BILL ANALYSIS                                                                                                                                                                                                    



                                                                       


           ------------------------------------------------------------ 
          |SENATE RULES COMMITTEE            |                  AB 1278|
          |Office of Senate Floor Analyses   |                         |
          |1020 N Street, Suite 524          |                         |
          |(916) 445-6614         Fax: (916) |                         |
          |327-4478                          |                         |
           ------------------------------------------------------------ 
           
                                         
                                 THIRD READING


          Bill No:  AB 1278
          Author:   Wayne (D)
          Amended:  7/9/01 in Senate
          Vote:     21

           
           SENATE JUDICIARY COMMITTEE  :  4-2, 7/3/01
          AYES:  Escutia, Kuehl, O'Connell, Peace
          NOES:  Ackerman, Haynes

           ASSEMBLY FLOOR  :  73-0, 4/19/01 - See last page for vote


           SUBJECT  :    Health care decisions

           SOURCE  :     California Law Revision Commission


           DIGEST  :    This bill makes revisions to the Health Care  
          Decisions Law at the recommendation of the California Law  
          Revision Commission.

          The revisions clarify duties and liabilities of an  
          appointed agent for health care with respect to funeral  
          decisions and the relationship between a "surrogate" and an  
          "agent," and remove authority to make health care decisions  
          from the authority that may be given by a person having  
          capacity to an attorney-in-fact under a general power of  
          attorney.  The bill redefines "capacity" as used in the  
          Health Care Decisions Law and specify use of a court  
          petition to enforce health care instructions by the person  
          or his or her agent or surrogate.

           ANALYSIS  :    Under the Health Care Decisions Law (the  
                                                           CONTINUED





                                                               AB 1278
                                                                Page  
          2

          HCDL), a person having capacity may authorize another to  
          make decisions on his or her behalf pursuant to a power of  
          attorney or pursuant to an advance health care directive,  
          as specified.  The HCDL defines a legally sufficient health  
          care directive, specifies how a power of attorney that  
          suffices as a health care directive is to be limited, and  
          specifies the powers of an agent appointed by the principal  
          of a power of attorney for health care.  Under the HCDL, a  
          patient in a health care facility or intermediate care  
          facility may also appoint a surrogate, orally or in  
          writing, and communicate that to the supervising health  
          care provider.

          This bill:

          1.Clarifies that an attorney-in fact under a general power  
            of attorney is not authorized to make health care  
            decisions for the principal.

          2.Redefines"capacity" with respect to a person's ability to  
            understand, make, and communicate decisions, including  
            health care decisions.

          3.Clarifies the duties and liabilities of an agent with  
            respect to funeral decisions.

          4.Clarifies the authority of a "surrogate" rather than an  
            "agent" to make health care decisions if both were  
            appointed

          5.Clarifies who may and may not make health care decisions  
            as a surrogate under the HCDL or an agent under a power  
            of attorney for health care.

          6.Specifies use of a court petition to honor individual  
            health care instructions or to enforce health care  
            decisions by an agent or surrogate.

           Background

           California's HCDL was enacted in 1999 (AB 891, Alquist,  
          Chapter 658, Statutes of 1999), and became operative on  
          July 1, 2000. The HCDL provides for the creation, form, and  
          revocation of advance health care directives, and for the  







                                                               AB 1278
                                                                Page  
          3

          manner of making health care decisions for patients without  
          surrogates.  While there were inconsistent and unclear  
          guidelines being used by the medical profession and the bar  
          before AB 891 was passed, the Act now provides uniform  
          statutory rules for determining succession to  
          decisionmaking in the case of an incapacitated person,  
          especially one who has no appointed surrogate.

          Since it became operative last year, health care  
          institutions and professional groups that have begun to  
          implement the new law have uncovered several problems and  
          reported them to the California Law Revision Commission  
          (CLRC).  This bill contains all of the CLRC's  
          recommendations for resolving those reported problems and  
          other minor issues.  
           
           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  No    
          Local:  No

           SUPPORT  :   (Verified  7/9/01)

          National Senior Citizens Law Center
          California Medical Association
          American Association of Retired Persons - California
          Protection and Advocacy, Inc.

           ARGUMENTS IN SUPPORT  :    The miscellaneous revisions to the  
          HCDL proposed by the CLRC arose from a follow-up study of  
          the HCDL since it became effective July 1, 2000.  The CLRC  
          states that the revisions are necessary to avoid unintended  
          consequences of the HCDL, and to clarify ambiguities that  
          have surfaced or that may cause problems later on.


           ASSEMBLY FLOOR  : 
          AYES:  Alquist, Aroner, Ashburn, Bates, Bogh, Briggs,  
            Calderon, Bill Campbell, John Campbell, Canciamilla,  
            Cardenas, Cardoza, Chan, Chavez, Cogdill, Cohn, Corbett,  
            Correa, Cox, Daucher, Diaz, Dickerson, Dutra, Firebaugh,  
            Florez, Goldberg, Harman, Havice, Hollingsworth, Horton,  
            Jackson, Keeley, Kehoe, Koretz, La Suer, Leach, Leslie,  
            Liu, Longville, Lowenthal, Maddox, Maldonado, Matthews,  
            Migden, Mountjoy, Nakano, Nation, Negrete McLeod,  
            Oropeza, Robert Pacheco, Rod Pacheco, Papan, Pavley,  







                                                               AB 1278
                                                                Page  
          4

            Pescetti, Reyes, Richman, Runner, Salinas, Shelley,  
            Simitian, Steinberg, Strickland, Strom-Martin, Thomson,  
            Vargas, Washington, Wayne, Wesson, Wiggins, Wyland,  
            Wyman, Zettel, Hertzberg


          RJG:cm  7/6/01   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

                                ****  END  ****