MODIFY HC POA/ADV DIRECT. (NEW)

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View NCGA Bill Details2025-2026 Session
House Bill 349 (Public) Filed Monday, March 10, 2025
AN ACT UPDATING REQUIREMENTS FOR HEALTH CARE POWERS OF ATTORNEY AND ADVANCE HEALTH CARE DIRECTIVES AND AUTHORIZING THE SECRETARY OF STATE TO RECEIVE ELECTRONIC FILINGS OF ADVANCE HEALTH CARE DIRECTIVES.
Intro. by Huneycutt, Potts, Cunningham, Campbell.
Status: Re-ref Com On Rules and Operations of the Senate (Senate action) (Jun 17 2026)

SOG comments (2):

Long title change

Submitted by iveybyrd on

Previous title was AN ACT UPDATING REQUIREMENTS FOR HEALTH CARE POWERS OF ATTORNEY AND ADVANCE HEALTH CARE DIRECTIVES; AND AUTHORIZING THE SECRETARY OF STATE TO RECEIVE ELECTRONIC FILINGS OF ADVANCE HEALTH CARE DIRECTIVES.

Long title change

Submitted by jhenders@sog.unc.edu on

Committee substitute to the 3rd edition changed the long title. Previous title was AN ACT UPDATING REQUIREMENTS FOR HEALTH CARE POWERS OF ATTORNEY AND ADVANCE HEALTH CARE DIRECTIVES, AUTHORIZING THE SECRETARY OF STATE TO RECEIVE ELECTRONIC FILINGS OF ADVANCE HEALTH CARE DIRECTIVES, AND ALLOWING PARENT CHOICE IN NURSING SERVICE PROVIDERS REQUIRED BY AN INDIVIDUALIZED EDUCATION PROGRAM.

Bill History:

H 349

Bill Summaries:

  • Bill H 349 (2025-2026)
    Summary date: Jun 17 2026 - View Summary

    Senate committee substitute to the 3rd edition makes the following changes.

    Removes provisions allowing parent choice in nursing service providers required under an individualized education plan. Makes conforming changes to act's titles. 

    Part I.

    Removes the act’s changes to GS 32A-16(3) pertaining to health care powers of attorney. Instead, amends GS 32A-16(6), pertaining to qualified witnesses, as follows. Makes organizational changes. Adds the requirement that the witness both (1) received training on recognizing  whether the declarant meets the legal requirements for competency to execute the health care power of attorney and (2) has been designated by his or her employer to serve as a witness to the execution of the health care power of attorney.

    Modifies the Health Care Power of Attorney form so that a notary is required to confirm the identity of the two witnesses; removes proposed election to have it notarized instead of witnessed. Adds provisions from existing form language pertaining to designation of health care agent, effectiveness of appointment, revocation, general statements of authority granted, special provisions and limitations, organ donation, guardianship, reliance of third parties on health care agent, and miscellaneous provisions. Makes conforming change to account for changes to GS 32A-16. Makes organizational changes.

    Part II.

    Makes technical changes to GS 90-321(c). Makes organizational change. Requires the declaration to have been signed before two witnesses (previous edition allowed it be done before a notary public). Allows for health care provider employees of the declarant’s attending physician that have both (i) received training on recognizing whether the declarant meets the legal requirements for competency to execute the Advanced Directive for a Natural Death and (ii) been designated by his or her employer to serve as a witness to the execution of the Advanced Directive for a Natural Death to serve as a witness to advance directive for a natural death (i.e., a living will). Modifies the statutory form as follows. Requires that the two witnesses sign in front of a notary public. Adds the following provisions from existing form language: when my directives apply, directives about prolonging life, exceptions (artificial nutrition or hydration), wish to be made as comfortable as possible, acknowledgement of understanding of their advance directive, if there is an advanced health care agent, authorizing a health care provider to rely upon the directive, an option for the directive to be effective anywhere, and the right to revoke the directive at any time. Makes conforming changes to the form.

    Changes the effective date to October 1, 2026.

    Courts/Judiciary, Civil, Civil Law, Government, State Agencies, Secretary of State, Health and Human Services, Health, Health Care Facilities and Providers, Public Health
    GS 32A, GS 90, GS 130A
  • Bill H 349 (2025-2026)
    Summary date: May 22 2025 - View Summary

    Senate committee substitute to the 2nd edition adds the following new Part IV. Makes organizational changes. Makes conforming changes to act’s effective date and its short and long titles. Clarifies that except as otherwise provided in Parts I-IV, the act is effective when it becomes law.

    Part IV.

    Deletes the limitation in GS 115C-111.2 (contract with private service providers) which directed that the local educational agencies are only able to contract with private special education facilities or providers when the local entity is unable to provide the service, so that local educational agencies may contract with private providers for any service. Defines nursing services. Adds new GS 115C-111.2(b) specifying the following conditions that must be met before a local education agency must make available a parent’s choice of nurse when providing nursing services under an Individualized Education Plan (IEP): (1) the IEP requires nursing services; (2) the child received nursing services from the nurse (i) prior to the nursing services being required by the child's IEP or (ii) prior to the child enrolling in his or her current school; (3) the parent's choice of nurse is employed by a nursing agency and willing to provide the nursing services required by the child's IEP; (4) the nursing agency employing the parent's choice of nurse meets all standard contract terms required for any other nursing agency contracted by the local educational agency, including licensing and liability requirements; and (5) the contracted rate is equal to or less than the contracted rate of other nurses contracted by the local educational agency. Specifies that GS 115C-111.2 should not be construed to limit the local education agency’s responsibility to provide free public education. Applies beginning with the 2025-26 school year.

    Courts/Judiciary, Civil, Civil Law, Education, Elementary and Secondary Education, Government, State Agencies, Secretary of State, Health and Human Services, Health, Health Care Facilities and Providers, Public Health
    GS 32A, GS 90, GS 115C, GS 130A
  • Bill H 349 (2025-2026)
    Summary date: Mar 25 2025 - View Summary

    House committee substitute makes the following changes to the 1st edition. 

    Part I.

    Makes organizational changes to witness information lines in the statutory form for health care power of attorney, set forth in GS 32A-25.1. 

    Part II.

    Makes organizational changes to witness information lines in the statutory form for advance directive for a natural death in GS 90-321(d1). 

     

    Courts/Judiciary, Civil, Civil Law, Government, State Agencies, Secretary of State, Health and Human Services, Health, Health Care Facilities and Providers, Public Health
    GS 32A, GS 90, GS 130A
  • Bill H 349 (2025-2026)
    Summary date: Mar 10 2025 - View Summary

    Part I.

    Changes the requirements for a health care power of attorney under GS 32A-16(3) to now require the written instrument to be signed in the presence of two qualified witnesses or acknowledged before a notary public (previously, required signature in the presence of two qualified witnesses and acknowledgement before a notary public). Makes conforming changes to the statutory form for health care power of attorney, set forth in GS 32A-25.1. No longer provides a weblink to the Advance Health Care Directive Registry.

    Part II.

    Changes the requirements for a health care declaration under GS 90-321 to now require the written document to be either (1) signed by the declarant in the presence of a notary public or two witnesses (was, two witnesses only) who believe the declarant to be of sound mind and who state that they are not four specified individuals with respect to the declarant, or (2) proved before a clerk or assistant clerk of superior court or a notary public (previously, required signature in the presence of two witnesses as described and to be proven before a clerk, assistant clerk or notary public). Makes conforming changes to the definition given for declaration. Makes conforming changes to the statutory form for advance directive for a natural death set forth in subsection (d1). No longer provides a weblink to the Advance Health Care Directive Registry.

    Part III.

    Allows for submission of specified documents and revocations to the Secretary of State for filing in the Advance Health Care Directive Registry under GS 130A-466 in electronic or hard copy format. No longer requires documents and revocations to be notarized (previously, only anatomical gift declarations were not required to be notarized). Adds a Health Insurance Portability and Accountability Act (HIPAA) waiver to the documents and revocations that can be filed.

    Amends GS 130A-468 to direct the Secretary of State to file documents received in electronic format that can be filed with the registry to enter that document into the registry database and send a wallet-size card containing the document's file number and password to the person who submitted the document. Makes clarifying changes to specify existing similar procedures apply to hard copy documents received. Authorizes the Secretary of State to remove documents of deceased registrants from the registry upon notification of death in writing in a form acceptable to the Secretary of State.

    Part IV.

    Effective October 1, 2025. 

    Courts/Judiciary, Civil, Civil Law, Government, State Agencies, Secretary of State, Health and Human Services, Health, Health Care Facilities and Providers, Public Health
    GS 32A, GS 90, GS 130A
View: All Summaries for Bill