HB 1597 -- Advanced Directive for Mental Health Care

Sponsor:  Harding

This bill establishes procedures pertaining to advanced
directives for mental health care treatment.

In its main provisions, the bill:

(1)  Authorizes any competent adult person to make an advanced
mental health care directive.  The directive will remain in
effect for three years or until revoked;

(2)  Requires that the authority of an attorney-in-fact and any
alternative attorney-in-fact remain effective for the duration of
the directive or when the attorney-in-fact withdraws;

(3)  Requires that the directive continues if the principal
(patient) becomes incapable but would be void if the principal
becomes capable again after the three-year term of the directive;

(4)  Requires all health care and mental health care
organizations to maintain written policies and procedures
pertaining to the receipt of mental health care treatment by any
competent adult.  The policies and procedures include information
pertaining to the rights of mental health patients, the
directive, and ensuring organizational compliance with Missouri
law pertaining to mental health treatment;

(5)  Requires organizations to provide patients with a copy of
the directive;

(6)  Requires that the provision pertaining to the disclosure of
the directive to the principal is in addition to and consistent
with federal law.  Health care and mental health care
organizations are prohibited from acting inconsistently with the
federal law or contrary to their philosophical beliefs;

(7)  Exempts health care and mental health care organizations
from criminal prosecution or civil liability for failing to
maintain and provide written policies and procedures for the
directive;

(8)  Specifies that any competent adult can be designated as an
attorney-in-fact or an alternative attorney-in-fact who is
responsible for making decisions for mental health care treatment
received by the principal;

(9)  Specifies the procedures for establishing and effecting the
directive;

(10)  Prohibits an attorney-in-fact from making mental health
care decisions unless the principal is incapable.  The attorney-
in-fact is not responsible for charges incurred for mental health
care treatment received by the principal;

(11)  Requires the attorney-in-fact to act in accordance with the
known desires of the principal and to act in the best interests
of the principal if his or her desires are unknown;

(12)  Requires the attorney-in-fact to receive information
pertaining to treatment received by the principal and grants
access to the principal's medical records as specified in the
bill;

(13)  Exempts an attorney-in-fact from criminal prosecution,
civil liability, or professional disciplinary action for acting
in good faith pertaining to the directive;

(14)  Prohibits executing or refraining from executing a
directive as a condition for receiving insurance, mental or
physical services, or as a condition for discharge from a health
care facility;

(15)  Specifies the procedures requiring physicians to record the
directive in the principal's medical records and to comply with
the provisions of the directive.  Physicians or providers can
withdraw from providing treatment according to the procedures
contained in the bill;

(16)  Specifies the conditions when a physician or provider may
subject the principal to mental health care treatment contrary to
the principal's desires contained in the directive;

(17)  Specifies the conditions for revoking a directive in whole
or in part;

(18)  Exempts physicians or other providers who administer or who
do not administer mental health care treatment from criminal
prosecution, civil liability, or professional disciplinary action
if a directive is determined to be invalid;

(19)  Specifies the persons prohibited from acting as an
attorney-in-fact and from serving as a witness to the signing of
the directive;

(20)  Specifies the procedures pertaining to the withdrawal of
the attorney-in-fact and the procedures for rescinding the
withdrawal; and

(21)  Contains the format for creating a legally binding advanced
mental health care directive.

Missouri House of Representatives
Last Updated October 11, 2002 at 9:01 am