when you need it and is |
willing to accept this important role. |
WHAT IF MY AGENT IS NOT AVAILABLE OR IS |
UNWILLING TO MAKE DECISIONS FOR ME? |
If the person who is your first choice is unable to carry |
out this role, then the second agent you chose will make the |
decisions; if your second agent is not available, then the |
third agent you chose will make the decisions. The second and |
third agents are called your successor agents and they |
function as back-up agents to your first choice agent and may |
act only one at a time and in the order you list them. |
WHAT WILL HAPPEN IF I DO NOT |
CHOOSE A HEALTH CARE AGENT? |
If you become unable to make your own health care |
decisions and have not named an agent in writing, your |
physician and other health care providers will ask a family |
member, friend, or guardian to make decisions for you. In |
Illinois, a law directs which of these individuals will be |
consulted. In that law, each of these individuals is called a |
"surrogate". |
There are reasons why you may want to name an agent rather |
than rely on a surrogate: |
(i) The person or people listed by this law may not be |
who you would want to make decisions for you. |
(ii) Some family members or friends might not be able |
or willing to make decisions as you would want them to. |
(iii) Family members and friends may disagree with one |
another about the best decisions. |
(iv) Under some circumstances, a surrogate may not be |
able to make the same kinds of decisions that an agent can |
make. |
WHAT IF THERE IS NO ONE AVAILABLE |
WHOM I TRUST TO BE MY AGENT? |
In this situation, it is especially important to talk to |
your physician and other health care providers and create |
written guidance about what you want or do not want, in case |
you are ever critically ill and cannot express your own |
wishes. You can complete a living will. You can also write your |
wishes down and/or discuss them with your physician or other |
health care provider and ask him or her to write it down in |
your chart. You might also want to use written or online |
on-lineresources to guide you through this process. |
WHAT DO I DO WITH THIS FORM ONCE I COMPLETE IT? |
Follow these instructions after you have completed the |
form: |
(i) Sign the form in front of a witness. See the form |
for a list of who can and cannot witness it. |
(ii) Ask the witness to sign it, too. |
(iii) There is no need to have the form notarized. |
(iv) Give a copy to your agent and to each of your |
successor agents. |
(v) Give another copy to your physician. |
(vi) Take a copy with you when you go to the hospital. |
(vii) Show it to your family and friends and others |
who care for you. |
WHAT IF I CHANGE MY MIND? |
You may change your mind at any time. If you do, tell |
someone who is at least 18 years old that you have changed your |
mind, and/or destroy your document and any copies. If you |
wish, fill out a new form and make sure everyone you gave the |
old form to has a copy of the new one, including, but not |
limited to, your agents and your physicians. If you are |
concerned you may revoke your power of attorney at a time when |
you may need it the most, you may initial the box at the end of |
the form to indicate that you would like a 30-day waiting |
period after you voice your intent to revoke your power of |
attorney. This means if your agent is making decisions for you |
during that time, your agent can continue to make decisions on |
your behalf. This election is purely optional, and you do not |
have to choose it. If you do not choose this option, you can |
change your mind and revoke the power of attorney at any time. |
WHAT IF I DO NOT WANT TO USE THIS FORM? |
In the event you do not want to use the Illinois statutory |
form provided here, any document you complete must be executed |
by you, designate an agent who is over 18 years of age and not |
prohibited from serving as your agent, and state the agent's |
powers, but it need not be witnessed or conform in any other |
respect to the statutory health care power. |
If you have questions about the use of any form, you may |
want to consult your physician, other health care provider, |
and/or an attorney. |
MY POWER OF ATTORNEY FOR HEALTH CARE |
THIS POWER OF ATTORNEY REVOKES ALL PREVIOUS POWERS OF ATTORNEY |
FOR HEALTH CARE. (You must sign this form and a witness must |
also sign it before it is valid) |
My name (Print your full name):. |
My address:. |
I WANT THE FOLLOWING PERSON TO BE MY HEALTH CARE AGENT |
(an agent is your personal representative under state and |
federal law): |
(Agent name). |
(Agent address). |
(Agent phone number). |
(Please check box if applicable) . If a guardian of my |
person is to be appointed, I nominate the agent acting under |
this power of attorney as guardian. |
SUCCESSOR HEALTH CARE AGENT(S) (optional): |
If the agent I selected is unable or does not want to make |
health care decisions for me, then I request the person(s) I |
name below to be my successor health care agent(s). Only one |
person at a time can serve as my agent (add another page if you |
want to add more successor agent names): |
| . |
(Successor agent #1 name, address and phone number) |
| . |
(Successor agent #2 name, address and phone number) |
MY AGENT CAN MAKE HEALTH CARE DECISIONS FOR ME, INCLUDING: |
(i) Deciding to accept, withdraw, or decline treatment |
for any physical or mental condition of mine, including |
life-and-death decisions. |
(ii) Agreeing to admit me to or discharge me from any |
hospital, home, or other institution, including a mental |
health facility. |
(iii) Having complete access to my medical and mental |
health records, and sharing them with others as needed, |
including after I die. |
(iv) Carrying out the plans I have already made, or, |
if I have not done so, making decisions about my body or |
remains, including organ, tissue or whole body donation, |
autopsy, cremation, and burial. |
The above grant of power is intended to be as broad as |
possible so that my agent will have the authority to make any |
decision I could make to obtain or terminate any type of health |
care, including withdrawal of nutrition and hydration and |
other life-sustaining measures. |
I AUTHORIZE MY AGENT TO (please check any one box): |
. Make decisions for me only when I cannot make them for |
myself. The physician(s) taking care of me will determine |
when I lack this ability. |
(If no box is checked, then the box above shall be |
implemented.) OR |
. Make decisions for me only when I cannot make them for |
myself. The physician(s) taking care of me will determine |
when I lack this ability. Starting now, for the purpose of |
assisting me with my health care plans and decisions, my |
agent shall have complete access to my medical and mental |
health records, the authority to share them with others as |
needed, and the complete ability to communicate with my |
personal physician(s) and other health care providers, |
including the ability to require an opinion of my |
physician as to whether I lack the ability to make |
decisions for myself. OR |
. Make decisions for me starting now and continuing |
after I am no longer able to make them for myself. While I |
am still able to make my own decisions, I can still do so |
if I want to. |
The subject of life-sustaining treatment is of particular |
importance. Life-sustaining treatments may include tube |
feedings or fluids through a tube, breathing machines, and |
CPR. In general, in making decisions concerning |
life-sustaining treatment, your agent is instructed to |
consider the relief of suffering, the quality as well as the |
possible extension of your life, and your previously expressed |
wishes. Your agent will weigh the burdens versus benefits of |
proposed treatments in making decisions on your behalf. |
Additional statements concerning the withholding or |
removal of life-sustaining treatment are described below. |
These can serve as a guide for your agent when making decisions |
for you. Ask your physician or health care provider if you have |
any questions about these statements. |
SELECT ONLY ONE STATEMENT BELOW THAT BEST EXPRESSES YOUR |
WISHES (optional): |
. The quality of my life is more important than the |
length of my life. If I am unconscious and my attending |
physician believes, in accordance with reasonable medical |
standards, that I will not wake up or recover my ability to |
think, communicate with my family and friends, and |
experience my surroundings, I do not want treatments to |
prolong my life or delay my death, but I do want treatment |
or care to make me comfortable and to relieve me of pain. |
. Staying alive is more important to me, no matter how |
sick I am, how much I am suffering, the cost of the |
procedures, or how unlikely my chances for recovery are. I |
want my life to be prolonged to the greatest extent |
possible in accordance with reasonable medical standards. |
SPECIFIC LIMITATIONS TO MY AGENT'S DECISION-MAKING AUTHORITY: |
The above grant of power is intended to be as broad as |
possible so that your agent will have the authority to make any |
decision you could make to obtain or terminate any type of |
health care. If you wish to limit the scope of your agent's |
powers or prescribe special rules or limit the power to |
authorize autopsy or dispose of remains, you may do so |
specifically in this form. |
| . |
| . |
My signature:. |
Today's date:. |
DELAYED REVOCATION |
. I elect to delay revocation of this power of attorney |
for 30 days after I communicate my intent to revoke it. |
. I elect for the revocation of this power of attorney |
to take effect immediately if I communicate my intent to |
revoke it. |
HAVE YOUR WITNESS AGREE TO WHAT IS WRITTEN BELOW, AND THEN |
COMPLETE THE SIGNATURE PORTION: |
I am at least 18 years old. (check one of the options |
below): |
. I saw the principal sign this document, or |
. the principal told me that the signature or mark on |
the principal signature line is his or hers. |
I am not the agent or successor agent(s) named in this |
document. I am not related to the principal, the agent, or the |
successor agent(s) by blood, marriage, or adoption. I am not |
the principal's physician, advanced practice registered nurse, |
dentist, podiatric physician, optometrist, psychologist, or a |
relative of one of those individuals. I am not an owner or |
operator (or the relative of an owner or operator) of the |
health care facility where the principal is a patient or |
resident. |
Witness printed name:. |
Witness address:. |
Witness signature:. |
Today's date:. |
(c) The statutory short form power of attorney for health |
care (the "statutory health care power") authorizes the agent |
to make any and all health care decisions on behalf of the |
principal which the principal could make if present and under |
no disability, subject to any limitations on the granted |
powers that appear on the face of the form, to be exercised in |
such manner as the agent deems consistent with the intent and |
desires of the principal. The agent will be under no duty to |
exercise granted powers or to assume control of or |
responsibility for the principal's health care; but when |
granted powers are exercised, the agent will be required to |
use due care to act for the benefit of the principal in |
accordance with the terms of the statutory health care power |
and will be liable for negligent exercise. The agent may act in |
person or through others reasonably employed by the agent for |
that purpose but may not delegate authority to make health |
care decisions. The agent may sign and deliver all |
instruments, negotiate and enter into all agreements, and do |
all other acts reasonably necessary to implement the exercise |
of the powers granted to the agent. Without limiting the |
generality of the foregoing, the statutory health care power |
shall include the following powers, subject to any limitations |
appearing on the face of the form: |
(1) The agent is authorized to give consent to and |
authorize or refuse, or to withhold or withdraw consent |
to, any and all types of medical care, treatment, or |
procedures relating to the physical or mental health of |
the principal, including any medication program, surgical |
procedures, life-sustaining treatment, or provision of |
food and fluids for the principal. |
(2) The agent is authorized to admit the principal to |
or discharge the principal from any and all types of |
hospitals, institutions, homes, residential or nursing |
facilities, treatment centers, and other health care |
institutions providing personal care or treatment for any |
type of physical or mental condition. The agent shall have |
the same right to visit the principal in the hospital or |
other institution as is granted to a spouse or adult child |
of the principal, any rule of the institution to the |
contrary notwithstanding. |
(3) The agent is authorized to contract for any and |
all types of health care services and facilities in the |
name of and on behalf of the principal and to bind the |
principal to pay for all such services and facilities, and |
to have and exercise those powers over the principal's |
property as are authorized under the statutory property |
power, to the extent the agent deems necessary to pay |
health care costs; and the agent shall not be personally |
liable for any services or care contracted for on behalf |
of the principal. |
(4) At the principal's expense and subject to |
reasonable rules of the health care provider to prevent |
disruption of the principal's health care, the agent shall |
have the same right the principal has to examine and copy |
and consent to disclosure of all the principal's medical |
records that the agent deems relevant to the exercise of |
the agent's powers, whether the records relate to mental |
health or any other medical condition and whether they are |
in the possession of or maintained by any physician, |
psychiatrist, psychologist, therapist, hospital, nursing |
home, or other health care provider. The authority under |
this paragraph (4) applies to any information governed by |
the Health Insurance Portability and Accountability Act of |
1996 ("HIPAA") and regulations thereunder. The agent |
serves as the principal's personal representative, as that |
term is defined under HIPAA and regulations thereunder. |
(5) The agent is authorized: to direct that an autopsy |
be made pursuant to Section 2 of the Autopsy Act; to make a |
disposition of any part or all of the principal's body |
pursuant to the Illinois Anatomical Gift Act, as now or |
hereafter amended; and to direct the disposition of the |
principal's remains. |
(6) At any time during which there is no executor or |
administrator appointed for the principal's estate, the |
agent is authorized to continue to pursue an application |
or appeal for government benefits if those benefits were |
applied for during the life of the principal. |
(d) A physician may determine that the principal is unable |
to make health care decisions for himself or herself only if |
the principal lacks decisional capacity, as that term is |
defined in Section 10 of the Health Care Surrogate Act. |
(e) If the principal names the agent as a guardian on the |
statutory short form, and if a court decides that the |
appointment of a guardian will serve the principal's best |
interests and welfare, the court shall appoint the agent to |
serve without bond or security. |
(f) If the agent presents the statutory short form |
electronically, an attending physician, emergency medical |
services personnel as defined by Section 3.5 of the Emergency |
Medical Services (EMS) Systems Act, or health care provider |
shall not refuse to give effect to a health care agency if the |
agent presents an electronic device displaying an electronic |
copy of an executed form as proof of the health care agency. |
Any person or entity that provides a statutory short form to |
the public shall post for a period of 2 years information on |
its website regarding the changes made by this amendatory Act |
of the 102nd General Assembly. |
(Source: P.A. 101-81, eff. 7-12-19; 101-163, eff. 1-1-20; |
102-38, eff. 6-25-21; 102-181, eff. 7-30-21; revised 9-22-21.)
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