|Public Act 102-0794|
|HB5047 Enrolled||LRB102 23511 LNS 32691 b|
AN ACT concerning civil law.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
The Illinois Power of Attorney Act is amended
by changing Sections 4-4.1, 4-7, and 4-10 as follows:
(755 ILCS 45/4-4.1)
Documents, writings, forms, and copies
referred to in this Article may be in hard copy or electronic
format. Nothing in this Article is intended to prevent the
population of a written instrument of a health care agency,
document, writing, or form with electronic data.
An agent may
present an electronic device displaying an electronic copy of
an executed form as proof of the health care agency.
(Source: P.A. 101-163, eff. 1-1-20
(755 ILCS 45/4-7)
(from Ch. 110 1/2, par. 804-7)
Duties of health care providers and others in
health care agencies.
Each health care provider
and each other person with
whom an agent deals under a health
care agency shall be subject to the
following duties and
(a) It is the responsibility of the agent or patient to
health care provider of the existence of the health
care agency and any
amendment or revocation thereof.
may present an electronic device displaying an electronic copy
of an executed form as proof of the health care agency.
health care provider furnished with a
copy of a health care
agency shall make it a part of the patient's medical
and shall enter in the records any change in or termination of
health care agency by the principal that becomes known to
Whenever a provider believes a patient may lack
capacity to give informed
consent to health care which the
provider deems necessary, the provider
shall consult with any
available health care agent known to the provider
who then has
power to act for the patient under a health care agency.
(b) A health care decision made by an agent in accordance
with the terms
of a health care agency shall be complied with
by every health care
provider to whom the decision is
communicated, subject to the provider's
right to administer
treatment for the patient's comfort care or alleviation
pain; but if the provider is unwilling to comply with the
the provider shall promptly inform the agent
who shall then be responsible
to make the necessary
arrangements for the transfer of the patient to
provider. It is understood that a
provider who is unwilling to
comply with the agent's decision will continue
reasonably necessary consultation and care in connection with
(c) At the patient's expense and subject to reasonable
rules of the
health care provider to prevent disruption of the
patient's health care,
each health care provider shall give an
agent authorized to receive
such information under a health
care agency the same right the principal
has to examine and
copy any part or all of the patient's medical records
agent deems relevant to the exercise of the agent's powers,
whether the records relate to mental health or any other
and whether they are in the possession of or
maintained by any physician,
therapist, hospital, nursing home or other
(d) If and to the extent a health care agency empowers the
agent to (1)
make an anatomical gift on behalf of the principal
under the Illinois Anatomical Gift Act, as now or hereafter
amended, or (2) authorize
autopsy of the principal's body
pursuant to Section 2 of "An Act in
relation to autopsy of dead
bodies", approved August 13, 1965, as now or
amended, or (3) direct
the disposition of the principal's
remains, the decision by an authorized
agent as to anatomical
approval or remains disposition shall be deemed
the act of the principal
and shall control over the decision of
other persons who might otherwise
person to whom a direction by the agent in accordance with the
terms of the agency is communicated shall comply with such
(Source: P.A. 93-794, eff. 7-22-04.)
(755 ILCS 45/4-10)
(from Ch. 110 1/2, par. 804-10)
Statutory short form power of attorney for
(a) The form prescribed in this Section (sometimes also
referred to in this Act as the
"statutory health care power")
may be used to grant an agent powers with
respect to the
principal's own health care; but the statutory health care
power is not intended to be exclusive nor to cover delegation
of a parent's
power to control the health care of a minor
child, and no provision of this
Article shall be construed to
invalidate or bar use by the principal of any
different form of power of attorney for health care.
care powers must be
executed by the
principal, designate the agent and the agent's powers, and
comply with the limitations in Section 4-5 of this Article,
but they need not be witnessed or
conform in any other respect
to the statutory health care power.
No specific format is required for the statutory health
care power of attorney other than the notice must precede the
form. The statutory health care power may be included in or
combined with any
other form of power of attorney governing
property or other matters.
The signature and execution requirements set forth in this
Article are satisfied by: (i) written signatures or initials;
or (ii) electronic signatures or computer-generated signature
codes. Electronic documents under this Act may be created,
signed, or revoked electronically using a generic,
technology-neutral system in which each user is assigned a
unique identifier that is securely maintained and in a manner
that meets the regulatory requirements for a digital or
electronic signature. Compliance with the standards defined in
the Uniform Electronic Transactions Act or the implementing
rules of the Hospital Licensing Act for medical record entry
authentication for author validation of the documentation,
content accuracy, and completeness meets this standard.
(b) The Illinois Statutory Short Form Power of Attorney
for Health Care shall be substantially as follows:
NOTICE TO THE INDIVIDUAL SIGNING
THE POWER OF ATTORNEY FOR HEALTH CARE
No one can predict when a serious illness or accident
might occur. When it does, you may need someone else to speak
or make health care decisions for you. If you plan now, you can
increase the chances that the medical treatment you get will
be the treatment you want.
In Illinois, you can choose someone to be your "health
care agent". Your agent is the person you trust to make health
care decisions for you if you are unable or do not want to make
them yourself. These decisions should be based on your
personal values and wishes.
It is important to put your choice of agent in writing. The
written form is often called an "advance directive". You may
use this form or another form, as long as it meets the legal
requirements of Illinois. There are many written and
resources to guide you and your loved ones in having a
conversation about these issues. You may find it helpful to
look at these resources while thinking about and discussing
your advance directive.
WHAT ARE THE THINGS I WANT MY
HEALTH CARE AGENT TO KNOW?
The selection of your agent should be considered
carefully, as your agent will have the ultimate
decision-making authority once this document goes into effect,
in most instances after you are no longer able to make your own
decisions. While the goal is for your agent to make decisions
in keeping with your preferences and in the majority of
circumstances that is what happens, please know that the law
does allow your agent to make decisions to direct or refuse
health care interventions or withdraw treatment. Your agent
will need to think about conversations you have had, your
personality, and how you handled important health care issues
in the past. Therefore, it is important to talk with your agent
and your family about such things as:
(i) What is most important to you in your life?
(ii) How important is it to you to avoid pain and
(iii) If you had to choose, is it more important to you
to live as long as possible, or to avoid prolonged
suffering or disability?
(iv) Would you rather be at home or in a hospital for
the last days or weeks of your life?
(v) Do you have religious, spiritual, or cultural
beliefs that you want your agent and others to consider?
(vi) Do you wish to make a significant contribution to
medical science after your death through organ or whole
(vii) Do you have an existing advance directive, such
as a living will, that contains your specific wishes about
health care that is only delaying your death? If you have
another advance directive, make sure to discuss with your
agent the directive and the treatment decisions contained
within that outline your preferences. Make sure that your
agent agrees to honor the wishes expressed in your advance
WHAT KIND OF DECISIONS CAN MY AGENT MAKE?
If there is ever a period of time when your physician
determines that you cannot make your own health care
decisions, or if you do not want to make your own decisions,
some of the decisions your agent could make are to:
(i) talk with physicians and other health care
providers about your condition.
(ii) see medical records and approve who else can see
(iii) give permission for medical tests, medicines,
surgery, or other treatments.
(iv) choose where you receive care and which
physicians and others provide it.
(v) decide to accept, withdraw, or decline treatments
designed to keep you alive if you are near death or not
likely to recover. You may choose to include guidelines
and/or restrictions to your agent's authority.
(vi) agree or decline to donate your organs or your
whole body if you have not already made this decision
yourself. This could include donation for transplant,
research, and/or education. You should let your agent know
whether you are registered as a donor in the First Person
Consent registry maintained by the Illinois Secretary of
State or whether you have agreed to donate your whole body
for medical research and/or education.
(vii) decide what to do with your remains after you
have died, if you have not already made plans.
(viii) talk with your other loved ones to help come to
a decision (but your designated agent will have the final
say over your other loved ones).
Your agent is not automatically responsible for your
health care expenses.
WHOM SHOULD I CHOOSE TO BE MY HEALTH CARE AGENT?
You can pick a family member, but you do not have to. Your
agent will have the responsibility to make medical treatment
decisions, even if other people close to you might urge a
different decision. The selection of your agent should be done
carefully, as he or she will have ultimate decision-making
authority for your treatment decisions once you are no longer
able to voice your preferences. Choose a family member,
friend, or other person who:
(i) is at least 18 years old;
(ii) knows you well;
(iii) you trust to do what is best for you and is
willing to carry out your wishes, even if he or she may not
agree with your wishes;
(iv) would be comfortable talking with and questioning
your physicians and other health care providers;
(v) would not be too upset to carry out your wishes if
you became very sick; and
(vi) can be there for you when you need it and is
willing to accept this important role.
WHAT IF MY AGENT IS NOT AVAILABLE OR IS
UNWILLING TO MAKE DECISIONS FOR ME?
If the person who is your first choice is unable to carry
out this role, then the second agent you chose will make the
decisions; if your second agent is not available, then the
third agent you chose will make the decisions. The second and
third agents are called your successor agents and they
function as back-up agents to your first choice agent and may
act only one at a time and in the order you list them.
WHAT WILL HAPPEN IF I DO NOT
CHOOSE A HEALTH CARE AGENT?
If you become unable to make your own health care
decisions and have not named an agent in writing, your
physician and other health care providers will ask a family
member, friend, or guardian to make decisions for you. In
Illinois, a law directs which of these individuals will be
consulted. In that law, each of these individuals is called a
There are reasons why you may want to name an agent rather
than rely on a surrogate:
(i) The person or people listed by this law may not be
who you would want to make decisions for you.
(ii) Some family members or friends might not be able
or willing to make decisions as you would want them to.
(iii) Family members and friends may disagree with one
another about the best decisions.
(iv) Under some circumstances, a surrogate may not be
able to make the same kinds of decisions that an agent can
WHAT IF THERE IS NO ONE AVAILABLE
WHOM I TRUST TO BE MY AGENT?
In this situation, it is especially important to talk to
your physician and other health care providers and create
written guidance about what you want or do not want, in case
you are ever critically ill and cannot express your own
wishes. You can complete a living will. You can also write your
wishes down and/or discuss them with your physician or other
health care provider and ask him or her to write it down in
your chart. You might also want to use written or
resources to guide you through this process.
WHAT DO I DO WITH THIS FORM ONCE I COMPLETE IT?
Follow these instructions after you have completed the
(i) Sign the form in front of a witness. See the form
for a list of who can and cannot witness it.
(ii) Ask the witness to sign it, too.
(iii) There is no need to have the form notarized.
(iv) Give a copy to your agent and to each of your
(v) Give another copy to your physician.
(vi) Take a copy with you when you go to the hospital.
(vii) Show it to your family and friends and others
who care for you.
WHAT IF I CHANGE MY MIND?
You may change your mind at any time. If you do, tell
someone who is at least 18 years old that you have changed your
mind, and/or destroy your document and any copies. If you
wish, fill out a new form and make sure everyone you gave the
old form to has a copy of the new one, including, but not
limited to, your agents and your physicians. If you are
concerned you may revoke your power of attorney at a time when
you may need it the most, you may initial the box at the end of
the form to indicate that you would like a 30-day waiting
period after you voice your intent to revoke your power of
attorney. This means if your agent is making decisions for you
during that time, your agent can continue to make decisions on
your behalf. This election is purely optional, and you do not
have to choose it. If you do not choose this option, you can
change your mind and revoke the power of attorney at any time.
WHAT IF I DO NOT WANT TO USE THIS FORM?
In the event you do not want to use the Illinois statutory
form provided here, any document you complete must be executed
by you, designate an agent who is over 18 years of age and not
prohibited from serving as your agent, and state the agent's
powers, but it need not be witnessed or conform in any other
respect to the statutory health care power.
If you have questions about the use of any form, you may
want to consult your physician, other health care provider,
and/or an attorney.
MY POWER OF ATTORNEY FOR HEALTH CARE
THIS POWER OF ATTORNEY REVOKES ALL PREVIOUS POWERS OF ATTORNEY
FOR HEALTH CARE. (You must sign this form and a witness must
also sign it before it is valid)
My name (Print your full name):..........
I WANT THE FOLLOWING PERSON TO BE MY HEALTH CARE AGENT
(an agent is your personal representative under state and
(Agent phone number).........................................
(Please check box if applicable) .... If a guardian of my
person is to be appointed, I nominate the agent acting under
this power of attorney as guardian.
SUCCESSOR HEALTH CARE AGENT(S) (optional):
If the agent I selected is unable or does not want to make
health care decisions for me, then I request the person(s) I
name below to be my successor health care agent(s). Only one
person at a time can serve as my agent (add another page if you
want to add more successor agent names):
(Successor agent #1 name, address and phone number)
(Successor agent #2 name, address and phone number)
MY AGENT CAN MAKE HEALTH CARE DECISIONS FOR ME, INCLUDING:
(i) Deciding to accept, withdraw
or decline treatment
for any physical or mental condition of mine, including
(ii) Agreeing to admit me to or discharge me from any
hospital, home, or other institution, including a mental
(iii) Having complete access to my medical and mental
health records, and sharing them with others as needed,
including after I die.
(iv) Carrying out the plans I have already made, or,
if I have not done so, making decisions about my body or
remains, including organ, tissue or whole body donation,
autopsy, cremation, and burial.
The above grant of power is intended to be as broad as
possible so that my agent will have the authority to make any
decision I could make to obtain or terminate any type of health
care, including withdrawal of nutrition and hydration and
other life-sustaining measures.
I AUTHORIZE MY AGENT TO (please check any one box):
.... Make decisions for me only when I cannot make them for
myself. The physician(s) taking care of me will determine
when I lack this ability.
(If no box is checked, then the box above shall be
.... Make decisions for me only when I cannot make them for
myself. The physician(s) taking care of me will determine
when I lack this ability. Starting now, for the purpose of
assisting me with my health care plans and decisions, my
agent shall have complete access to my medical and mental
health records, the authority to share them with others as
needed, and the complete ability to communicate with my
personal physician(s) and other health care providers,
including the ability to require an opinion of my
physician as to whether I lack the ability to make
decisions for myself. OR
.... Make decisions for me starting now and continuing
after I am no longer able to make them for myself. While I
am still able to make my own decisions, I can still do so
if I want to.
The subject of life-sustaining treatment is of particular
importance. Life-sustaining treatments may include tube
feedings or fluids through a tube, breathing machines, and
CPR. In general, in making decisions concerning
life-sustaining treatment, your agent is instructed to
consider the relief of suffering, the quality as well as the
possible extension of your life, and your previously expressed
wishes. Your agent will weigh the burdens versus benefits of
proposed treatments in making decisions on your behalf.
Additional statements concerning the withholding or
removal of life-sustaining treatment are described below.
These can serve as a guide for your agent when making decisions
for you. Ask your physician or health care provider if you have
any questions about these statements.
SELECT ONLY ONE STATEMENT BELOW THAT BEST EXPRESSES YOUR
.... The quality of my life is more important than the
length of my life. If I am unconscious and my attending
physician believes, in accordance with reasonable medical
standards, that I will not wake up or recover my ability to
think, communicate with my family and friends, and
experience my surroundings, I do not want treatments to
prolong my life or delay my death, but I do want treatment
or care to make me comfortable and to relieve me of pain.
.... Staying alive is more important to me, no matter how
sick I am, how much I am suffering, the cost of the
procedures, or how unlikely my chances for recovery are. I
want my life to be prolonged to the greatest extent
possible in accordance with reasonable medical standards.
SPECIFIC LIMITATIONS TO MY AGENT'S DECISION-MAKING AUTHORITY:
The above grant of power is intended to be as broad as
possible so that your agent will have the authority to make any
decision you could make to obtain or terminate any type of
health care. If you wish to limit the scope of your agent's
powers or prescribe special rules or limit the power to
authorize autopsy or dispose of remains, you may do so
specifically in this form.
.... I elect to delay revocation of this power of attorney
for 30 days after I communicate my intent to revoke it.
.... I elect for the revocation of this power of attorney
to take effect immediately if I communicate my intent to
HAVE YOUR WITNESS AGREE TO WHAT IS WRITTEN BELOW, AND THEN
COMPLETE THE SIGNATURE PORTION:
I am at least 18 years old. (check one of the options
.... I saw the principal sign this document, or
.... the principal told me that the signature or mark on
the principal signature line is his or hers.
I am not the agent or successor agent(s) named in this
document. I am not related to the principal, the agent, or the
successor agent(s) by blood, marriage, or adoption. I am not
the principal's physician, advanced practice registered nurse,
dentist, podiatric physician, optometrist, psychologist, or a
relative of one of those individuals. I am not an owner or
operator (or the relative of an owner or operator) of the
health care facility where the principal is a patient or
Witness printed name:............
(c) The statutory short form power of attorney for health
"statutory health care power") authorizes the agent
to make any and all
health care decisions on behalf of the
principal which the principal could
make if present and under
no disability, subject to any limitations on the
powers that appear on the face of the form, to be exercised in
manner as the agent deems consistent with the intent and
desires of the
principal. The agent will be under no duty to
exercise granted powers or
to assume control of or
responsibility for the principal's health care;
granted powers are exercised, the agent will be required to
due care to act for the benefit of the principal in
accordance with the
terms of the statutory health care power
and will be liable
for negligent exercise. The agent may act in
person or through others
reasonably employed by the agent for
but may not delegate authority to make health
care decisions. The agent
may sign and deliver all
instruments, negotiate and enter into all
all other acts reasonably necessary to implement the
of the powers granted to the agent. Without limiting the
generality of the foregoing, the statutory health care power
the following powers, subject to any limitations
appearing on the face of the form:
(1) The agent is authorized to give consent to and
authorize or refuse,
or to withhold or withdraw consent
to, any and all types of medical care,
procedures relating to the physical or mental health of
principal, including any medication program, surgical
or provision of
food and fluids for the principal.
(2) The agent is authorized to admit the principal to
or discharge the
principal from any and all types of
hospitals, institutions, homes,
residential or nursing
facilities, treatment centers
and other health care
institutions providing personal care or treatment for any
type of physical
or mental condition. The agent shall have
the same right to visit the
principal in the hospital or
other institution as is granted to a spouse or
of the principal, any rule of the institution to the
(3) The agent is authorized to contract for any and
all types of health
care services and facilities in the
name of and on behalf of the principal
and to bind the
principal to pay for all such services and facilities,
to have and exercise those powers over the principal's
property as are
authorized under the statutory property
power, to the extent the agent
deems necessary to pay
health care costs; and
the agent shall not be personally
liable for any services or care contracted
for on behalf
of the principal.
(4) At the principal's expense and subject to
reasonable rules of the
health care provider to prevent
disruption of the principal's health care,
the agent shall
have the same right the principal has to examine and copy
and consent to disclosure of all the principal'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
the possession of or maintained by any physician,
psychologist, therapist, hospital, nursing
or other health care
provider. The authority under
this paragraph (4) applies to any information governed by
the Health Insurance Portability and Accountability Act of
1996 ("HIPAA") and regulations thereunder. The agent
serves as the principal's personal representative, as that
term is defined under HIPAA and regulations thereunder.
(5) The agent is authorized: to direct that an autopsy
be made pursuant
to Section 2 of the Autopsy Act;
to make a
disposition of any
part or all of the principal's body
pursuant to the Illinois Anatomical Gift
Act, as now or
hereafter amended; and to direct the disposition of the
(6) At any time during which there is no executor or
administrator appointed for the principal's estate, the
agent is authorized to continue to pursue an application
or appeal for government benefits if those benefits were
applied for during the life of the principal.
(d) A physician may determine that the principal is unable
to make health care decisions for himself or herself only if
the principal lacks decisional capacity, as that term is
defined in Section 10 of the Health Care Surrogate Act.
(e) If the principal names the agent as a guardian on the
statutory short form, and if a court decides that the
appointment of a guardian will serve the principal's best
interests and welfare, the court shall appoint the agent to
serve without bond or security.
(f) If the agent presents the statutory short form
electronically, an attending physician, emergency medical
services personnel as defined by Section 3.5 of the Emergency
Medical Services (EMS) Systems Act, 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.
Any person or entity that provides a statutory short form to
the public shall post for a period of 2 years information on
its website regarding the changes made by this amendatory Act
of the 102nd General Assembly.
(Source: P.A. 101-81, eff. 7-12-19; 101-163, eff. 1-1-20;
102-38, eff. 6-25-21; 102-181, eff. 7-30-21; revised 9-22-21.)