00 CS FOR HOUSE BILL NO. 25(JUD) 01 "An Act relating to health care decisions, including do not resuscitate orders, 02 anatomical gifts, and mental health treatment decisions, and to powers of attorney 03 relating to health care, including anatomical gifts and mental health treatment 04 decisions; and providing for an effective date." 05 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 06  * Section 1. The uncodified law of the State of Alaska is amended by adding a new section 07 to read: 08 PURPOSE. A principal purpose of this Act is to provide a comprehensive coordinated 09 approach to the making of health care decisions, including anatomical gifts. To achieve this 10 purpose, this Act repeals the current statutory devices that cover health care decisions and 11 consolidates the subject into one chapter.  12  * Sec. 2. AS 12.65.100 is amended to read: 13 Sec. 12.65.100. Unclaimed bodies. When a person dies and no person 14 appears to claim the body for burial, and no provision is made for the body under 01 AS 13.52 [AS 13.50], the Department of Health and Social Services, upon 02 notification, shall request a court order authorizing the body to be plainly and decently 03 buried or cremated and the remains decently interred. A judicial officer shall issue the 04 requested order upon the sworn testimony or statement of a representative of the 05 Department of Health and Social Services that a person has not appeared to claim the 06 body for burial and provision is not made for the body under AS 13.52 [AS 13.50]. 07  * Sec. 3. AS 13 is amended by adding a new chapter to read: 08 Chapter 52. Health Care Decisions Act. 09 Sec. 13.52.010. Advance health care directives. (a) Except as provided in 10 AS 13.52.170(a) an adult or emancipated minor may give an individual instruction. 11 The instruction may be oral or written. The instruction may be limited to take effect 12 only if a specified condition arises. 13 (b) An adult or emancipated minor may execute a durable power of attorney 14 for health care, which may authorize the agent to make any health care decision the 15 principal could have made while having capacity. The power remains in effect 16 notwithstanding the principal's later incapacity and may include individual 17 instructions. The power must be in writing, contain the date of its execution, be 18 signed by the principal, and be witnessed by one of the following methods: 19 (1) signed by at least two individuals, each of whom witnessed either 20 the signing of the instrument by the principal or the principal's acknowledgment of the 21 signature of the instrument; or 22 (2) acknowledged before a notary public at a place in this state. 23 (c) Unless related to the principal by blood, marriage, or adoption, an agent 24 under a durable power of attorney for health care may not be an owner, operator, or 25 employee of the health care institution at which the principal is receiving care. 26 (d) A witness for a durable power of attorney for health care may not be 27 (1) a health care provider; 28 (2) an employee of a health care provider or facility; or 29 (3) the agent. 30 (e) At least one of the individuals used as a witness for a durable power of 31 attorney for health care shall be someone who is not 01 (1) related to the principal by blood, marriage, or adoption; or 02 (2) entitled to a portion of the estate of the principal upon the 03 principal's death under a will or codicil of the principal existing at the time of 04 execution of the durable power of attorney for health care or by operation of law then 05 existing. 06 (f) Unless otherwise specified in the durable power of attorney for health care, 07 the authority of an agent becomes effective only upon a determination that the 08 principal lacks capacity and ceases to be effective upon a determination that the 09 principal has recovered capacity. 10 (g) Unless otherwise specified in a written advance health care directive, a 11 determination that an individual lacks or has recovered capacity, or that another 12 condition exists that affects an individual instruction or the authority of an agent, shall 13 be made by 14 (1) the primary physician, except in the case of mental illness; 15 (2) a court in the case of mental illness, unless the situation is an 16 emergency; or 17 (3) the primary physician or another health care provider in the case of 18 mental illness where the situation is an emergency. 19 (h) An agent shall make a health care decision in accordance with the 20 principal's individual instructions, if any, and other wishes to the extent known to the 21 agent. Otherwise, the agent shall make the decision in accordance with the agent's 22 determination of the principal's best interest. In determining the principal's best 23 interest, the agent shall consider the principal's personal values to the extent known to 24 the agent. 25 (i) A health care decision made by an agent for a principal is effective without 26 judicial approval. 27 (j) A written advance health care directive may include the individual's 28 nomination of a guardian of the person. 29 (k) An advance health care directive is valid for purposes of this chapter if it 30 complies with this chapter or if it was executed in compliance with the laws of the 31 state where it was executed. 01 Sec. 13.52.020. Revocation of advance health care directive. (a) Except in 02 the case of mental illness under (c) of this section, an individual may revoke the 03 designation of an agent only by a signed writing or by personally informing the 04 supervising health care provider. 05 (b) Except in the case of mental illness under (c) of this section, an individual 06 may revoke all or part of an advance health care directive, other than the designation 07 of an agent, at any time and in any manner that communicates an intent to revoke. 08 (c) In the case of mental illness, an advance health care directive may 09 be revoked in whole or in part at any time by the principal if the principal does not 10 lack capacity and is not incompetent, a revocation is effective when a capable, 11 competent principal communicates the revocation to the attending physician or other 12 health care provider, and the attending physician or other health care provider shall 13 note the revocation on the principal's medical record. In the case of mental illness, the 14 authority of a named agent and an alternative agent named in the advance health care 15 directive continues in effect as long as the advance health care directive appointing the 16 agent is in effect or until the agent has withdrawn. For the purposes of this subsection, 17 a person is considered incompetent when it is the opinion of the court in a 18 guardianship proceeding under AS 13.26, the opinion of two physicians, at least one 19 of whom is a psychiatrist, or the opinion of a physician and a professional mental 20 health clinician, that an individual's ability to receive and evaluate information 21 effectively or communicate decisions is impaired to the extent that the individual lacks 22 the capacity to make mental health treatment decisions. 23 (d) A health care provider, agent, guardian, or surrogate who is informed of a 24 revocation shall promptly communicate the fact of the revocation to the supervising 25 health care provider and to any health care institution at which the patient is receiving 26 care. 27 (e) A decree of annulment, divorce, dissolution of marriage, or legal 28 separation revokes a previous designation of a spouse as agent unless otherwise 29 specified in the decree or in a durable power of attorney for health care. 30 (f) An advance health care directive that conflicts with an earlier advance 31 health care directive revokes the earlier directive to the extent of the conflict. 01 Sec. 13.52.025. Rescission of withdrawal by agent. A person who has 02 withdrawn as an agent may rescind the withdrawal by executing an acceptance after 03 the date of the withdrawal. A person who rescinds a withdrawal shall give notice to 04 the principal if the principal is capable or to the principal's health care provider if the 05 principal is incapable. 06 Sec. 13.52.030. Decisions by surrogate. (a) Except in the case of mental 07 health treatment, a surrogate may make a health care decision for a patient who is an 08 adult or emancipated minor if an agent or guardian has not been appointed or the agent 09 or guardian is not reasonably available, and if the patient has been determined by the 10 primary physician to lack capacity. 11 (b) A surrogate may make a decision regarding mental health treatment for a 12 patient who is an adult or emancipated minor if 13 (1) an agent or guardian has not been appointed or the agent or 14 guardian is not reasonably available; 15 (2) the mental health treatment is needed on an emergency basis; and 16 (3) the patient has been determined to lack capacity by 17 (A) two physicians, one of whom is a psychiatrist; or 18 (B) a physician and a professional mental health clinician. 19 (c) Except as provided for anatomical gifts in AS 13.52.170(b), an adult or 20 emancipated minor may designate an individual to act as surrogate by personally 21 informing the supervising health care provider. In the absence of a designation, or if 22 the designee is not reasonably available, a member of the following classes of the 23 patient's family who is reasonably available, in descending order of priority, may act 24 as surrogate: 25 (1) the spouse, unless legally separated; 26 (2) an adult child; 27 (3) a parent; or 28 (4) an adult sibling. 29 (d) If none of the individuals eligible to act as surrogate under (c) of this 30 section is reasonably available, an adult who has exhibited special care and concern 31 for the patient, who is familiar with the patient's personal values, and who is 01 reasonably available may act as surrogate. 02 (e) A surrogate shall communicate the surrogate's assumption of authority as 03 promptly as practicable to the members of the patient's family specified in (c) of this 04 section who can be readily contacted. 05 (f) If more than one member of a class under (c)(2) - (4) of this section 06 assumes authority to act as surrogate, the members of that class do not agree on a 07 health care decision, and the supervising health care provider is informed of the 08 disagreement, the supervising health care provider shall comply with the decision of a 09 majority of the members of that class who have communicated their views to the 10 provider. If the class is evenly divided concerning the health care decision and the 11 supervising health care provider is informed of the even division, that class and all 12 individuals having a lower priority under (c)(2) - (4) of this section are disqualified 13 from making the decision, and the primary physician shall make the decision based on 14 the best interests of the patient. 15 (g) A surrogate shall make a health care decision in accordance with the 16 patient's individual instructions, if any, and other wishes to the extent known to the 17 surrogate. Otherwise, the surrogate shall make the decision in accordance with the 18 surrogate's determination of the patient's best interest. In determining the patient's best 19 interest, the surrogate shall consider the patient's personal values to the extent known 20 to the surrogate. 21 (h) A health care decision made by a surrogate for a patient is effective 22 without judicial approval. 23 (i) An individual may, at any time, disqualify another person, including a 24 member of the individual's family, from acting as the individual's surrogate by a 25 signed writing or by personally informing the supervising health care provider of the 26 disqualification. 27 (j) Unless related to the patient by blood, marriage, or adoption, a surrogate 28 may not be an owner, operator, or employee of a residential long-term health care 29 institution at which the patient is receiving care. 30 (k) A supervising health care provider may require an individual claiming the 31 right to act as a surrogate for a patient to provide a written declaration under penalty of 01 perjury stating facts and circumstances reasonably sufficient to establish the claimed 02 authority. 03 Sec. 13.52.040. Decisions by guardian. (a) A guardian shall comply with 04 the ward's individual instructions and may not revoke a ward's advance health care 05 directive executed before the ward's incapacity. 06 (b) Unless there is a court order to the contrary, a health care decision of an 07 agent takes precedence over that of a guardian. 08 (c) Except as provided in (a) of this section, a health care decision made by a 09 guardian for the ward is effective without judicial approval. 10 Sec. 13.52.050. Obligations of health care provider. (a) Before 11 implementing a health care decision made for a patient, a supervising health care 12 provider, if possible, shall promptly communicate to the patient the decision made and 13 the identity of the person making the decision. 14 (b) A supervising health care provider who knows of the existence of an 15 advance health care directive, a revocation of an advance health care directive, or a 16 designation or disqualification of a surrogate shall promptly record its existence in the 17 patient's health care record, shall request a copy if it is in writing, and shall arrange for 18 its maintenance in the health care record if a copy is furnished. 19 (c) A supervising health care provider who makes or is informed of a 20 determination that a patient lacks or has recovered capacity, or that another condition 21 exists that affects an individual instruction or the authority of an agent, a guardian, or a 22 surrogate, shall promptly record the determination in the patient's health care record 23 and communicate the determination to the patient, if possible, and to any person then 24 authorized to make health care decisions for the patient. 25 (d) Except as provided in (e) and (f) of this section, a health care provider or 26 institution providing care to a patient shall comply with 27 (1) an individual instruction of the patient and with a reasonable 28 interpretation of that instruction made by a person then authorized to make health care 29 decisions for the patient; and 30 (2) a health care decision for the patient made by a person then 31 authorized to make health care decisions for the patient to the same extent as if the 01 decision had been made by the patient while having capacity. 02 (e) A health care provider may decline to comply with an individual 03 instruction or a health care decision for reasons of conscience, except for a do not 04 resuscitate order. A health care institution may decline to comply with an individual 05 instruction or health care decision if the instruction or decision is contrary to a policy 06 of the institution that is expressly based on reasons of conscience and if the policy was 07 timely communicated to the patient or to a person then authorized to make health care 08 decisions for the patient. 09 (f) A health care provider or institution may decline to comply with an 10 individual instruction or a health care decision that requires medically ineffective 11 health care or health care contrary to generally accepted health care standards 12 applicable to the health care provider or institution. 13 (g) A health care provider or institution that declines to comply with an 14 individual instruction or a health care decision shall 15 (1) promptly inform the patient, if possible, and any person then 16 authorized to make health care decisions for the patient that the provider or institution 17 has declined to comply with the instruction or decision; 18 (2) provide continuing care to the patient until a transfer is effected; 19 and 20 (3) unless the patient or person then authorized to make health care 21 decisions for the patient refuses assistance, immediately make all reasonable efforts to 22 assist in the transfer of the patient to another health care provider or institution that is 23 willing to comply with the instruction or decision. 24 (h) Except as provided for civil commitments under AS 47.30.817, a health 25 care provider or institution may not require or prohibit the execution or revocation of 26 an advance health care directive as a condition for providing health care. 27 Sec. 13.52.060. Do not resuscitate protocol and identification  28 requirements. (a) An attending physician may issue a do not resuscitate order for a 29 patient of the physician. The physician shall document the grounds for the order in the 30 patient's medical file. 31 (b) The department shall by regulation adopt a protocol, subject to the 01 approval of the State Medical Board, for do not resuscitate orders that set out a 02 standardized method of procedure for the withholding of cardiopulmonary 03 resuscitation by health care providers and health care institutions. 04 (c) The department shall develop standardized designs and symbols for do not 05 resuscitate identification cards, forms, necklaces, and bracelets that signify, when 06 carried or worn, that the carrier or wearer is an individual for whom a physician has 07 issued a do not resuscitate order. 08 (d) A health care provider other than a physician shall comply with the 09 protocol adopted under (b) of this section for do not resuscitate orders when the health 10 care provider is presented with a do not resuscitate identification, an oral do not 11 resuscitate order issued directly by a physician if the applicable hospital allows oral do 12 not resuscitate orders, or a written do not resuscitate order entered on and as required 13 by a form prescribed by the department. 14 (e) Notwithstanding (d) of this section, if an individual has made an 15 anatomical gift to occur at death and is in a hospital when a do not resuscitate order is 16 to be implemented for the individual, the do not resuscitate order may not be 17 implemented until the subject of the anatomical gift can be evaluated to determine if it 18 is suitable for donation. 19 (f) A physician may not revoke a do not resuscitate order at the request of a 20 person, and a person may not make a do not resuscitate order ineffective, unless the 21 person making the request or proposing to make the order ineffective is the person for 22 whom the order has been issued. However, if the person for whom the order has been 23 issued is not capable of expressing an opinion on the subject, the request or proposal 24 may be made by the parent or guardian of the person for whom the order has been 25 issued if the person for whom the order has been issued is under 18 years of age. 26 Sec. 13.52.070. Health care information. Unless otherwise specified in an 27 advance health care directive, a person then authorized to make health care decisions 28 for a patient has the same rights as the patient to request, receive, examine, copy, and 29 consent to the disclosure of medical or other health care information. 30 Sec. 13.52.080. Immunities. (a) A health care provider or institution acting 31 in good faith and in accordance with generally accepted health care standards 01 applicable to the health care provider or institution is not subject to civil or criminal 02 liability or to discipline for unprofessional conduct for 03 (1) complying with a health care decision of a person apparently 04 having authority to make a health care decision for a patient, including a decision to 05 withhold or withdraw health care; 06 (2) declining to comply with a health care decision of a person based 07 on a reasonable belief that the person then lacked authority; 08 (3) complying with an advance health care directive and reasonably 09 assuming that the directive was valid when made and has not been revoked or 10 terminated; 11 (4) participating in the withholding or withdrawal of cardiopulmonary 12 resuscitation or other life-sustaining procedures under the direction or with the 13 authorization of a physician or upon discovery of do not resuscitate identification upon 14 an individual; 15 (5) causing or participating in providing cardiopulmonary resuscitation 16 or other life-sustaining procedures 17 (A) under AS 13.52.060(e) when an individual has made an 18 anatomical gift; or 19 (B) because an individual has made a do not resuscitate order 20 ineffective under AS 13.52.060(f) or another provision of this chapter; or 21 (6) acting in good faith under the terms of this chapter or the law of 22 another state relating to anatomical gifts. 23 (b) An individual acting as an agent, a guardian, or a surrogate under this 24 chapter is not subject to civil or criminal liability or to discipline for unprofessional 25 conduct for health care decisions made in good faith. 26 Sec. 13.52.090. Statutory damages. (a) A health care provider or institution 27 that intentionally violates this chapter is liable to the aggrieved individual or the 28 individual's estate for damages of $500 or actual damages resulting from the violation, 29 whichever is greater, plus attorney fees as provided by court rule. 30 (b) A person who intentionally falsifies, forges, conceals, defaces, or 31 obliterates an individual's advance health care directive or a revocation of an advance 01 health care directive without the individual's consent, or who coerces or fraudulently 02 induces an individual to give, revoke, or not to give an advance health care directive, 03 is liable to that individual for damages of $2,500 or actual damages resulting from the 04 action, whichever is greater, plus attorney fees as provided by court rule. 05 Sec. 13.52.100. Capacity. (a) This chapter does not affect the right of an 06 individual to make health care decisions while having capacity to make health care 07 decisions. 08 (b) An individual is rebuttably presumed to have capacity to make a health 09 care decision, to give or revoke an advance health care directive, and to designate or 10 disqualify a surrogate. 11 (c) An individual who is a qualified patient, including an individual for whom 12 a physician has issued a do not resuscitate order, has the right to make a decision 13 regarding the use of cardiopulmonary resuscitation and other life-sustaining 14 procedures as long as the individual is able to make the decision. If an individual who 15 is a qualified patient, including an individual for whom a physician has issued a do not 16 resuscitate order, is not able to make the decision, the protocol adopted under 17 AS 13.52.060 for do not resuscitate orders governs a decision regarding the use of 18 cardiopulmonary resuscitation and other life-sustaining procedures. 19 Sec. 13.52.110. Status of copy.  A copy of a written advance health care 20 directive, revocation of an advance health care directive, or designation or 21 disqualification of a surrogate has the same effect as the original. 22 Sec. 13.52.120. Effect of this chapter. (a) This chapter does not create a 23 presumption concerning the intention of an individual who has not made or who has 24 revoked an advance health care directive. 25 (b) Notwithstanding any other provision of law, if the withholding or 26 withdrawal of cardiopulmonary resuscitation or other life-sustaining procedures is 27 consistent with this chapter, death resulting from the withholding or withdrawal of 28 cardiopulmonary resuscitation or other life-sustaining procedures under a do not 29 resuscitate order, under the protocol for do not resuscitate orders established under 30 AS 13.52.060, or under a do not resuscitate identification found on an individual does 31 not, for any purpose, constitute a suicide or homicide. 01 (c) The issuance of a do not resuscitate order under this chapter, the 02 possession of do not resuscitate identification under this chapter, or the making of a 03 health care directive under this chapter does not affect in any manner the sale, 04 procurement, or issuance of a policy of life insurance, and does not modify the terms 05 of an existing policy of life insurance. A policy of life insurance is not legally 06 impaired or invalidated in any manner by the withholding or withdrawal of life- 07 sustaining procedures from an insured individual or the withholding or withdrawal of 08 cardiopulmonary resuscitation from an individual who possesses do not resuscitate 09 identification or for whom a do not resuscitate order has been issued, notwithstanding 10 any term of the policy to the contrary. 11 (d) This chapter does not create a presumption concerning the intention or 12 intended treatment of an individual who does not have do not resuscitate 13 identification, has not executed a health care directive, or for whom a do not 14 resuscitate order has not been issued with respect to the use, withholding, or 15 withdrawal of cardiopulmonary resuscitation or other life-sustaining procedures. 16 (e) This chapter does not increase or decrease the right of an individual to 17 make decisions regarding the use of cardiopulmonary resuscitation or other life- 18 sustaining procedures as long as the individual is able to do so, and does not impair or 19 supersede any right or responsibility that a person has to effect the withholding or 20 withdrawal of medical care in a lawful manner. 21 (f) This chapter does not authorize mercy killing, assisted suicide, euthanasia, 22 or the provision, withholding, or withdrawal of health care, to the extent prohibited by 23 other statutes of this state. 24 (g) This chapter does not authorize or require a health care provider or 25 institution to provide health care contrary to generally accepted health care standards 26 applicable to the health care provider or institution. 27 (h) This chapter does not authorize an agent or a surrogate to consent to the 28 admission of an individual to a mental health facility unless the individual's written 29 advance health care directive expressly so provides, and the period of admission may 30 not exceed 17 days. 31 (i) This chapter does not affect other statutes of this state governing treatment 01 for mental illness of an individual involuntarily committed to a mental health facility. 02 Sec. 13.52.130. Prohibited requirements. As a condition of receiving or 03 being insured for health care services, a health care provider, a health care institution, 04 a health care service plan, an insurer issuing health insurance, a self-insured employee 05 welfare benefit plan, or a nonprofit hospital plan may not require an individual to 06 execute a health care directive, obtain a do not resuscitate order from a physician, or 07 possess do not resuscitate identification. 08 Sec. 13.52.140. Judicial relief. On petition of a patient, the patient's agent, 09 guardian, or surrogate, or a health care provider or institution involved with the 10 patient's care, the superior court may enjoin or direct a health care decision or order 11 other equitable relief. A proceeding under this section is governed by AS 13.26.165 - 12 13.26.320. 13 Sec. 13.52.150. Uniformity of application and construction.  This chapter 14 shall be applied and construed to carry out its general purpose to make uniform the 15 law with respect to the subject of this chapter among states enacting it. 16 Sec. 13.52.160. Do not resuscitate orders and identification of other  17 jurisdictions. A do not resuscitate order or a do not resuscitate identification 18 executed, issued, or authorized in another state or a territory or possession of the 19 United States in compliance with the law of that jurisdiction is effective for the 20 purposes of this chapter. 21 Sec. 13.52.170. Persons who may make an anatomical gift. (a) A person 22 who is 18 years of age or older and who has capacity may make an anatomical gift to 23 take effect upon the person's death of all or a part of the person's body. 24 (b) Notwithstanding AS 13.52.030(c), when, in the priority list set out in this 25 section, there is not a person in a prior class who is available at the time of death, and 26 in the absence of actual notice of contrary indications by the decedent or actual notice 27 of opposition by a member of the same or a prior class, any of the following persons, 28 listed in order of priority, may make an anatomical gift of all or a part of a decedent's 29 body for a purpose specified in AS 13.52.220: 30 (1) the spouse; 31 (2) an adult son or daughter; 01 (3) a parent; 02 (4) an adult brother or sister; 03 (5) a guardian of the decedent at the time of death; 04 (6) another person authorized or under obligation to dispose of the 05 body. 06 (c) The persons authorized by (b) of this section may make the anatomical gift 07 after or immediately before death. 08 Sec. 13.52.180. Acceptance of anatomical gift. If the donee of an anatomical 09 gift has actual notice of a contrary indication by the decedent or that a gift by a 10 member of a class identified in AS 13.52.170(b) is opposed by a member of the same 11 class or a prior class, the donee may not accept the gift. However, an anatomical gift 12 that is not revoked by the donor before death is irrevocable and does not require the 13 consent or concurrence of any person after the donor's death. 14 Sec. 13.52.190. Examination authorized. An anatomical gift authorizes an 15 examination necessary to assure medical acceptability of the gift for the purposes 16 intended. 17 Sec. 13.52.200. Superiority of donee's rights. The rights of the donee 18 created by the gift are superior to the rights of other persons, except as provided for 19 autopsies under AS 13.52.270. 20 Sec. 13.52.210. Investigations by law enforcement and medical personnel. 21 Law enforcement or medical personnel who respond to the scene of an accident or 22 emergency involving the death of a person shall make a reasonable search for an 23 anatomical gift document or other information identifying the bearer as a donor or as 24 an individual who has refused to make an anatomical gift. If the law enforcement or 25 medical personnel know that the person executed an anatomical gift, they shall inform 26 appropriate hospital personnel or an appropriate organization that arranges for or 27 otherwise handles anatomical gifts of the gift. Failure to make a reasonable search 28 required under this section is not a basis for civil or criminal liability but may be the 29 basis for appropriate disciplinary sanctions. 30 Sec. 13.52.220. Manner of making anatomical gifts. (a) An anatomical gift 31 may be made by will. If made by will, the gift takes effect upon the death of the 01 testator before probate. If the will is not probated or is declared invalid for 02 testamentary purposes, the gift, to the extent that it has been acted upon in good faith, 03 is valid and effective. 04 (b) An anatomical gift may be made by a document other than a will, 05 including an advance health care directive under AS 13.52.300. The gift takes effect 06 upon the death of a donor. The document, which may be a card designed to be carried 07 on a person, shall be signed by a donor, or by another person at the donor's direction, 08 although the execution of an advance health care directive under AS 13.52.010(b) may 09 not be done by one person at the direction of another person. If signed by another 10 person at a donor's direction, the signer shall sign in the presence of two persons or a 11 person who is qualified to take acknowledgments under AS 09.63.010. Delivery of 12 the document of an anatomical gift during a donor's lifetime is not necessary to make 13 the gift valid. 14 Sec. 13.52.230. Anatomical gifts without specified donees. An anatomical 15 gift may be made to a specified donee or without specifying a donee. If a donee is not 16 specified, the gift may be accepted by the attending physician as donee upon or after 17 the death of a donor. If the gift is made to a specified donee who is not available at the 18 time and place of death of a donor, the attending physician, upon or following the 19 death of a donor, in the absence of any express indication that the donor desired 20 otherwise, may accept the gift as donee. 21 Sec. 13.52.240. Anatomical gifts by other persons. An anatomical gift by a 22 person designated in AS 13.52.170(b) shall be made by a document signed by the 23 person or made by the person's telegraphic message, recorded telephonic message, 24 witnessed telephonic consent, or another recorded message. 25 Sec. 13.52.250. Delivery of document of an anatomical gift. If an 26 anatomical gift is made by a donor to a specified donee, the will, card, or other 27 document, or an executed copy of it, may be delivered to a donee to expedite the 28 appropriate procedure for removing or transplanting a part of the donor's body 29 immediately after death. Delivery of a document is not necessary for a valid gift. The 30 will, card, or other document, or an executed copy of it, may be deposited in a 31 hospital, bank, storage facility, or registry office to facilitate the procedure for 01 removing or transplanting a part of a donor's body after death. On the request of an 02 interested person on or after a donor's death, the person in possession of the document 03 shall produce the document for examination. In this section, the terms "bank" and 04 "storage facility" mean a facility licensed, accredited, or approved under the laws of 05 any state for storage of human bodies or parts of human bodies. 06 Sec. 13.52.260. Rights and duties at death. (a) The time of death shall be 07 determined by a physician who attends a donor at death, or, if a physician is not 08 attending a donor at death, by the physician who certifies the death. The physician 09 may not participate in the procedures for removing or transplanting a part of the body. 10 (b) A donee may accept or reject an anatomical gift. If a donee accepts a gift 11 of an entire body, a donee may, subject to the terms of the gift, authorize embalming 12 and the use of the body in funeral services. If a gift is of a part of the body, a donee, 13 upon the death of a donor and, before embalming, shall have the part removed without 14 unnecessary mutilation. 15 (c) After removal of the part of the body, custody of the remainder of the body 16 vests in the surviving spouse, next of kin, or a person other than the spouse or next of 17 kin who is authorized to dispose of the body. A person described in AS 13.52.170(b) 18 and the estate of a donor may not be held liable for the cost of an examination under 19 AS 13.52.190 or any costs related to the removal, storage, or transportation of an 20 anatomical gift. 21 Sec. 13.52.280. State autopsy laws. The provisions of AS 13.52.170 - 22 13.52.260 are subject to the autopsy provisions of AS 12.65. 23 Sec. 13.52.290. Recognition of anatomical gifts executed, issued, or  24 authorized in other states.  An anatomical gift executed, issued, or authorized in 25 another state in compliance with the law of that jurisdiction is effective for the 26 purposes of this chapter. 27 Sec. 13.52.300. Optional form. The following sample form may be used to 28 create an advance health care directive. The other sections of this chapter govern the 29 effect of this or any other writing used to create an advance health care directive. This 30 form may be duplicated. This form may be modified to suit the needs of the person, or 31 a completely different form may be used that contains the substance of the following 01 form or otherwise complies with this chapter: 02 ADVANCE HEALTH CARE DIRECTIVE 03 Explanation 04 You have the right to give instructions about your own health 05 care. You also have the right to name someone else to make health 06 care decisions for you. This form lets you do either or both of these 07 things. It also lets you express your wishes regarding the designation 08 of your health care provider. If you use this form, you may complete or 09 modify all or any part of it. You are free to use a different form if the 10 form contains the substance of this form or otherwise complies with the 11 requirements of AS 13.52. 12 Part 1 of this form is a durable power of attorney for health 13 care. Part 1 lets you name another individual as an agent to make 14 health care decisions for you if you become incapable of making your 15 own decisions or if you want someone else to make those decisions for 16 you now even though you are still capable. You may name an alternate 17 agent to act for you if your first choice is not willing, able, or 18 reasonably available to make decisions for you. Unless related to you, 19 your agent may not be an owner, operator, or employee of a health care 20 institution where you are receiving care. 21 Unless the form you sign limits the authority of your agent, 22 your agent may make all health care decisions for you. This form has a 23 place for you to limit the authority of your agent. You do not have to 24 limit the authority of your agent if you wish to rely on your agent for all 25 health care decisions that may have to be made. If you choose not to 26 limit the authority of your agent, your agent will have the right to 27 (a) consent or refuse consent to any care, treatment, service, or 28 procedure to maintain, diagnose, or otherwise affect a physical or 29 mental condition, including the administration or discontinuation of 30 psychotropic medication; 31 (b) select or discharge health care providers and institutions; 01 (c) approve or disapprove proposed diagnostic tests, surgical 02 procedures, programs of medication, and do not resuscitate orders; and 03 (d) direct the provision, withholding, or withdrawal of artificial 04 nutrition and hydration and all other forms of health care; and 05 (e) make an anatomical gift following your death. 06 Part 2 of this form lets you give specific instructions for your 07 end-of-life health care. Choices are provided for you to express your 08 wishes regarding the provision, withholding, or withdrawal of 09 treatment to keep you alive, including the provision of artificial 10 nutrition and hydration, as well as the provision of pain relief 11 medication. Space is provided for you to add to the choices you have 12 made or for you to write out any additional wishes. 13 Part 3 of this form lets you express an intention to make an 14 anatomical gift following your death. 15 Part 4 of this form lets you make decisions in advance about 16 certain types of mental health treatment. 17 Part 5 of this form lets you designate a physician to have 18 primary responsibility for your health care. 19 After completing this form, sign and date the form at the end 20 and have the form witnessed by one of the two alternative methods 21 listed below. Give a copy of the signed and completed form to your 22 physician, to any other health care providers you may have, to any 23 health care institution at which you are receiving care, and to any health 24 care agents you have named. You should talk to the person you have 25 named as your agent to make sure that the person understands your 26 wishes and is willing to take the responsibility. 27 You have the right to revoke this advance health care directive 28 or replace this form at any time, except that you may not revoke this 29 declaration when you are determined to be incapable by a court, by two 30 physicians, at least one of whom shall be a psychiatrist, or by both a 31 physician and a professional mental health clinician. 01 PART 1 02 DURABLE POWER OF ATTORNEY FOR HEALTH CARE DECISIONS 03 (1) DESIGNATION OF AGENT. I designate the 04 following individual as my agent to make health care decisions for me: 05 _________________________________________________________ 06 (name of individual you choose as agent) 07 _________________________________________________________ 08 (address) (city) (state) (zip code) 09 _________________________________________________________ 10 (home phone) (work phone) 11 OPTIONAL: If I revoke my agent's authority or if my agent is 12 not willing, able, or reasonably available to make a health care decision 13 for me, I designate as my first alternate agent 14 _________________________________________________________ 15 (name of individual you choose as first alternate agent) 16 _________________________________________________________ 17 (address) (city) (state) (zip code) 18 _________________________________________________________ 19 (home phone) (work phone) 20 OPTIONAL: If I revoke the authority of my agent and first 21 alternate agent or if neither is willing, able, or reasonably available to 22 make a health care decision for me, I designate as my second alternate 23 agent 24 _________________________________________________________ 25 (name of individual you choose as second alternate agent) 26 _________________________________________________________ 27 (address) (city) (state) (zip code) 28 _________________________________________________________ 29 (home phone) (work phone) 30 (2) AGENT'S AUTHORITY. My agent is authorized 31 to make all health care decisions for me, including decisions to provide, 01 withhold, or withdraw artificial nutrition and hydration, and all other 02 forms of health care to keep me alive, except as I state here: 03 _________________________________________________________ 04 _________________________________________________________ 05 _________________________________________________________ 06 (Add additional sheets if needed.) 07 (3) WHEN AGENT'S AUTHORITY BECOMES 08 EFFECTIVE. Except in the case of mental illness, my agent's authority 09 becomes effective when my primary physician determines that I am 10 unable to make my own health care decisions unless I mark the 11 following box. In the case of mental illness, unless I mark the 12 following box, my agent's authority becomes effective when a court 13 determines I am unable to make my own decisions, or, in an 14 emergency, if my primary physician or another health care provider 15 determines I am unable to make my own decisions. If I mark this box 16 [ ], my agent's authority to make health care decisions for me takes 17 effect immediately. 18 (4) AGENT'S OBLIGATION. My agent shall make 19 health care decisions for me in accordance with this durable power of 20 attorney for health care, any instructions I give in Part 2 of this form, 21 and my other wishes to the extent known to my agent. To the extent 22 my wishes are unknown, my agent shall make health care decisions for 23 me in accordance with what my agent determines to be in my best 24 interest. In determining my best interest, my agent shall consider my 25 personal values to the extent known to my agent. 26 (5) NOMINATION OF GUARDIAN. If a guardian of 27 my person needs to be appointed for me by a court, I nominate the 28 agent designated in this form. If that agent is not willing, able, or 29 reasonably available to act as guardian, I nominate the alternate agents 30 whom I have named under (1) above, in the order designated. 31 PART 2 01 INSTRUCTIONS FOR HEALTH CARE 02 If you are satisfied to allow your agent to determine what is best 03 for you in making health care decisions, you do not need to fill out this 04 part of the form. If you do fill out this part of the form, you may strike 05 any wording you do not want. There is a state protocol that governs the 06 use of do not resuscitate orders by physicians and other health care 07 providers. You may obtain a copy of the protocol from the state 08 Department of Health and Social Services. 09 (6) END-OF-LIFE DECISIONS. I direct that my 10 health care providers and others involved in my care provide, withhold, 11 or withdraw treatment in accordance with the choice I have marked 12 below: (Check only one box.) 13 [ ] (A) Choice To Prolong Life 14 I want my life to be prolonged as long as 15 possible within the limits of generally accepted health care 16 standards; OR 17 [ ] (B) Choice Not To Prolong Life 18 I do not want my life to be prolonged if (i) I have 19 an incurable and irreversible condition that will result in my 20 death within a relatively short time; (ii) I become unconscious 21 and, to a reasonable degree of medical certainty, I will not 22 regain consciousness; or (iii) the likely risks and burdens of 23 treatment would outweigh the expected benefits. 24 (7) ARTIFICIAL NUTRITION AND HYDRATION. 25 Artificial nutrition and hydration must be provided, withheld, or 26 withdrawn in accordance with the choice I have made in paragraph (6) 27 unless I mark the following box. If I mark this box [ ], artificial 28 nutrition and hydration must be provided regardless of my condition 29 and regardless of the choice I have made in paragraph (6). 30 (8) RELIEF FROM PAIN. If I mark this box [ ], I 31 direct that treatment to alleviate pain or discomfort should be provided 01 to me even if it hastens my death. 02 (9) OTHER WISHES. (If you do not agree with any of 03 the optional choices above and wish to write your own, or if you wish 04 to add to the instructions you have given above, you may do so here.) I 05 direct that 06 _________________________________________________________ 07 _________________________________________________________ 08 Conditions or limitations: ______________________________ 09 _________________________________________________________. 10 (Add additional sheets if needed.) 11 PART 3 12 ANATOMICAL GIFT AT DEATH 13 (OPTIONAL) 14 If you are satisfied to allow your agent to determine whether to 15 make an anatomical gift at your death, you do not need to fill out this 16 part of the form. 17 (10) Upon my death: (mark applicable box) 18 [ ] (A) I give any needed organs, tissues, or 19 other body parts, OR 20 [ ] (B) I give the following organs, tissues, or 21 other body parts only_________________________________ 22 __________________________________________________ 23 [ ] (C) My gift is for the following purposes 24 (strike any of the following you do not want): 25 (i) transplant; 26 (ii) therapy; 27 (iii) research; 28 (iv) education; 29 PART 4 30 MENTAL HEALTH TREATMENT 31 This part of the declaration allows you to make decisions in 01 advance about mental health treatment. The instructions that you 02 include in this declaration will be followed only if a court, two 03 physicians that include a psychiatrist, or a physician and a professional 04 mental health clinician believe that you are incapable of making 05 treatment decisions. Otherwise, you will be considered capable to give 06 or withhold consent for the treatments. 07 If you are satisfied to allow your agent to determine what is best 08 for you in making these mental health decisions, you do not need to fill 09 out this part of the form. If you do fill out this part of the form, you 10 may strike any wording you do not want. 11 (11) PSYCHOTROPIC MEDICATIONS. If I become 12 incapable of giving or withholding informed consent for mental health 13 treatment, my wishes regarding psychotropic medications are as 14 follows: 15 ________ I consent to the administration of the following 16 medications: ______________________________________________ 17 ________ I do not consent to the administration of the 18 following medications:_______________________________________ 19 Conditions or limitations:_______________________________ 20 _________________________________________________________. 21 (12) ELECTROCONVULSIVE TREATMENT. If I 22 become incapable of giving or withholding informed consent for 23 mental health treatment, my wishes regarding electroconvulsive 24 treatment are as follows: 25 ________ I consent to the administration of electroconvulsive 26 treatment. 27 ________ I do not consent to the administration of 28 electroconvulsive treatment. 29 Conditions or limitations: ______________________________ 30 _________________________________________________________. 31 (13) ADMISSION TO AND RETENTION IN 01 FACILITY. If I become incapable of giving or withholding informed 02 consent for mental health treatment, my wishes regarding admission to 03 and retention in a health care facility for mental health treatment are as 04 follows: 05 ________ I consent to being admitted to a health care facility 06 for mental health treatment for up to ________ days. (The number of 07 days not to exceed 17.) 08 ________ I do not consent to being admitted to a health care 09 facility for mental health treatment. 10 Conditions or limitations:_______________________________ 11 _________________________________________________________. 12 OTHER WISHES OR INSTRUCTIONS 13 _________________________________________________________ 14 _________________________________________________________ 15 _________________________________________________________ 16 Conditions or limitations:_______________________________ 17 _________________________________________________________. 18 PART 5 19 PRIMARY PHYSICIAN 20 (OPTIONAL) 21 (14) I designate the following physician as my primary 22 physician: 23 _________________________________________________________ 24 (name of physician) 25 _________________________________________________________ 26 (address) (city) (state) (zip code) 27 _________________________________________________________ 28 (phone) 29 OPTIONAL: If the physician I have designated above is 30 not willing, able, or reasonably available to act as my primary 31 physician, I designate the following physician as my primary physician: 01 _________________________________________________________ 02 (name of physician) 03 _________________________________________________________ 04 (address) (city) (state) (zip code) 05 _________________________________________________________ 06 (phone) 07 (15) EFFECT OF COPY. A copy of this form has the 08 same effect as the original. 09 (16) SIGNATURES. Sign and date the form here: 10 _________________________________________________________ 11 (date)(sign your name) 12 _________________________________________________________ 13 (print your name) 14 _________________________________________________________ 15 (address) (city) (state) (zip code) 16 (17) WITNESSES. This advance care health directive 17 will not be valid for making health care decisions unless it is 18 (A) signed by two qualified adult witnesses who 19 are personally known to you and who are present when you sign 20 or acknowledge your signature; or 21 (B) acknowledged before a notary public in the 22 state. 23 ALTERNATIVE NO. 1 24 Witness 25 I swear under penalty of perjury under AS 11.56.200 that the 26 principal is personally known to me, that the principal signed or 27 acknowledged this durable power of attorney in my presence, that the 28 principal appears to be of sound mind and under no duress, fraud, or 29 undue influence, that I am not the person appointed as agent by this 30 document, and that I am not a health care provider or an employee of a 31 health care provider or facility. 01 ________________________________________________________ 02 (date)(signature of witness) 03 ________________________________________________________ 04 (printed name of witness) 05 ________________________________________________________ 06 (address) (city) (state) (zip code) 07 Witness 08 I swear under penalty of perjury under AS 11.56.200 that the 09 principal is personally known to me, that the principal signed or 10 acknowledged this durable power of attorney in my presence, that the 11 principal appears to be of sound mind and under no duress, fraud, or 12 undue influence, that I am not the person appointed as agent by this 13 document, and that I am not a health care provider, or an employee of a 14 health care provider or facility. 15 _______________________________________________________ 16 (date)(signature of witness) 17 _______________________________________________________ 18 (printed name of witness) 19 _______________________________________________________ 20 (address) (city) (state) (zip code) 21 ALTERNATIVE NO. 2 22 State of Alaska 23 ________________ Judicial District 24 On this ____ day of ___________________, in the year 25 ______________, before me, _______________________________ 26 (insert name of notary public) appeared 27 _______________________________, personally known to me (or 28 proved to me on the basis of satisfactory evidence) to be the person 29 whose name is subscribed to this instrument, and acknowledged that 30 the person executed it. 31 Notary Seal 01 ___________________________ 02 (Signature of Notary Public) 03 Sec. 13.52.390. Definitions. In this chapter, unless the context otherwise 04 requires, 05 (1) "advance health care directive" means an individual instruction or a 06 durable power of attorney for health care; 07 (2) "agent" means an individual designated in a durable power of 08 attorney for health care to make a health care decision for the individual granting the 09 power; 10 (3) "anatomical gift" means an individual instruction that makes a gift 11 of all or a part of a person's body; 12 (4) "best interest" means that the benefits to the individual resulting 13 from a treatment outweigh the burdens to the individual resulting from that treatment 14 and includes 15 (A) the effect of the treatment on the physical, emotional, and 16 cognitive functions of the patient; 17 (B) the degree of physical pain or discomfort caused to the 18 individual by the treatment or the withholding or withdrawal of the treatment; 19 (C) the degree to which the individual's medical condition, the 20 treatment, or the withholding or withdrawal of treatment, results in a severe 21 and continuing impairment; 22 (D) the effect of the treatment on the life expectancy of the 23 patient; 24 (E) the prognosis of the patient for recovery, with and without 25 the treatment; 26 (F) the risks, side effects, and benefits of the treatment or the 27 withholding of treatment; and 28 (G) the religious beliefs and basic values of the individual 29 receiving treatment, to the extent that these may assist in determining benefits 30 and burdens; 31 (5) "capacity" means an individual's ability to understand the 01 significant benefits, risks, and alternatives to proposed health care and to make and 02 communicate a health care decision; 03 (6) "cardiopulmonary resuscitation" means cardiopulmonary 04 resuscitation or a component of cardiopulmonary resuscitation; 05 (7) "decedent" means a deceased individual, stillborn infant, or fetus; 06 (8) "department" means the Department of Health and Social Services; 07 (9) "donor" means an individual who makes an anatomical gift; 08 (10) "do not resuscitate identification" means an identification card, 09 form, necklace, or bracelet that carries the standardized design or symbol developed 10 by the department under AS 13.52.060 to signify, when carried or worn, that the 11 carrier or wearer is an individual for whom a physician has issued a do not resuscitate 12 order; 13 (11) "do not resuscitate order" means a directive from a licensed 14 physician that emergency cardiopulmonary resuscitation should not be administered to 15 a qualified patient; 16 (12) "emancipated minor" means a minor whose disabilities have been 17 removed under AS 09.55.590 or who has arrived at the age of majority as determined 18 under AS 25.20.020; 19 (13) "generally accepted health care standards" includes the protocol 20 for do not resuscitate orders that is adopted under AS 13.52.060; 21 (14) "guardian" means a judicially appointed person having authority 22 to make a health care decision for an individual; 23 (15) "health care" means any care, treatment, service, or procedure to 24 maintain, diagnose, or otherwise affect an individual's physical or mental condition; 25 (16) "health care decision" means a decision made by an individual or 26 the individual's agent, guardian, or surrogate regarding the individual's health care, 27 including 28 (A) selection and discharge of health care providers and 29 institutions; 30 (B) approval or disapproval of proposed diagnostic tests, 31 surgical procedures, programs of medication, and do not resuscitate orders; 01 (C) direction to provide, withhold, or withdraw artificial 02 nutrition and hydration if withholding or withdrawing artificial nutrition, 03 artificial hydration, or artificial nutrition and hydration is in accord with 04 generally accepted health care standards applicable to health care providers or 05 institutions; and 06 (D) the administration or withdrawal of psychotropic 07 medications, the use of electroconvulsive treatment, and the admission to a 08 mental health facility; 09 (E) making an anatomical gift at death; 10 (17) "health care institution" means an institution, facility, or agency 11 licensed, certified, or otherwise authorized or permitted by law to provide health care 12 in the ordinary course of business; 13 (18) "health care provider" means an individual licensed, certified, or 14 otherwise authorized or permitted by law to provide health care in the ordinary course 15 of business or practice of a profession; 16 (19) "hospital" means 17 (A) a hospital licensed, accredited, or approved under the laws 18 of a state; or 19 (B) a hospital operated by the United States government or a 20 subdivision of the United States government; 21 (20) "individual instruction" means an individual's direction 22 concerning a health care decision for the individual; 23 (21) "life-sustaining procedures" means medical procedures or 24 interventions that, when administered to a qualified patient, will serve only to prolong 25 the dying process; 26 (22) "mental health facility" has the meaning given to "designated 27 treatment facility" in AS 47.30.915; 28 (23) "mental health treatment" means electroconvulsive treatment, 29 treatment with psychotropic medication, or admission to and retention in a health care 30 facility for mental health treatment; 31 (24) "part" means organs, tissues, eyes, bones, arteries, blood, fluids, 01 or another portion of a human body; 02 (25) "person" means an individual, corporation, business trust, estate, 03 trust, partnership, association, joint venture, government, governmental subdivision, 04 agency, instrumentality, or another legal or commercial entity; 05 (26) "physician" means an individual authorized to practice medicine 06 or osteopathy under AS 08.64; 07 (27) "power of attorney for health care" means the designation of an 08 agent to make health care decisions for the individual granting the power; 09 (28) "primary physician" means a physician designated by an 10 individual, or by the individual's agent, guardian, or surrogate, to have primary 11 responsibility for the individual's health care or, in the absence of a designation or if 12 the designated physician is not reasonably available, a physician who undertakes the 13 responsibility; 14 (29) "qualified patient" means a patient who has been determined by 15 the attending physician to be in a terminal condition; in this paragraph, "terminal 16 condition" means a progressive incurable or irreversible condition that, without the 17 administration of life-sustaining procedures, will, in the opinion of two physicians, 18 when available, who have personally examined the patient, one of whom must be the 19 attending physician, result in death within a relatively short time; 20 (30) "reasonably available" means able to be contacted with a level of 21 diligence appropriate to the seriousness and urgency of a patient's health care needs, 22 and willing and able to act in a timely manner considering the urgency of the patient's 23 health care needs; 24 (31) "state" means a state of the United States, the District of 25 Columbia, the Commonwealth of Puerto Rico, or a territory or insular possession 26 subject to the jurisdiction of the United States; 27 (32) "supervising health care provider" means the primary physician or 28 the physician's designee, or the health care provider or the provider's designee who has 29 undertaken primary responsibility for an individual's health care; 30 (33) "surrogate" means an individual, other than a patient's agent or 31 guardian, authorized under this chapter to make a health care decision for the patient.  01 Sec. 13.52.395. Short title. This chapter may be cited as the Health Care 02 Decisions Act. 03  * Sec. 4. AS 18.65.311 is amended to read: 04 Sec. 18.65.311. Anatomical gift [OR LIVING WILL DOCUMENT]. (a) 05 The department shall provide, at the time that an identification card is issued, a form 06 for a document by which the card holder may make an anatomical gift under AS 13.52 07 [AS 13.50 (UNIFORM ANATOMICAL GIFTS ACT) OR A LIVING WILL UNDER 08 AS 18.12 (LIVING WILLS AND DO NOT RESUSCITATE ORDERS)]. The 09 document (1) may not be larger than an identification card, (2) must contain sufficient 10 space for the signature of two witnesses [OR A PERSON WHO IS QUALIFIED TO 11 TAKE ACKNOWLEDGMENTS UNDER AS 09.63.010], and (3) [MUST USE THE 12 FORMS AND DESIGNS DEVELOPED UNDER AS 18.12.037, AND (4)] must 13 provide a means by which the card holder may cancel the gift [OR THE LIVING 14 WILL]. If the document is executed by the applicant, it shall be sealed in plastic and 15 attached to the identification card. [A SYMBOL DEVELOPED UNDER 16 AS 18.12.037 INDICATING THE EXISTENCE OF THE ANATOMICAL GIFT OR 17 LIVING WILL DOCUMENT MUST BE DISPLAYED IN THE LOWER RIGHT- 18 HAND CORNER ON THE FACE OF THE IDENTIFICATION CARD.] 19 (b) An employee of the department who processes an identification card 20 application, other than an application received by mail, shall ask the applicant orally 21 whether the applicant wishes to execute an anatomical gift [OR A LIVING WILL]. 22 The department shall, by placement of posters and brochures in the office where the 23 application is taken, and by oral advice, if requested, make known to the applicant the 24 procedure necessary to execute an anatomical [A] gift under AS 13.52 [AS 13.50 OR 25 A LIVING WILL UNDER AS 18.12]. 26  * Sec. 5. AS 28.10.021(c) is amended to read: 27 (c) An employee of the department who processes an application for 28 registration or renewal of registration, other than an application received by mail or an 29 application for registration under AS 28.10.152, shall ask the applicant orally whether 30 the applicant wishes to execute an anatomical gift [OR A LIVING WILL]. The 31 department shall make known to all applicants the procedure for executing an  01 anatomical [A] gift under AS 13.52 (Health Care Decisions Act) [AS 13.50 02 (UNIFORM ANATOMICAL GIFTS ACT) OR A LIVING WILL UNDER AS 18.12 03 (LIVING WILLS AND DO NOT RESUSCITATE ORDERS)] by displaying posters 04 in the offices in which applications are taken, by providing a brochure or other written 05 information to each person who applies in person or by mail, and, if requested, by 06 providing oral advice. 07  * Sec. 6. AS 28.15.061(d) is amended to read: 08 (d) An employee of the department who processes a driver's license 09 application, other than an application received by mail, shall ask the applicant orally 10 whether the applicant wishes to execute an anatomical gift [OR A LIVING WILL]. 11 The department shall make known to all applicants the procedure for executing an  12 anatomical [A] gift under AS 13.52 (Health Care Decisions Act) [AS 13.50 13 (UNIFORM ANATOMICAL GIFTS ACT) OR A LIVING WILL UNDER AS 18.12 14 (LIVING WILLS AND DO NOT RESUSCITATE ORDERS)] by displaying posters 15 in the offices in which applications are taken, by providing a brochure or other written 16 information to each person who applies in person or by mail, and, if requested, by 17 providing oral advice. 18  * Sec. 7. AS 28.15.111(b) is amended to read: 19 (b) The department shall provide, at the time that an operator's license is 20 issued, a form for a document by which the owner of a license may make an 21 anatomical gift under AS 13.52 [AS 13.50 OR A LIVING WILL UNDER AS 18.12]. 22 The document (1) may not be larger than an operator's license, (2) must contain 23 sufficient space for the signature of two witnesses [OR A PERSON WHO IS 24 QUALIFIED TO TAKE ACKNOWLEDGMENTS UNDER AS 09.63.010], and (3) 25 [MUST USE THE FORMS AND DESIGNS DEVELOPED UNDER AS 18.12.037, 26 AND (4)] must provide a means by which the owner may cancel the anatomical gift 27 [OR THE LIVING WILL]. If the document is executed by the applicant, it shall be 28 sealed in plastic and attached to the license. [A SYMBOL DEVELOPED UNDER 29 AS 18.12.037 INDICATING THE EXISTENCE OF THE ANATOMICAL GIFT OR 30 LIVING WILL DOCUMENT MUST BE DISPLAYED IN THE LOWER RIGHT- 31 HAND CORNER ON THE FACE OF THE DRIVER'S LICENSE.] 01  * Sec. 8. AS 47.30 is amended by adding a new section to article 9 to read: 02 Sec. 47.30.817. Advance health care directives. A health care provider or a 03 health care institution may not require or prohibit the execution or revocation of an 04 advance health care directive as a condition for admission, discharge, or providing 05 health care. In this section, "advance health care directive," "health care institution," 06 and "health care provider" have the meanings given in AS 13.52.390. 07  * Sec. 9. AS 47.30.825(b) is amended to read: 08 (b) The patient and the following persons, at the request of the patient, are 09 entitled to participate in formulating the patient's individualized treatment plan and to 10 participate in the evaluation process as much as possible, at minimum to the extent of 11 requesting specific forms of therapy, inquiring why specific therapies are or are not 12 included in the treatment program, and being informed as to the patient's present 13 medical and psychological condition and prognosis: (1) the patient's counsel, (2) the 14 patient's guardian, (3) a mental health professional previously engaged in the patient's 15 care outside of the evaluation facility or designated treatment facility, (4) a 16 representative of the patient's choice, (5) a person designated as the patient's agent or  17 surrogate [ATTORNEY-IN-FACT] with regard to mental health treatment decisions 18 under AS 13.52 [AS 13.26.332 - 13.26.358, AS 47.30.950 - 47.30.980, OR OTHER 19 POWER-OF-ATTORNEY], and (6) the adult designated under AS 47.30.725. The 20 mental health care professionals may not withhold any of the information described in 21 this subsection from the patient or from others if the patient has signed a waiver of 22 confidentiality or has designated the person who would receive the information as an 23 agent or surrogate under AS 13.52 [ATTORNEY-IN-FACT] with regard to mental 24 health treatment. 25  * Sec. 10. AS 47.30.825(f) is amended to read: 26 (f) A patient capable of giving informed consent has the absolute right to 27 accept or refuse electroconvulsive therapy or aversive conditioning. A patient who 28 lacks substantial capacity to make this decision may not be given this therapy or 29 conditioning without a court order unless the patient expressly authorized that 30 particular form of treatment in an advance health care directive [A 31 DECLARATION] properly executed under AS 13.52 [AS 47.30.950 - 47.30.980] or 01 has authorized an agent or surrogate under AS 13.52 [ATTORNEY-IN-FACT] to 02 make this decision and the agent or surrogate [ATTORNEY-IN-FACT] consents to 03 the treatment on behalf of the patient. 04  * Sec. 11. AS 47.30.836 is amended to read: 05 Sec. 47.30.836. Psychotropic medication in nonemergency. An evaluation 06 facility or designated treatment facility may not administer psychotropic medication to 07 a patient in a situation that does not involve a crisis under AS 47.30.838(a)(1) unless 08 the patient 09 (1) has the capacity to give informed consent to the medication, as 10 described in AS 47.30.837, and gives that consent; the facility shall document the 11 consent in the patient's medical chart; 12 (2) authorized the use of psychotropic medication in an advance  13 health care directive [A DECLARATION] properly executed under AS 13.52 14 [AS 47.30.950 - 47.30.980] or authorized an agent or surrogate under AS 13.52 15 [ATTORNEY-IN-FACT] to consent to the use of psychotropic medication for the 16 patient and the agent or surrogate [ATTORNEY-IN-FACT] does consent; or 17 (3) is determined by a court to lack the capacity to give informed 18 consent to the medication and the court approves use of the medication under 19 AS 47.30.839. 20  * Sec. 12. AS 47.30.838(d) is amended to read: 21 (d) An evaluation facility or designated treatment facility may administer 22 psychotropic medication to a patient without the patient's informed consent if the 23 patient is unable to give informed consent but has authorized the use of psychotropic 24 medication in an advance health care directive [A DECLARATION] properly 25 executed under AS 13.52 [AS 47.30.950 - 47.30.980] or has authorized an agent or  26 surrogate under AS 13.52 [ATTORNEY-IN-FACT] to consent to this form of 27 treatment for the patient and the agent or surrogate [ATTORNEY-IN-FACT] does 28 consent. 29  * Sec. 13. AS 47.30.839(d) is amended to read: 30 (d) Upon the filing of a petition under (b) of this section, the court shall direct 31 the office of public advocacy to provide a visitor to assist the court in investigating the 01 issue of whether the patient has the capacity to give or withhold informed consent to 02 the administration of psychotropic medication. The visitor shall gather pertinent 03 information and present it to the court in written or oral form at the hearing. The 04 information must include documentation of the following: 05 (1) the patient's responses to a capacity assessment instrument 06 administered at the request of the visitor; 07 (2) any expressed wishes of the patient regarding medication, 08 including wishes that may have been expressed in a power of attorney, a living will, 09 an advance health care directive under AS 13.52, or oral statements of the patient, 10 including conversations with relatives and friends that are significant persons in the 11 patient's life as those conversations are remembered by the relatives and friends; oral 12 statements of the patient should be accompanied by a description of the circumstances 13 under which the patient made the statements, when possible. 14  * Sec. 14. AS 47.33.070(a) is amended to read: 15 (a) An assisted living home shall maintain, for each resident of the home, a 16 file that includes 17 (1) the name and birth date, and, if provided by the resident, the social 18 security number of the resident; 19 (2) the name, address, and telephone number of the resident's closest 20 relative, service coordinator, if any, and representative, if any; 21 (3) a statement of what actions, if any, the resident's representative is 22 authorized to take on the resident's behalf; 23 (4) a copy of the resident's assisted living plan; 24 (5) a copy of the residential services contract between the home and 25 the resident; 26 (6) a notice, as required under AS 47.33.030, regarding the depository 27 in which the resident's advance payment money is being held; 28 (7) written acknowledgment [ACKNOWLEDGEMENT] by the 29 resident or the resident's representative that the resident has received a copy of and has 30 read, or has been read the 31 (A) resident's rights under AS 47.33.300; 01 (B) resident's right to pursue a grievance under AS 47.33.340; 02 (C) resident's right to protection from retaliation under 03 AS 47.33.350; 04 (D) provisions of AS 47.33.510, regarding immunity; and 05 (E) home's house rules; 06 (8) an acknowledgment [ACKNOWLEDGEMENT] and agreement 07 relating to home safekeeping and management of the resident's money, as required by 08 AS 47.33.040; 09 (9) a copy of the resident's living will, if any, or an advance health  10 care directive made under AS 13.52, if any; and 11 (10) a copy of a power of attorney or other written designation,  12 including an advance health care directive made under AS 13.52, of an agent, 13 representative, or surrogate by the resident. 14  * Sec. 15. AS 13.26.332(L), 13.26.335(1), 13.26.344(l); AS 13.50.010, 13.50.014, 15 13.50.016, 13.50.020, 13.50.030, 13.50.040, 13.50.050, 13.50.060, 13.50.065, 13.50.068, 16 13.50.070, 13.50.080, 13.50.090; AS 18.12.010, 18.12.020, 18.12.030, 18.12.035, 18.12.037, 17 18.12.040, 18.12.050, 18.12.060, 18.12.070, 18.12.080, 18.12.090, 18.12.100; AS 47.30.950, 18 47.30.952, 47.30.954, 47.30.956, 47.30.958, 47.30.960, 47.30.962, 47.30.964, 47.30.966, 19 47.30.968, 47.30.970, 47.30.972, and 47.30.980 are repealed. 20  * Sec. 16. The uncodified law of the State of Alaska is amended by adding a new section to 21 read: 22 CONTINUING EFFECT OF EXISTING DOCUMENTS. (a) An anatomical gift 23 made under AS 13.50 or AS 18.12, repealed by sec. 15 of this Act, before the effective date of 24 secs. 1 - 15 of this Act continues in effect under AS 13.50 or AS 18.12, as those chapters exist 25 before the effective date of secs. 1 - 15 of this Act, until the donation is revoked. 26 (b) A power of attorney that is made under AS 13.26.332(L), 13.26.335(1), or 27 13.26.344(l), repealed by sec. 15 of this Act, before the effective date of secs. 1 - 15 of this 28 Act and that contains authority for health care services under AS 13.26.332(L), 29 AS 13.26.335(1), or 13.26.344(l), repealed by sec. 15 of this Act, continues in effect under 30 AS 13.26.332(L), 13.26.335(1), and 13.26.344(l), as those provisions exist before the 31 effective date of secs. 1 - 15 of this Act, until the power of attorney is revoked. 01 (c) A declaration made under AS 18.12, repealed by sec. 15 of this Act, before the 02 effective date of secs. 1 - 15 of this Act continues in effect under AS 18.12, as that chapter 03 exists before the effective date of secs. 1 - 15 of this Act, until the declaration is revoked. 04 (d) A declaration made under AS 47.30.950 - 47.30.980, repealed by sec. 15 of this 05 Act, before the effective date of secs. 1 - 15 of this Act continues in effect under 06 AS 47.30.950 - 47.30.980, as those sections exist before the effective date of secs. 1 - 15 of 07 this Act, until the declaration is revoked. 08  * Sec. 17. The uncodified law of the State of Alaska is amended by adding a new section to 09 read: 10 EFFECT ON EXISTING INSURANCE POLICIES AND ANNUITIES. 11 AS 13.52.120(c), added by sec. 3 of this Act, does not apply to a policy of insurance or an 12 annuity that was entered into before the effective date of secs. 1 - 15 of this Act. 13  * Sec. 18. The uncodified law of the State of Alaska is amended by adding a new section to 14 read: 15 TRANSITION: REGULATIONS. The Department of Health and Social Services 16 may proceed to adopt regulations necessary to implement the changes made by secs. 1 - 15 of 17 this Act. The regulations take effect under AS 44.62 (Administrative Procedure Act), but not 18 before January 1, 2004. 19  * Sec. 19. The uncodified law of the State of Alaska is amended by adding a new section to 20 read: 21 CONTINUING EFFECT OF CURRENT REGULATIONS. (a) The regulations 22 found at 7 AAC 16, as modified by (b) of this section, continue in effect on and after 23 January 1, 2004, until the Department of Health and Social Services adopts the regulations 24 authorized under sec. 18 of this Act. 25 (b) The regulations attorney in the Department of Law shall 26 (1) in 7 AAC 16.010(a), replace the reference to "AS 18.12.035(b)" with 27 "AS 13.52.060(b)"; 28 (2) in 7 AAC 16.010(d)(4), replace the reference to "AS 18.12.090" with 29 "AS 13.52.160"; 30 (3) in 7 AAC 16.010(f), replace the reference to "AS 18.12" with "AS 13.52"; 31 (4) in 7 AAC 16.090(1), replace the reference to "AS 18.12.100" with 01 "AS 13.52.390"; 02 (5) in 7 AAC 16.090(3), replace ""do-not-resuscitate order" in AS 18.12.100" 03 with ""do not resuscitate order" in AS 13.52.390." 04 * Sec. 20. Section 18 of this Act takes effect immediately under AS 01.10.070(c). 05 * Sec. 21. Except as provided in sec. 20 of this Act, this Act takes effect January 1, 2004.