A Guide on How to Plan for Illness and Incapacity in Oklahoma
Introduction
1. Durable Power of Attorney
Under the Uniform Durable Power of Attorney Act, Title 58 0.5. seq. 3002 et seq., a person may give an agent the power to act for them. This agent is known as the "attorney-in-fact". This document must be signed before a Notary Public and two adult witnesses who are not related by blood or marriage to the principal. The language in the document must state that the power to act given to the attorney-in-fact will endure past the time the person signing it becomes incompetent. It must state that the durable power intended as a durable power of attorney given under the provisions of the Act and "shall not be affected by subsequent disability or incapacity or lapse of time". This Uniform Act has been adopted by many states, including Oklahoma.
It is important to know when this Power of Attorney becomes effective. Sometimes they are effective immediately upon signing or at a future date when the principal becomes disabled or incapacitated.
The Durable Power of Attorney document should reference that the person giving the authority to the attorney-in-fact
"Waives the restriction imposed by the Health Insurance Portability and Accountability Act, (HIPAA)," which means a person consents to the disclosure by their physicians to the attorney-in-fact the listed medical records. Without this wavier, many physicians and hospitals will not accept a Durable Power of Attorney document.
Practical Usage
If you become physically or mentally incapacitated before death and the power of attorney contains the authority to make medical decisions, the attorney-in-fact appointed under this document can consult with your doctors, nurses, and hospital about your care. They may authorize treatment, surgery, testing and decide about nursing home and other care issues. Our Trust Department considers this document a crucial part of every estate plan.
2. Advanced Directive for Health Care
Oklahoma Health Care Agent Act Title 63 0.5. Sec. 3111.1 et. seq. This Directive deals with instructions to your family and doctors about your wishes to refuse or withdraw artificial food and water, oxygen, etc. if you are in a constant vegetative state (brain dead) or terminally ill. These medical documents should be discussed with your attorney and how they could be helpful to your future medical needs. The individual signing the Advance Directive must answer a series of questions dealing with his or her care, as well as appointing a Health Care Proxy (another agent) to consult with the physicians and enforce the Advance Directive.
The Do Not Resuscitate Act in Title 63 0.5. Sec 3131.1 et. seq. is based on the" DNR Act" for use of a "Do-Not-Resuscitate Orders". The DNR order is kept in the patient's medical records and is transferable between various health care facilities (i.e., hospital to nursing home). The purpose is for the patient not to receive CPR. If your client has one of these orders and is receiving home healthcare, those medical providers must have a copy of the document, so they know not to perform CPR on the patient. A healthcare Power of Attorney may authorize the agent to sign a DNR for the patient, but the agent cannot sign an Advanced Healthcare Directive for them.
Practical Usage
Failure to sign or have a loved one sign this type of medical directive can cause undue emotional and financial stress when you or a family member is only being kept alive by machines and artificial administration of food, water, etc. Do not put that kind of stress and pressure on your family. Discuss this very important document with your attorney.
3. Failure to Plan - Guardianship
If you or a family member has failed to address the issues of future incapacity problems when your or their estate plans were prepared, please discuss them with your
attorney now. Without the proper legal documents, sudden and severe medical conditions may receive delayed treatment and guardianship proceedings may have to be instituted by the patient's family and attorney. If the patient has failed to plan ahead, a guardianship petition may have to be filed in the district court in the county where the patient resided to deal with health issues and manage assets, pay bills, etc., while the patient is incapacitated. These are called "Guardianship of the Person" (meaning health care and living arrangements) or "Guardianship of the Estate" (which means asset management prior to death). Once a court ordered guardianship is in place, an annual report must be submitted updating the court on the patient's care and living arrangements. If the guardianship is for the person's asset management too, then an accounting must be filed annually with the court which summarizes the income and expenses. This is usually more expensive than other asset management methods, like a trust or even a Durable Power of Attorney.
4. Other Considerations
In 1997 the Oklahoma legislature passed the "DNR Act" in Title 63.0 0.5. Sec 3131.1 et. seq. for use of "Do-Not-Resuscitate Orders". The DNR order is kept in the patient's medical records and is transferable between various health care facilities (i.e. hospital to nursing home). The purpose is for the patient to elect not to receive CPR
(cardio-pulmonary resuscitation) in case of cardiac or respiratory arrest (failure for heart to beat or to breathe). This type of a medical document is usually only considered when a patient is in the last stage of illness or so seriously injured that death is expected to occur. Under the current law in Oklahoma, patients are presumed to consent to CPR unless a document like a DNR has been signed.
Facing the Issue of Mental or Physical Incapacity
Vision Bank has had a Trust Department since the 1942. Our capable staff of trained trust officers has helped hundreds of families and individuals with their estate plans. Together they have also faced the challenges and tough decisions that illness and incapacity issues present to their families and loved ones. This brochure summarizes the medical documents that can be used with your estate planning documents to form a complete plan for the care of your assets and your health issues.
Conclusion
Consider these medical documents as an addition to your estate planning documents, like your will or trust agreements. Most attorneys who do estate planning will include these medical documents in their discussions with you about your personal situation and needs. Be sure to review carefully who you want to list as your attorney-in-fact in the Durable Power of Attorney as well as your Health Care Proxy in the Advanced Health Care Directive. Consider carefully who will be named as the second person listed in case the first person named is unavailable.
Remember, your documents need to include the HIPAA waiver, or they may not be accepted by the medical professionals.
Disclosures:
Trust investments are not a deposit; not FDIC insured; not guaranteed by any federal government agency; not guaranteed by the bank; and may go down in value.