The California Medical Association (CMA) has released a newly updated Advance Health Care Directive (AHCD) Kit, incorporating recent legal developments that clarify the scope of authority a designated health care agent may be granted, including power to make decisions related to personal care decisions and claims, litigation, and/or arbitration related to health and personal care services.

Under California law, "health care decisions" include choices about medical treatment, care settings and end-of-life instructions. In Harrod v. Country Oaks Partners, LLC (2024), the California Supreme Court clarified that health care agents may make decisions about who provides care and what can be done to a person’s body in health, sickness, or death, but that decisions regarding arbitration fall outside the scope of a health care agent’s standard authority and require separate, explicit authorization.

CMA’s AHCD Kit has been updated to expressly include an individual’s right to grant their designated agent with the authority to make personal care decisions and decisions regarding claims, litigation, and/or arbitration arising out of the provision of health or personal care services, including entering into agreements for binding arbitration with health care providers, facilities, and other entities in connection with the provision of professional health and personal care services.

These powers have now been expressly incorporated into the AHCD Kit’s health care power of attorney form. Thus, if elected by the principal and when properly executed, the AHCD will now expressly authorize an appointed agent to act on behalf of the principal in relation to personal care decisions and claims, litigation, and/or arbitration related to health and personal care services.

This expanded clarity is especially important in ensuring that an individual’s wishes are carried out fully, without legal ambiguity, in cases where disputes or care coordination extend beyond direct medical decisions.

The revised AHCD Kit includes:

• An updated AHCD form reflecting the expanded scope of agent authority
• Wallet cards for quick reference in emergencies
• Step-by-step instructions for completing the form
• Answers to frequently asked questions, including an overview of the recent legal changes

The English-language AHCD Kit is available to purchase now. The Spanish-language version is currently on backorder and will be available to order in July.

For more information on advance care planning or to access CMA’s health law library document #3451, “Decisions Regarding Life-Sustaining Treatment – Advance Directives and POLST,” and visit cmadocs.org/end-of-life.

Questions about the updated AHCD Kit can be directed to the CMA Center for Legal Affairs at legalinfo@cmadocs.org. Please note that CMA cannot offer individual legal advice.