Rep. Jennifer Gong-Gershowitz

Filed: 2/18/2022





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2    AMENDMENT NO. ______. Amend House Bill 5047 by replacing
3everything after the enacting clause with the following:
4    "Section 5. The Illinois Power of Attorney Act is amended
5by changing Sections 4-4.1, 4-7, and 4-10 as follows:
6    (755 ILCS 45/4-4.1)
7    Sec. 4-4.1. Format. Documents, writings, forms, and copies
8referred to in this Article may be in hard copy or electronic
9format. Nothing in this Article is intended to prevent the
10population of a written instrument of a health care agency,
11document, writing, or form with electronic data. An agent may
12present an electronic device displaying an electronic copy of
13an executed form as proof of the health care agency.
14(Source: P.A. 101-163, eff. 1-1-20.)
15    (755 ILCS 45/4-7)  (from Ch. 110 1/2, par. 804-7)



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1    Sec. 4-7. Duties of health care providers and others in
2relation to health care agencies. Each health care provider
3and each other person with whom an agent deals under a health
4care agency shall be subject to the following duties and
6    (a) It is the responsibility of the agent or patient to
7notify the health care provider of the existence of the health
8care agency and any amendment or revocation thereof. An agent
9may present an electronic device displaying an electronic copy
10of an executed form as proof of the health care agency. A
11health care provider furnished with a copy of a health care
12agency shall make it a part of the patient's medical records
13and shall enter in the records any change in or termination of
14the health care agency by the principal that becomes known to
15the provider. Whenever a provider believes a patient may lack
16capacity to give informed consent to health care which the
17provider deems necessary, the provider shall consult with any
18available health care agent known to the provider who then has
19power to act for the patient under a health care agency.
20    (b) A health care decision made by an agent in accordance
21with the terms of a health care agency shall be complied with
22by every health care provider to whom the decision is
23communicated, subject to the provider's right to administer
24treatment for the patient's comfort care or alleviation of
25pain; but if the provider is unwilling to comply with the
26agent's decision, the provider shall promptly inform the agent



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1who shall then be responsible to make the necessary
2arrangements for the transfer of the patient to another
3provider. It is understood that a provider who is unwilling to
4comply with the agent's decision will continue to afford
5reasonably necessary consultation and care in connection with
6the transfer.
7    (c) At the patient's expense and subject to reasonable
8rules of the health care provider to prevent disruption of the
9patient's health care, each health care provider shall give an
10agent authorized to receive such information under a health
11care agency the same right the principal has to examine and
12copy any part or all of the patient's medical records that the
13agent deems relevant to the exercise of the agent's powers,
14whether the records relate to mental health or any other
15medical condition and whether they are in the possession of or
16maintained by any physician, psychiatrist, psychologist,
17therapist, hospital, nursing home or other health care
19    (d) If and to the extent a health care agency empowers the
20agent to (1) make an anatomical gift on behalf of the principal
21under the Illinois Anatomical Gift Act, as now or hereafter
22amended, or (2) authorize an autopsy of the principal's body
23pursuant to Section 2 of "An Act in relation to autopsy of dead
24bodies", approved August 13, 1965, as now or hereafter
25amended, or (3) direct the disposition of the principal's
26remains, the decision by an authorized agent as to anatomical



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1gift, autopsy approval or remains disposition shall be deemed
2the act of the principal and shall control over the decision of
3other persons who might otherwise have priority; and each
4person to whom a direction by the agent in accordance with the
5terms of the agency is communicated shall comply with such
7(Source: P.A. 93-794, eff. 7-22-04.)
8    (755 ILCS 45/4-10)  (from Ch. 110 1/2, par. 804-10)
9    Sec. 4-10. Statutory short form power of attorney for
10health care.
11    (a) The form prescribed in this Section (sometimes also
12referred to in this Act as the "statutory health care power")
13may be used to grant an agent powers with respect to the
14principal's own health care; but the statutory health care
15power is not intended to be exclusive nor to cover delegation
16of a parent's power to control the health care of a minor
17child, and no provision of this Article shall be construed to
18invalidate or bar use by the principal of any other or
19different form of power of attorney for health care.
20Nonstatutory health care powers must be executed by the
21principal, designate the agent and the agent's powers, and
22comply with the limitations in Section 4-5 of this Article,
23but they need not be witnessed or conform in any other respect
24to the statutory health care power.
25    No specific format is required for the statutory health



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1care power of attorney other than the notice must precede the
2form. The statutory health care power may be included in or
3combined with any other form of power of attorney governing
4property or other matters.
5    The signature and execution requirements set forth in this
6Article are satisfied by: (i) written signatures or initials;
7or (ii) electronic signatures or computer-generated signature
8codes. Electronic documents under this Act may be created,
9signed, or revoked electronically using a generic,
10technology-neutral system in which each user is assigned a
11unique identifier that is securely maintained and in a manner
12that meets the regulatory requirements for a digital or
13electronic signature. Compliance with the standards defined in
14the Uniform Electronic Transactions Act or the implementing
15rules of the Hospital Licensing Act for medical record entry
16authentication for author validation of the documentation,
17content accuracy, and completeness meets this standard.
18    (b) The Illinois Statutory Short Form Power of Attorney
19for Health Care shall be substantially as follows:
22    No one can predict when a serious illness or accident
23might occur. When it does, you may need someone else to speak
24or make health care decisions for you. If you plan now, you can
25increase the chances that the medical treatment you get will



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1be the treatment you want.
2    In Illinois, you can choose someone to be your "health
3care agent". Your agent is the person you trust to make health
4care decisions for you if you are unable or do not want to make
5them yourself. These decisions should be based on your
6personal values and wishes.
7    It is important to put your choice of agent in writing. The
8written form is often called an "advance directive". You may
9use this form or another form, as long as it meets the legal
10requirements of Illinois. There are many written and online
11on-line resources to guide you and your loved ones in having a
12conversation about these issues. You may find it helpful to
13look at these resources while thinking about and discussing
14your advance directive.
17    The selection of your agent should be considered
18carefully, as your agent will have the ultimate
19decision-making authority once this document goes into effect,
20in most instances after you are no longer able to make your own
21decisions. While the goal is for your agent to make decisions
22in keeping with your preferences and in the majority of
23circumstances that is what happens, please know that the law
24does allow your agent to make decisions to direct or refuse
25health care interventions or withdraw treatment. Your agent



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1will need to think about conversations you have had, your
2personality, and how you handled important health care issues
3in the past. Therefore, it is important to talk with your agent
4and your family about such things as:
5        (i) What is most important to you in your life?
6        (ii) How important is it to you to avoid pain and
7    suffering?
8        (iii) If you had to choose, is it more important to you
9    to live as long as possible, or to avoid prolonged
10    suffering or disability?
11        (iv) Would you rather be at home or in a hospital for
12    the last days or weeks of your life?
13        (v) Do you have religious, spiritual, or cultural
14    beliefs that you want your agent and others to consider?
15        (vi) Do you wish to make a significant contribution to
16    medical science after your death through organ or whole
17    body donation?
18        (vii) Do you have an existing advance directive, such
19    as a living will, that contains your specific wishes about
20    health care that is only delaying your death? If you have
21    another advance directive, make sure to discuss with your
22    agent the directive and the treatment decisions contained
23    within that outline your preferences. Make sure that your
24    agent agrees to honor the wishes expressed in your advance
25    directive.



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2    If there is ever a period of time when your physician
3determines that you cannot make your own health care
4decisions, or if you do not want to make your own decisions,
5some of the decisions your agent could make are to:
6        (i) talk with physicians and other health care
7    providers about your condition.
8        (ii) see medical records and approve who else can see
9    them.
10        (iii) give permission for medical tests, medicines,
11    surgery, or other treatments.
12        (iv) choose where you receive care and which
13    physicians and others provide it.
14        (v) decide to accept, withdraw, or decline treatments
15    designed to keep you alive if you are near death or not
16    likely to recover. You may choose to include guidelines
17    and/or restrictions to your agent's authority.
18        (vi) agree or decline to donate your organs or your
19    whole body if you have not already made this decision
20    yourself. This could include donation for transplant,
21    research, and/or education. You should let your agent know
22    whether you are registered as a donor in the First Person
23    Consent registry maintained by the Illinois Secretary of
24    State or whether you have agreed to donate your whole body
25    for medical research and/or education.
26        (vii) decide what to do with your remains after you



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1    have died, if you have not already made plans.
2        (viii) talk with your other loved ones to help come to
3    a decision (but your designated agent will have the final
4    say over your other loved ones).
5    Your agent is not automatically responsible for your
6health care expenses.
8    You can pick a family member, but you do not have to. Your
9agent will have the responsibility to make medical treatment
10decisions, even if other people close to you might urge a
11different decision. The selection of your agent should be done
12carefully, as he or she will have ultimate decision-making
13authority for your treatment decisions once you are no longer
14able to voice your preferences. Choose a family member,
15friend, or other person who:
16        (i) is at least 18 years old;
17        (ii) knows you well;
18        (iii) you trust to do what is best for you and is
19    willing to carry out your wishes, even if he or she may not
20    agree with your wishes;
21        (iv) would be comfortable talking with and questioning
22    your physicians and other health care providers;
23        (v) would not be too upset to carry out your wishes if
24    you became very sick; and
25        (vi) can be there for you when you need it and is



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1    willing to accept this important role.
4    If the person who is your first choice is unable to carry
5out this role, then the second agent you chose will make the
6decisions; if your second agent is not available, then the
7third agent you chose will make the decisions. The second and
8third agents are called your successor agents and they
9function as back-up agents to your first choice agent and may
10act only one at a time and in the order you list them.
13    If you become unable to make your own health care
14decisions and have not named an agent in writing, your
15physician and other health care providers will ask a family
16member, friend, or guardian to make decisions for you. In
17Illinois, a law directs which of these individuals will be
18consulted. In that law, each of these individuals is called a
20    There are reasons why you may want to name an agent rather
21than rely on a surrogate:
22        (i) The person or people listed by this law may not be
23    who you would want to make decisions for you.
24        (ii) Some family members or friends might not be able



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1    or willing to make decisions as you would want them to.
2        (iii) Family members and friends may disagree with one
3    another about the best decisions.
4        (iv) Under some circumstances, a surrogate may not be
5    able to make the same kinds of decisions that an agent can
6    make.
9    In this situation, it is especially important to talk to
10your physician and other health care providers and create
11written guidance about what you want or do not want, in case
12you are ever critically ill and cannot express your own
13wishes. You can complete a living will. You can also write your
14wishes down and/or discuss them with your physician or other
15health care provider and ask him or her to write it down in
16your chart. You might also want to use written or online
17on-line resources to guide you through this process.
19    Follow these instructions after you have completed the
21        (i) Sign the form in front of a witness. See the form
22    for a list of who can and cannot witness it.
23        (ii) Ask the witness to sign it, too.
24        (iii) There is no need to have the form notarized.



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1        (iv) Give a copy to your agent and to each of your
2    successor agents.
3        (v) Give another copy to your physician.
4        (vi) Take a copy with you when you go to the hospital.
5        (vii) Show it to your family and friends and others
6    who care for you.
8    You may change your mind at any time. If you do, tell
9someone who is at least 18 years old that you have changed your
10mind, and/or destroy your document and any copies. If you
11wish, fill out a new form and make sure everyone you gave the
12old form to has a copy of the new one, including, but not
13limited to, your agents and your physicians. If you are
14concerned you may revoke your power of attorney at a time when
15you may need it the most, you may initial the box at the end of
16the form to indicate that you would like a 30-day waiting
17period after you voice your intent to revoke your power of
18attorney. This means if your agent is making decisions for you
19during that time, your agent can continue to make decisions on
20your behalf. This election is purely optional, and you do not
21have to choose it. If you do not choose this option, you can
22change your mind and revoke the power of attorney at any time.
24    In the event you do not want to use the Illinois statutory



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1form provided here, any document you complete must be executed
2by you, designate an agent who is over 18 years of age and not
3prohibited from serving as your agent, and state the agent's
4powers, but it need not be witnessed or conform in any other
5respect to the statutory health care power.
6    If you have questions about the use of any form, you may
7want to consult your physician, other health care provider,
8and/or an attorney.

11FOR HEALTH CARE. (You must sign this form and a witness must
12also sign it before it is valid)
13My name (Print your full name):..........
14My address:..................................................
16(an agent is your personal representative under state and
17federal law):
18(Agent name).................
19(Agent address).............
20(Agent phone number).........................................
21(Please check box if applicable) .... If a guardian of my



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1person is to be appointed, I nominate the agent acting under
2this power of attorney as guardian.
4    If the agent I selected is unable or does not want to make
5health care decisions for me, then I request the person(s) I
6name below to be my successor health care agent(s). Only one
7person at a time can serve as my agent (add another page if you
8want to add more successor agent names):
10(Successor agent #1 name, address and phone number)
12(Successor agent #2 name, address and phone number)
14        (i) Deciding to accept, withdraw, or decline treatment
15    for any physical or mental condition of mine, including
16    life-and-death decisions.
17        (ii) Agreeing to admit me to or discharge me from any
18    hospital, home, or other institution, including a mental
19    health facility.
20        (iii) Having complete access to my medical and mental
21    health records, and sharing them with others as needed,
22    including after I die.
23        (iv) Carrying out the plans I have already made, or,
24    if I have not done so, making decisions about my body or



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1    remains, including organ, tissue or whole body donation,
2    autopsy, cremation, and burial.
3    The above grant of power is intended to be as broad as
4possible so that my agent will have the authority to make any
5decision I could make to obtain or terminate any type of health
6care, including withdrawal of nutrition and hydration and
7other life-sustaining measures.
8I AUTHORIZE MY AGENT TO (please check any one box):
9    .... Make decisions for me only when I cannot make them for
10    myself. The physician(s) taking care of me will determine
11    when I lack this ability.
12        (If no box is checked, then the box above shall be
13    implemented.) OR
14    .... Make decisions for me only when I cannot make them for
15    myself. The physician(s) taking care of me will determine
16    when I lack this ability. Starting now, for the purpose of
17    assisting me with my health care plans and decisions, my
18    agent shall have complete access to my medical and mental
19    health records, the authority to share them with others as
20    needed, and the complete ability to communicate with my
21    personal physician(s) and other health care providers,
22    including the ability to require an opinion of my
23    physician as to whether I lack the ability to make
24    decisions for myself. OR
25    .... Make decisions for me starting now and continuing



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1    after I am no longer able to make them for myself. While I
2    am still able to make my own decisions, I can still do so
3    if I want to.
4    The subject of life-sustaining treatment is of particular
5importance. Life-sustaining treatments may include tube
6feedings or fluids through a tube, breathing machines, and
7CPR. In general, in making decisions concerning
8life-sustaining treatment, your agent is instructed to
9consider the relief of suffering, the quality as well as the
10possible extension of your life, and your previously expressed
11wishes. Your agent will weigh the burdens versus benefits of
12proposed treatments in making decisions on your behalf.
13    Additional statements concerning the withholding or
14removal of life-sustaining treatment are described below.
15These can serve as a guide for your agent when making decisions
16for you. Ask your physician or health care provider if you have
17any questions about these statements.
19WISHES (optional):
20    .... The quality of my life is more important than the
21    length of my life. If I am unconscious and my attending
22    physician believes, in accordance with reasonable medical
23    standards, that I will not wake up or recover my ability to
24    think, communicate with my family and friends, and



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1    experience my surroundings, I do not want treatments to
2    prolong my life or delay my death, but I do want treatment
3    or care to make me comfortable and to relieve me of pain.
4    .... Staying alive is more important to me, no matter how
5    sick I am, how much I am suffering, the cost of the
6    procedures, or how unlikely my chances for recovery are. I
7    want my life to be prolonged to the greatest extent
8    possible in accordance with reasonable medical standards.
10    The above grant of power is intended to be as broad as
11possible so that your agent will have the authority to make any
12decision you could make to obtain or terminate any type of
13health care. If you wish to limit the scope of your agent's
14powers or prescribe special rules or limit the power to
15authorize autopsy or dispose of remains, you may do so
16specifically in this form.
19My signature:..................
20Today's date:................................................
22    .... I elect to delay revocation of this power of attorney
23for 30 days after I communicate my intent to revoke it.



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1    .... I elect for the revocation of this power of attorney
2to take effect immediately if I communicate my intent to
3revoke it.
6    I am at least 18 years old. (check one of the options
8    .... I saw the principal sign this document, or
9    .... the principal told me that the signature or mark on
10    the principal signature line is his or hers.
11    I am not the agent or successor agent(s) named in this
12document. I am not related to the principal, the agent, or the
13successor agent(s) by blood, marriage, or adoption. I am not
14the principal's physician, advanced practice registered nurse,
15dentist, podiatric physician, optometrist, psychologist, or a
16relative of one of those individuals. I am not an owner or
17operator (or the relative of an owner or operator) of the
18health care facility where the principal is a patient or
20Witness printed name:............
21Witness address:..............
22Witness signature:...............
23Today's date:................................................
24    (c) The statutory short form power of attorney for health



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1care (the "statutory health care power") authorizes the agent
2to make any and all health care decisions on behalf of the
3principal which the principal could make if present and under
4no disability, subject to any limitations on the granted
5powers that appear on the face of the form, to be exercised in
6such manner as the agent deems consistent with the intent and
7desires of the principal. The agent will be under no duty to
8exercise granted powers or to assume control of or
9responsibility for the principal's health care; but when
10granted powers are exercised, the agent will be required to
11use due care to act for the benefit of the principal in
12accordance with the terms of the statutory health care power
13and will be liable for negligent exercise. The agent may act in
14person or through others reasonably employed by the agent for
15that purpose but may not delegate authority to make health
16care decisions. The agent may sign and deliver all
17instruments, negotiate and enter into all agreements, and do
18all other acts reasonably necessary to implement the exercise
19of the powers granted to the agent. Without limiting the
20generality of the foregoing, the statutory health care power
21shall include the following powers, subject to any limitations
22appearing on the face of the form:
23        (1) The agent is authorized to give consent to and
24    authorize or refuse, or to withhold or withdraw consent
25    to, any and all types of medical care, treatment, or
26    procedures relating to the physical or mental health of



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1    the principal, including any medication program, surgical
2    procedures, life-sustaining treatment, or provision of
3    food and fluids for the principal.
4        (2) The agent is authorized to admit the principal to
5    or discharge the principal from any and all types of
6    hospitals, institutions, homes, residential or nursing
7    facilities, treatment centers, and other health care
8    institutions providing personal care or treatment for any
9    type of physical or mental condition. The agent shall have
10    the same right to visit the principal in the hospital or
11    other institution as is granted to a spouse or adult child
12    of the principal, any rule of the institution to the
13    contrary notwithstanding.
14        (3) The agent is authorized to contract for any and
15    all types of health care services and facilities in the
16    name of and on behalf of the principal and to bind the
17    principal to pay for all such services and facilities, and
18    to have and exercise those powers over the principal's
19    property as are authorized under the statutory property
20    power, to the extent the agent deems necessary to pay
21    health care costs; and the agent shall not be personally
22    liable for any services or care contracted for on behalf
23    of the principal.
24        (4) At the principal's expense and subject to
25    reasonable rules of the health care provider to prevent
26    disruption of the principal's health care, the agent shall



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1    have the same right the principal has to examine and copy
2    and consent to disclosure of all the principal's medical
3    records that the agent deems relevant to the exercise of
4    the agent's powers, whether the records relate to mental
5    health or any other medical condition and whether they are
6    in the possession of or maintained by any physician,
7    psychiatrist, psychologist, therapist, hospital, nursing
8    home, or other health care provider. The authority under
9    this paragraph (4) applies to any information governed by
10    the Health Insurance Portability and Accountability Act of
11    1996 ("HIPAA") and regulations thereunder. The agent
12    serves as the principal's personal representative, as that
13    term is defined under HIPAA and regulations thereunder.
14        (5) The agent is authorized: to direct that an autopsy
15    be made pursuant to Section 2 of the Autopsy Act; to make a
16    disposition of any part or all of the principal's body
17    pursuant to the Illinois Anatomical Gift Act, as now or
18    hereafter amended; and to direct the disposition of the
19    principal's remains.
20        (6) At any time during which there is no executor or
21    administrator appointed for the principal's estate, the
22    agent is authorized to continue to pursue an application
23    or appeal for government benefits if those benefits were
24    applied for during the life of the principal.
25    (d) A physician may determine that the principal is unable
26to make health care decisions for himself or herself only if



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1the principal lacks decisional capacity, as that term is
2defined in Section 10 of the Health Care Surrogate Act.
3    (e) If the principal names the agent as a guardian on the
4statutory short form, and if a court decides that the
5appointment of a guardian will serve the principal's best
6interests and welfare, the court shall appoint the agent to
7serve without bond or security.
8    (f) If the agent presents the statutory short form
9electronically, an attending physician, emergency medical
10services personnel as defined by Section 3.5 of the Emergency
11Medical Services (EMS) Systems Act, or health care provider
12shall not refuse to give effect to a health care agency if the
13agent presents an electronic device displaying an electronic
14copy of an executed form as proof of the health care agency.
15Any person or entity that provides a statutory short form to
16the public shall post for a period of 2 years information on
17its website regarding the changes made by this amendatory Act
18of the 102nd General Assembly.
19(Source: P.A. 101-81, eff. 7-12-19; 101-163, eff. 1-1-20;
20102-38, eff. 6-25-21; 102-181, eff. 7-30-21; revised