Bill Text: GA HB339 | 2009-2010 | Regular Session | Comm Sub

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Bill Title: Mental health; competent adult to control directly or indirectly mental health care decisions; provisions

Spectrum: Bipartisan Bill

Status: (Introduced - Dead) 2009-04-03 - House Withdrawn, Recommitted [HB339 Detail]

Download: Georgia-2009-HB339-Comm_Sub.html

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09 LC 21 0420S

The House Committee on Judiciary offers the following substitute to HB 339:

A BILL TO BE ENTITLED
AN ACT

To amend Title 37 of the Official Code of Georgia Annotated, relating to mental health, so as to provide a means for a competent adult to control either directly through instructions written in advance or indirectly through appointing an agent to make mental health care decisions on behalf of such person according to a written psychiatric advance directive; to provide a short title; to provide definitions; to provide for standards and limitations with respect to psychiatric advance directives; to provide for the responsibilities and duties of physicians and other mental health care providers and agents under psychiatric advance directives; to provide a statutory psychiatric advance directive form; to provide for construction of such form; to provide for applicability; to provide for statutory construction of chapter; to provide for related matters; to repeal conflicting laws; and for other purposes.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:

SECTION 1.

Title 37 of the Official Code of Georgia Annotated, relating to mental health, is amended by adding a new chapter to the end of such title to read as follows:

"CHAPTER 11

37-11-1.

This chapter shall be known and may be cited as the 'Psychiatric Advance Directive Act.'

37-11-2.

As used in this chapter, the term:

(1) 'Attending physician' means the physician who has primary responsibility at the time of reference for the treatment and care of the patient.

(2) 'Competent adult' means a person of sound mind who is 18 years of age or older.

(3) 'Declarant' means the person executing a psychiatric advance directive pursuant to this chapter.

(4) 'Hospital' means:

(A) A facility which has a valid permit or provisional permit issued under Chapter 7 of Title 31 and which is primarily engaged in providing to inpatients, by or under the supervision of physicians, diagnostic services and therapeutic services for medical diagnosis, treatment, and care of injured, disabled, or sick persons;

(B) A state owned, state operated, or private facility providing services which include, but are not limited to, inpatient care and the diagnosis, care, and treatment or habilitation of persons with:

(i) Mental or emotional illness;

(ii) Developmental disability, as defined in Code Section 37-2-2; or

(iii) Addictive disease, as defined in Code Section 37-2-2.

Such hospital may also provide or manage state owned or operated programs in the community;

(C) An emergency receiving facility, as defined in Code Section 37-3-1; and

(D) An evaluating facility, as defined in Code Section 37-3-1.

(5) 'Incapable' means that, in the opinion of the court in a guardianship proceeding or in the opinions of two physicians or a physician and a psychologist who have personally examined the patient, a person's ability to receive and evaluate information effectively or communicate decisions is impaired to such an extent that the person currently lacks the capacity to make mental health care decisions.

(6) 'Mental health care' means any care, treatment, service, or procedure to maintain, diagnose, treat, or provide for the patient's mental health.

(7) 'Mental health care agent' or 'agent' means a person appointed by a declarant pursuant to this chapter to act for and on behalf of the declarant to make decisions related to mental health care when the declarant is incapable. This term shall include any alternate mental health care agent appointed by the declarant.

(8) 'Mental health care provider' or 'provider' means the attending physician and any other person administering mental health care to the patient at the time of reference who is licensed, certified, or otherwise authorized or permitted by law to administer mental health care in the ordinary course of business or the practice of a profession, including but not limited to professional counselors, psychologists, clinical social workers, and clinical nurse specialists in psychiatric/mental health, and any person employed by or acting for any such authorized person.

(9) 'Patient' means the declarant.

(10) 'Physician' means a person licensed to practice medicine under Article 2 of Chapter 34 of Title 43.

(11) 'Prospective consent' means consent given by a competent adult that is valid for treatment at a time when a person is incapable.

(12) 'Psychiatric advance directive' or 'directive' means a written document governing any type of mental health care voluntarily executed by a declarant in accordance with the requirements of this chapter.

(13) 'Skilled nursing facility' means a facility which has a valid permit or provisional permit issued under Chapter 7 of Title 31 and which provides skilled nursing care and supportive care to patients whose primary need is for availability of skilled nursing care on an extended basis.

(14) 'State-wide hot line' means a state-wide, toll-free hot line available 24 hours per day, 7 days per week, managed and funded by the State of Georgia for mental health and addiction crises.

37-11-3.

(a) A competent adult may execute a psychiatric advance directive of preferences or instructions regarding his or her mental health care. The directive may include, but is not limited to, consent to or refusal of specified mental health care.

(b)(1) A competent adult may choose not to appoint a mental health agent, in which case the instructions and desires of the declarant as set forth in the directive shall be followed to the fullest extent possible by every health care provider to whom the directive is communicated, subject to the right of any such health care provider to refuse to comply with the directive as set forth in Code Section 37-11-4.

(2) A psychiatric advance directive may designate a competent adult to act as agent to make decisions about mental health care for the declarant. An alternative agent may also be designated to act as agent if the original designee is unable or unwilling to act at any time. An agent who has accepted the appointment in writing may make decisions about mental health care on behalf of the declarant different from or contrary to the declarant's decisions only when the declarant is incapable. An agent shall be under no duty to exercise granted powers or to assume control of or responsibility for the declarant's mental health care; provided, however, that when granted powers are exercised, the agent shall use due care to act for the benefit of the declarant in accordance with the terms of the directive. An agent shall exercise granted powers in such manner as the agent deems consistent with the intentions and desires of the declarant. If a declarant's intentions and desires are unclear, the agent shall act in the declarant's best interest considering the benefits, burdens, and risks of the declarant's circumstances and treatment options and shall make such decisions consistent with the instructions and desires of the declarant, as expressed in the directive.

(c) A directive shall be effective only if it is signed by the declarant and two competent adult witnesses. The witnesses shall attest that the declarant is known to them, signed the directive in their presence, appears to be of sound mind, and is not under duress, fraud, or undue influence. Persons specified in subsection (e) of Code Section 37-11-4 may not act as witnesses.

(d) A directive shall become effective when it is delivered to the declarant's physician or other mental health care provider and shall remain in effect unless otherwise specified in the directive or until revoked by the declarant. The physician or provider shall be authorized to act in accordance with a directive when the declarant has been found to be incapable. The physician or provider shall continue to obtain the declarant's consent to all mental health care decisions if the declarant is capable of providing consent or refusal.

(e)(1) An agent shall not have authority to make mental health care decisions unless the declarant is incapable.

(2) An agent shall not be, solely as a result of acting in that capacity, personally liable for the cost of treatment provided to the declarant.

(3) Except to the extent that a right is limited by a directive or by any federal law, an agent shall have the same right as the declarant to receive information regarding the proposed mental health care and to receive, review, and consent to disclosure of medical records relating to that care. This right of access shall not waive any evidentiary privilege.

(f) The authority of a named agent and any alternative agent shall continue in effect so long as the directive appointing the agent is in effect or until the agent has withdrawn.

(g) A person may not be required to execute or to refrain from executing a directive as a criterion for insurance, as a condition for receiving mental or physical health care services, or as a condition of discharge from a hospital or skilled nursing facility.

37-11-4.

(a) Upon being presented with a psychiatric advance directive, a physician shall make the directive a part of the declarant's medical record. When acting under authority of a directive, a physician or other provider shall comply with it to the fullest extent possible, consistent with reasonable medical practice, the availability of treatments requested, and applicable law. If the physician or other provider is unwilling at any time to comply with the declarant's wishes as set forth in the directive or with the decision of the agent, if an agent has been appointed, the physician or provider shall promptly notify the declarant and the agent, if an agent has been appointed, and otherwise next of kin or legal guardian of the declarant and document the notification in the declarant's medical record. The agent, if an agent has been appointed, and otherwise next of kin or legal guardian of the declarant, shall then be responsible for arranging for the declarant's transfer to another health care provider.

(b) A physician or provider may subject a declarant to mental health treatment in a manner contrary to the declarant's wishes, as expressed in a psychiatric advance directive, only if:

(1) A court order contradicts the declarant's wishes as specified in the psychiatric advance directive;

(2) The declarant presents a substantial risk of imminent harm to himself or herself or to others; or

(3) A physician or mental health care provider determines that the declarant's wishes as expressed in the directive are contraindicated or could result in harm to the declarant.

(c) A directive shall not limit any authority to take a person into custody or admit or retain a person in the custody of a local mental health authority pursuant to Article 3 of Chapter 3 of Title 37 or any other applicable law.

(d) A directive may be revoked in whole or in part by the declarant at any time so long as the declarant is not incapable. Such revocation shall be effective when the declarant communicates the revocation to the attending physician or other provider. The attending physician or other provider shall note the revocation as part of the declarant's medical record.

(e) None of the following persons may serve as an agent or as witnesses to the signing of a directive:

(1) The declarant's attending physician or mental health care provider or an employee of that physician or provider;

(2) An employee of the Department of Human Resources or of a local mental health authority or any organization that contracts with a local mental health authority; provided, however, that this shall not apply to family members, friends, or other associates of the declarant if the declarant so wishes.

(f) An agent may withdraw by giving written notice to the declarant. If a declarant is incapable, the agent may withdraw by giving written notice to the attending physician or provider. The attending physician shall note the withdrawal as part of the declarant's medical record.

37-11-5.

(a) The statutory psychiatric advance directive form contained in this subsection may be used to grant an agent powers with respect to the declarant's own mental health care; but the statutory psychiatric advance directive form is not intended to be exclusive or to cover delegation of a parent's power to control the mental health care of a minor child, and no provision of this chapter shall be construed to bar use by the declarant of any other or different form of directive or power of attorney for mental health care that complies with the provisions of this chapter. If a different form of psychiatric advance directive is used, it may contain any or all of the provisions set forth or referred to in the following form. When a directive in substantially the following form is used, and notice substantially similar to that contained in the form below has been provided to the patient, it shall have the same meaning and effect as prescribed in this chapter. Substantially similar forms may include forms from other states. The statutory psychiatric advance directive may be included in or combined with any other form of advance directive governing property or other matters, and no provision of this chapter shall be construed to bar use by the declarant of a durable power of attorney for health care form pursuant to Chapter 36 of Title 31, either solely or in addition to the form contained in this subsection.

Psychiatric Advance Directive

Name: __________________________________________________
Date: ___________________________________________________

Mental Health Care Agent:

Name: __________________________________________________
Address: _________________________________________________
_________________________________________________________
Day Phone Number: ________________________________________

Evening Phone Number: ______________________________________________

STATEMENT OF INTENT

I, (your name) , being of sound mind, willfully and voluntarily execute this psychiatric advance directive to assure that, during periods of incapacity resulting from psychiatric illness, my choices regarding my mental health care will be expressed in writing despite my inability to make informed decisions on my own behalf. In the event that a decision maker is appointed by a court to make mental health care decisions for me, I intend this document to take precedence over all other means of ascertaining my intent while competent.

By this document, I intend to create a psychiatric advance directive as authorized by state law, the U.S. Constitution and the federal Patient Self-Determination Act of 1990 (P.L. 101-508) to indicate my wishes regarding mental health treatment. I understand that this directive will become operative upon my incapacity to make my own mental health decisions and shall continue in operation only during that incapacity.

I intend that this document should be honored whether or not my agent dies or withdraws or if I have no agent appointed at the time of the execution of this document.

Incomplete sections in this psychiatric advance directive (i.e., not completed certain sections) should not affect its validity in any way. I intend that all completed sections be followed.

If any part of this psychiatric advance directive is invalid or ineffective under relevant law, this fact should not affect the validity or effectiveness of the other parts. It is my intention that each part of this psychiatric advance directive stand alone. If some parts of this document are invalid or ineffective, I desire that all other parts be followed.

I intend this psychiatric advance directive to take precedence over any and all living will documents and/or durable power of attorney for health care documents and/or other advance directives I have previously executed, to the extent that these other documents relate to my mental health care.

Name: ___________________________________________________________
_________________________________________________________________

I have discussed this form with my treating clinician: YES______ NO_______.
Treating physician's name: ________________________ Phone number______________
_________________________________________________________________
_________________________________________________________________

Optional: As the declarant's treating clinician, I declare that the declarant is competent at the time of signing this directive.
Treating Clinician _______________________________Date: ____________________

Instructions Included in My Psychiatric Advance Directive
Put your initials in the space next to each section you have completed.

_______ Designation of my mental health care agent.
_______ Designation of alternate mental health care agent.
_______ Authority granted to my mental health care agent.
_______ When spouse is mental health care agent.
_______ Symptoms.
_______ When my plan is no longer needed.
_______ Clinicians.
_______ Medications.
_______ Hospitalization is not my first choice.
_______ Treatment facilities.
_______ Acceptable interventions.
_______ Preferred interventions.
_______ Help from others.
_______ State-wide hot line.
_______ Prospective Consent.
_______ Signature page.
_______ Record of psychiatric advance directive.

APPOINTMENT OF AGENT FOR MENTAL HEALTH CARE
If you do not wish to appoint an agent, do not complete the sections below.

Make sure you give your agent a copy of all sections of this document.

Statement of Intent to Appoint an Agent:

I, (your name) , being of sound mind, authorize a mental health care agent to make certain decisions on my behalf regarding my mental health treatment when I do not have the capacity to do so. I intend that those decisions should be made in accordance with my expressed wishes as set forth in this document. If I have not expressed a choice in this document, I authorize my agent to make the decisions that my agent determines are the decisions I would make if I had the capacity to do so. When making mental health care decisions for me, my mental health care agent should consider actions that would be consistent with past conversations we have had, my wishes as expressed herein, my religious and other beliefs and values, and how I have handled medical and other important issues in the past. If what I would decide is still unclear, then my mental health care agent should make decisions for me that my mental health care agent believes are in my best interest, considering the benefits, burdens, and risks of my current circumstances and treatment options.
Designation of Mental Health Care Agent
A. I hereby designate and appoint the following person as my agent to make mental health care decisions for me as authorized in this document. In the event that admission for psychiatric treatment is being considered, my agent must be notified/consulted before any decision is finalized.

Name: __________________________________________________________________
Address: ________________________________________________________________
________________________________________________________________________
Day Phone Number ________________ Evening Phone Number______________________

B. Agent's Acceptance: I hereby accept the designation as agent for

(Your name) _____________________________________________________________

(Your agent's signature)____________________________________________________
I certify that I do not, have not, and will not provide health care and treatment for this person.

Designation of Alternate Mental Health Care Agent
If the person named above is unavailable or unable to serve as my agent, I hereby appoint and desire immediate notification of my alternate agent as follows:

Name: __________________________________________________________________
Address: ________________________________________________________________
________________________________________________________________________
Day Phone Number ________________ Evening Phone Number______________________

Alternate Agent's Acceptance: I hereby accept the designation as alternate agent for

(Your name) ______________________________________________________________

(Your agent's signature)____________________________________________________
I certify that I do not, have not, and will not provide health care and treatment for this person.

Authority Granted to My Mental Health Care Agent
Initial if you agree with a statement; leave blank if you do not.

A. ________ If I become incapable of giving consent to mental health care treatment, I hereby grant to my agent full power and authority to make mental health care decisions for me, including the right to consent, refuse consent, or withdraw consent to any mental health care, mental health care treatment, mental health care provider, or mental health care service or procedure, consistent with any instructions and/or limitations I have set forth in this psychiatric advance directive. If I have not expressed a choice in this advance directive, I authorize my agent to make decisions that my agent determines are the decisions I would make if I had the capacity to do so. When making mental health care decisions for me, my mental health care agent should consider actions that would be consistent with past conversations we have had, my wishes as expressed herein, my religious and other beliefs and values, and how I have handled medical and other important issues in the past. If what I would decide is still unclear, then my mental health care agent should make decisions for me that my mental health care agent believes are in my best interest, considering the benefits, burdens, and risks of my current circumstances and treatment options.

B._________ If I am incapable of authorizing the release of my medical records, I hereby grant to my agent full power and authority to request these records on my behalf.

C. _________ If I choose to discharge or replace my agent, all other provisions of this psychiatric advance directive shall remain in effect and shall only be revocable or changeable by me.

When Spouse Is Mental Health Care Agent and If There Has Been a Legal Separation, Annulment, or Dissolution of the Marriage
Initial if you agree with this statement; leave blank if you do not.

__________ I desire the person I have named as my agent, who is now my spouse, to remain as my agent even if we become legally separated or our marriage is dissolved.

The following sections outline my wishes regarding when my psychiatric advance directive should be activated, when it no longer needs to be used, and details regarding my care, treatment, and preferred interventions.

Symptoms
When I exhibit the following symptoms or behaviors, this would indicate that an evaluation is needed regarding whether or not I am incapable of making mental health care decisions and that my psychiatric advance directive needs to be enacted:
________________________________________________________________________
________________________________________________________________________

When My Directive Is No Longer Needed
When I exhibit the following behaviors, an evaluation is needed regarding whether or not I am capable of making mental health care decisions and whether my psychiatric advance directive no longer needs to be utilized:
________________________________________________________________________
________________________________________________________________________

Clinicians
The names of my doctors, therapists, pharmacists, and service providers and their telephone numbers are:

Name Phone #
________________________________________________________________________________________________________________________________________________

I prefer treatment from the following clinicians:

Name
________________________________________________________________________
________________________________________________________________________

I prefer not to be treated by the following clinicians:

Name
________________________________________________________________________
________________________________________________________________________

Medications
(include all medications, whether for mental health care treatment or general health care treatment)
I am currently using the following medications for:
________________________________________________________________________
________________________________________________________________________
If additional medications become necessary, I prefer to take the following medications:
________________________________________________________________________
________________________________________________________________________

I cannot tolerate the following medications because:
________________________________________________________________________
________________________________________________________________________

I am allergic to the following medications:
________________________________________________________________________
________________________________________________________________________

Hospitalization is not my first choice
It is my intention, if possible, to stay at home or in the community with the following supports:
________________________________________________________________________
________________________________________________________________________

Treatment Facilities
If it becomes necessary for me to be hospitalized, I would prefer to be treated at the following facilities:
________________________________________________________________________
________________________________________________________________________

I do not wish to be treated at the following facilities:
________________________________________________________________________
________________________________________________________________________

Acceptable Interventions: (Please place your initials in the blanks)

Medication in pill form Yes ________No ________

Liquid medication Yes ________No ________

Medication by injection Yes ________No ________

Seclusion Yes ________No ________

Physical restraints Yes ________No ________

Seclusion and physical restraints Yes ________No ________

Experimental treatment Yes ________No ________

Electroconvulsive therapy (ECT) Yes ________No ________

____ I consent to the administration of electroconvulsive therapy with the following conditions:
________________________________________________________________________
________________________________________________________________________

Acceptable Preferred Interventions:
________________________________________________________________________
________________________________________________________________________

Prospective consent
At a time when I am incapable of making mental health care decisions, and no agent is available, I intend for this document to constitute authorization and consent for treatment that is consistent with the preferences I have expressed in this document and is medically indicated.

Yes____________ (Initials) No___________
Specific limitations on consent: _______________________________________________
________________________________________________________________________

Help from Others
List your supporters and the ways they can help you. Be sure to write their names, phone numbers, and responsibilities (mail, bills, pet, child care, etc.).

Name Phone Number Responsibility
________________________________________________________________________
________________________________________________________________________

State-wide Hot Line
I am submitting a copy of this psychiatric advance directive to the state-wide hot line, which has my permission to access such directive if contacted by me or someone else on my behalf to assist in informing health care providers of my preferences listed in this directive when appropriate. Such hot line may also share this directive with a hospital physician if I present for evaluation.

Name of hot line: __________________________________________________________
Date submitted to hot line: __________________________________________________

I signed this psychiatric advance directive on (date) __________________.
Any plan with a more recent date supersedes this one.
Signed ____________________________________________ Date _________________
Witness ___________________________________________ Date _________________
Witness ___________________________________________ Date _________________
(for use by the notary)
STATE OF____________________, County of__________________________________
Subscribed and sworn to or affirmed before me by the Principal,
______________________________________________________,
and (names of witnesses)
___________________________________________________ and
___________________________________________________,
witnesses, as the voluntary act and deed of the Principal, this ______ day of___________.
____________________.
My commission expires:
_______________________________________________________
_______________________________________________________
Notary Public

Record of Psychiatric Advance Directive

I have given copies of my psychiatric advance directive to:

Name/Location: ______________________________________________________

Address: ______________________________________________________

Phone Numbers: ______________________________________________________

Name/Location: ______________________________________________________

Address: ______________________________________________________

Phone Numbers: ______________________________________________________

You may revoke this completed form at any time. This executed form will take precedence over any advance directive for health care, durable power of attorney for health care, health care proxy, or living will that you have executed prior to executing this form to the extent that such other documents relate to mental health care and are inconsistent with this executed form.

(b) An agent appointed by a declarant pursuant to this chapter is authorized to make any and all mental health care decisions on behalf of the declarant which the declarant could make if present and capable of making such decisions. An agent shall exercise granted powers in such manner as the agent deems consistent with the intent and desires of the declarant. The agent shall be under no duty to exercise granted powers or to assume control of or responsibility for the declarant's mental health care; but, when granted powers are exercised, the agent shall be required to use due care to act for the benefit of the declarant in accordance with the terms of the psychiatric advance directive. The agent may not delegate authority to make mental 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. If a declarant's intentions and desires are unclear, the agent shall act in the declarant's best interest considering the benefits, burdens, and risks of the declarant's circumstances and treatment options. A mental health care agent shall not have the authority to make a particular mental health care decision different from or contrary to the declarant's decision, if any, if the declarant is able to understand the general nature of the mental health care procedure or treatment being consented to or refused, as determined by the declarant's attending physician based on such physician's good faith judgment. Without limiting the generality of the foregoing, the statutory psychiatric advance directive form shall, and any different form of mental health care agency may, include the following powers, subject to any limitations appearing on the face of the form:

(1) The agent is authorized to 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 mental health of the declarant, including any medication program;

(2) The agent is authorized to admit the declarant to or discharge the declarant from any and all types of hospitals, institutions, homes, residential or nursing facilities, treatment centers, and other health care institutions providing mental health care or treatment for any type of mental condition;

(3) The agent is authorized to contract for any and all types of mental health care services and facilities in the name of and on behalf of the declarant, and the agent shall not be personally liable for any services or care contracted for on behalf of the declarant; and

(4) At the declarant's expense and subject to reasonable rules of the mental health care provider to prevent disruption of the declarant's mental health care, the agent shall have the same right the declarant has to examine and copy and consent to disclosure of all the declarant'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, skilled nursing facility, or other health care provider, notwithstanding the provisions of any statute or other rule of law to the contrary. This authority shall include all rights that the declarant has under the federal Health Insurance Portability and Accountability Act of 1996 ('HIPAA'), P.L. 104-191, and its implementing regulations regarding the use and disclosure of individually identifiable health information and other medical records.

37-11-6.

(a) Each physician, mental health care provider, hospital, skilled nursing facility, and any other person who acts in good faith reliance on any direction or decision by the mental health care agent shall be protected and released to the same extent as though such person had interacted directly with the declarant as a fully capable person. Without limiting the generality of the foregoing, the following specific provisions shall also govern, protect, and validate the acts of the mental health care agent and each such physician, mental health care provider, hospital, skilled nursing facility, and any other person acting in good faith reliance on such direction or decision:

(1) No such physician, mental health care provider, hospital, skilled nursing facility, or person shall be subject to civil or criminal liability or discipline for unprofessional conduct solely for complying with any direction or decision by the mental health care agent, even if death or injury to the declarant ensues;

(2) No such physician, mental health care provider, hospital, skilled nursing facility, or person shall be subject to civil or criminal liability or discipline for unprofessional conduct solely for failure to comply with any direction or decision by the mental health care agent, as long as such physician, mental health care provider, hospital, skilled nursing facility, or person promptly informs the mental health care agent of such physician's, mental health care provider's, hospital's, skilled nursing facility's, or person's refusal or failure to comply with such direction or decision by the mental health care agent. The mental health care agent shall then be responsible for arranging the declarant's transfer to another health care provider, hospital or skilled nursing facility. A physician, mental health care provider, hospital, skilled nursing facility, or person who is unwilling to comply with the health care agent's decision shall continue to provide reasonably necessary consultation and care in connection with the pending transfer;

(3) If the actions of a physician, mental health care provider, hospital, skilled nursing facility, or person who fails to comply with any direction or decision by the mental health care agent are substantially in accord with reasonable medical standards at the time of reference and cooperates in the transfer of the declarant pursuant to paragraph (2) of this subsection, the physician, mental health care provider, hospital, skilled nursing facility, or person shall not be subject to civil or criminal liability or discipline for unprofessional conduct for failure to comply with the psychiatric advance directive;

(4) No mental health care agent who, in good faith, acts with due care for the benefit of the declarant and in accordance with the terms of a psychiatric advance directive, or who fails to act, shall be subject to civil or criminal liability for such action or inaction; and

(5) If the authority granted by a psychiatric advance directive is revoked under this chapter, a physician, mental health care provider, hospital, skilled nursing facility, or person shall not be subject to criminal prosecution or civil liability for acting in good faith reliance upon such psychiatric advance directive unless such physician, mental health care provider, hospital, skilled nursing facility, or person had actual knowledge of the revocation.

(d) No person who witnesses a psychiatric advance directive in good faith and in accordance with this chapter shall be civilly or criminally liable or guilty of unprofessional conduct for such action.

37-11-7.

(a) This chapter applies to all mental health care providers and other persons in relation to all psychiatric advance directives executed on and after July 1, 2009. This chapter supersedes all other provisions of law or parts thereof existing on July 1, 2009, to the extent such other provisions are inconsistent with the terms and operation of this chapter, provided that this chapter does not affect the provisions of law governing emergency health care. If the declarant has executed a durable power of attorney for health care pursuant to the former Chapter 36 of Title 31, an advance directive for health care pursuant to Chapter 32 of Title 31, a health care proxy, or living will, as now or hereafter amended, the most recently executed advance directive will control to the extent that such other documents relate to mental health care and are inconsistent with such directive. Notwithstanding the foregoing, in the event the declarant does not indicate which of these documents is to take precedence with regard to mental health decisions, the document executed last shall take precedence with regard to such decisions to the extent that such other documents relate to mental health care and are inconsistent with such document.

(b) This chapter does not in any way affect or invalidate any directive executed or any act of an agent prior to July 1, 2009, or affect any claim, right, or remedy that accrued prior to July 1, 2009.

(c) This chapter is wholly independent of the provisions of Title 53, relating to wills, trusts, and the administration of estates, and nothing in this chapter shall be construed to affect in any way the provisions of said Title 53."

SECTION 2.

All laws and parts of laws in conflict with this Act are repealed.