GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2025
H 2
HOUSE BILL 349
Committee Substitute Favorable 3/25/25
Short Title: Update Reqs./Advance Health Care Directives. (Public)
Sponsors:
Referred to:
March 11, 2025
*H349 -v-2*
A BILL TO BE ENTITLED 1
AN ACT UPDATING REQU IREMENTS FOR HEALTH CARE POWERS OF ATTOR NEY 2
AND ADVANCE HEALTH C ARE DIRECTIVES; AND AUTHORIZING THE 3
SECRETARY OF STATE T O RECEIVE ELECTRONIC FILINGS OF ADVANCE 4
HEALTH CARE DIRECTIVES. 5
The General Assembly of North Carolina enacts: 6
7
PART I. HEALTH CARE POWERS OF ATTORNEY 8
SECTION 1.1. G.S. 32A-16(3) reads as rewritten: 9
"(3) Health care power of attorney. – Except as provided in G.S. 32A-16.1, a 10
written instrument that substantially meets the requirements of this Article, 11
that is signed in the presence of two qualified witnesses, and witnesses or 12
acknowledged before a notary public, pursuant to which an attorney-in-fact or 13
agent is appointed to act for the principal in matters relating to the health care 14
of the principal. The notary who takes the acknowledgement may but is not 15
required to be a paid employee of the attending physician or mental health 16
treatment provider, a paid employee of a health facility in which the principal 17
is a patient, or a paid employee of a nursing home or any adult care home in 18
which the principal resides." 19
SECTION 1.2. G.S. 32A-25.1(a) reads as rewritten: 20
"(a) The use of the following form in the creation of a health care power of attorney is 21
lawful and, when used, it shall meet the requirements of and be construed in accordance with the 22
provisions of this Article: 23
24
HEALTH CARE POWER OF ATTORNEY 25
26
NOTE: YOU SHOULD USE THIS DOCUMENT TO NAME A PERSON AS YOUR 27
HEALTH CARE AGENT IF YOU ARE COMFORTABLE GIVING THAT PERSON 28
BROAD AND SWEEPING POWERS TO MAKE HEALTH CARE DECISIONS FOR 29
YOU. THERE IS NO LEGAL REQUIREMENT THAT ANYONE EXECUTE A 30
HEALTH CARE POWER OF ATTORNEY. 31
32
EXPLANATION: You have the right to name someone to make health care decisions for you 33
when you cannot make or communicate those decisions. This form may be used to create a health 34
care power of attorney, and meets the requirements of North Carolina law. However, you are 35
not required to use this form, and North Carolina law allows the use of other forms that meet 36 General Assembly Of North Carolina Session 2025
Page 2 House Bill 349-Second Edition
certain requirements. If you prepare your own health care power of attorney, you should be very 1
careful to make sure it is consistent with North Carolina law. 2
3
This document gives the person you designate as your health care agent broad powers to make 4
health care decisions for you when you cannot make the decision yourself or cannot communicate 5
your decision to other people. You should discuss your wishes concerning life-prolonging 6
measures, mental health treatment, and other health care decisions with your health care agent. 7
Except to the extent that you express specific limitations or restrictions in this form, your health 8
care agent may make any health care decision you could make yourself. 9
10
This form does not impose a duty on your health care agent to exercise granted powers, but when 11
a power is exercised, your health care agent will be obligated to use due care to act in your best 12
interests and in accordance with this document. 13
14
This Health Care Power of Attorney form is intended to be valid in any jurisdiction in which it 15
is presented, but places outside North Carolina may impose requirements that this form does not 16
meet. 17
18
If you want to use this form, you must complete it, sign it, and have your signature witnessed by 19
two qualified witnesses and or proved by a notary public. Follow the instructions about which 20
choices you can initial very carefully. Do not sign this form until two witnesses and or a notary 21
public are present to watch you sign it. You then should give a copy to your health care agent 22
and to any alternates you name. You should consider filing it with the Advance Health Care 23
Directive Registry maintained by the North Carolina Secretary of State: 24
http://www.nclifelinks.org/ahcdr/State. 25
26
… 27
28
By signing here, I indicate that I am mentally alert and competent, fully informed as to the 29
contents of this document, and understand the full import of this grant of powers to my health 30
care agent. 31
32
This the _____ day of ______________, 20____. 33
34
________________________(SEAL)(SIGNATURE) 35
36
I hereby state that the principal, _______________, being of sound mind, signed (or directed 37
another to sign on the principal's behalf) the foregoing health care power of attorney in my 38
presence, and that I am not related to the principal by blood or marriage, and I would not be 39
entitled to any portion of the estate of the principal under any existing will or codicil of the 40
principal or as an heir under the Intestate Succession Act, if the principal died on this date without 41
a will. I also state that I am not the principal's attending physician, nor a licensed health care 42
provider or mental health treatment provider who is (1) an employee of the principal's attending 43
physician or mental health treatment provider, (2) an employee of the health facility in which the 44
principal is a patient, or (3) an employee of a nursing home or any adult care home where the 45
principal resides. I further state that I do not have any claim against the principal or the estate of 46
the principal. 47
48
Box #1 49
If you elect to have your declaration witnessed, complete the following section: 50
51 General Assembly Of North Carolina Session 2025
House Bill 349-Second Edition Page 3
Date: _____________________________ Witness: ___________________________ 1
(Signature of witness) 2
3
_________________________ 4
(type/print name of witness) 5
Date: _____________________________ Witness: ___________________________ 6
(Signature of witness) 7
8
_________________________ 9
(type/print name of witness) 10
11
Box #2 12
If you elect to have your declaration notarized, have the following section completed by a 13
qualified notary public: 14
15
________________COUNTY, _________________STATE 16
17
Sworn to (or affirmed) and subscribed before me this day by _____________________ 18
(type/print name of signer) 19
______________________ 20
(type/print name of witness) 21
22
______________________ 23
(type/print name of witness) 24
25
26
Date: ___________________________ ______________________________ 27
(Official Seal) Signature of Notary Public 28
29
__________________, Notary Public 30
Printed or typed name 31
32
My commission expires: __________" 33
34
PART II. ADVANCE HEALTH CARE DIRECTIVES 35
SECTION 2.1. G.S. 90-321(c)(3) reads as rewritten: 36
"(3) Except as provided in G.S. 90-321.1, that has been signed by the declarant in 37
the presence of a notary public or two witnesses who believe the declarant to 38
be of sound mind and who state that they (i) are not related within the third 39
degree to the declarant or to the declarant's spouse, (ii) do not know or have a 40
reasonable expectation that they would be entitled to any portion of the estate 41
of the declarant upon the declarant's death under any will of the declarant or 42
codicil thereto then existing or under the Intestate Succession Act as it then 43
provides, (iii) are not the attending physician, licensed health care providers 44
who are paid employees of the attending physician, paid employees of a health 45
facility in which the declarant is a patient, or paid employees of a nursing 46
home or any adult care home in which the declarant resides, and (iv) do not 47
have a claim against any portion of the estate of the declarant at the time of 48
the declaration; andor" 49
SECTION 2.2. G.S. 90-321(a)(1a) reads as rewritten: 50 General Assembly Of North Carolina Session 2025
Page 4 House Bill 349-Second Edition
"(1a) Declaration. – Except as provided in G.S. 90-321.1, any signed, witnessed, 1
dated, and proved signed, witnessed or proved, and dated document meeting 2
the requirements of subsection (c) of this section." 3
SECTION 2.3. G.S. 90-321(d1) reads as rewritten: 4
"(d1) The following form is specifically determined to meet the requirements of subsection 5
(c) of this section: 6
7
ADVANCE DIRECTIVE FOR A NATURAL DEATH ( "LIVING WILL") 8
9
NOTE: YOU SHOULD USE THIS DOCUMENT TO GIVE YOUR HEALTH CARE 10
PROVIDERS INSTRUCTIONS TO WITHHOLD OR WITHDRAW 11
LIFE-PROLONGING MEASURES IN CERTAIN SITUATIONS. THERE IS NO LEGAL 12
REQUIREMENT THAT ANYONE EXECUTE A LIVING WILL. 13
14
GENERAL INSTRUCTIONS: You can use this Advance Directive ("Living Will") form to give 15
instructions for the future if you want your health care providers to withhold or withdraw 16
life-prolonging measures in certain situations. You should talk to your doctor about what these 17
terms mean. The Living Will states what choices you would have made for yourself if you were 18
able to communicate. Talk to your family members, friends, and others you trust about your 19
choices. Also, it is a good idea to talk with professionals such as your doctors, clergypersons, 20
and lawyers before you complete and sign this Living Will. 21
22
You do not have to use this form to give those instructions, but if you create your own Advance 23
Directive you need to be very careful to ensure that it is consistent with North Carolina law. 24
25
This Living Will form is intended to be valid in any jurisdiction in which it is presented, but places 26
outside North Carolina may impose requirements that this form does not meet. 27
28
If you want to use this form, you must complete it, sign it, and have your signature witnessed by 29
two qualified witnesses and or proved by a notary public. Follow the instructions about which 30
choices you can initial very carefully. Do not sign this form until two witnesses and or a notary 31
public are present to watch you sign it. You then should consider giving a copy to your primary 32
physician and/or a trusted relative, and should consider filing it with the Advanced Health Care 33
Directive Registry maintained by the North Carolina Secretary of State: 34
http://www.nclifelinks.org/ahcdr/State. 35
36
My Desire for a Natural Death 37
38
I, ____________________, being of sound mind, desire that, as specified below, my life not be 39
prolonged by life-prolonging measures: 40
41
… 42
43
I hereby state that the declarant, ______________________, being of sound mind, signed (or 44
directed another to sign on declarant's behalf) the foregoing Advance Directive for a Natural 45
Death in my presence, and that I am not related to the declarant by blood or marriage, and I would 46
not be entitled to any portion of the estate of the declarant under any existing will or codicil of 47
the declarant or as an heir under the Intestate Succession Act, if the declarant died on this date 48
without a will. I also state that I am not the declarant's attending physician, nor a licensed health 49
care provider who is (1) an employee of the declarant's attending physician, (2) nor an employee 50
of the health facility in which the declarant is a patient, or (3) an employee of a nursing home or 51 General Assembly Of North Carolina Session 2025
House Bill 349-Second Edition Page 5
any adult care home where the declarant resides. I further state that I do not have any claim 1
against the declarant or the estate of the declarant. 2
3
Box #1 4
If you elect to have your declaration witnessed, complete the following section: 5
6
Date: _____________________________ Witness: ___________________________ 7
(Signature of witness) 8
9
_________________________ 10
(type/print name of witness) 11
12
Date: _____________________________ Witness: ___________________________ 13
(Signature of witness) 14
15
_________________________ 16
(type/print name of witness) 17
18
Box #2 19
If you elect to have your declaration notarized, have the following section completed by a 20
qualified notary public: 21
22
________________COUNTY, _________________STATE 23
24
Sworn to (or affirmed) and subscribed before me this day by _____________________ 25
(type/print name of declarant) 26
27
________________________ 28
(type/print name of witness) 29
30
________________________ 31
(type/print name of witness) 32
33
Date ___________________________ ______________________________ 34
(Official Seal) Signature of Notary Public 35
36
__________________, Notary Public 37
Printed or typed name 38
39
My commission expires: _________" 40
41
PART III. ELECTRONIC FILING OF HEALTH CARE POWERS OF ATTORNE Y AND 42
ADVANCE HEALTH CARE DIRECTIVES WITH THE NORTH CAROLINA 43
SECRETARY OF STATE 44
SECTION 3.1. G.S. 130A-466 reads as rewritten: 45
"§ 130A-466. Filing requirements. 46
(a) A person may submit any of the following documents and the revocations of these 47
documents to the Secretary of State in electronic or hard copy format for filing in the Advance 48
Health Care Directive Registry established pursuant to this Article: 49
(1) A health care power of attorney under Article 3 of Chapter 32A of the General 50
Statutes. 51 General Assembly Of North Carolina Session 2025
Page 6 House Bill 349-Second Edition
(2) A declaration of a desire for a natural death under Article 23 of Chapter 90 of 1
the General Statutes. 2
(3) An advance instruction for mental health treatment under Part 2 of Article 3 3
of Chapter 122C of the General Statutes. 4
(4) A declaration of an anatomical gift under Part 3A of Article 16 of Chapter 5
130A of the General Statutes. 6
(5) A Health Insurance Portability and Accountability Act (HIPAA) waiver. 7
(b) Any document and any revocation of a document submitted for filing in the registry 8
shall be notarized regardless of whether notarization is required for its validity. This subsection 9
does not apply to a declaration of an anatomical gift described in subdivision (a)(4) of this 10
section. 11
(c) The document may be submitted for filing only by the person who executed the 12
document. 13
(d) The person who submits the document shall supply a return address. 14
(e) The document shall be accompanied by any fee required by this Article." 15
SECTION 3.2. G.S. 130A-468 reads as rewritten: 16
"§ 130A-468. Filing of documents with the registry. 17
(a) When the Secretary of State receives a hard copy of a document that may be filed 18
with the registry pursuant to this Article, the Secretary shall create a digital reproduction of that 19
document and enter the reproduced document into the registry database. When the Secretary of 20
State receives a document in electronic format that may be filed with the registry pursuant to this 21
Article, the Secretary shall enter that document into the registry database. The Secretary is not 22
required to review a document to ensure that it complies with the particular statutory 23
requirements applicable to the document. Each document entered into the registry database shall 24
be assigned a unique file number and password. 25
(b) Upon entering the a reproduced hard copy of a document into the registry database, 26
the Secretary shall return the original hard copy of the document and a wallet-size card containing 27
the document's file number and password to the person who submitted the document. Upon 28
entering into the registry database a document that was received in electronic format, the 29
Secretary shall send a wallet-size card containing the document's file number and password to 30
the person who submitted the document. 31
(c) When the Secretary of State receives a revocation of a document that is filed with the 32
registry and that document's file number and password, or a request to remove that document 33
from the registry without its revocation, the Secretary shall delete that document from the registry 34
database. 35
(c1) The Secretary of State may remove documents of deceased registrants from the 36
registry upon notification of death in writing in a form acceptable to the Secretary of State. 37
(d) The Secretary of State's entry of a document into, or removal of a document from, the 38
registry database does not do any of the following: 39
(1) Affect the validity of the document in whole or in part. 40
(2) Relate to the accuracy of information contained in the document. 41
(3) Create a presumption regarding the validity of the document, regarding the 42
accuracy of information contained in the document, or that the statutory 43
requirements for the document have been met." 44
45
PART IV. EFFECTIVE DATE 46
SECTION 4.1. This act becomes effective October 1, 2025. 47