State of Illinois
2021 and 2022


Introduced 1/27/2022, by Rep. Jennifer Gong-Gershowitz


20 ILCS 2310/2310-434 new
755 ILCS 45/4-4.1
755 ILCS 45/4-7  from Ch. 110 1/2, par. 804-7
755 ILCS 45/4-10  from Ch. 110 1/2, par. 804-10

    Amends the Department of Public Health Powers and Duties Law of the Civil Administrative Code of Illinois. Requires the Department of Public Health to post on its website information regarding the physical or electronic possession of a statutory short form power of attorney for health care. Requires the Department to create an information campaign regarding the changes made by the amendatory Act. Amends the Powers Of Attorney For Health Care Article of the Illinois Power of Attorney Act. Changes the statutory short form power of attorney for health care to include the option to present the form electronically as proof of agency. Provides that, if the principal has authorized the agent to present the statutory short form electronically, an attending physician, emergency medical services personnel, or health care provider shall not refuse to give effect to a health care agency if the agent presents an electronic device displaying an electronic copy of an executed form as proof of the health care agency. Requires any person or entity that provides a statutory short form to the public to post information on its website regarding the changes made by the amendatory Act for a period of 2 years. Makes conforming changes.

LRB102 23511 LNS 32691 b





HB5047LRB102 23511 LNS 32691 b

1    AN ACT concerning civil law.
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
4    Section 5. The Department of Public Health Powers and
5Duties Law of the Civil Administrative Code of Illinois is
6amended by adding Section 2310-434 as follows:
7    (20 ILCS 2310/2310-434 new)
8    Sec. 2310-434. Power of attorney requirements.
9    (a) The Department shall post on its website information
10regarding the physical or electronic possession of a statutory
11short form power of attorney for health care under the
12Illinois Power of Attorney Act.
13    (b) The Department shall create and implement an
14information campaign to inform the public of the changes made
15by this amendatory Act of the 102nd General Assembly to the
16statutory short form power of attorney for health care under
17the Illinois Power of Attorney Act.
18    Section 10. The Illinois Power of Attorney Act is amended
19by changing Sections 4-4.1, 4-7, and 4-10 as follows:
20    (755 ILCS 45/4-4.1)
21    Sec. 4-4.1. Format. Documents, writings, forms, and copies



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1referred to in this Article may be in hard copy or electronic
2format. Nothing in this Article is intended to prevent the
3population of a written instrument of a health care agency,
4document, writing, or form with electronic data. An agent may
5present an electronic device displaying an electronic copy of
6an executed form as proof of the health care agency.
7(Source: P.A. 101-163, eff. 1-1-20.)
8    (755 ILCS 45/4-7)  (from Ch. 110 1/2, par. 804-7)
9    Sec. 4-7. Duties of health care providers and others in
10relation to health care agencies. Each health care provider
11and each other person with whom an agent deals under a health
12care agency shall be subject to the following duties and
14    (a) It is the responsibility of the agent or patient to
15notify the health care provider of the existence of the health
16care agency and any amendment or revocation thereof. An agent
17may present an electronic device displaying an electronic copy
18of an executed form as proof of the health care agency. A
19health care provider furnished with a copy of a health care
20agency shall make it a part of the patient's medical records
21and shall enter in the records any change in or termination of
22the health care agency by the principal that becomes known to
23the provider. Whenever a provider believes a patient may lack
24capacity to give informed consent to health care which the
25provider deems necessary, the provider shall consult with any



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1available health care agent known to the provider who then has
2power to act for the patient under a health care agency.
3    (b) A health care decision made by an agent in accordance
4with the terms of a health care agency shall be complied with
5by every health care provider to whom the decision is
6communicated, subject to the provider's right to administer
7treatment for the patient's comfort care or alleviation of
8pain; but if the provider is unwilling to comply with the
9agent's decision, the provider shall promptly inform the agent
10who shall then be responsible to make the necessary
11arrangements for the transfer of the patient to another
12provider. It is understood that a provider who is unwilling to
13comply with the agent's decision will continue to afford
14reasonably necessary consultation and care in connection with
15the transfer.
16    (c) At the patient's expense and subject to reasonable
17rules of the health care provider to prevent disruption of the
18patient's health care, each health care provider shall give an
19agent authorized to receive such information under a health
20care agency the same right the principal has to examine and
21copy any part or all of the patient's medical records that the
22agent deems relevant to the exercise of the agent's powers,
23whether the records relate to mental health or any other
24medical condition and whether they are in the possession of or
25maintained by any physician, psychiatrist, psychologist,
26therapist, hospital, nursing home or other health care



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2    (d) If and to the extent a health care agency empowers the
3agent to (1) make an anatomical gift on behalf of the principal
4under the Illinois Anatomical Gift Act, as now or hereafter
5amended, or (2) authorize an autopsy of the principal's body
6pursuant to Section 2 of "An Act in relation to autopsy of dead
7bodies", approved August 13, 1965, as now or hereafter
8amended, or (3) direct the disposition of the principal's
9remains, the decision by an authorized agent as to anatomical
10gift, autopsy approval or remains disposition shall be deemed
11the act of the principal and shall control over the decision of
12other persons who might otherwise have priority; and each
13person to whom a direction by the agent in accordance with the
14terms of the agency is communicated shall comply with such
16(Source: P.A. 93-794, eff. 7-22-04.)
17    (755 ILCS 45/4-10)  (from Ch. 110 1/2, par. 804-10)
18    Sec. 4-10. Statutory short form power of attorney for
19health care.
20    (a) The form prescribed in this Section (sometimes also
21referred to in this Act as the "statutory health care power")
22may be used to grant an agent powers with respect to the
23principal's own health care; but the statutory health care
24power is not intended to be exclusive nor to cover delegation
25of a parent's power to control the health care of a minor



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1child, and no provision of this Article shall be construed to
2invalidate or bar use by the principal of any other or
3different form of power of attorney for health care.
4Nonstatutory health care powers must be executed by the
5principal, designate the agent and the agent's powers, and
6comply with the limitations in Section 4-5 of this Article,
7but they need not be witnessed or conform in any other respect
8to the statutory health care power.
9    No specific format is required for the statutory health
10care power of attorney other than the notice must precede the
11form. The statutory health care power may be included in or
12combined with any other form of power of attorney governing
13property or other matters.
14    The signature and execution requirements set forth in this
15Article are satisfied by: (i) written signatures or initials;
16or (ii) electronic signatures or computer-generated signature
17codes. Electronic documents under this Act may be created,
18signed, or revoked electronically using a generic,
19technology-neutral system in which each user is assigned a
20unique identifier that is securely maintained and in a manner
21that meets the regulatory requirements for a digital or
22electronic signature. Compliance with the standards defined in
23the Uniform Electronic Transactions Act or the implementing
24rules of the Hospital Licensing Act for medical record entry
25authentication for author validation of the documentation,
26content accuracy, and completeness meets this standard.



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1    (b) The Illinois Statutory Short Form Power of Attorney
2for Health Care shall be substantially as follows:
5    No one can predict when a serious illness or accident
6might occur. When it does, you may need someone else to speak
7or make health care decisions for you. If you plan now, you can
8increase the chances that the medical treatment you get will
9be the treatment you want.
10    In Illinois, you can choose someone to be your "health
11care agent". Your agent is the person you trust to make health
12care decisions for you if you are unable or do not want to make
13them yourself. These decisions should be based on your
14personal values and wishes.
15    It is important to put your choice of agent in writing. The
16written form is often called an "advance directive". You may
17use this form or another form, as long as it meets the legal
18requirements of Illinois. There are many written and online
19on-line resources to guide you and your loved ones in having a
20conversation about these issues. You may find it helpful to
21look at these resources while thinking about and discussing
22your advance directive.



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1    The selection of your agent should be considered
2carefully, as your agent will have the ultimate
3decision-making authority once this document goes into effect,
4in most instances after you are no longer able to make your own
5decisions. While the goal is for your agent to make decisions
6in keeping with your preferences and in the majority of
7circumstances that is what happens, please know that the law
8does allow your agent to make decisions to direct or refuse
9health care interventions or withdraw treatment. Your agent
10will need to think about conversations you have had, your
11personality, and how you handled important health care issues
12in the past. Therefore, it is important to talk with your agent
13and your family about such things as:
14        (i) What is most important to you in your life?
15        (ii) How important is it to you to avoid pain and
16    suffering?
17        (iii) If you had to choose, is it more important to you
18    to live as long as possible, or to avoid prolonged
19    suffering or disability?
20        (iv) Would you rather be at home or in a hospital for
21    the last days or weeks of your life?
22        (v) Do you have religious, spiritual, or cultural
23    beliefs that you want your agent and others to consider?
24        (vi) Do you wish to make a significant contribution to
25    medical science after your death through organ or whole
26    body donation?



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1        (vii) Do you have an existing advance directive, such
2    as a living will, that contains your specific wishes about
3    health care that is only delaying your death? If you have
4    another advance directive, make sure to discuss with your
5    agent the directive and the treatment decisions contained
6    within that outline your preferences. Make sure that your
7    agent agrees to honor the wishes expressed in your advance
8    directive.
10    If there is ever a period of time when your physician
11determines that you cannot make your own health care
12decisions, or if you do not want to make your own decisions,
13some of the decisions your agent could make are to:
14        (i) talk with physicians and other health care
15    providers about your condition.
16        (ii) see medical records and approve who else can see
17    them.
18        (iii) give permission for medical tests, medicines,
19    surgery, or other treatments.
20        (iv) choose where you receive care and which
21    physicians and others provide it.
22        (v) decide to accept, withdraw, or decline treatments
23    designed to keep you alive if you are near death or not
24    likely to recover. You may choose to include guidelines
25    and/or restrictions to your agent's authority.



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1        (vi) agree or decline to donate your organs or your
2    whole body if you have not already made this decision
3    yourself. This could include donation for transplant,
4    research, and/or education. You should let your agent know
5    whether you are registered as a donor in the First Person
6    Consent registry maintained by the Illinois Secretary of
7    State or whether you have agreed to donate your whole body
8    for medical research and/or education.
9        (vii) decide what to do with your remains after you
10    have died, if you have not already made plans.
11        (viii) talk with your other loved ones to help come to
12    a decision (but your designated agent will have the final
13    say over your other loved ones).
14    Your agent is not automatically responsible for your
15health care expenses.
17    You can pick a family member, but you do not have to. Your
18agent will have the responsibility to make medical treatment
19decisions, even if other people close to you might urge a
20different decision. The selection of your agent should be done
21carefully, as he or she will have ultimate decision-making
22authority for your treatment decisions once you are no longer
23able to voice your preferences. Choose a family member,
24friend, or other person who:
25        (i) is at least 18 years old;



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1        (ii) knows you well;
2        (iii) you trust to do what is best for you and is
3    willing to carry out your wishes, even if he or she may not
4    agree with your wishes;
5        (iv) would be comfortable talking with and questioning
6    your physicians and other health care providers;
7        (v) would not be too upset to carry out your wishes if
8    you became very sick; and
9        (vi) can be there for you when you need it and is
10    willing to accept this important role.
13    If the person who is your first choice is unable to carry
14out this role, then the second agent you chose will make the
15decisions; if your second agent is not available, then the
16third agent you chose will make the decisions. The second and
17third agents are called your successor agents and they
18function as back-up agents to your first choice agent and may
19act only one at a time and in the order you list them.
22    If you become unable to make your own health care
23decisions and have not named an agent in writing, your
24physician and other health care providers will ask a family



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1member, friend, or guardian to make decisions for you. In
2Illinois, a law directs which of these individuals will be
3consulted. In that law, each of these individuals is called a
5    There are reasons why you may want to name an agent rather
6than rely on a surrogate:
7        (i) The person or people listed by this law may not be
8    who you would want to make decisions for you.
9        (ii) Some family members or friends might not be able
10    or willing to make decisions as you would want them to.
11        (iii) Family members and friends may disagree with one
12    another about the best decisions.
13        (iv) Under some circumstances, a surrogate may not be
14    able to make the same kinds of decisions that an agent can
15    make.
18    In this situation, it is especially important to talk to
19your physician and other health care providers and create
20written guidance about what you want or do not want, in case
21you are ever critically ill and cannot express your own
22wishes. You can complete a living will. You can also write your
23wishes down and/or discuss them with your physician or other
24health care provider and ask him or her to write it down in
25your chart. You might also want to use written or online



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1on-line resources to guide you through this process.
3    Follow these instructions after you have completed the
5        (i) Sign the form in front of a witness. See the form
6    for a list of who can and cannot witness it.
7        (ii) Ask the witness to sign it, too.
8        (iii) There is no need to have the form notarized.
9        (iv) Give a copy to your agent and to each of your
10    successor agents.
11        (v) Give another copy to your physician.
12        (vi) Take a copy with you when you go to the hospital.
13        (vii) Show it to your family and friends and others
14    who care for you.
16    You may change your mind at any time. If you do, tell
17someone who is at least 18 years old that you have changed your
18mind, and/or destroy your document and any copies. If you
19wish, fill out a new form and make sure everyone you gave the
20old form to has a copy of the new one, including, but not
21limited to, your agents and your physicians. If you are
22concerned you may revoke your power of attorney at a time when
23you may need it the most, you may initial the box at the end of
24the form to indicate that you would like a 30-day waiting



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1period after you voice your intent to revoke your power of
2attorney. This means if your agent is making decisions for you
3during that time, your agent can continue to make decisions on
4your behalf. This election is purely optional, and you do not
5have to choose it. If you do not choose this option, you can
6change your mind and revoke the power of attorney at any time.
8    In the event you do not want to use the Illinois statutory
9form provided here, any document you complete must be executed
10by you, designate an agent who is over 18 years of age and not
11prohibited from serving as your agent, and state the agent's
12powers, but it need not be witnessed or conform in any other
13respect to the statutory health care power.
14    If you have questions about the use of any form, you may
15want to consult your physician, other health care provider,
16and/or an attorney.

19FOR HEALTH CARE. (You must sign this form and a witness must
20also sign it before it is valid)
21My name (Print your full name):..........
22My address:..................................................



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2(an agent is your personal representative under state and
3federal law):
4(Agent name).................
5(Agent address).............
6(Agent phone number).........................................
7(Please check box if applicable) .... If a guardian of my
8person is to be appointed, I nominate the agent acting under
9this power of attorney as guardian.
11    If the agent I selected is unable or does not want to make
12health care decisions for me, then I request the person(s) I
13name below to be my successor health care agent(s). Only one
14person at a time can serve as my agent (add another page if you
15want to add more successor agent names):
17(Successor agent #1 name, address and phone number)
19(Successor agent #2 name, address and phone number)
20(Please check box if applicable) .... If presentation of this
21form is required to carry out health care decisions set forth
22in this form, I authorize the use of an electronic device to



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1display a copy of this form as proof of the health care agency.
3        (i) Deciding to accept, withdraw, or decline treatment
4    for any physical or mental condition of mine, including
5    life-and-death decisions.
6        (ii) Agreeing to admit me to or discharge me from any
7    hospital, home, or other institution, including a mental
8    health facility.
9        (iii) Having complete access to my medical and mental
10    health records, and sharing them with others as needed,
11    including after I die.
12        (iv) Carrying out the plans I have already made, or,
13    if I have not done so, making decisions about my body or
14    remains, including organ, tissue or whole body donation,
15    autopsy, cremation, and burial.
16    The above grant of power is intended to be as broad as
17possible so that my agent will have the authority to make any
18decision I could make to obtain or terminate any type of health
19care, including withdrawal of nutrition and hydration and
20other life-sustaining measures.
21I AUTHORIZE MY AGENT TO (please check any one box):
22    .... Make decisions for me only when I cannot make them for
23    myself. The physician(s) taking care of me will determine
24    when I lack this ability.



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1        (If no box is checked, then the box above shall be
2    implemented.) OR
3    .... Make decisions for me only when I cannot make them for
4    myself. The physician(s) taking care of me will determine
5    when I lack this ability. Starting now, for the purpose of
6    assisting me with my health care plans and decisions, my
7    agent shall have complete access to my medical and mental
8    health records, the authority to share them with others as
9    needed, and the complete ability to communicate with my
10    personal physician(s) and other health care providers,
11    including the ability to require an opinion of my
12    physician as to whether I lack the ability to make
13    decisions for myself. OR
14    .... Make decisions for me starting now and continuing
15    after I am no longer able to make them for myself. While I
16    am still able to make my own decisions, I can still do so
17    if I want to.
18    The subject of life-sustaining treatment is of particular
19importance. Life-sustaining treatments may include tube
20feedings or fluids through a tube, breathing machines, and
21CPR. In general, in making decisions concerning
22life-sustaining treatment, your agent is instructed to
23consider the relief of suffering, the quality as well as the
24possible extension of your life, and your previously expressed
25wishes. Your agent will weigh the burdens versus benefits of



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1proposed treatments in making decisions on your behalf.
2    Additional statements concerning the withholding or
3removal of life-sustaining treatment are described below.
4These can serve as a guide for your agent when making decisions
5for you. Ask your physician or health care provider if you have
6any questions about these statements.
8WISHES (optional):
9    .... The quality of my life is more important than the
10    length of my life. If I am unconscious and my attending
11    physician believes, in accordance with reasonable medical
12    standards, that I will not wake up or recover my ability to
13    think, communicate with my family and friends, and
14    experience my surroundings, I do not want treatments to
15    prolong my life or delay my death, but I do want treatment
16    or care to make me comfortable and to relieve me of pain.
17    .... Staying alive is more important to me, no matter how
18    sick I am, how much I am suffering, the cost of the
19    procedures, or how unlikely my chances for recovery are. I
20    want my life to be prolonged to the greatest extent
21    possible in accordance with reasonable medical standards.
23    The above grant of power is intended to be as broad as
24possible so that your agent will have the authority to make any



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1decision you could make to obtain or terminate any type of
2health care. If you wish to limit the scope of your agent's
3powers or prescribe special rules or limit the power to
4authorize autopsy or dispose of remains, you may do so
5specifically in this form.
8My signature:..................
9Today's date:................................................
11    .... I elect to delay revocation of this power of attorney
12for 30 days after I communicate my intent to revoke it.
13    .... I elect for the revocation of this power of attorney
14to take effect immediately if I communicate my intent to
15revoke it.
18    I am at least 18 years old. (check one of the options
20    .... I saw the principal sign this document, or
21    .... the principal told me that the signature or mark on
22    the principal signature line is his or hers.
23    I am not the agent or successor agent(s) named in this



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1document. I am not related to the principal, the agent, or the
2successor agent(s) by blood, marriage, or adoption. I am not
3the principal's physician, advanced practice registered nurse,
4dentist, podiatric physician, optometrist, psychologist, or a
5relative of one of those individuals. I am not an owner or
6operator (or the relative of an owner or operator) of the
7health care facility where the principal is a patient or
9Witness printed name:............
10Witness address:..............
11Witness signature:...............
12Today's date:................................................
13    (c) The statutory short form power of attorney for health
14care (the "statutory health care power") authorizes the agent
15to make any and all health care decisions on behalf of the
16principal which the principal could make if present and under
17no disability, subject to any limitations on the granted
18powers that appear on the face of the form, to be exercised in
19such manner as the agent deems consistent with the intent and
20desires of the principal. The agent will be under no duty to
21exercise granted powers or to assume control of or
22responsibility for the principal's health care; but when
23granted powers are exercised, the agent will be required to
24use due care to act for the benefit of the principal in
25accordance with the terms of the statutory health care power



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1and will be liable for negligent exercise. The agent may act in
2person or through others reasonably employed by the agent for
3that purpose but may not delegate authority to make health
4care decisions. The agent may sign and deliver all
5instruments, negotiate and enter into all agreements, and do
6all other acts reasonably necessary to implement the exercise
7of the powers granted to the agent. Without limiting the
8generality of the foregoing, the statutory health care power
9shall include the following powers, subject to any limitations
10appearing on the face of the form:
11        (1) The agent is authorized to give consent to and
12    authorize or refuse, or to withhold or withdraw consent
13    to, any and all types of medical care, treatment, or
14    procedures relating to the physical or mental health of
15    the principal, including any medication program, surgical
16    procedures, life-sustaining treatment, or provision of
17    food and fluids for the principal.
18        (2) The agent is authorized to admit the principal to
19    or discharge the principal from any and all types of
20    hospitals, institutions, homes, residential or nursing
21    facilities, treatment centers, and other health care
22    institutions providing personal care or treatment for any
23    type of physical or mental condition. The agent shall have
24    the same right to visit the principal in the hospital or
25    other institution as is granted to a spouse or adult child
26    of the principal, any rule of the institution to the



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1    contrary notwithstanding.
2        (3) The agent is authorized to contract for any and
3    all types of health care services and facilities in the
4    name of and on behalf of the principal and to bind the
5    principal to pay for all such services and facilities, and
6    to have and exercise those powers over the principal's
7    property as are authorized under the statutory property
8    power, to the extent the agent deems necessary to pay
9    health care costs; and the agent shall not be personally
10    liable for any services or care contracted for on behalf
11    of the principal.
12        (4) At the principal's expense and subject to
13    reasonable rules of the health care provider to prevent
14    disruption of the principal's health care, the agent shall
15    have the same right the principal has to examine and copy
16    and consent to disclosure of all the principal's medical
17    records that the agent deems relevant to the exercise of
18    the agent's powers, whether the records relate to mental
19    health or any other medical condition and whether they are
20    in the possession of or maintained by any physician,
21    psychiatrist, psychologist, therapist, hospital, nursing
22    home, or other health care provider. The authority under
23    this paragraph (4) applies to any information governed by
24    the Health Insurance Portability and Accountability Act of
25    1996 ("HIPAA") and regulations thereunder. The agent
26    serves as the principal's personal representative, as that



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1    term is defined under HIPAA and regulations thereunder.
2        (5) The agent is authorized: to direct that an autopsy
3    be made pursuant to Section 2 of the Autopsy Act; to make a
4    disposition of any part or all of the principal's body
5    pursuant to the Illinois Anatomical Gift Act, as now or
6    hereafter amended; and to direct the disposition of the
7    principal's remains.
8        (6) At any time during which there is no executor or
9    administrator appointed for the principal's estate, the
10    agent is authorized to continue to pursue an application
11    or appeal for government benefits if those benefits were
12    applied for during the life of the principal.
13    (d) A physician may determine that the principal is unable
14to make health care decisions for himself or herself only if
15the principal lacks decisional capacity, as that term is
16defined in Section 10 of the Health Care Surrogate Act.
17    (e) If the principal names the agent as a guardian on the
18statutory short form, and if a court decides that the
19appointment of a guardian will serve the principal's best
20interests and welfare, the court shall appoint the agent to
21serve without bond or security.
22    (f) If the principal has authorized the agent to present
23the statutory short form electronically, an attending
24physician, emergency medical services personnel as defined by
25Section 3.5 of the Emergency Medical Services (EMS) Systems
26Act, or health care provider shall not refuse to give effect to



HB5047- 23 -LRB102 23511 LNS 32691 b

1a health care agency if the agent presents an electronic
2device displaying an electronic copy of an executed form as
3proof of the health care agency. Any person or entity that
4provides a statutory short form to the public shall post for a
5period of 2 years information on its website regarding the
6changes made by this amendatory Act of the 102nd General
8(Source: P.A. 101-81, eff. 7-12-19; 101-163, eff. 1-1-20;
9102-38, eff. 6-25-21; 102-181, eff. 7-30-21; revised 9-22-21.)