Rhode Island Healthcare Power of Attorney Requirements

Introduction

Key Things to Know

1. 1

   A Rhode Island Durable Power of Attorney for Health Care puts your named agent in charge of your medical decisions the moment you actually become unable to decide for yourself, no doctor's written incapacity certification and no terminal diagnosis required.

2. 2

   Your agent's authority is not tied to a terminal diagnosis or a physician's written certification. Rhode Island law simply provides that once you are not able to make your own health care decisions, the document governs (R.I. Gen. Laws Section 23-4.10-5(a)).

3. 3

   Unless you limit it in the document, your agent can make any health care decision you could make yourself, including consenting to, refusing, or withdrawing treatment, and reviewing your medical records.

4. 4

   Your treating health care provider or an operator of a community care facility can never serve as your agent, and a nonrelative employee of either is also barred, though a relative employee is allowed (Section 23-4.10-2).

5. 5

   You can sign in front of two qualified adult witnesses, or sign before a notary public instead. Notarization is a full substitute for witnessing, not an extra step; you do not need both.

6. 6

   You can revoke the document at any time, regardless of your mental or physical condition, simply by communicating your intent to revoke. It becomes effective as to a given physician or provider only once that person is actually told (Section 23-4.10-3).

7. 7

   If you name your spouse as agent, they automatically become ineligible to continue serving if your marriage is later dissolved.

8. 8

   Rhode Island has no central state registry for this document. Keep the signed original and give copies to your physician, your agent, and any alternate agents.

9. 9

   This is a different document from Rhode Island's Short Form Power of Attorney (Title 18, Chapter 16), which covers property and financial decisions, not health care.

Rhode Island Requirements for Healthcare Power of Attorney

• Statutory Authority (Rhode Island General Laws Section 23-4.10-1 et seq.)

  The Durable Power of Attorney for Health Care is authorized by Rhode Island General Laws Title 23, Chapter 4.10, captioned Health Care Power of Attorney (Sections 23-4.10-1 through 23-4.10-12). Its general and financial power of attorney statute is the separate Rhode Island Short Form Power of Attorney Act (Title 18, Chapter 16), a different chapter covering property and financial matters.

• Principal Capacity (Rhode Island General Laws Section 23-4.10-2)

  The principal must be at least eighteen years of age and a resident of the state for the document to be legally valid. A witness must also declare that the principal appears to be of sound mind and not under duress, fraud, or undue influence.

• Agent Qualifications (Rhode Island General Laws Section 23-4.10-2)

  None of the following may be designated as agent: the principal's treating health care provider, a nonrelative employee of that provider, an operator of a community care facility, or a nonrelative employee of an operator of a community care facility.

• Execution Requirements (Rhode Island General Laws Section 23-4.10-2)

  The document must be signed by the principal and either witnessed by two qualified adult witnesses or signed with the signature acknowledged before a notary public.

• Witness Restrictions (Rhode Island General Laws Section 23-4.10-2)

  Neither witness may be the principal's designated agent or alternate agent, a health care provider, an employee of a health care provider, an operator of a community care facility, or an employee of an operator of a community care facility, with no relative exception for any of these categories. At least one of the two witnesses must also not be related to the principal by blood, marriage, or adoption, and must not be entitled to any part of the principal's estate.

• Notarization as a Full Execution Alternative (Rhode Island General Laws Section 23-4.10-2)

  The document must be either witnessed by two qualified adults or acknowledged before a notary public.

• Agent Authority Scope (Rhode Island General Laws Section 23-4.10-2)

  The statutory form grants the agent full power and authority to make health care decisions for the principal to the same extent the principal could make them personally, including consenting to, refusing, or withdrawing treatment, and reviewing and disclosing medical records, subject to any limitation the principal states in the document.

• Activation Conditions (Rhode Island General Laws Section 23-4.10-5(a))

  The principal has the right to make health care decisions as long as able to do so; once the principal is not able to make those decisions, the document governs. Rhode Island law does not require a written physician certification of incapacity for this document to take effect.

• Alternate Agents (Rhode Island General Laws Section 23-4.10-2)

  The statutory form lets the principal designate one or more alternate agents to serve, in a stated order, if the primary agent is unavailable, ineligible, or loses capacity, or if the principal revokes the primary agent's authority. If the designated agent is the principal's spouse, that agent automatically becomes ineligible if the marriage is later dissolved.

• HIPAA Authorization (45 CFR Section 164.508)

  Federal HIPAA regulations govern how the agent can be authorized to access the principal's protected health information once the document is in effect.

• Revocation Provisions (Rhode Island General Laws Section 23-4.10-3)

  The principal may revoke the document at any time and in any manner communicating an intent to revoke, regardless of mental or physical condition. A revocation is effective as to a given physician, health care provider, or emergency medical services provider only once communicated to that person by the principal or by someone who witnessed the revocation, and a physician or provider who learns of it must add it to the medical record.

• Life-Prolonging Care Preferences (Rhode Island General Laws Section 23-4.10-2)

  The statutory form itself includes a statement-of-desires section where the principal may record wishes concerning life-prolonging care, treatment, services, and procedures, directly within the Durable Power of Attorney for Health Care.

• Anatomical Gift Authorization (Rhode Island General Laws Section 23-18.6.1-1 et seq.)

  The statutory form's own organ-and-tissue-donation election lets the principal direct the agent to inform family or next of kin of a wish to be an organ and tissue donor, consistent with the Rhode Island Revised Uniform Anatomical Gift Act's framework for making anatomical gifts.

• Mental Health Treatment Decisions (Rhode Island General Laws Section 40.1-5-1 et seq.)

  Rhode Island's Mental Health Law (Title 40.1, Chapter 5) governs admission and treatment of patients with mental disability.

• Pregnancy Provisions (Rhode Island General Laws Section 23-4.10-5(c))

  Under Rhode Island law, if the attending physician knows the principal is pregnant, the Durable Power of Attorney for Health Care has no force or effect as long as it is probable the fetus could develop to the point of live birth with continued life-sustaining procedures (Chapter 23-4.10).

• Out-of-State Recognition (Rhode Island General Laws Section 23-4.10-11)

  A durable power of attorney executed in another state in compliance with that state's law is validly executed for purposes of Rhode Island's chapter.

• Patient Self-Determination Act Compliance (42 U.S.C. Section 1395cc(a)(1)(Q))

  Facilities that participate in Medicare and Medicaid must maintain written policies informing patients of their rights under state law to make advance directives, including a Durable Power of Attorney for Health Care.

• Interstate Portability if the Principal Relocates (Rhode Island General Laws Section 23-4.10-11)

  Rhode Island recognizes a durable power of attorney executed in another state in compliance with that state's law, but Rhode Island's own statute cannot control whether a different state will recognize a document executed here; that depends on the destination state's own law.