SPONSOR: |
Sen. Hall-Long & Rep. Bentz & Rep. Heffernan |
|
Sens.
Ennis, Hocker, Sokola; Reps.
Briggs King, Dukes, Kowalko, Paradee, B. Short, Wilson |
DELAWARE STATE SENATE 148th GENERAL ASSEMBLY |
SENATE BILL NO. 230 |
AN ACT TO AMEND TITLE 16 OF THE DELAWARE CODE RELATING TO SUPPORTED DECISION-MAKING. |
Section 1. Amend Part IX, Title 16 of the Delaware Code by making deletions as shown by strike through and insertions as shown by underline as follows:
§ 9401A. Short title.
This Act may be cited as the
Supported Decision-Making Act.
§ 9402A. Purpose; interpretation.
(a) The purpose of this chapter is to
do all of the following:
(1) Provide assistance in gathering and assessing
information, making informed decisions, and communicating decisions to adults
who do not need a guardian or other substitute decision-maker for such
activities, but who would benefit from decision-making assistance.
(2) Give supporters legal status to be with the adult
and participate in discussions with others when the adult is making decisions
or attempting to obtain information.
(3) Enable supporters to assist in
making and communicating decisions for the adult but not substitute as the
decision maker for that adult.
(b) This chapter is to be
administered and interpreted in accordance with all of the following
principles:
(1) All adults should be able to live
in the manner they wish and to accept or refuse support, assistance, or protection
as long as they do not harm others and are capable of making decisions about
those matters.
(2) All adults should be able to be
informed about and, to the best of their ability, participate in the management
of their affairs.
(3) All adults should receive the
most effective yet least restrictive and intrusive form of support, assistance,
or protection when they are unable to care for themselves or manage their
affairs alone.
(4) The values, beliefs, wishes,
cultural norms, and traditions that an adult holds should be respected in
managing an adult’s affairs.
§ 9403A. Definitions.
For
the purposes of this chapter:
(1) “Adult” means an individual who is
18 years of age or older.
(2) “Affairs” means personal, health care, and
financial matters arising in the course of activities of daily living and
includes all of the following:
a. Those health care and personal affairs in which an adult
makes his or her own health care decisions, including monitoring his or her own
health; obtaining, scheduling, and coordinating health and support services; understanding
health care information and options; and making personal decisions, including
those to provide for his or her own care and comfort.
b. Those financial affairs in which an adult manages his
or her income and assets and its use for clothing, support, care, comfort,
education, shelter, and payment of other liabilities of the individual.
(3) “Good faith” means honesty in fact.
(4) “Health-care institution” means “health-care
institution” as defined in § 2501 of this title.
(5) “Health-care provider” means “health-care
provider” as defined in § 2501 of this title.
(6) “Immediate family member” means a
spouse, child, sibling, parent, grandparent, grandchild, stepparent, stepchild,
or stepsibling.
(7) “Person” means an adult; health-care
institution; health-care provider; corporation; partnership; limited liability
company; association; joint venture; government; governmental subdivision,
agency, or instrumentality; public corporation; or any other legal or
commercial entity.
(8) “Principal” means an adult who
seeks to enter, or has entered, into a supported decision-making agreement with
a supporter under this chapter.
(9) “Supported decision-making
agreement” or “the agreement” means an agreement between a principal and a
supporter entered into under this chapter.
(10) “Supporter” means a person who is
named in a supported decision-making agreement and is not prohibited from
acting under § 9406A(b) of this title or under regulations enacted under § 9410A
of this title.
(11) “Support services” means a
coordinated system of social and other services supplied by private, state,
institutional, or community providers designed to help maintain the
independence of an adult, including any of the following:
a. Homemaker-type
services, including house repair, home cleaning, laundry, shopping, and meal-provision.
b. Companion-type
services, including transportation, escort, and facilitation of written, oral,
and electronic communication.
c. Visiting
nurse and attendant care.
d. Health-care
provider.
e. Physical
and psychosocial assessments.
f. Financial
assessments and advisement on banking, taxes, loans, investments, and
management of real property.
g. Legal
assessments and advisement.
h. Education
and educational assessment and advisement.
i. Hands-on
treatment or care, including assistance with activities of daily living such as
bathing, dressing, eating, range of motion, toileting, transferring, and
ambulation.
j. Care
planning.
k. Other
services needed to maintain the independence of an adult.
§
9404A. Presumption of capability.
(a)
All adults are presumed to be capable of managing their affairs and to have
capacity unless otherwise determined by the Court of Chancery.
(b)
The manner in which an adult communicates with others is not grounds for
deciding that the adult is incapable of managing the adult’s affairs.
(c)
Execution of a supported decision-making agreement may not be used as evidence
of incapacity and does not preclude the ability of the adult who has entered
into such an agreement to act independently of the agreement.
§
9405A. Supported decision-making agreements.
(a)
An adult may enter into a supported decision-making agreement if all of the
following apply:
(1) The adult enters into the agreement voluntarily
and without coercion or undue influence.
(2) The adult understands the nature and effect of
the agreement.
(b)
A supported decision-making agreement must include all of the following:
(1) Designation of at least 1 supporter.
(2) The types of decisions for which the supporter is
authorized to assist.
(3) The types of decisions, if any, for which the
supporter may not assist.
(c)
A supported decision-making agreement may include any of the following:
(1) Designation of more than 1 supporter.
(2) Provision for an alternate to act in the place of
a supporter in such circumstances as may be specified in the agreement.
(3) Authorization for a supporter to share
information with any other supporter named in the agreement, as a supporter
believes is necessary.
(d)
A supported decision-making agreement is valid only if all of the following
occur:
(1) The agreement is in writing on a form developed
by the Department of Health and Social Services as required under § 9410A(a) of
this title.
(2) The agreement is dated.
(3) Each party to the agreement signed the agreement
in the presence of 2 adult witnesses..
(e)
The 2 adult witnesses required by paragraph (d)(3) of this section may not be
any of the following:
(1) A supporter for the principal.
(2) An employee or agent of a supporter named in the supported
decision-making agreement.
(3) Any person who does not understand the type of
communication the principal uses, unless an individual who understands the principal’s
means of communication is present to assist during the execution of the supported
decision-making agreement.
(f)
A supported decision-making agreement must contain a separate declaration
signed by each supporter named in the agreement indicating all of the following:
(1) The supporter’s relationship to the principal.
(2) The supporter’s willingness to act as a
supporter.
(3) The supporter’s acknowledgement of the duties of
a supporter under this chapter.
(g)
A supported decision-making agreement may authorize a supporter to assist the principal
to decide whether to give or refuse consent to care within the meaning of Chapter
25 of this title.
(h)
A principal or a supporter may revoke a supported decision-making agreement at
any time in writing and with notice to the other parties to the agreement.
(i)
An authorization in a supported decision-making agreement may be prospectively
limited or abrogated, in whole or part, by a judicial determination that the
principal lacks the capacity to engage in the making of specific decisions covered
by the agreement despite the assistance of a supporter.
§
9406A. Supporters.
(a)
Except as otherwise provided by a supported decision-making agreement, a
supporter may do all of the following:
(1) Assist the principal in understanding
information, options, responsibilities, and consequences of the principal’s
life decisions, including those decisions relating to the principal’s affairs or
support services.
(2) Help the principal access, obtain, and understand
any information that is relevant to any given life decision, including medical,
psychological, financial, or educational decisions, or any treatment records or
records necessary to manage the principal’s affairs or support services.
(3) Assist the principal in finding, obtaining,
making appointments for, and implementing the principal’s support services or
plans for support services.
(4) Help the principal monitor information about the principal’s
affairs or support services, including keeping track of future necessary or
recommended services.
(5) Ascertain the wishes and decisions of the principal,
assist in communicating those wishes and decisions to other persons, and
advocate to ensure that the wishes and decisions of the principal are
implemented.
(b)
Except as permitted by regulation promulgated under § 9410A of this title, any
of the following are disqualified from acting as a supporter:
(1) A person who is an employer or employee of the principal,
unless the person is an immediate family member of the principal.
(2) A person directly providing paid support services
to the principal, with the exception of supported decision-making services,
unless the person is an immediate family member of the principal.
(3) An individual against whom the principal has
obtained an order of protection from abuse or an individual who is the subject
of a civil or criminal order prohibiting contact with the principal.
(c)
A supporter is prohibited from doing any of the following:
(1) Exerting undue influence upon, or making
decisions on behalf of, the principal.
(2) Obtaining, without the consent of the principal, information
that is not reasonably related to matters with which the supporter is authorized
to assist under the supported decision-making agreement.
(3) Using, without the consent of the principal,
information acquired for a purpose other than assisting the principal to make a
decision under the supported decision-making agreement.
§
9407A. Recognition of supporters.
A
decision or request made or communicated with the assistance of a supporter in
conformity with this chapter shall be recognized for the purposes of any
provision of law as the decision or request of the principal and may be
enforced by the principal or supporter in law or equity on the same basis as a
decision or request of the principal.
§
9408A. Limitation of liability.
A person who in
good faith acts in reliance on an authorization in a supported decision-making
agreement, or who in good faith declines to honor an authorization in a
supported decision-making agreement, is not subject to civil or criminal
liability or to discipline for unprofessional conduct for any of the following:
(1) Complying with an authorization in a supported decision-making
agreement based on an assumption that the underlying supported decision-making
agreement was valid when made and has not been revoked or abrogated under §
9405A of this title.
(2) Declining to comply with an authorization in a supported
decision-making agreement based on actual knowledge that the agreement is
invalid or has been revoked or abrogated under § 9405A of this title.
(3) Declining to comply with an authorization related to health care in
a supported decision-making agreement because the action proposed to be taken
under the agreement is contrary to the conscience or good faith medical
judgment of the person or to a written policy of a health-care institution that
is based on reasons of conscience.
§
9409A. Access to information.
(a)
A supporter may assist the principal with obtaining any information to which
the principal is entitled, including, with a signed and dated specific consent,
protected health information under the Health Insurance Portability and
Accountability Act of 1996 [P. L. 104-191] or educational records under the
Family Educational Rights and Privacy Act of 1974 [20 U.S.C. § 1232g].
(b)
The supporter shall ensure all information collected on behalf of the principal
under this section is kept privileged and confidential, as applicable; is not
subject to unauthorized access, use, or disclosure; and is properly disposed of
when appropriate.
§
9410A. Forms; regulatory authority.
(a)
The Department of Health and Social Services shall develop the forms necessary
to implement this chapter.
(b)
The Secretary of the Department of Health and Social Services may promulgate
regulations necessary to implement this chapter.
SYNOPSIS
This Act creates the option of a supported decision-making agreement for adults who do not need a guardian but who need assistance in gathering information, making decisions, and communicating those decisions. The Act allows these adults, called “principals” in this Act, to select and appoint one or more trusted friends or relatives or a paid provider to act as a supporter. The supporter can provide assistance and guidance on issues affecting the principal, such as coordinating health care and services; making health and service-related decisions; and dealing with housing issues, daily living activities, and routine financial matters. The supporter is not empowered to make decisions for the principal or to substitute the supporter’s judgment for the principal’s. This Act includes safeguards such as limiting who can act as a supporter and requiring a written document with disinterested witnesses. This Act gives the supporter legal status to participate in the decision-making process by gathering information and assisting the principal in making and communicating decisions. A decision or a request communicated by the supporter must be honored on the same basis as a decision or request of the principal. |
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Author: Senator Hall-Long