Chapter 01. Advance Directive Registry
Regulation .01 Scope.LinkCopy Citation
This chapter defines key terms and sets out requirements and procedures for an Advance Directive Registry.
Regulation .02 Definitions.LinkCopy Citation
A.
In this chapter, the following terms have the meanings indicated.
B.
Terms Defined.
(1)
Advance Directive.
(a)
“Advance directive” has the meaning stated in Health-General Article, §5-601, Annotated Code of Maryland.
(b)
“Advance directive” includes an Instructions on Current Life-Sustaining Treatment Options form developed under Health-General Article, §5-608.1, Annotated Code of Maryland.
(2)
“Authorized person” means an individual:
(a)
Designated in writing by a registrant; or
(b)
Under the conditions specified in federal or State law, authorized to obtain access to the medical records of the registrant.
(3)
“Department” means the Maryland Department of Health.
(4)
“Filing” means the presentation of an advance directive for registration to the Secretary.
(5)
“Health care facility” has the meaning stated in Health-General Article, §19-114, Annotated Code of Maryland.
(6)
“Health care provider” has the meaning stated in Health-General Article, §5-601, Annotated Code of Maryland.
(7)
“Instructions on a Current Life-Sustaining Treatment Options form” means the form developed under Health-General Article, §5-608.1, Annotated Code of Maryland.
(8)
“Registrant” means an individual who registers the individual's advance directive with the Department.
(9)
“Registry” means the depository for advance directives in the Department.
(10)
“Secretary” means the Secretary of Health or a designee of the Secretary.
Regulation .03 Filing and Registration.LinkCopy Citation
A.
An individual may submit an advance directive to the Department for registration.
B.
In order for the Department to register an advance directive, a registrant shall provide to the Department:
(1)
A completed application on the form provided by the Department;
(2)
The required fee, as set forth in Regulation .06 of this chapter; and
(3)
An advance directive that contains:
(a)
The registrant's signature;
(b)
The date on which the advance directive was signed by the registrant; and
(c)
The signatures of:
(i)
Two witnesses as provided in Health-General Article, §5-602, Annotated Code of Maryland; or
(ii)
If an Instructions on a Current Life-Sustaining Treatment Options form is submitted and the registrant is incapable of making an informed decision, the registrant's health care agent or surrogate and the registrant's attending physician.
C.
On receipt of the items set forth in §B of this regulation, the Department shall:
(1)
Create a digital reproduction of the form and advance directive;
(2)
Enter the reproduced form and advance directive into the advance directive database; and
(3)
Assign each advance directive a file number and password.
D.
After processing the advance directive presented for registration, the Department shall provide to each registrant:
(1)
A copy of the registrant's documents on file in the Registry;
(2)
Instructions for accessing a copy of the registrant's advance directive;
(3)
Instructions for amending or revoking an advance directive;
(4)
A wallet card indicating registration of an advance directive; and
(5)
A sticker to affix to a driver's license or identification card that shows that an advance directive has been filed with the Department.
Regulation .04 Nonregistration of Advance Directive.LinkCopy Citation
A.
An individual is not required to register an advance directive with the Department.
B.
An advance directive that is not submitted to the Registry is valid in accordance with applicable law.
Regulation .05 Amendment or Revocation of a Registered Advance Directive.LinkCopy Citation
A.
The registrant shall notify the Registry if a registered advance directive has been:
(1)
Amended; or
(2)
Revoked.
B.
The Department shall amend the file of a registrant on receipt of:
(1)
An application for amendment on a form provided by the Department;
(2)
A copy of the amended advance directive that:
(a)
Is complete; and
(b)
Contains all information set forth in Regulation .03B of this chapter.
C.
A health care provider that becomes aware that a registrant has amended or revoked a registered advance directive shall, at the request of the registrant, provide the registrant with information on how to notify the Registry of the amendment or revocation.
D.
The Department shall delete the file of a registrant on receipt of:
(1)
An application for revocation on a form provided by the Department; and
(2)
Written documentation of revocation as provided in Health-General Article, §5-604, Annotated Code of Maryland.
Regulation .06 Fees — Repealed.LinkCopy Citation
Regulation .07 Disclosure of Information.LinkCopy Citation
A.
The Department shall provide access to a registered advance directive to:
(1)
The registrant; or
(2)
An authorized person.
B.
To access an advance directive:
(1)
A registrant or a registrant's designee shall supply the registrant's file number and password; and
(2)
A representative of a health care facility shall supply the facility's username and password.
Regulation .08 Storage of Data.LinkCopy Citation
A.
The Department shall establish a Registry that is:
(1)
Secure, in accordance with data security standards customarily applied to the protection of electronic medical records; and
(2)
Available 24 hours a day, 7 days a week.
B.
The Department may provide for services related to the establishment and operation of the Registry through contract with a person or agency.
C.
The Department or its contractor may store in the Registry only documents that are:
(1)
Identical to those submitted by the registrant; and
(2)
In a digital, read-only format preventing modification.
D.
The Department shall destroy the paper copy of an advance directive submitted by a registrant when the paper copy has been fully and accurately converted to digital copy.
Regulation .09 Public Outreach.LinkCopy Citation
The Department shall carry out educational and outreach efforts to increase public awareness of the Registry.
Regulation .10 Liability of Health Care Providers.LinkCopy Citation
A health care provider is not subject to criminal prosecution or civil liability and may not be determined to have engaged in unprofessional conduct by the appropriate licensing authority for:
A.
Failure to access the Registry; or
B.
Relying on information provided by the Registry.
Regulation .11 Registry Funding.LinkCopy Citation
Implementation of this chapter is contingent on the availability of funds, in accordance with State Finance and Procurement Article, §§7-234 and 7-235, Annotated Code of Maryland.
Chapter annotations
Authority: Health-General Article, §§5-620 — 5-626, Annotated Code of Maryland
History: Effective date: December 6, 2007 (34:24 Md. R. 2158)
History: Regulation .05B amended effective August 29, 2016 (43:17 Md. R. 953)
History: Regulation .06 repealed effective August 29, 2016 (43:17 Md. R. 953)