iMIS
Originally posted on April 4, 2022
Hierarchy for Determining Healthcare Decisionmaker
Supported Decisionmaking
Advance Directive & Mental Health Treatment
Remote Online Notaries
Prison Visitation and Serious Illness
As introduced, AB 2338 (Gipson) would specify individuals, in an order of priority, who may be chosen as a surrogate if a patient lacks the capacity to make a health care decision or to designate a surrogate. Specifically, a surrogate may be chosen from any of the following persons, in the following descending order of priority:
CCCC believes that a rigid hierarchy is culturally inappropriate and likely to cause more harm than good. CCCC supports use of the model policy for Selection of Health Care Surrogates developed by the California Hospital Association (CHA) and California Medical Association (CMA). CCCC is working closely with CHA, CMA, the Alliance of Catholic Healthcare and the California Association of Long-Term Care Medicine (CALTCM) to obtain amendments to this bill that would eliminate required adherence to the rigid hierarchy.
In the wake of Brittany Spears’ conservatorship battle, AB 1663 (Maienschein) has been introduced. This bill would revise the conservatorship process to help identify situations where less restrictive alternatives could be used, including supported decisionmaking. More specifically, this bill would:
CCCC has been a proponent of Supported Decisionmaking for years. We produced Thinking Ahead Matters, which examines alternatives to conservatorship for persons with developmental disabilities and recommends a move toward supported decisionmaking. CCCC also served an advisor in the creation of Partners in Health: Implementing Supported Healthcare Decision-Making for Users of Augmentative and Alternative Communication on using Supported Decisionmaking with augmented communication.
AB 2288 (Choi) would make technical changes to the statutory advance health care directive to explicitly state that instructions on mental health conditions are permitted In March, Governor Newsom unveiled the Community Assistance, Recovery, and Empowerment (CARE) Court, which is a new policy framework to assist people living with untreated mental health and substance abuse challenges. His new proposal offers court-ordered individualized interventions and services, stabilization medication, including advance mental health directives.
For healthcare organizations committed to assisting patients with completing advance healthcare directives, online remote notarization is a key tool for getting these documents fully completed in the healthcare setting. The intention of AB 1093 (Jones-Sawyer) is to make it possible for notaries in California to perform the notarial process remotely through audio-video communication. Unfortunately, as is common with legislation related to business professionals’ scope of practice, this bill is currently caught up in politics. This time related to whether California is better off allowing or prohibiting the ability of notaries outside of California to perform these services. While CCCC is supportive of online remote notarization because it’s ability to increase advance directive completion, due to politics around the specifics how best to regular online notarization, CCCC is following this bill.
COVID-19 laid bare some of the challenges that incarcerated people and their families experience during serious illness. Prisons were hit particularly hard during the pandemic. Due to their very nature of confinement, which led to increased contamination, hundreds of incarcerated people died. Many of these people died alone —no family members were present or notified to be a comfort to them in their time of need. SB 1139 (Kamlager) is designed implement a format of guided steps and tools to afford incarcerated people and their families a humane health care process during serious illness. This bill would:
CCCC is supportive of SB 1139.