Struck = removed from the bill ·
added = the amendment's new text.
SenateSession Bill(80th) A SB121 292 Amendment No.
121–Committee292 onSenate JudiciaryAmendment CHAPTER..........to Senate Bill No.
121 (BDR 13-99) Proposed by:
Senate Committee on Judiciary Amends:
Summary:
No Title:
No Preamble:
No Joint Sponsorship:
No Digest:
Yes ASSEMBLY ACTION Initial and Dat| SENATE ACTION Initial and Date Adopted Lost | Adopted Lost Concurred In Not | Concurred In Not Receded Not | Receded Not EXPLANATION:
Matter in (1) blue bold italics is new language in the original bill;
(2) variations of green bold underlining is language proposed to be added in this amendment;
(3) red strikethrough is deleted language in the original bill;
(4) purple double strikethrough is language proposed to be deleted in this amendment;
(5) orange double underlining is deleted language in the original bill proposed to be retained in this amendment.
KMN/NCA - Date:
4/20/2019 S.B.
No.
121—Revises provisions relating to fiduciaries.
(BDR 13-99) Page 1 of 30 *A_SB121_292* Senate Amendment No.
292 to Senate Bill No.
121 Page 3 SENATE BILLN O.
121–COMMITTEE ON JUDICIARY (O NB EHALF OF THECOMMITTEE TO S TUDY THEN EEDS RELATED TO THEB EHAVIORAL AND COGNITIVE CARE OF OLDER PERSONS ) PREFILEDJANUARY 29,2019 _______________ Referred to Committee on Judiciary SUMMARY—Revises provisions relating to fiduciaries.
(BDR 13-99) FISCAL NOTE:
Effect on Local Government:
May have Fiscal Impact.
Effect on the State:
No.
~ EXPLANATION – Matter in bolded italics is new;
matter between brackets [omitted material] is material to be omitted.
(NRS 162A.860, 162A.865) Section [1] 1.5 of this bill provides a form for a power of attorney for health care decisions for persons with any form of dementia that is based on the form for a power of attorney for health care decisions for adults with intellectual disabilities.
Sections 2 and 3 of this bill specify that a person who has executed a power of attorney for financial matters continues to have the authority to act on his or her own behalf and that any decision or instruction communicated by that person supersedes any decision or instruction communicated by an agent appointed under the power of attorney, unless the powExisting law requires certain forms relating to the appointment of a guardian, a general power of attorney, a power of attorney removesfor thishealth authority.care decisions and a power of attorney for health care decisions for an adult with an intellectual disability to be notarized with a declaration from the notary public declaring under penalty of perjury that the persons whose names are on the form appear to be of sound mind and under no duress, fraud or undue influence.
general power of attorney, a power of attorney for health care decisions and aian, a power of attorney for health care decisions for an adult with an intellectual disability to be notarized with a declaration from the notary public declaring under penalty of perjury that the persons whose names are on the form appear to be of sound mind and under no duress, fraud or undue influence.
Section 1.5 removes the same declaration for the form for a power of attorney for health care decisions for persons with any formExistingform lawof authorizesdementia. a public guardian to:
(1)Existing investigatelaw theauthorizes financiala status, assets and personal and family history of any person for whom the public guardian hasto: been appointed as guardian, without hiring or being licensed as a private investigator in accordance with existing law;
(1) investigate the financial status, assets and (2)personal requireand family history of any person for whom the public guardian has been appointed as guardianguardian, orwithout anyhiring spouse, parent, child or otherbeing relativelicensed ofas thata personprivate toinvestigator givein anyaccordance informationSenate orAmendment executeNo. any written requests or authorizations necessary to provide the public guardian with access to records needed by the public guardian.
(NRS292 253.220) Section 7 of this bill additionally petition a court to takeSenate theseBill actionsNo. with respect to any potential protected person for whom the public guardian has received a referral from the Aging and Disability Services Division of the Department of Health and Human Services, a law enforcement agency or a court in connection with a civil or criminal matter relating to the potential protected person.
Section121 7Page defines4 “potentialappointed protectedas person”guardian andor “protectedany person”spouse, forparent, thechild purposesor other relative of thisthat section.person to give any information or execute any written requests or authorizations necessary to provide the public guardian with access to records needed by the public guardian.
-(NRS 80th253.220) SessionSection (2019)7 –of 2this –bill EXPLANATIONauthorizes –the Matterpublic inguardian boldedof italicsany iscounty new;to take such actions with respect to a protected person.
matterSection between7 bracketsadditionally [omittedauthorizes material]a ispublic materialguardian of a county with a population of less than 100,000 to bepetition omitted.a court to take these actions with respect to any potential protected person for whom the public guardian has received a referral from the Aging and Disability Services Division of the Department of Health and Human Services, a potential protected person.
THESection SENATE7 ANDdefines ASSEMBLY,“potential DOprotected ENACTperson” ASand FOLLOWS:D“protectedto INthe Sectionperson” 1.for the purposes of this section.
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1.
- 80th Session (2019) – 3 – 5.
private,6. for-profit guardian serve as my appointed guardian.y (YOU MUST DATE AND SIGN THIS DOCUMENT) I sign my name to this document on .................
(date)I ................................................................................do not, under any circumstances, desire to have any private, for- profit guardian serve as my appointed guardian.
(Signature)Senate (YOUAmendment MUSTNo. HAVE TWO QUALIFIED ADULT WITNESSES DATE AND SIGN THIS DOCUMENT) I declare under penalty of perjury that the principal is personally known to me, that the principal signed this request to nominate a guardian in my presence, that the principal understand and execute this document and is under no duress, fraud or undue influence, and that I have no interest, financial or otherwise, in the estate of the principal.
..............................................292 to Senate Bill No.
(Signature121 ofPage first5 witness)(YOU ..............................................MUST DATE AND SIGN THIS DOCUMENT) 3 I sign my name to this document on .................
(Print(date) name)................................................................................................. ..............................................
(Date)(Signature) ..............................................7 (YOU MUST HAVE TWO QUALIFIED ADULT WITNESSES DATE AND SIGN THIS DOCUMENT) I declare under penalty of perjury that the principal is personally known to me, that the principal signed this request to nominate a guardian in my presence, that the principal appears to be of sound mind, has the mental capacity to understand and execute this document and is under no duress, fraud or undue influence, and that I have no interest, financial or otherwise, in the estate of the principal.
(Signature........................................................ of second witness) ..............................................
(Print(Signature name)of ............(Date)............................first witness) ........................................................
-(Print 80thname) Session........................................................ (2019) – 4 – CERTIFICATE OF ACKNOWLEDGMENT OF NOTARY PUBLIC State of Nevada } County of ........................} On this ..........
(Date) ........................................................
(Signature of second witness) ........................................................
(Print name) ........................................................
(Date) CERTIFICATE OF ACKNOWLEDGMENT OF NOTARY PUBLIC State of Nevada } } County of .................................} On this ..........
[I declare under penalty of perjury that the persons whose names are subscribed to this instrument appear to be of sound mind and under no duress, fraud or undue influence.] ......................................................................................................
(Signatu(Seal,(Signature ifof any)notarial officer) (Seal, if any) 4.
Sec.Senate Amendment No.
1.5.292 to Senate Bill No.
Chapter121 162APage of6 NRS[Section is1.] herebySec. amended by adding thereto a new section to read as follows:
1.5.Chapter 162A of NRS is hereby amended by adding thereto a new section to read as follows:
7 DURABLE POWER OF ATTORNEY FOR HEALTH CARE DECISIONS My name is ....................
(insert the name of the person you wish to designate as your agent for health care decisions for you) as my agent for health care decisions for me if I am - 80th Session (2019) – 5 – sick or hurt and need to see a doctor or go to the hospital.
After we speak with the doctor, if I have the capacity to understand, I would like my agent to speak with me about the care or treatment.
When we have madespeakmade with decisions about the care or treatment, my agent will tell the doctor about our decisions and sign any necessary papers.
I would like my agent to help me decide if I need to see a dentist and help me make decisions about what care or mytreatment agentI willshould signreceive anyfrom necessarythe paperwork..dentist.
Once we decide, I would also like my agent towill besign ableany tonecessary seepaperwork. and have copies of all my medical records.
I would also like my agent to be able to see and have copies of all my medical records.
(insert the name of another person you wish to designate as your alternative - 80th Session (2019) – 6 – agent to make health care decisions for you) as my agent to make health care decisions for me as authorized in this document.
(YOUSenate MUSTAmendment DATENo. AND SIGN THIS POWER OF ATTORNEY) I sign my name to this Durable Power of Attorney for Health Care on ..............
292 to Senate Bill No.
121 Page 7 (YOU MUST DATE AND SIGN THIS POWER OF ATTORNEY) 3 I sign my name to this Durable Power of Attorney for Health Care on ..............
(state) ................................................................................................
(Signature) 8 AGENT SIGNATURE As agent for ..........
I have a duty to act in a manner consistent with the documentdesires orof otherwise made known by ..........
(insert nameinname this of principal),principal) oras ifstated hisin orthis herdocument desiresor areotherwise unknown,made toknown actby in.......... his or her best interest.
(insert name of principal), or if his or her desires are unknown, to act in his or her best interest.
The provisions of NRS 162A.840 prohibit me from being named as an agent to make health care decisions in this document if I am a provider of health care, an employee - 80th Session (2019) – 7 – of the principal’s provider of health care or an operator or employee of a health care facility caring for the principal, unless I am the spouse, legal guardian or next of kin of the principal.
(c)(b) Psychosurgery;atment;Convulsive treatment;
(c) Psychosurgery;
(insert name of principal), as designated in the attached addendum.Senate Amendment No.
292 to Senate Bill No.
121 Page 8 addendum.
4 Signature:
....................................................Residence Address:
Residence................. Address:
.............
.................................................................................................................................................
.............................................................................................................................................................
Relationship to principal:
...........................................................................
........................................................................................................
(THIS POWER OF ATTORNEY WILL NOT BE VALID FOR MAKING HEALTH CARE DECISIONS UNLESS IT IS EITHER (1) SIGNED BY AT LEAST TWO QUALIFIED WITNESSES WHO YOU KNOW AND WHO ARE PRESENT WHEN YOU SIGN OR ACKNOWLEDGE YOUR SIGNATURE OR (2) ACKNOWLEDGED BEFORE A NOTARY PUBLIC.) - 80th Session (2019) – 8 – CERTIFICATE OF ACKNOWLEDGMENT OF NOTARY PUBLIC (You may use acknowledgment before a notary public instead of the statement of witnesses.) State of Nevada } }ss.
County of ........................}................................} On this ..........
[I declare under penalty of perjury that the person whose name is ascribed to this instrument appears to be of sound mind and under no duress, fraud or undue influence.] NOTARY SEAL ................................................................................................
At least one of the witnesses must make the additional declaration set out following the place where the witnesses sign.) I declare under penalty of perjury that the principal is personally known to me, that the principal signed or acknowledged this durable power of attorney in my presence, that the principal appears to be of sound mind notand theunder personno appointedduress, asfraud agentor byundue thisinfluence, document and that I am not a provider of health care, an employee of a provider of health care, the operatorperson ofappointed aas healthagent careby facilitythis ordocument anand employeethat ofI anam operatornot of a healthSenate careAmendment facility.No.
-292 80thto SessionSenate (2019)Bill –No. 9 – Signature:
...........................121 Page 9 provider of health care, an employee of a provider of health care, the operator of a health care facility or an employee of an operator of a health care facility.
Residence5 Address:Signature:
......................................Residence Address:
.................
...................................................................................................................................................
...............................................................................................................................................................
9 Signature:
....................................................Residence Address:
Residence................. Address:
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................................................................................
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------------------------------------------------------------------------------------------------------------------------------------------------------------------- Names:
...........................Address:............................Address:
...................................................................
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You do not have to complete this form, but if you do, your agent must do as you ask if you cannot speak for yourself.) - 80th Session (2019) – 10 – ....................
IfSenate youAmendment areNo. not able to talk to ....................
292 to Senate Bill No.
121 Page 10 If you are not able to talk to ....................
5 Here are your choices.
8 1.
YES NO (YOU MUST DATDECISIONSDATE ADDENDUM)-OF-LIFEAND SIGN THIS END-OF-LIFE DECISIONS ADDENDUM) I sign my name to this End-of-Life Decisions Addendum on ..............
(date) at ....................................................
(city), .............................................
(state) ................................................................................................
OR (2) ACKNOWLEDGED BEFORE A NOTARY PUBLIC.) - 80th Session (2019) – 11 – CERTIFICATE OF ACKNOWLEDGMENT OF NOTARY PUBLIC (You may use acknowledgment before a notary public instead of the statement of witnesses.) State of Nevada } }ss.
County of ........................}................................} On this ..........
NOTARY[I SEALdeclare ...........................................under penalty of perjury that the person whose name is ascribed to this Senate Amendment No.
(Signature)292 STATEMENT OF WITNESSES (If you choose to useSenate witnessesBill insteadNo. of having this document notarized, you must use two qualified adult witnesses.
121 Page 11 instrument appears to be of sound mind and under no duress, fraud or undue influence.] 4 NOTARY SEAL .....................................................
(Signature) 7 STATEMENT OF WITNESSES 9 (If you choose to use witnesses instead of having this document notarized, you must use two qualified adult witnesses.
At least one of the witnesses must make the additional declaration set out following the place where the witnesses sign.) I declare under penalty of perjury that the principal is personally known to me, that the principal signed or acknowledged this End-of-Life Decisions Addendum in my presence, that the principal appears to be of sound mind and under no duress, fraud or undue influence, that I am not the person appointed as agent by the power of attorney for health care and that I am not a provider of health care, an employee of a provider of health care, the operator of a health care facility or an employee of an operator of a health care facility.
- 80th Session (2019) – 12 – Signature:
....................................................Residence Address:
Residence................. Address:
.............
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..............................................................................................................................................................
....................................................Residence Address:
Residence................. Address:
.............
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..............................................................................................................................................................
................................................................................
................................................................................
------------------------------------------------------------------------------------------------------------------------------------------------------------------- Names:
...........................Address:............................Address:
...................................................................
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COPIES:Senate Amendment No.
292 to Senate Bill No.
121 Page 12 COPIES:
The End-of-Life Decisions Addendum should be available so a copy may be Sec.given to your providers of health care.
2.enSec. tNRS 162A.460 is hereby amended to read as follows:
2.
NRS 162A.460 is hereby amended to read as follows:
- 80th Session (2019) – 13 – 4.
An act performed by an agent pursuant to a power of attorney has the same effect and inures to the benefit of and binds the principal and the principal’s successors in interest as if thesthe principal had performed the act.
BEFORE EXECUTING THIS IMPORTANTDOCUMENT, FACTS:YOUYOU SHOULD KNOW THESE 1.IMPORTANT FACTS:
1.
- 80th Session (2019) – 14 – 3.
THE PERSON YOU DESIGNATE IN THIS DOCUMENT HAS A DUTY TO ACT CONSISTENT WITH YOUR DESIRES AS STATED IN THIS DOCUMENT OR OTHERWISE MADE KNOWN OR, IF YOURSenate DESIRESAmendment ARENo. UNKNOWN, TO ACT IN YOUR BEST INTERESTS.
292 to Senate Bill No.
121 Page 13 YOUR DESIRES ARE UNKNOWN, TO ACT IN YOUR BEST INTERESTS.
THIS FORM PROVIDES FOR DESIGNATION OF ONE AGENTAGENT. YOU MAY NAME A CO-AGENT IN THE SPECIAL INSTRUCTIONS.
CO-AGENTSIF AREYOU NOTWISH REQUIRED TO ACTNAME TOGETHERMORE UNLESSTHAN ONE AGENT YOU INCLUDEMAY THATNAME REQUIREMENTA CO-AGENT IN THE SPECIAL INSTRUCTIONS.
CO- AGENTS ARE NOT REQUIRED TO ACT TOGETHER UNLESS YOU INCLUDE THAT REQUIREMENT IN THE SPECIAL INSTRUCTIONS.
- 80th Session (2019) – 15 – 1.
I, ......................................................................................................................................................................................................
...........................................................................................................................................................................
...................................................................................................................................................................
................................................................................................................................
as my agent to make decisions for me and in my name, place powersand asstead authorizedand infor thismy document.nduse and benefit and to exercise the 2.powers as authorized in this document.
2.
First Alternative Agent Name:................................................................Name:................................................................................
Address:............................................................Address:.............................................................................
Telephone Number:Number:...........................................................
..........................................Senate Amendment No.
B.292 to Senate Bill No.
Second121 Name:................................................................Page 14 B.
Address:............................................................Second Alternative Agent Name:................................................................................
TelephoneAddress:............................................................................. Number:
..........................................Telephone Number:...........................................................
6 3.
If, after execution of this Power of Attorney, proceedings seeking an adjudication of incapacity are initiated either for my estate or my person, I hereby nominate as my guardian or - 80th Session (2019) – 16 – conservator for consideration by the court my agent herein named, in the order named.
If you wish to grant general authority over all of the subjects you may initial “All Preceding Subjects” instead of initialing each subject.) [.....][.....]Real Real Property [.....][.....]Tangible Tangible Personal Property [.....][.....]Stocks Stocks and Bonds [.....][.....]Commodities Commodities and Options [.....][.....]Banks Banks and Other Financial Institutions [.....][.....]Safe Safe Deposit Boxes [.....][.....]Operation Operation of Entity or Business [.....][.....]Insurance Insurance and Annuities [.....][.....]Estates, Estates, Trusts and Other Beneficial Interests [.....][.....]Legal Legal Affairs, Claims and Litigation [.....][.....]Personal Personal Maintenance [.....][.....]Benefits Benefits from Governmental Programs or Civil or Military Service [.....][.....]Retirement Retirement Plans [.....][.....]Taxes Taxes[.....]All [.....] All Preceding Subjects 6.
My agent MAY NOT do any of the following specific acts for me UNLESS I have INITIALED the specific authorityactsauthority listed below:
INITIAL ONLY the specific authority you WANT to give your agent.) [.....][.....]Create, Create, amend, revoke or terminate an inter vivos, family, living, irrevocable or revocable trust [.....][.....]Make Make a gift, subject to the limitations of NRS and any special instructions in this Power of Attorney -[.....]Create 80th Session (2019) – 17 – [.....] Create or change rights of survivorship [.....][.....]Create Create or change a beneficiary designation [.....]Senate WaiveAmendment theNo. principal’s right to be a beneficiary of a joint and survivor annuity, including a survivor benefit under a retirement plan [.....] Exercise fiduciary powers that the principal has authority to delegate [.....] Disclaim or refuse an interest in property, including a power of appointment 7.
292 to Senate Bill No.
121 Page 15 [.....Waive the principal’s right to be a beneficiary of a joint and survivor annuity, including a survivor benefit under a retirement plan [.....Exercise fiduciary powers that the principal has authority to delegate [.....Disclaim or refuse an interest in property, including a power of appointment 7 7.
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Except as otherwise expressly provided in this Power of Attorney, the authority of a principal to act on his or her own behalf continues after executing this Power of Attorney and any decision or instruction communicated by the principal supersedes any inconsistent decision or instruction communicated by an agent appointed pursuant to this Powe[9.]Power 10.of Attorney.
[9.] 10.
(INITIAL the clause(s) that applies.) [.....][.....DURABLE. DURABLE.
[.....][.....SPRINGING SPRINGING POWER.
It is my intention and direction that my designated agent, and any person or entity that my designated agent may transact business with on my behalf, may rely on a written medical opinion issued by a licensed medical doctor stating that I am disabled or incapacitated, and incapable of managing my affairs, and that said medical opinion shall establish whether or not I am under a disability for the purpose of establishing the authority of my - 80th Session (2019) – 18 – designated agent to act in accordance with this Power of Attorney.
[.....][.....I I wish to have this Power of Attorney become effective on the following date:
[.....I wish to have this Power of Attorney end on the following date:
.....e..... this Power of Attorney end on the [10.] 11.
[10.] 11.
I agree to, authorize and allow full release of information, by any government agency, business, creditor or third party who may have information pertaining to my assets or income, to my agent named herein.
[12.]Senate 13.Amendment No.
292 to Senate Bill No.
121 Page 16 [12.] 13.
6 I sign my name to this Power of Attorney on ..............
(state) ................................................................................................
County of ........................}.................................} - 80th Session (2019) – 19 – On this ..........
[I declare under penalty of perjury that the person whose name is ascribed to this instrument appears to be of sound mind and under no duress, fraud or undue influence.] NOTARY SEAL ................................................................................................
Agent’s Duties.Duties.When you accept the authority granted under this Power of Attorney, a special legal relationship is created between you and the principal.
When you accept the authority granted under this Power of Attorney, a special legal relationship is created between you and the principal.
and (d) Disclose your identity as an agent whenever you act for the principal by writing or printing the name of the principal and signing your own name as “agent” in thethethe following manner:
(d)Senate KeepAmendment aNo. record of all receipts, disbursements and transactions made on behalf of the principal;
(e)292 Cooperate with any person that has authority to makeSenate healthBill careNo. decisions for the principal to do what you know - 80th Session (2019) – 20 – the principal reasonably expects or, if you do not know the principal’s expectations, to act in the principal’s best interest;
121 Page 17 (d) Keep a record of all receipts, disbursements and transactions made on behalf of the principal;
(e) Cooperate with any person that has authority to make health care decisions for the principal to do what you know the principal reasonably expects or, if you do not know the principal’s expectations, to act in the principal’s best interest;
Termination of Agent’s Authority.Authority.You must stop acting on behalf of the principal if you learn of any event that terminates this Power of Attorney or your authority under this Power of Attorney.
YouEvents must stop acting on behalf of the principal if you learn of any event that terminatesterminate thisa Power of Attorney or your authority under this or your authority to act under a Power of Attorney include:yinclude: (a) Death of the principal;
(a) Death of the principal;
Liability of Agent.AgentThe meaning of the authority granted to you is defined in NRS 162A.200 to 162A.660, inclusive.
The meaning of the authority granted to you is defined in NRS 162A.200 to 162A.660, inclusive.
162A.700 NRS 162A.700 to 162A.865, inclusive, and section [1] 1.5 of this act apply to any power of attorney containing theionthe authority to make health care decisions.
162A.710 As used in NRS 162A.700 to 162A.865, inclusive, and section [1] 1.5 of this act, unless the context otherwise requires, the words and terms defined in NRS 162A.720 to 162A.780, inclusive, have the meanings ascribed to them in those sections.
162A.860 Except as otherwise provided in NRS 162A.865, and section [1] 1.5 of this act, the form of a power of attorney for health care may be substantially in the following form, and must be witnessed or executed in the same manner as the following form:
- 80th Session (2019) – 21 – DURABLE POWER OF ATTORNEY FOR HEALTH CARE DECISIONS WARNING TO PERSON EXECUTING THIS DOCUMENT THIS IS AN IMPORTANT LEGAL DOCUMENT.
THIS DOCUMENT GIVES THE PERSON YOU DESIGNATE AS YOUR AGENT THE POWER TO MAKE HEALTH CARE DECISIONSSenate FORAmendment YOU.No.
292 to Senate Bill No.
121 Page 18 DECISIONS FOR YOU.
THE POWER TO MAKE HEALTH CARE DECISIONS FOR YOU MAY INCLUDE CONSENT, REFUSAL OF CONSENT OR WITHDRAWAL OF CONSENT TO ANY CARE, TREATMENT, SERVICE OR PROCEDURE TO MAINTAIN, DIAGNOSE OR TREAT A PHYSICAL OR MENTAL CONDITION.
YOU MAYEATMAY A STATE IN THIS DOCUMENT ANY TYPES OF TREATMENT OR PLACEMENTS THAT YOU DO NOT DESIRE.
3.EXCEPT3. AS YOU OTHERWISE SPECIFY IN THIS DOCUMENT, THE POWER OF THE PERSON YOU DESIGNATE TO MAKE HEALTH CARE DECISIONS FOR YOU MAY INCLUDE THE POWER TO CONSENT TO YOUR DOCTOR NOT GIVING TREATMENT OR STOPPING TREATMENT WHICH WOULD KEEP YOU ALIVE.
4.UNLESSEXCEPT AS YOU OTHERWISE SPECIFY A SHORTER PERIOD IN THIS DOCUMENT, THISTHE POWER WILLOF EXIST INDEFINITELY FROM THE DATEPERSON YOU EXECUTEDESIGNATE THIS DOCUMENT AND, IF YOU ARE UNABLE TO MAKE HEALTH CARE DECISIONS FOR YOURSELF,YOU THISMAY POWERINCLUDE WILLTHE CONTINUEPOWER TO EXISTCONSENT UNTILTO THEYOUR TIMEDOCTOR -NOT 80thGIVING SessionTREATMENT (2019)OR –STOPPING 22TREATMENT –WHICH WHENWOULD KEEP YOU BECOMEALIVE. ABLE TO MAKE HEALTH CARE DECISIONS FOR YOURSELF.
5.NOTWITHSTANDING4. THIS DOCUMENT, YOU HAVE THE RIGHT TO MAKE MEDICAL AND OTHER HEALTH CARE DECISIONS FOR YOURSELF SO LONG AS YOU CAN GIVE INFORMED CONSENT WITH RESPECT TO THE PARTICULAR DECISION.
UNLESS YOU SPECIFY A SHORTER PERIOD IN THIS DOCUMENT, THIS POWER WILL EXIST INDEFINITELY FROM THE DATE YOU EXECUTE THIS DOCUMENT AND, IF YOU ARE UNABLE TO MAKE HEALTH CARE DECISIONS FOR YOURSELF, THIS POWER WILL CONTINUE TO EXIST UNTIL THE TIME WHEN YOU BECOME ABLE TO MAKE HEALTH CARE DECISIONS FOR YOURSELF.
5.
NOTWITHSTANDING THIS DOCUMENT, YOU HAVE THE RIGHT TO MAKE MEDICAL AND OTHER HEALTH CARE DECISIONS FOR YOURSELF SO LONG AS YOU CAN GIVE INFORMED CONSENT WITH RESPECT TO THE PARTICULAR DECISION.
6.YOU6. HAVE THE RIGHT TO REVOKE THE APPOINTMENT OF THE PERSON DESIGNATED IN THIS DOCUMENT TO MAKE HEALTH CARE DECISIONS FOR YOU BY NOTIFYING THAT PERSON OF THE REVOCATION ORALLY OR IN WRITING.
7.YOUYOU HAVE THE RIGHT TO REVOKE THE AUTHORITYAPPOINTMENT GRANTEDOF TO THE PERSON DESIGNATED IN THIS DOCUMENT TO MAKE THEHEALTH TREATINGCARE PHYSICIAN,DECISIONS HOSPITALFOR ORYOU OTHERGBY PROVIDERNOTIFYING THAT PERSON OF HEALTHTHE CAREREVOCATION ORALLY OR IN WRITING.
7.
YOU HAVE THE RIGHT TO REVOKE THE AUTHORITY GRANTED TO THE PERSON DESIGNATED IN THIS DOCUMENT TO MAKE HEALTH CARE DECISIONS FOR YOU BY NOTIFYING THE TREATING PHYSICIAN, HOSPITAL OR OTHER PROVIDER OF HEALTH CARE ORALLY OR IN WRITING.
10.IF10. THERE IS ANYTHING IN THIS DOCUMENT THAT YOU DO NOT UNDERSTAND, YOU SHOULD ASK A LAWYER TO EXPLAIN IT TO YOU.
1.DESIGNATIONIF OFTHERE HEALTHIS CAREANYTHING AGENT.IN THIS DOCUMENT THAT YOU DO NOT UNDERSTAND, YOU SHOULD ASK A LAWYER TO EXPLAIN IT TO YOU.
I,Senate ........................................................................................Amendment No.
292 to Senate Bill No.
121 Page 19 1.
DESIGNATION OF HEALTH CARE AGENT.
I, ............................................................................................................
5 Name:
..............................................................................................................................................................
......................................................................................................................................................
..................................................................................................................
-9 80th Session (2019) – 23 – as my agent to make health care decisions for me as authorized in this document.
(3) an operator of a health care facility.)orfacility; (4) an employee of an operator of a health care 2.
or (4) an employee of an operator of a health care facility.) 2.
to execute on my behalf any releases or other documents that may be required to obtain medical care and/or medical and hospital records, EXCEPT any power to enter into any arbitration agreements or execute any arbitration clauses in connection with admission to any health care facility including any skilled nursing facility;
If there are any other types of treatment or placement that you do not want your agent’s authority to give consent for or other restrictions you wish to - 80th Session (2019) – 24 – place on his or her agent’s authority, you should list them in the space below.
If you do not write any limitations, your agent will have the broad powers to make health care decisions on your behalf which are set forth in paragraph 3, excInexcept to the extent that there are limits provided by law.) In exercising the authority under this durable power of.)of attorney for health care, the authority of my agent is subject to the following special provisions and limitations:
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..................................................................................................Senate Amendment No.
..................................................................................................292 to Senate Bill No.
5.121 Page 20 .......................................................................................................................
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4 5.
If I am unable to make health care decisions for myself when this power of attorney expires, the authority I have granted my agent will continue to exist until forthe myself.entime when I become able to make health care decisions (IFfor APPLICABLE)myself. I wish to have this power of attorney end on the following date:
..............................................................(IF APPLICABLE) I wish to have this power of attorney end on the following date:
.....
(With respect to decisions to withhold or withdraw life-life-sustaining sustaining treatment, your agent must make health care decisions that are consistent with your known desires.
If you wish to indicate your desires, you may INITIAL the statement or statements that reflect your desires and/or write your own statements in the space below.) - 80th Session (2019) – 25 – (If the statement reflects your desires, initial the box next to the statement.) 1.
I desire that my life be prolonged to the greatest extent possible, without regard to my condition, the chances I have for recovery or long-term survival, or the cost of the procedures.,procedures. [........................] 2.
[..............................] 2.
(Also should utilize provisions of NRS 449A.400 to 449A.481, inclusive, if this subparagraph is initialed.) [........................][..............................] 3.
(Also should utilize provisions of NRS 449A.400 to 449A.481, inclusive, if this subparagraph is initialed.)sinitialed.) [........................][..............................] 4.
Withholding or withdrawal of artificial nutrition and hydration may result in death by starvation or dehydration.Senate Amendment No.
292 to Senate Bill No.
121 Page 21 dehydration.
[........................][..............................] - 80th Session (2019) – 26 – 5.
[........................][..............................] (If you wish to change your answer, you may do so by drawing an “X” through the answer you do not want, and circling the answer you prefer.) Other or Additional Statements of Desires:Desires:.............................................
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Also, if the agent designated in paragraph 1 is your spouse, his or her designation as your agent is automatically revoked by law if youIfyour marriage is dissolved.) If the person designated in paragraph 1 as my agent is unable to make health care decisions for me, then I designate the following persons to serve as my agent to make health care decisions for me as authorized in this document, such persons to serve in the order listed below:
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- 80th Session (2019) – 27 – B.
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If my designated agent is my spouse or is one of my children, then I waive any conflict of interest in carrying out the provisions of this Durable Power of Attorney for Health Care that said spouse or child may have by reason of the fact that he or she may be a beneficiary of my estate.
10.Senate Amendment No.
292 to Senate Bill No.
121 Page 22 10.
If, after execution of this Durable Power of Attorney for Health Care, proceedings seeking an adjudication of incapacity are initiated either for my estate or my person, I hereby nominate as my guardian or conservator for consideration by the court my agent herein named, in the orde12.amRELEASEorder OFnamed. INFORMATION.
12.
RELEASE OF INFORMATION.
- 80th Session (2019) – 28 – (YOU MUST DATE AND SIGN THIS POWER OF ATTORNEY) I sign my name to this Durable Power of Attorney for .........................Health Care on ..............
(state)te)(date) at ..............................
(city), ....................................................................
(state) .....................................................
County of ........................}.................................} On this................this..........day...of...........in..the year...,before me,................................
day of................, in the year..., before me,................................
[I declare under penalty of perjury that the person whose name is ascribed to this instrument appears to influence.]be of sound mind and under no duress, fraud or undue NOTARYinfluence.] SEALSenate ...........................................Amendment No.
(Signature292 ofto NotarySenate Public)Bill -No. 80th Session (2019) – 29 – STATEMENT OF WITNESSES (You should carefully read and follow this witnessing procedure.
This121 documentPage will23 notNOTARY beSEAL valid..................................................... unless you witnesses instead of having this document notarized, youe must use two qualified adult witnesses.
(Signature of Notary Public) 4 STATEMENT OF WITNESSES 6 (You should carefully read and follow this witnessing procedure.
This document will not be valid unless you comply with the witnessing procedure.
If you elect to use witnesses instead of having this document notarized, you must use two qualified adult witnesses.
At least one of the witnesses must make the additional declaration set out following the place where the witnesses sign.) I declare under penalty of perjury that the principal is personally known to me, that the principal signed or acknowledged this durable power of attorney in my presence, that the principal appears to be of sound mind and under no duress, fraud or undue influence, that I am not the person appointed as agent by this document and that I am not a provider of health care, an employee of a provider of health care, the operator of a health care facility or an employee of an operator of a health care facility.
......................................................Residence Address:
Residence................. Address:
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Residence................. Address:
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(AT LEAST ONE OF THE ABOVE WITNESSES MUST ALSO SIGN THE FOLLOWING DECLARATION.) I declare under penalty of perjury that I am not related to the principal by blood, marriage or adoption and that to the to best of my knowledge, I am not entitled to any part of the estate of the principal upon the death of the principal under a will now existing or by operation of law.
- 80th Session (2019) – 30 – Signature:
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Signature:
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documentCOPIES: and give one to your agent.
You should retain an executed copy of this document and give one to your agent.
6.5.6.5.NRS 162A.865 is hereby amended to read as follows:
NRSSenate 162A.865Amendment isNo. hereby amended to read as follows:
162A.865292 1.to Senate Bill No.
121 Page 24 162A.865 1.
5 DURABLE POWER OF ATTORNEY FOR HEALTH CARE DECISIONS 8 My name is....................
I undIfunderstand Iwhat amthis sickmeans. or hurt, my agent should take me to the doctor.
If I am sick or hurt, my agent should take me to the doctor.
If I go to the hospital, I would like the people who - 80th Session (2019) – 31 – work at the hospital to try very hard to care for me.
If I am able to communicate, I would like the doctor at the hospital to speak with me and my agent about what care or treatment I should receive, even if I am unable to understand what is likebeing mysaid agentabout tome. help me decide what care or treatment Iould should receive.
After we speak with the doctor, I would like my agent to help me decide what care or treatment I should receive.
I understand that my agent cannot make me receive any care or treatment that I do not want.
(state) ...........................................Senate Amendment No.
(Signature)292 -to 80thSenate SessionBill (2019)No. – 32 – AGENT SIGNATURE As agent for..........
(insert121 namePage of25 principal),..................................................... I agree that a physician, health care facility or other provider of health care, acting in good faith, may rely on this power of attorney for health care and the signatures herein, and I understand that pursuant to NRS 162A.815, a physician, health care facility or other provider of health care that in good faith accepts an acknowledged power of attorney for health care is not subject conduct for giving effect to a declaration contained within the power of attorney for health care or for following the direction of an agent named in the power of attorney for health care.
(Signature) 4 AGENT SIGNATURE 6 As agent for..........
(insert name of principal), I agree that a physician, health care facility or other provider of health care, acting in good faith, may rely on this power of attorney for health care and the signatures herein, and I understand that pursuant to NRS 162A.815, a physician, health care facility or other provider of health care that in good faith accepts an acknowledged power of attorney for health care is not subject to civil or criminal liability or discipline for unprofessional conduct for giving effect to a declaration contained within the power of attorney for health care or for following the direction of an agent named in the power of attorney for health care.
The provisions of NRS 162A.840 prohibit me from being named as an agent to make health care decisions in this document if I am a provider of health care, an employee of the principal’s provider of health care or an operator or employee of a health care facility caring for the principal, unless I am the spouse, legal guardian or next of kin of the principal.
- 80th Session (2019) – 33 – (f) Aversive intervention, as it is defined in NRS 449A.203;
(insert name of principal), as designated in suchthe decisionsattached mustaddendum. be made in consultation with theknown, principal’s treating physicians.
If his or her wishes are not known, such decisions must be made in consultation with the principal’s treating physicians.
...................Residence......................Residence Address:
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LengthSenate ofAmendment relationshipNo. to principal:
........................................292 to Senate Bill No.
(THIS121 POWERPage OF26 ATTORNEYLength WILL NOT BE VALID FOR MAKING HEALTH CARE DECISIONS UNLESS IT IS EITHER (1) SIGNED BY AT LEAST TWO QUALIFIED WITNESSES WHO YOU KNOW AND WHO ARE PRESENT WHEN YOU SIGN OR ACKNOWLEDGE YOUR SIGNATURE OR (2) ACKNOWLEDGED BEFORE A NOTARY PUBLIC.) CERTIFICATE OF ACKNOWLEDGMENT OF NOTARY PUBLIC (You may use acknowledgment before a notary public instead of therelationship statementto ofprincipal: witnesses.) State of Nevada } }ss.
County.............................................................. of......................................} On this..........
3 (THIS POWER OF ATTORNEY WILL NOT BE VALID FOR MAKING HEALTH CARE DECISIONS UNLESS IT IS EITHER (1) SIGNED BY AT LEAST TWO QUALIFIED WITNESSES WHO YOU KNOW AND WHO ARE PRESENT WHEN YOU SIGN OR ACKNOWLEDGE YOUR SIGNATURE OR (2) ACKNOWLEDGED BEFORE A NOTARY PUBLIC.) CERTIFICATE OF ACKNOWLEDGMENT OF NOTARY PUBLIC (You may use acknowledgment before a notary public instead of the statement of witnesses.) State of Nevada } }ss.
County of.................................................
} On this..........
[I - 80th Session (2019) – 34 – declare under penalty of perjury that the person whose name is ascribed to this instrument appears to be of sound mind and under no duress, fraud or undue influence.] NOTARY SEAL ............................................................................................
(Signature) STATEMENT OF WITNESSES (If you choose to use witnesses instead of having this document notarized, you must use two qualified adultisadult witnesses.
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Print Name:
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PrintSenate Name:Amendment No.
.....................................................................292 to Senate Bill No.
121 Page 27 Print Name:
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4 (AT LEAST ONE OF THE ABOVE WITNESSES MUST ALSO SIGN THE FOLLOWING DECLARATION.) 7 I declare under penalty of perjury that I am not related to the principal by blood, marriage or adoption and that to the best of my knowledge, I am not entitled to any part of the - 80th Session (2019) – 35 – estate of the principal upon the death of the principal under a will now existing or by operation of law.
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The form for end-of-life decisions of a power of attorney for health care for an adult with an intellectual disability may be executedsubstantially in the samefollowing mannerform, asand themust followingbe form:itnessedwitnessed or END-OF-LIFEexecuted DECISIONSin ADDENDUMthe STATEMENTsame OFmanner DESIRESas (Youthe can,following butform: are not required to, state what you want to happen if you get very sick and are not likely to get well.
END-OF-LIFE DECISIONS ADDENDUM STATEMENT OF DESIRES (You can, but are not required to, state what you want to happen if you get very sick and are not likely to get well.
- 80th Session (2019) – 36 – 1.
YES NO 2.Senate Amendment No.
292 to Senate Bill No.
121 Page 28 2.
I do not want to take medicine or receive treatment if I am very sick and suffering and the medicine or treatment will not help me get better.bettYES NO 4.
YESI want to get food and water even if I do not want to take medicine or receive treatment.YES NO 4.(YOU MUST DATE AND SIGN THIS END-OF-LIFE DECISIONS ADDENDUM) I sign my name to this End-of-Life Decisions Addendum on ..............
I want to get food and water even if I do not want to take medicine or receive treatment.
YES NO (YOU MUST DATE AND SIGN THIS END-OF-LIFE DECISIONS ADDENDUM) I sign my name to this End-of-Life Decisions Addendum on ..............
(state) ................................................................................................
(Signature) (THIS END-OF-LIFE DECISIONS ADDENDUM WILL NOT BE VALID UNLESS IT IS EITHER (1) SIGNED BY AT LEAST TWO QUALIFIED WITNESSES WHO YOU ACKNOWLEDGEOKNOW AND WHO ARE PRESEYOURHENPRESENT YOSIGNATUREWHEN YOU SIGN OR ACKNOWLEDGE YOUR SIGNATURE OR (2) ACKNOWLEDGED BEFORE A NOTARY PUBLIC.) CERTIFICATE OF ACKNOWLEDGMENT OF NOTARY PUBLIC (You may use acknowledgment before a notary public instead of the statement of witnesses.) State of Nevada } }ss.
County of......................................}of................................................. - 80th Session (2019) – 37 – On this..........
} On this..........
[I declare under penalty of perjury that the person whose name is ascribed to this instrument appears to be of sound mind and under no duress, fraud or undue influence.] NOTARY SEAL ............................................................................................
or (5) an employee of an operator of a health care facility.Senate Amendment No.
At292 least one of the witnesses must make the additional declaration set out following the place where the witnesses sign.) I declare under penalty of perjury that the principal is personally known to me,Senate thatBill theNo. principal signed or acknowledged this End-of-Life Decisions Addendum in my presence, that the principal appears to be of sound mind and under no duress, fraud or undue influence, that I am not the care and that I am not a provider of health care, an employee of a provider of health care, the operator of a health care facility or an employee of an operator of a health care facility.
121 Page 29 facility.
At least one of the witnesses must make the additional declaration set out following the place where the witnesses sign.) I declare under penalty of perjury that the principal is personally known to me, that the principal signed or acknowledged this End-of-Life Decisions Addendum in my presence, that the principal appears to be of sound mind and under no duress, fraud or undue influence, that I am not the person appointed as agent by the power of attorney for health care and that I am not a provider of health care, an employee of a provider of health care, the operator of a health care facility or an employee of an operator of a health care facility.
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- 80th Session (2019) – 38 – (AT LEAST ONE OF THE ABOVE WITNESSES MUST ALSO SIGN THE FOLLOWING DECLARATION.) I declare under penalty of perjury that I am not related to the principal by blood, marriage or adoption and that to the best of my knowledge, I am not entitled to any part of the estate of the principal upon the death of the principal under a will now existing or by operation of law.
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A public guardian may investigate the financial status, assets and personal and family history of any protected personperson, for whom the public guardian has been appointed as guardian, without hiring or being licensed as a private investigator pursuant to chapter 648 of NRS.
In connection with the investigation, the public guardian may require theany protected person or any spouse, parent, child or other kindred of the protected person, to give any information and to execute and deliver any written requests or authorizations necessary to provide the public guardian with access to records, otherwise confidential, which are needed by the public guardian.
In a county whose population is less than 100,000, a public guardian may petition a court to investigate the financial status, assets and personal and family history of any [person for whom the public guardian has been appointed as guardian,]Senate potentialAmendment protectedNo. person for whom the public guardian has received a referral from the Aging and Disability Services Division of the Department of - 80th Session (2019) – 39 – Health and Human Services, a law enforcement agency or a court in connection with a criminal or civil matter relating to the potential protected person, without hiring or being licensed as a private investigator pursuant to chapter 648 of NRS.
In292 connection with the investigation, the public guardian may require [any protected person] the potential protected person or any spouse, parent, child or other kindred of the [protected person] potential protected person, to giveSenate anyBill informationNo. and to execute and deliver any written requests or authorizations necessary to provide the which are needed by the public guardian.
121 Page 30 guardian, or a] potential protected person for whom the public guardian has received a referral from the Aging and Disability Services Division of the Department of Health and Human Services, a law enforcement agency or a court in connection with a criminal or civil matter relating to the potential protected person, without hiring or being licensed as a private investigator pursuant to chapter 648 of NRS.
In connection with the investigation, the public guardian may require any [protected person or] potential protected person or any spouse, parent, child or other kindred of the [protected person or] potential protected person, to give any information and to execute and deliver any written requests or authorizations necessary to provide the public guardian with access to records, otherwise confidential, which are needed by the public guardian.
[2.] 3.
As used in this section:section [, “protected] :
~~~~~ 19 - 80th Session (2019)