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Planning for Incapacity: Using Advance Health Care Directives, HIPAA Authorizations & Physician Orders

Kind nurse with clipboard in her hands registering senior woman's healthcare stats. Estate planning is not only about deciding what happens to your assets after you pass away; it also involves planning for what happens if you become unable to make important decisions for yourself. In California, incapacity planning ensures that your medical and personal wishes are respected and that trusted individuals can act on your behalf when needed. Three essential tools for accomplishing this are the Advance Health Care Directive, HIPAA Authorization, and Physician Orders for Life-Sustaining Treatment (POLST). Each plays a unique role in protecting your rights and ensuring your health care decisions are carried out according to your values. For help incorporating these documents into your California estate plan in Los Angeles or the San Gabriel Valley, contact the Claremont advance directive attorneys at Blasser Law for personal service and expertise in estate planning.

The Importance of Incapacity Planning

Incapacity can result from illness, injury, dementia, or any condition that prevents you from communicating or making informed decisions. Without proper planning, your loved ones may face legal challenges in obtaining the authority to make medical choices or access necessary information. Court intervention through a conservatorship may become necessary, which can be time-consuming and emotionally difficult.

Incapacity planning allows you to maintain control by designating trusted individuals to make decisions in accordance with your preferences. These documents provide clear instructions for your medical care and eliminate uncertainty or disputes among family members.

Advance Health Care Directives

An Advance Health Care Directive (AHCD) is one of the most important components of an incapacity plan. In California, it combines two functions: a power of attorney for health care and a living will. This document allows you to appoint an agent, often called a health care proxy, to make medical decisions on your behalf if you cannot. It also lets you specify your wishes regarding medical treatments, life support, organ donation, and end-of-life care.

With an AHCD, you can:

Name one or more individuals to act as your health care agent.
Provide detailed instructions about medical interventions you would or would not want.
Specify whether you want to donate organs or participate in medical research.
Express preferences for pain management, resuscitation, and long-term care.

Because it is a legally binding document recognized under California Probate Code sections 4670-4679, an AHCD gives your chosen agent clear authority to act, helping medical providers and family members respect your decisions.

HIPAA Authorizations

Even with an Advance Health Care Directive, federal privacy laws can create barriers for loved ones trying to access your medical information. The Health Insurance Portability and Accountability Act (HIPAA) restricts the disclosure of personal health information to protect your privacy. However, this can sometimes prevent your designated agent or family members from communicating effectively with doctors or hospitals.

A HIPAA Authorization ensures that specific individuals can obtain and share your medical information with health care providers, insurers, or other professionals as necessary. Without this authorization, even your closest family members may be denied access to critical information during an emergency.

When drafting a HIPAA Authorization, it is important to:

Identify all individuals who should have access to your medical information.
Clearly define the scope of the authorization (for example, limited to certain providers or types of information).
Coordinate the authorization with your AHCD to ensure consistency.

By combining a HIPAA Authorization with your AHCD, you create a comprehensive system that both designates decision-making authority and facilitates communication between your medical team and your chosen representatives.

Physician Orders for Life-Sustaining Treatment (POLST)

While an Advance Health Care Directive outlines your general health care wishes, a Physician Orders for Life-Sustaining Treatment (POLST) form translates those preferences into actionable medical orders. A POLST is intended for individuals with serious illnesses or frailty who want to ensure their treatment choices are honored across all care settings.

The POLST form is completed with your physician (or other authorized medical professional) and includes decisions regarding resuscitation, medical interventions, and artificially administered nutrition. Unlike an AHCD, which can be used by anyone regardless of health status, a POLST is specifically designed for patients facing advanced illness or end-of-life care.

Key differences between an AHCD and a POLST include:

Scope: The AHCD is broader, covering many types of future health care decisions, while the POLST focuses on immediate medical orders.
Who completes it: The POLST must be signed by both the patient (or their decision-maker) and a licensed health care provider.
Where it applies: The POLST travels with the patient and must be followed by all health care professionals, including EMTs and hospital staff.

Having both an AHCD and a POLST ensures that your medical care preferences are clearly communicated and legally enforceable in any situation.

Coordinating Your Documents

Each of these documents plays a distinct but complementary role in incapacity planning. Together, they provide a robust framework for managing health care decisions:

The Advance Health Care Directive designates a decision-maker and expresses your long-term wishes.
The HIPAA Authorization grants access to the medical information needed to make informed decisions.
The POLST provides specific, physician-approved medical orders for patients with serious conditions.

To ensure consistency, it is important that these documents are properly drafted and do not contain conflicting instructions. Your estate planning attorney can help align all elements of your plan and coordinate them with your broader estate documents, such as your will or trust.

Why Professional Guidance Matters

Because incapacity planning involves legal, medical, and ethical considerations, professional assistance is essential. An experienced California estate planning attorney can help you:

Draft legally compliant documents that reflect your values.
Ensure all forms meet California’s specific statutory requirements.
Coordinate with your medical providers and loved ones to make sure your documents are on file and accessible when needed.
Review your documents periodically as your health and preferences change.

Without these preparations, your family may face unnecessary stress and uncertainty during a medical crisis. By taking proactive steps today, you can maintain control over your care and protect your loved ones from difficult decisions.

Get Help with Your Incapacity Plan

At Blasser Law, we help clients throughout Los Angeles and the San Gabriel Valley create comprehensive estate plans that include incapacity planning. Whether you need to establish an Advance Health Care Directive, HIPAA Authorization, or Physician Orders for Life-Sustaining Treatment, our attorneys can guide you through every step of the process.

Contact Blasser Law in Claremont today to learn how we can help you plan for the future and ensure your medical wishes are honored with clarity and compassion.