Massachusetts 2025-2026 Regular Session

Massachusetts Senate Bill S1133 Compare Versions

Only one version of the bill is available at this time.

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1	1	1 of 1
2	2	SENATE DOCKET, NO. 1099 FILED ON: 1/15/2025
3	3	SENATE . . . . . . . . . . . . . . No. 1133
4	4	The Commonwealth of Massachusetts
5	5	_________________
6	6	PRESENTED BY:
7	7	Patricia D. Jehlen
8	8	_________________
9	9	To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
10	10	Court assembled:
11	11	The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
12	12	An Act relative to caregiver authorization affidavits.
13	13	_______________
14	14	PETITION OF:
15	15	NAME:DISTRICT/ADDRESS :Patricia D. JehlenSecond Middlesex 1 of 13
16	16	SENATE DOCKET, NO. 1099 FILED ON: 1/15/2025
17	17	SENATE . . . . . . . . . . . . . . No. 1133
18	18	By Ms. Jehlen, a petition (accompanied by bill, Senate, No. 1133) of Patricia D. Jehlen for
19	19	legislation relative to caregiver authorization affidavits. The Judiciary.
20	20	[SIMILAR MATTER FILED IN PREVIOUS SESSION
21	21	SEE SENATE, NO. 1010 OF 2023-2024.]
22	22	The Commonwealth of Massachusetts
23	23	_______________
24	24	In the One Hundred and Ninety-Fourth General Court
25	25	(2025-2026)
26	26	_______________
27	27	An Act relative to caregiver authorization affidavits.
28	28	Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
29	29	of the same, as follows:
30	30	1 SECTION 1. Section 1 of Chapter 201F, as appearing in the 2022 Official Edition, is
31	31	2hereby amended by striking out, in line 7, the words “with whom a minor resides.” and inserting
32	32	3in place thereof:-
33	33	4 who has been so designated by an authorizing party in an affidavit pursuant to this
34	34	5chapter.
35	35	6 SECTION 2. Section 2 of Chapter 201F, as appearing in the 2022 Official Edition, is
36	36	7hereby amended by striking out the first paragraph and inserting in the place thereof the
37	37	8following paragraph:-
38	38	9 A parent, legal guardian or legal custodian of one of more minor children, by a caregiver
39	39	10authorization affidavit, may authorize a designated caregiver to exercise certain concurrent 2 of 13
40	40	11parental rights and responsibilities relative to any designated minor child's education, health care,
41	41	12recreational and enrichment activities as described in section 3(b). If a conflicting decision is
42	42	13made under these concurrent rights and responsibilities, the decision of the authorizing party
43	43	14shall supersede the decision of the caregiver.
44	44	15 SECTION 3. Said chapter 201F is hereby further amended by striking out section 3, as
45	45	16appearing in the 2022 Official Edition, and inserting in the place thereof the following section:-
46	46	17 Section 3.
47	47	18 (a) A caregiver shall reside with the minor child or children during the time the caregiver
48	48	19is authorized to act relative to said child or children.
49	49	20 (b) Under a caregiver authorization affidavit, a caregiver may:
50	50	21 (1) give consent to medical, surgical, dental, developmental, mental health or other
51	51	22treatment for the minor under the supervision of or upon the advice of a health care professional
52	52	23licensed to practice in the commonwealth;
53	53	24 (2) exercise parental rights to obtain records and other information with regard to health
54	54	25care services and insurance provided to the minor;
55	55	26 (3) make educational decisions (including daycare) on behalf of the minor and in all other
56	56	27ways stand in for the authorizing party with respect to federal, state and district educational
57	57	28policy, including, but not limited to, accessing the minor's educational records, representing the
58	58	29minor in enrollment, disciplinary, curricular, special education or other educational matters,
59	59	30signing permission slips for school activities and any other decision that facilitates the minor's
60	60	31educational experience; 3 of 13
61	61	32 (4) make decisions on behalf of the minor regarding recreational and enrichment
62	62	33activities including, but not limited to, enrollment, signing permission slips for sports, clubs,
63	63	34lessons, camps, and activities and any other recreational and enrichment activities.
64	64	35 (5) apply for health insurance and dental insurance coverage for the minor; services and
65	65	36support for disabilities; and any other public or private services to address the education or health
66	66	37needs of the minor.
67	67	38 SECTION 4. Section 4 of Chapter 201F, as appearing in the 2022 Official Edition, is
68	68	39hereby amended by inserting, in line 1, after the words “relies on a caregiver” the following
69	69	40words:- or alternate caregiver
70	70	41 SECTION 5. Said chapter 201F is hereby further amended by striking out section 5, as
71	71	42appearing in the 2022 Official Edition, and inserting in the place thereof the following section:-
72	72	43 Section 5. The caregiver (and alternate caregiver, if any) authorization affidavit shall
73	73	44include the following information: —
74	74	45 (1) the name, address and telephone number of the parent, legal guardian or legal
75	75	46custodian;
76	76	47 (2) the name, address and telephone number of the caregiver;
77	77	48 (3) the name, address and telephone number of the alternate caregiver, if any;
78	78	49 (4) the name and date of birth of the minor;
79	79	50 (5) the relationship of the caregiver(s) to the minor; 4 of 13
80	80	51 (6) a statement by the authorizing party that there are no court orders in effect which
81	81	52would prohibit the authorizing party from exercising or conferring the rights and responsibilities
82	82	53sought to be conferred upon the caregiver or alternate;
83	83	54 (7) a statement of the authority being conferred and of any prohibitions;
84	84	55 (8) a statement that the affidavit is not for the purposes of circumventing any state or
85	85	56federal law, for the purposes of attendance at a particular school, or to re-confer rights to a
86	86	57caregiver from whom those rights have been removed by a court of law; and
87	87	58 (9) a statement by the authorizing party of when the authority of the appointed caregiver
88	88	59commences and when it ends (if specified).
89	89	60 The affidavit shall be signed under the pains and penalties of perjury by the authorizing
90	90	61party in the presence of 2 adult witnesses, neither of whom may be the caregiver nor alternate
91	91	62caregiver, and the affidavit shall be notarized. The affidavit also shall be signed by the caregiver,
92	92	63and by the alternate caregiver, if any, who shall attest to being an adult with whom the minor
93	93	64resides or will reside.
94	94	65 The caregiver authorization affidavit shall be valid for up to 2 years from the date that it
95	95	66comes into effect unless a shorter time is specified, and may be reauthorized. The authorizing
96	96	67party may reauthorize, amend or revoke the caregiver authorization affidavit by notifying the
97	97	68caregiver in writing. The authorizing party shall provide the amended affidavit or revocation to
98	98	69all parties to whom he has provided the original affidavit. The caregiver shall provide the
99	99	70amended affidavit or revocation to all parties to whom he has provided the original affidavit
100	100	71prior to further exercising any rights or responsibilities under the affidavit. 5 of 13
101	101	72 SECTION 6: Said chapter 201F is hereby further amended by striking out section 6, as
102	102	73appearing in the 2022 Official Edition, and inserting in the place thereof the following section:-
103	103	74 Section 6. The caregiver authorization affidavit shall be substantially in the following
104	104	75form, except that the use of alternative language consistent with the statute shall not be
105	105	76precluded:
106	106	77 Caregiver Authorization Affidavit
107	107	78 I. What this form enables: A parent, legal guardian or legal custodian of a minor, by this
108	108	79affidavit, may authorize a designated caregiver, who is an adult with whom the minor child
109	109	80resides or will reside, to exercise certain concurrent parental rights and responsibilities relative to
110	110	81a designated minor's education, health care, and recreational and enrichment activities. If a
111	111	82conflicting decision is made under these concurrent rights and responsibilities, the decision of the
112	112	83authorizing party or a legal guardian or legal custodian appointed subsequent to the execution of
113	113	84the affidavit shall supersede the decision of the caregiver.
114	114	85 The caregiver authorization affidavit shall only authorize those rights and responsibilities
115	115	86that the authorizing party possesses and shall not divest the authorizing party of his rights or
116	116	87responsibilities.
117	117	88 Under a caregiver authorization affidavit, a caregiver may:
118	118	89 (1) consent to medical, surgical, dental, developmental, mental health or other treatment
119	119	90for the minor under the supervision or upon the advice of a health care professional licensed to
120	120	91practice in the commonwealth; 6 of 13
121	121	92 (2) exercise parental rights to obtain records and other information with regard to health
122	122	93care services and insurance provided to the minor; and
123	123	94 (3) make educational decisions (including daycare) on behalf of the minor and in all other
124	124	95ways stand in for the authorizing party with respect to federal, state and district educational
125	125	96policy, including, but not limited to, accessing the minor's educational records, representing the
126	126	97minor in enrollment, disciplinary, curricular, special education or other educational matters,
127	127	98signing permission slips for school activities and any other decision that facilitates the minor's
128	128	99educational experience; and
129	129	100 (4) make decisions on behalf of the minor regarding recreational and enrichment
130	130	101activities including, but not limited to, enrollment, signing permission slips for sports, clubs,
131	131	102lessons, camps and activities, and any other recreational and enrichment activities; and
132	132	103 (5) apply for health insurance and dental insurance coverage for the minor; for services
133	133	104and support for disabilities; and for any other public or private services to address the education
134	134	105or health needs of the minor.
135	135	106 II. Steps to authorize caregiver rights and responsibilities:
136	136	107 1. AUTHORIZING PARTY
137	137	108 I, [name of authorizing party], residing at [address of authorizing party] am the
138	138	109parent/legal guardian/legal custodian of the minor child(ren) listed below.
139	139	110 I, [name of parent or legal guardian or legal custodian], do hereby authorize [name of
140	140	111caregiver], residing at [address of caregiver], to exercise concurrently the rights and 7 of 13
141	141	112responsibilities, except those prohibited below, that I possess relative to the education, health
142	142	113care, recreational and enrichment activities of the minor child(ren) listed:
143	143	114 Minor Child's/Children Name(s) Date(s) of Birth
144	144	115 ___ ___
145	145	116 ___ ___
146	146	117 ___ ___
147	147	118 The caregiver may NOT:
148	148	119 (Please list specifically any education, health care, recreational, or enrichment rights and
149	149	120responsibilities that you do NOT wish to confer upon the caregiver.)
150	150	121 In the event the above-named caregiver is unavailable or unwilling to serve as caregiver,
151	151	122I do hereby authorize [name of alternate caregiver] residing at [address of alternate caregiver], to
152	152	123exercise the rights referenced above. (This section is optional)
153	153	124 There are no court orders in effect that would prohibit me from exercising or conferring
154	154	125the rights and responsibilities that I wish to confer upon the caregiver. (If you are the legal
155	155	126guardian or custodian, attach the court order.)
156	156	127 I am not using this affidavit to circumvent any state or federal law, for the purposes of
157	157	128attendance at a particular school, or to re-confer rights to a caregiver from whom those rights
158	158	129have been removed by a court of law. 8 of 13
159	159	130 I confer these rights and responsibilities freely and knowingly in order to provide for the
160	160	131child(ren) named herein, and not as a result of pressure, threats or payments by any person or
161	161	132agency.
162	162	133 I understand that, if the affidavit is amended or revoked, I must provide the amended
163	163	134affidavit or revocation to all parties to whom I have provided this affidavit.
164	164	135 The authority of the caregiver shall commence upon (choose one):
165	165	136 a date certain __________; or
166	166	137 the date of the incapacity of the authorizing party to make or carry out day-to-day
167	167	138decisions concerning the minor, as established by written certification of a licensed physician, or
168	168	139the date of the unavailability of the authorizing party to make or carry out day-to-day decisions
169	169	140concerning the minor due to circumstances such as, but not limited to, incarceration, voluntary or
170	170	141involuntary commitment to a treatment program, detention, deportation, or active military duty,
171	171	142as established by attestation of the named caregiver.
172	172	143 This document shall remain in effect until (choose one):
173	173	144 a date certain (up to two years hence) ________; or
174	174	145 two years from the date of the incapacity of the authorizing party to make or carry out
175	175	146day-to-day decisions concerning the minor, as established by written certification of a licensed
176	176	147physician, or the date of the unavailability of the authorizing party to make or carry out day-to-
177	177	148day decisions concerning the minor due to circumstances such as, but not limited to,
178	178	149incarceration, voluntary or involuntary commitment to a treatment program, detention,
179	179	150deportation, or active military duty, as established by attestation of the named caregiver. 9 of 13
180	180	151 unless or until I, as authorizing party, notify the caregiver (and alternate caregiver, if
181	181	152any), in writing that I have amended or revoked it, or until such time as the minor child(ren)
182	182	153reach the age of majority.
183	183	154 I hereby affirm that the above statements are true, under pains and penalties of perjury.
184	184	155 Signature:
185	185	156 Printed name:
186	186	157 Telephone number:
187	187	158 2. WITNESSES TO AUTHORIZING PARTY SIGNATURE
188	188	159 (To be signed by persons over the age of 18 who are not the designated caregiver or
189	189	160alternate caregiver.)
190	190	161 Witness No. 1 signature:
191	191	162 Witness No. 1 printed name and address:
192	192	163 Witness No. 2 signature:
193	193	164 Witness No. 2 printed name and address:
194	194	165 3. NOTARIZATION OF AUTHORIZING PARTY SIGNATURE
195	195	166 On this [date] before me, the undersigned notary public, personally appeared [name of
196	196	167authorizing party, and alternate caregiver, if any], proved to me through satisfactory evidence of
197	197	168identification, which was [driver's license, etc.], to be the person(s) signing the preceding 10 of 13
198	198	169document, and swore under the pains and penalties of perjury that the foregoing statements are
199	199	170true.
200	200	171 Signature and seal of notary:
201	201	172 Printed name of notary:
202	202	173 My commission expires:
203	203	174 4. CAREGIVER ACKNOWLEDGEMENT
204	204	175 I, [name of caregiver], am at least 18 years of age and the named minor child(ren)
205	205	176currently reside or will reside with me at [address of caregiver]. I am [relationship to the minors].
206	206	177 I understand that I may, without obtaining further consent from a parent, legal custodian
207	207	178or legal guardian of the minor child(ren), exercise concurrent rights and responsibilities relative
208	208	179to the education and health care of the minor child(ren), except those rights and responsibilities
209	209	180prohibited above.
210	210	181 I understand that I may not knowingly make a decision which conflicts with the decision
211	211	182of the child(ren)'s parent, legal guardian or legal custodian.
212	212	183 I understand that, if the affidavit is amended or revoked, I must provide the amended
213	213	184affidavit or revocation to all parties to whom I have provided this affidavit prior to further
214	214	185exercising any rights or responsibilities under the affidavit.
215	215	186 I understand that, if I become unable to carry out the responsibilities conferred by this
216	216	187affidavit, I will do so by immediately notifying the authorizing party and the alternate caregiver
217	217	188in writing. 11 of 13
218	218	189 I hereby affirm that the above statements are true, under pains and penalties of perjury.
219	219	190 Signature of caregiver:
220	220	191 Printed name:
221	221	192 Telephone Number:
222	222	193 5. ALTERNATE CAREGIVER ACKNOWLEDGEMENT (This section is optional)
223	223	194 I, [name of alternate caregiver], am at least 18 years of age and the child(ren) currently
224	224	195reside or will reside with me at [address of caregiver]. I am [relationship to the minor].
225	225	196 I understand that I may, in the case of inability or incapacity of the first designated
226	226	197caregiver to carry out the responsibilities conferred herein, and without obtaining further consent
227	227	198from a parent, legal custodian or legal guardian of the child(ren), exercise concurrent rights and
228	228	199responsibilities relative to the education and health care of the child(ren), except those rights and
229	229	200responsibilities prohibited above.
230	230	201 I understand that I may not knowingly make a decision that conflicts with the decision of
231	231	202the child(ren)'s parent, legal guardian or legal custodian.
232	232	203 I understand that, if the affidavit is amended or revoked, I must provide the amended
233	233	204affidavit or revocation to all parties to whom I have provided this affidavit prior to further
234	234	205exercising any rights or responsibilities under the affidavit.
235	235	206 I hereby affirm that the above statements are true, under pains and penalties of perjury.
236	236	207 Signature of caregiver: 12 of 13
237	237	208 Printed name:
238	238	209 Telephone Number:
239	239	210 6. ATTESTATION OF CAREGIVER AS TO AUTHORIZING PARTY’S
240	240	211UNAVAILABILITY<\/ul> (This section is optional)
241	241	212 I, [name of caregiver], attest that the authorizing party is unavailable due to
242	242	213___________________
243	243	214______________________________________________________________________________
244	244	215_.
245	245	216 I hereby affirm that the above statements are true, under pains and penalties of perjury.
246	246	217 Signature of caregiver:
247	247	218 Printed name:
248	248	219 Telephone Number:
249	249	220 7. ATTESTATION OF ALTERNATE CAREGIVER AS TO DESIGNATED
250	250	221CAREGIVER’S UNAVAILABILITY (This section is optional)
251	251	222 I, [name of alternate caregiver], attest that the designated caregiver is unavailable due to
252	252	223______________________________________________________________________________
253	253	224______.
254	254	225 I hereby affirm that the above statements are true, under pains and penalties of perjury.
255	255	226 Signature of alternate caregiver: 13 of 13
256	256	227 Printed name:
257	257	228 Telephone Number:
258	258	229 III. Explanations: This caregiver authorization affidavit is pursuant to chapter 201F of the
259	259	230General Laws. A dispute arising hereunder shall be the exclusive jurisdiction of the probate
260	260	231courts pursuant to section 3 of chapter 215 of the General Laws.
261	261	232 A person who relies on a caregiver authorization affidavit that is consistent with the
262	262	233requirements of said chapter 201F has no obligation to make any further inquiry or investigation
263	263	234and shall not incur any criminal or civil liability or be subject to professional discipline for doing
264	264	235so, unless he knows facts contrary to the affidavit or knows that an authorizing party has made a
265	265	236decision to supersede the caregiver's decision. The reliance on the affidavit shall not relieve a
266	266	237person from liability arising from other provisions of the law.