Honoring Choices Minnesota

2014 Healthcare Directives

Update

Introduction of New Short Form

Update & Revision of Original Form

Introducing the new Short Form

This one-page (front & back) Health Care Directive is based

on a similar form developed by HealthPartners.

The Short Form was designed with a few key populations in mind:

People who are young and healthy who may not feel the need for the full directive now, but can complete this short form as a “starter directive.”

1

Non-English speakers whose primary concern is naming their Health Care Agent.

2

People who are vulnerable in some way, for example

• Experiencing homelessness or

separating themselves from an abusive situation

• Cognitively able to understand the role of a Health Care Agent but possibly not the details in the longer directive

3

It consists of 2 sections:

• Naming of a Health Care Agent

• Statement of any health

care instructions or treatment preferences

Like the original Health Care Directive, it requires either a notary public or 2 witnesses to become a valid document.

On the back, there are instructions about completing the form, and additional space for more instructions or comments.

The original Health Care Directive, or “Long Form” underwent some updates and revisions. Generally, the language was edited to be easier to read and understand, and some sections were re-arranged to make the document easier to follow. The next few pages will highlight the changes made.

The introductory section was changed slightly. Upon advice of health care attorneys, it was determined that this Health Care Directive will not be used for patients requiring intrusive mental health treatments (electroconvulsive therapy or neuroleptic medications.) NOTE: Minnesota law provides an Advance Psychiatric Directive (which is available from the Minnesota Disability Law Center: www.mndlc.org) for patients requiring these treatments.

A new line was added to indicate whether a professional medical interpreter was involved in the completion of the directive. This addresses questions which sometimes arise in families of non-native English speakers. NOTE: This document will be translated into other languages, though a timetable has not yet been set. The previous version can still be used with patients who speak Russian, Hmong, Spanish or Somali.

At the bottom of every page, a simple change was made. In the previous version, there was a section which said

“For health care provider/clinic use only”

which made people unsure what to write there. That was removed, and now the bottom of each page clearly asks for the name of the person completing the directive, and the date of the directive. NOTE: This writing of name and date on every page is to ensure all pages are labeled in case they become separated. It is not a legal requirement for the validity of the document.

Page two has just a couple of changes: Initial boxes replaced check boxes (on this page and throughout the document) to add a level of confidence that nothing is checked accidentally. Pregnancy is brought out as a factor requiring special authorization, as opposed to being simply listed in an overview paragraph of powers of the Health Care Agent.

Pages 3 and 4 have been re-arranged, with slight changes in wording, but have no major content changes.

Instructions about organ donation and autopsy were moved to page 5. Page 6, My Hopes and Wishes, stayed basically the same.

Page 7, the Legal Authority page, was re-designed with boxes to help clarify each requirement for proper completion of the document.

The final page was re-written in first-person voice to be consistent with the rest of the document. On all pages, the bottom line gives the website address and a phone number which can be used by anyone with questions or concerns.

This has been a collaborative project involving the skills of many people.

Special thanks to the Task Force Members, the Advisory Committee, and the Program Coordinators of our member systems.

We are also grateful for the guidance and advice provided by

legal teams and editing departments at Allina, Fairview, HealthEast, HealthPartners, and Park Nicollet.

Questions and comments may be directed to Honoring Choices Minnesota [email protected] or 612-362-3704