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<section article="ghg" article_name="Health - General" number="5-615" title_number="5" title_name="Death" subtitle_number="6" subtitle_name="Health Care Decisions Act">
  <level label="a">
    <level label="1">
      <text>In this section the following words have the meanings indicated.</text>
    </level>
    <level label="2">
      <text>“Advance care planning document” has the meaning stated in § 19–145 of this article.</text>
    </level>
    <level label="3">
      <text>“Electronic advance care planning document” has the meaning stated in § 19–145 of this article.</text>
    </level>
    <level label="4">
      <text>“Electronic platform” means the platform developed in accordance with § 19–145(b)(2)(i) of this article to make electronic advance care planning documents accessible.</text>
    </level>
    <level label="5">
      <text>“Health care facility” has the meaning stated in § 19–114 of this article.</text>
    </level>
  </level>
  <level label="b">
    <level label="1">
      <text>Each health care facility shall provide each individual on admittance to the facility information concerning the rights of the individual to make decisions concerning health care, including the right to accept or refuse treatment, and the right to make an advance directive, including a living will.</text>
    </level>
    <level label="2">
      <text>Except as provided in paragraph (4) of this subsection, on admittance of an individual to a health care facility, the health care facility shall:</text>
      <level label="i">
        <text>Use the electronic platform to identify if the individual has uploaded or saved any electronic advance care planning documents;</text>
      </level>
      <level label="ii">
        <text>If the individual has uploaded or saved any electronic advance care planning documents, attempt to verify the contents and update the documents as necessary; and</text>
      </level>
      <level label="iii">
        <text>If the individual has not uploaded or saved any electronic advance care planning documents:</text>
        <level label="1">
          <text>Offer the individual the opportunity to scan any paper advance care planning documents the individual brought to the health care facility and upload or save them to the electronic platform; or</text>
        </level>
        <level label="2">
          <text>Provide the individual with an information sheet developed in accordance with this section.</text>
        </level>
      </level>
    </level>
    <level label="3">
      <text>If a health care facility maintains a website, after the tab on the State–designated health information exchange website required under § 19–145(b)(2)(iv) of this article is developed, the health care facility shall provide a link to the webpage that is accessed through the tab.</text>
    </level>
    <level label="4">
      <text>Paragraph (2) of this subsection does not apply to:</text>
      <level label="i">
        <text>A community provider as defined in § 7–307 of this article;</text>
      </level>
      <level label="ii">
        <text>A home health agency as defined in § 19–401 of this article;</text>
      </level>
      <level label="iii">
        <text>An assisted living facility as defined in § 19–1801 of this article; and</text>
      </level>
      <level label="iv">
        <text>A hospice as defined in § 19–901 of this article.</text>
      </level>
    </level>
  </level>
  <level label="c">
    <level label="1">
      <text>The Department, in consultation with the Office of the Attorney General, shall develop an information sheet that provides information relating to advance directives, which shall include:</text>
      <level label="i">
        <text>Written statements informing an individual that an advance directive:</text>
        <level label="1">
          <text>Can be updated or revoked by the individual at any time;</text>
        </level>
        <level label="2">
          <text>Is a useful, legal, and well established way for an individual to communicate the preferences of the individual for medical care, including the designation of a health care agent;</text>
        </level>
        <level label="3">
          <text>Allows an individual to specify the medical care that the individual may receive and can alleviate conflict among family members and health care providers;</text>
        </level>
        <level label="4">
          <text>Can help ensure that an individual’s religious beliefs are considered if medical care is provided;</text>
        </level>
        <level label="5">
          <text>Can be more effective if discussed with family members, or legal and religious advisors, if an individual desires;</text>
        </level>
        <level label="6">
          <text>Is available in many forms, including model forms developed by religious organizations, estate planners, and lawyers;</text>
        </level>
        <level label="7">
          <text>Does not have to be on any specific form and can be personalized;</text>
        </level>
        <level label="8">
          <text>If completed, should be copied for an individual’s family members, physicians, and legal advisors and, at the discretion of the individual, be uploaded or saved to the electronic platform; and</text>
        </level>
        <level label="9">
          <text>Is most effective if it is uploaded or saved to the electronic platform; and</text>
        </level>
      </level>
      <level label="ii">
        <text>The following written statements:</text>
        <level label="1">
          <text>That an individual is not required to complete an advance directive;</text>
        </level>
        <level label="2">
          <text>That an individual should discuss the appointment of a health care agent with the potential appointee;</text>
        </level>
        <level label="3">
          <text>That advance directives are for individuals of all ages; and</text>
        </level>
        <level label="4">
          <text>That in the absence of an appointed health care agent, the next of kin make an individual’s health care decisions when the individual is incapable of making or communicating those decisions.</text>
        </level>
      </level>
    </level>
    <level label="2">
      <text>The information sheet developed by the Department under this subsection shall be provided by:</text>
      <level label="i">
        <text>The Department, in accordance with § 15–109.1 of this article;</text>
      </level>
      <level label="ii">
        <text>The Motor Vehicle Administration, in accordance with § 12–303.1 of the Transportation Article;</text>
      </level>
      <level label="iii">
        <text>A carrier, in accordance with § 15–122.1 of the Insurance Article;</text>
      </level>
      <level label="iv">
        <text>The Maryland Health Benefit Exchange, in accordance with § 31–108(g) of the Insurance Article;</text>
      </level>
      <level label="v">
        <text>A licensed physician to a patient at an appropriate time during a scheduled appointment;</text>
      </level>
      <level label="vi">
        <text>A managed care organization in accordance with § 15–103.1(i)(1)(xvii) of this article;</text>
      </level>
      <level label="vii">
        <text>A health care facility in accordance with subsection (b) of this section;</text>
      </level>
      <level label="viii">
        <text>A nursing facility in accordance with § 19–301 of this article;</text>
      </level>
      <level label="ix">
        <text>An assisted living facility in accordance with § 19–1801 of this article; and</text>
      </level>
      <level label="x">
        <text>The State–designated health information exchange in accordance with § 19–145(b)(2)(iv) of this article.</text>
      </level>
    </level>
    <level label="3">
      <level label="i">
        <text>Except as provided in subparagraph (ii) of this paragraph, the information sheet developed by the Department under this subsection may not contain or promote a specific advance directive form or an electronic advance directive technology or service.</text>
      </level>
      <level label="ii">
        <text>The information sheet shall include links to:</text>
        <level label="1">
          <text>Websites for electronic advance directives services that the Maryland Health Care Commission has recognized under § 19–144 of this article; and</text>
        </level>
        <level label="2">
          <text>After the tab on the State–designated health information exchange website required under § 19–145(b)(2)(iv) of this article is developed, the webpage that is accessed through the tab.</text>
        </level>
      </level>
    </level>
    <level label="4">
      <text>The information sheet developed by the Department under this subsection at a minimum shall:</text>
      <level label="i">
        <text>Educate the public on the use of electronic advance directives;</text>
      </level>
      <level label="ii">
        <text>Encourage the use of electronic advance directives;</text>
      </level>
      <level label="iii">
        <text>Provide information about developing an electronic advance directive;</text>
      </level>
      <level label="iv">
        <text>Describe how electronic advance directives are made available at the point of care;</text>
      </level>
      <level label="v">
        <text>Indicate that the use of an electronic advance directive is not required;</text>
      </level>
      <level label="vi">
        <text>Indicate that individuals do not have to pay to have their electronic advance directives honored; and</text>
      </level>
      <level label="vii">
        <text>Emphasize the importance of uploading or saving an electronic advance directive to the electronic platform.</text>
      </level>
    </level>
  </level>
</section>
