Req. No. 329 Page 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 STATE OF OKLAHOMA 1st Session of the 60th Legislature (2025) SENATE BILL 937 By: Howard AS INTRODUCED An Act relating to health care; creating the Uniform Health Care Decisions Act of 2025; providing short title; specifying conditions for capacity for certain purpose; stipulating extent of certain right; providing for certain presumptions of capacity; providing for rebuttal of certain capacity; prohibiting certain individuals from making specified findings; authorizing creation of certain h ealth care instruction; requiring certain documentation; providing for revocat ion of health care instruction under certain condition; authorizing creation of certain power of attorney; providing for disqualification of agency under certain conditions; specifying effect of health care decision; stipulating requirements for adult witness; defining presence of witness; allowing certain power of attorney to include health care instruction; providing for codification; and providing an effective date. BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA: SECTION 1. NEW LAW A new section of law to be codified in the Oklahoma Statutes as Section 3105A.1 of Title 63, unless there is created a duplication in numbering, reads as fol lows: This act shall be known and may be cited as the “Uniform Health Care Decisions Act of 2025 ”. Req. No. 329 Page 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 SECTION 2. NEW LAW A new section of law to be codified in the Oklahoma Statutes as Section 3105A.2 of Title 63, unless there is created a duplication in numbering, reads as follows: A. An individual has capacit y for the purpose of this act if the individual: 1. Is willing and able to communicate a decision independently or with appropriate services, technological assistance, supported decision-making, or other reasonable accommodation; and 2. In making or revoking: a. a health care decision, understands the nature and consequences of the decision, including the primary risks and benefits of the decision, b. a health care instruction, understands the nature and consequences of the instruction, including the prim ary risks and benefits of the choices expressed in the instruction, and c. an appointment of an agent under a health care power of attorney or identification of a default surroga te, recognizes the identity of the individual being appointed or identified and understands the general nature of the relationship of the individual making the appointment or identification with the individual being appointed or identified. Req. No. 329 Page 3 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 B. The right of an individual who has capacity to make a decision about the individual ’s health care is not affected by whether the individual creates or revokes an advance health care directive. SECTION 3. NEW LAW A new section of law to be codi fied in the Oklahoma Statutes as Section 3105A.3 of Title 63, unless there is created a duplication in numbering, reads as follows: A. An individual is presumed to have capacity to make or revoke a health care decision, health care instruction, and power of attorney for health care unless: 1. A court has found the individual lacks capacity to do so; or 2. The presumption is rebutted under subsection B of this section. B. Subject to the provisions of this act, a presumption under subsection A of this sec tion may be rebutted by a finding that the individual lacks capacity: 1. Subject to subsection C of this section, made on the basis of a contemporaneous examination by any of the following: a. a physician, b. a psychologist licensed or otherwise authorize d to practice in this state, c. an individual with training and expertise in t he finding of lack of capacity who is licensed or otherwise authorized to practice in this state as: Req. No. 329 Page 4 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 (1) a physician assistant , (2) an Advanced Practice Registered Nurse, or (3) a social worker, or d. a responsible health care professional not described in subparagraph a, b, or c of this paragraph if: (1) the individual about whom the finding is to be made is experiencing a health condition requiring a decision regarding health care treatment to be made promptly to avoid loss of life or serious harm to the health of the individual, and (2) an individual listed in subparagraph a, b, or c of this paragraph is not reasonably available; 2. Made in accordance with accepted standards of the profession and the scope of practice of the individual making the finding and to a reasonable degree of certainty; and 3. Documented in a record signed by the individual making the finding that includes an opinion of the cause, nature, extent, and probable duration of the lack of capacity. C. The finding under subsection B of this section may not be made by: 1. A family member of the individual presumed to have capacity; 2. The cohabitant of the individual or a descendant of the cohabitant; or Req. No. 329 Page 5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 3. The individual’s surrogate, a family member of the surrogate, or a descendant of the surrogate. D. If the finding under subsection B of this section was based on a condition the individual no longer has , or a responsible health care professional subsequen tly has good cause to believe the individual has capacity, the individual is p resumed to have capacity unless a court finds the individual lacks capacity or the presumption is rebutted under subsection B of this section. SECTION 4. NEW LAW A new section of law to be codified in the Oklahoma Statutes as Section 3105A.4 of Title 63, unless there is created a duplication in numbering, reads as follows: A. An individual may create a health care instruction that expresses the individual ’s preferences for future health care, including preferences regarding: 1. Health care professionals or health care institutions; 2. How a health care decision will be made and communicated; 3. Persons that should or should not be consulted regarding a health care decision; 4. A person to serve as guardian for the individual if one is appointed; and 5. An individual to serve as a default surrogate. B. A health care professional to whom an individual communicates or provides an instruction under subsect ion A of this section shall document the instruction and the date of the Req. No. 329 Page 6 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 instruction in the individual ’s medical record or communicate the instruction and date of the instruction to an administrator with responsibility for medical records of the health care institution providing health care to the individual, who shall document the instruction and the date of the instruction in the individual ’s medical record. C. A health care instruction made by an individual that conflicts with an earlier health care instruction made by the individual, including an instruction documented in a medi cal order, revokes the earlier instruction to the extent of the conflict. D. A health care instruction may be in the same record as a power of attorney for health care. SECTION 5. NEW LAW A new section of law to be codified in the Oklahoma Statutes as Section 3105A.5 of Title 63, unless there is created a duplication in numbering, reads as follows: A. An individual may create a power of attorney for healt h care to appoint an agent to make health care decisions for the individual. B. An individual is disqualified from acting as agent for an individual who lacks capacity to make health care decisions if: 1. A court finds that the potential agent poses a da nger to the individual’s well-being, even if the court does not issue a restraining order against the potential agent; or Req. No. 329 Page 7 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 2. The potential agent is an owner, operator, employee, or contractor of a nursing home or other residential care facility in which the individual resides or is receiving care, unless the owner, operator, employee, or contractor is a family member of the individual, the cohabitant of the individual, or a descendant of the cohabitant. C. A health care decision made by an agent is effect ive without judicial approval. D. A power of attorney for health care must be in a record, signed by the individual creating the power, and signed by an adult witness who: 1. Reasonably believes the act of the individual to create the power of attorney is voluntary and knowing; 2. Is not: a. the agent appointed by the individual, b. the agent’s spouse, domestic partner, or cohabitant, or c. if the individual resides or is receiving care in a nursing home or other residential care facility, the owner, operator, employee, or contractor of the nursing home or other residential care facility; and 3. Is present when the individual signs the power of attorney or when the individual represents that the power of attorney reflects the individual ’s wishes. Req. No. 329 Page 8 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 E. A witness under subsection D of this section is considered present if the witness and the individual are: 1. Physically present in the same location; 2. Using electronic means that allow for real -time audio and visual transmission and communication in real time to the same extent as if the witness and the individual were physically present in the same location; or 3. Able to speak to and hear each other in real time through audio connection if: a. the identity of the individual is personally known to the witness, or b. the witness is able to authenticate the identity of the individual by receiving accurate answers from the individual that enable the authentication. F. A power of attorney for health care may include a health care instruction. SECTION 6. This act shall become effective November 1, 2025. 60-1-329 DC 1/16/2025 12:07:12 PM