Minnesota 2025-2026 Regular Session

Minnesota House Bill HF2753 Compare Versions

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

Old	New	Differences
1	1	1.1 A bill for an act
2	2	1.2 relating to civil law; creating default surrogate for health decisions and providing
3	3	1.3 a process to appoint default surrogate for health decisions; amending Minnesota
4	4	1.4 Statutes 2024, sections 145C.01, subdivision 2, by adding subdivisions; 145C.03,
5	5	1.5 by adding a subdivision; 145C.10; 145C.11; proposing coding for new law in
6	6	1.6 Minnesota Statutes, chapter 145C.
7	7	1.7BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
8	8	1.8 Section 1. Minnesota Statutes 2024, section 145C.01, is amended by adding a subdivision
9	9	1.9to read:
10	10	1.10 Subd. 1c.Default surrogate for health decisions.A physician, advanced practice
11	11	1.11registered nurse, or physician assistant shall not recognize a default surrogate for health
12	12	1.12decisions unless the individual for whom a health care decision is necessary is an
13	13	1.13unrepresented individual as defined in subdivision 10. "Default surrogate for health decisions"
14	14	1.14means either an individual or individuals age 18 or older, or an organization, so long as the
15	15	1.15individual, individuals, or organization is one of the following:
16	16	1.16 (1) an individual or individuals included in the unrepresented individual's kinship system;
17	17	1.17 (2) a friend or more than one friend of the unrepresented individual;
18	18	1.18 (3) a health care agent appointed by the unrepresented individual in a health care directive
19	19	1.19that does not include a designation of the power necessary to make the health care decision
20	20	1.20for which the physician, advanced practice registered nurse, or physician assistant seeks
21	21	1.21informed consent;
22	22	1Section 1.
23	23	REVISOR SGS/LJ 25-0381703/10/25
24	24	State of Minnesota
25	25	This Document can be made available
26	26	in alternative formats upon request
27	27	HOUSE OF REPRESENTATIVES
28	28	H. F. No. 2753
29	29	NINETY-FOURTH SESSION
30	30	Authored by Nadeau03/24/2025
31	31	The bill was read for the first time and referred to the Committee on Health Finance and Policy 2.1 (4) other individual or individuals designated in writing or verbally by the unrepresented
32	32	2.2individual or who are qualified or registered to assist the unrepresented individual in other
33	33	2.3respects, including but not limited to:
34	34	2.4 (i) a designated representative pursuant to section 144G.08, subdivision 19;
35	35	2.5 (ii) a client representative pursuant to section 144A.43, subdivision 1e;
36	36	2.6 (iii) a hospice patient's family pursuant to section 144A.75, subdivision 7;
37	37	2.7 (iv) an individual under section 144.651, subdivision 10;
38	38	2.8 (v) a responsible party pursuant to section 144.6501, subdivision 1, paragraph (e);
39	39	2.9 (vi) an individual appointed by the unrepresented individual in a valid power of attorney
40	40	2.10pursuant to chapter 523; and
41	41	2.11 (vii) a representative payee with respect to governmental benefits; or
42	42	2.12 (5) a professional or other individuals supportive of the unrepresented individual such
43	43	2.13as:
44	44	2.14 (i) clergy and religious order members;
45	45	2.15 (ii) care managers;
46	46	2.16 (iii) professional advocates;
47	47	2.17 (iv) supporters consistent with the definition of supported decision making in section
48	48	2.18524.5-102, subdivision 16a; and
49	49	2.19 (v) individuals associated with a health care agent organization.
50	50	2.20 Sec. 2. Minnesota Statutes 2024, section 145C.01, is amended by adding a subdivision to
51	51	2.21read:
52	52	2.22 Subd. 1d.Friends."Friends" means adults who exhibit good faith concern for the
53	53	2.23unrepresented individual and who are familiar with and supportive of the unrepresented
54	54	2.24individual.
55	55	2.25 Sec. 3. Minnesota Statutes 2024, section 145C.01, subdivision 2, is amended to read:
56	56	2.26 Subd. 2.Health care agent."Health care agent" means an individual age 18 or older
57	57	2.27who is or a health care agent organization appointed by a principal in a health care power
58	58	2.28of attorney to make health care decisions on behalf of the principal. "Health care agent"
59	59	2.29may also be referred to as "agent."
60	60	2Sec. 3.
61	61	REVISOR SGS/LJ 25-0381703/10/25 3.1 Sec. 4. Minnesota Statutes 2024, section 145C.01, is amended by adding a subdivision to
62	62	3.2read:
63	63	3.3 Subd. 2a.Health care agent organization."Health care agent organization" means an
64	64	3.4organization that maintains a group of individuals who are reasonably available to serve as
65	65	3.5health care agents pursuant to this chapter.
66	66	3.6 Sec. 5. Minnesota Statutes 2024, section 145C.01, is amended by adding a subdivision to
67	67	3.7read:
68	68	3.8 Subd. 7b.Kinship system."Kinship system" means a system of social relationships
69	69	3.9connecting people in a community or culture who are, or are held to be, related, and which
70	70	3.10defines and regulates the reciprocal obligations within the system, such as family members,
71	71	3.11religious communities, and ethnic communities.
72	72	3.12 Sec. 6. Minnesota Statutes 2024, section 145C.01, is amended by adding a subdivision to
73	73	3.13read:
74	74	3.14 Subd. 10.Unrepresented individual."Unrepresented individual" means an individual
75	75	3.15age 18 or older who:
76	76	3.16 (1) has not previously executed a health care directive containing health care instructions
77	77	3.17or appointing a health care agent;
78	78	3.18 (2) has previously executed a health care directive appointing a health care agent but
79	79	3.19the individual has revoked the health care power of attorney under section 145C.09, or has
80	80	3.20appointed a health care agent who is not reasonably available, or who has not given the
81	81	3.21health care agent in the reasonable professional judgment of the physician, advanced practice
82	82	3.22registered nurse, or physician assistant the powers that are necessary to make the health
83	83	3.23care decision for which the physician, advanced practice registered nurse, or physician
84	84	3.24assistant seeks informed consent;
85	85	3.25 (3) has previously executed a health care directive containing health care instructions
86	86	3.26which did not appoint a health care agent but has revoked the health care directive under
87	87	3.27section 145C.09, or has provided health care instructions insufficient in the reasonable
88	88	3.28professional judgment of the physician, advanced practice registered nurse, or physician
89	89	3.29assistant to permit the physician, advanced practice registered nurse, or physician assistant
90	90	3.30to act; or
91	91	3.31 (4) is not currently subject to a guardianship in which the power to make health care
92	92	3.32decisions has been granted pursuant to section 524.5-313, paragraph (c).
93	93	3Sec. 6.
94	94	REVISOR SGS/LJ 25-0381703/10/25 4.1 Sec. 7. Minnesota Statutes 2024, section 145C.03, is amended by adding a subdivision to
95	95	4.2read:
96	96	4.3 Subd. 4.Health care agent organization appointed as agent.If the principal executes
97	97	4.4a health care power of attorney appointing a health care agent organization as the principal's
98	98	4.5health care agent, the health care power of attorney shall include the name, address, telephone
99	99	4.6number, and email address of the health care agent organization, and the name of at least
100	100	4.7one individual associated with the health care agent organization designated by the principal
101	101	4.8to act as agent on behalf of the health care agent organization. The health care agent
102	102	4.9organization may designate a successor agent or agents if the initial agent is not reasonably
103	103	4.10available at the time the health care power of attorney becomes effective pursuant to section
104	104	4.11145C.06.
105	105	4.12 Sec. 8. Minnesota Statutes 2024, section 145C.10, is amended to read:
106	106	4.13 145C.10 PRESUMPTIONS.
107	107	4.14 (a) The principal is presumed to have the capacity to execute a health care directive and
108	108	4.15to revoke a health care directive, absent clear and convincing evidence to the contrary.
109	109	4.16 (b) A health care provider or health care agent may presume that a health care directive
110	110	4.17is legally sufficient absent actual knowledge to the contrary. A health care directive is
111	111	4.18presumed to be properly executed, absent clear and convincing evidence to the contrary.
112	112	4.19 (c) A health care agent or default surrogate for health decisions, and a health care provider
113	113	4.20acting pursuant to the direction of a health care agent or default surrogate for health decisions,
114	114	4.21are presumed to be acting in good faith, absent clear and convincing evidence to the contrary.
115	115	4.22 (d) A health care directive is presumed to remain in effect until the principal modifies
116	116	4.23or revokes it, absent clear and convincing evidence to the contrary.
117	117	4.24 (e) This chapter does not create a presumption concerning the intention of an individual
118	118	4.25who has not executed a health care directive and, except as otherwise provided by section
119	119	4.26145C.15, does not impair or supersede any right or responsibility of an individual to consent,
120	120	4.27refuse to consent, or withdraw consent to health care on behalf of another in the absence of
121	121	4.28a health care directive, including but not limited to a default surrogate for health decisions.
122	122	4.29 (f) A copy of a health care directive is presumed to be a true and accurate copy of the
123	123	4.30executed original, absent clear and convincing evidence to the contrary, and must be given
124	124	4.31the same effect as an original.
125	125	4Sec. 8.
126	126	REVISOR SGS/LJ 25-0381703/10/25 5.1 (g) When a patient lacks decision-making capacity and is pregnant, and in reasonable
127	127	5.2medical judgment there is a real possibility that if health care to sustain her life and the life
128	128	5.3of the fetus is provided the fetus could survive to the point of live birth, the health care
129	129	5.4provider shall presume that the patient would have wanted such health care to be provided,
130	130	5.5even if the withholding or withdrawal of such health care would be authorized were she not
131	131	5.6pregnant. This presumption is negated by health care directive provisions described in
132	132	5.7section 145C.05, subdivision 2, paragraph (a), clause (10), that are to the contrary, or, in
133	133	5.8the absence of such provisions, by clear and convincing evidence that the patient's wishes,
134	134	5.9while competent, were to the contrary.
135	135	5.10 Sec. 9. Minnesota Statutes 2024, section 145C.11, is amended to read:
136	136	5.11 145C.11 IMMUNITIES.
137	137	5.12 Subdivision 1.Health care agent and default surrogate for health decisions.A health
138	138	5.13care agent or default surrogate for health decisions is not subject to criminal prosecution or
139	139	5.14civil liability if the health care agent acts in good faith.
140	140	5.15 Subd. 2.Health care provider.(a) With respect to health care provided to a patient
141	141	5.16with a health care directive, a health care provider is not subject to criminal prosecution,
142	142	5.17civil liability, or professional disciplinary action if the health care provider acts in good
143	143	5.18faith and in accordance with applicable standards of care.
144	144	5.19 (b) A health care provider is not subject to criminal prosecution, civil liability, or
145	145	5.20professional disciplinary action if the health care provider relies on a health care decision
146	146	5.21made by the health care agent and the following requirements are satisfied:
147	147	5.22 (1) the health care provider believes in good faith that the decision was made by a health
148	148	5.23care agent appointed to make the decision and has no actual knowledge that the health care
149	149	5.24directive has been revoked; and
150	150	5.25 (2) the health care provider believes in good faith that the health care agent is acting in
151	151	5.26good faith.
152	152	5.27 (c) A health care provider who administers health care necessary to keep the principal
153	153	5.28alive, despite a health care decision of the health care agent or default surrogate for health
154	154	5.29decisions to withhold or withdraw that treatment, is not subject to criminal prosecution,
155	155	5.30civil liability, or professional disciplinary action if that health care provider promptly took
156	156	5.31all reasonable steps to:
157	157	5.32 (1) notify the health care agent or default surrogate for health decisions of the health
158	158	5.33care provider's unwillingness to comply;
159	159	5Sec. 9.
160	160	REVISOR SGS/LJ 25-0381703/10/25 6.1 (2) document the notification in the principal's medical record; and
161	161	6.2 (3) permit the health care agent or default surrogate for health decisions to arrange to
162	162	6.3transfer care of the principal to another health care provider willing to comply with the
163	163	6.4decision of the health care agent or default surrogate for health decisions.
164	164	6.5 (d) A health care provider is not subject to criminal prosecution, civil liability, or
165	165	6.6professional disciplinary action if the health care provider relies on a health care decision
166	166	6.7made by a default surrogate for health decisions when the following requirements are
167	167	6.8satisfied:
168	168	6.9 (1) the health care provider believes in good faith that the default surrogate for health
169	169	6.10decisions meets the requirements in section 145C.18, subdivision 1, clause (3); and
170	170	6.11 (2) the health care provider believes in good faith that the default surrogate for health
171	171	6.12decisions is acting in good faith.
172	172	6.13 Sec. 10. [145C.18] HEALTH CARE DECISIONS FOR UNREPRESENTED
173	173	6.14INDIVIDUALS.
174	174	6.15 Subdivision 1.Requirements to appoint.When a physician, advanced practice registered
175	175	6.16nurse, or physician assistant needs to obtain a health care decision from or on behalf of an
176	176	6.17individual, the physician, advanced practice registered nurse, or physician assistant may
177	177	6.18obtain the health care decision from a default surrogate for health decisions subject to the
178	178	6.19reasonable satisfaction, in the good faith and reasonable professional judgment of the
179	179	6.20physician, advanced practice registered nurse, or physician assistant of all the following
180	180	6.21conditions:
181	181	6.22 (1) the individual is an unrepresented individual pursuant to section 145C.01, subdivision
182	182	6.2310;
183	183	6.24 (2) the unrepresented individual does not have decision-making capacity pursuant to
184	184	6.25section 145C.01, subdivision 4, with respect to the health care decision and does not have
185	185	6.26the capacity pursuant to section 145C.02 to execute a health care directive, or has the capacity
186	186	6.27pursuant to section 145C.02 to execute a health care directive but declines to do so;
187	187	6.28 (3) each default surrogate for health decisions recognized by the physician, advanced
188	188	6.29practice registered nurse, or physician assistant:
189	189	6.30 (i) has demonstrated or expressed the willingness and ability to demonstrate good faith
190	190	6.31concern for the unrepresented individual;
191	191	6Sec. 10.
192	192	REVISOR SGS/LJ 25-0381703/10/25 7.1 (ii) is familiar with or is willing and able to become familiar with and supportive of the
193	193	7.2unrepresented individual's current personal values and life choices;
194	194	7.3 (iii) would be reasonably available to make health care decisions;
195	195	7.4 (iv) would act in good faith;
196	196	7.5 (v) would be reasonably acceptable to the unrepresented individual given the
197	197	7.6unrepresented individual's reasonably determinable personal values and life choices; and
198	198	7.7 (vi) would not be considered ineligible to serve as a health care agent consistent with
199	199	7.8section 145C.03, subdivision 2; and
200	200	7.9 (4) the physician, advanced practice nurse, or physician assistant documents the process
201	201	7.10undertaken to satisfy the foregoing conditions and the rationale for the recognition of each
202	202	7.11default surrogate for health decisions.
203	203	7.12 Subd. 2.Other laws.Each default surrogate for health decisions recognized pursuant
204	204	7.13to subdivision 1 shall be considered to have specific authorization in law, including but not
205	205	7.14limited to section 144.293, subdivision 2, clause (2), and Code of Federal Regulations, title
206	206	7.1545, sections 164.502 and 164.510, paragraph (b), with respect to access to patient records
207	207	7.16relevant to the health care decision for which the default surrogate for health decisions is
208	208	7.17recognized.
209	209	7Sec. 10.
210	210	REVISOR SGS/LJ 25-0381703/10/25