With the dramatic increase of coronavirus (COVID-19) cases in the United States, it is important for all of us to be prepared, especially when it comes to our health care directives. The best way to do this which you may already have done is by having a health care proxy who appoints an agent to make health care decisions on your behalf in the event you are incapacitated. Under the mandates of the federal
Health Insurance Portability & Accountability Act (HIPAA), you must execute a HIPAA release that authorizes the agent to communicate with your medical providers and review your medical records. This is included in a properly prepared Health Care Directive. The agent may also direct a DNR (“do not resuscitate” directive) if you do not want heroic end-of-life measures. This is also included in a properly prepared Health Care Directive. Below are crucial steps to ensure you are prepared.
- Locate the documents if you have them. This may be the most difficult thing to do if you have already prepared the documents. These should be the most recently executed documents. You should destroy any previous versions of these documents and only keep the most recent version.
- If Cohen Seglias prepared your documents for you and they were signed, please contact us and we will email you a PDF of your signed records. If you do not have the documents or cannot find them, you should have them drafted as soon as possible.
- You need to review your documents to ensure they still meet your wishes and address the current COVID-19 environment. The age of your documents alone may be important. Documents that were created and signed a long time ago may be viewed as stale by medical professionals. Sometimes the individual named in old documents is no longer able to serve as your agent. Would you still select that person? Or due to age, health and proximity issues, would you wish to change that person? The same would apply to any backup or successor agent you have named. Does your document need to be modified for the specifics regarding COVID-19? For example, a prohibition against intubation may prevent you from receiving the standard of care you need to survive which would be being intubated and being put on a ventilator. In addition, your agent should be expressly authorized to communicate decisions via Zoom, Skype, FaceTime, email, text, phone or other electronic means, and medical providers should be held harmless for acting on such instructions. Especially regarding the issue of intubation, few existing documents provide for this unique standard of care. Due to the highly contagious nature of COVID-19, the only practical way to communicate is electronically or telephonically.
- If necessary, you should execute new documents. These documents should take into consideration the rules of your state of residence, specifically regarding execution and the ability of your agent to act if necessary.
- You should discuss your wishes not only with your agent but with your family and your primary physician, by telemedicine if possible. However, you should not give your documents to the physician or health care facility at this time. Your agent will have the ability to transmit those documents in the event they are necessary. You should put together a ready bag similar to when someone is expecting a baby. The original and a copy of your health care directive should be placed in that bag. There should also be a list of all prescriptions, supplements with the dosage of each and an indication of known allergies. In addition, you should have a list of any other medications or supplements you have taken since the beginning of the spread of COVID-19, for example, any other medications you have taken, even briefly, since January 1, 2020. You should also include a copy of your insurance card. Being prepared should help speed up hospital admission, if necessary. On the front of the envelope containing this documentation, you should write your full legal name, address, age, date of birth, your emergency contact (you should ensure that your listed emergency contact and your agent are the same person), as well as the backup agent you have named. And finally, the name and contact information for your primary care physician.
- You should send your agent a copy of your health care documents as well as a photo or scan of what you have written on the outside of your envelope. You should take a screenshot of the email you have sent to your agent, save it as a new document, and send it to your agent as well. Finally, this should be done for all of your family members, both young and old.
