Protect Your Wishes: California Healthcare Directives
California’s Advance Health Care Directive (AHCD) lets you name a health care agent and leave treatment instructions in one legally recognized document. This overview covers what AHCDs do, key choices to consider, how to sign and witness properly, and how to keep your directive accessible and up to date.
What Is a California Advance Health Care Directive?
A California Advance Health Care Directive (AHCD) allows you to appoint an agent to make decisions if you cannot, and/or to give written instructions about your medical care. California law recognizes a combined approach that functions as both a health care power of attorney and a living will. The statutory form also includes optional sections for organ/tissue donation, autopsy, and disposition of remains. See the California Attorney General’s guidance and the Probate Code’s statutory form: OAG: Advance Health Care Directives; Probate Code § 4701.
Why Having a Directive Matters
An AHCD helps ensure your values guide your care, reduces uncertainty for loved ones, and gives clinicians clear authority to follow your expressed wishes. Without a directive, decisions may fall to others and providers may follow standard protocols that might not match your preferences. See OAG: Advance Health Care Directives.
What You Can Decide in an AHCD
- Appoint a health care agent and alternates. Authorize someone you trust to speak for you if you cannot.
- Provide treatment instructions. Specify what care you would or would not want, including life-sustaining measures and comfort-focused care.
- Pain management and comfort care. State goals and limits.
- Organ and tissue donation; autopsy; disposition of remains. Optional sections appear in the statutory form. See Probate Code § 4701.
- Choose a primary physician. You may identify your primary doctor in the directive. See Probate Code § 4701.
- When authority begins. You can make your agent’s authority effective immediately or only upon loss of capacity. See OAG guidance.
Who Can Serve as Your Health Care Agent
Your agent should be someone you trust who can advocate for you and communicate well with your medical team. California law limits certain choices—for example, your supervising health care provider generally cannot serve as your agent. See OAG: Advance Health Care Directives.
Execution Requirements: Signing, Witnessing, and Notarization
California provides a statutory AHCD form, but a custom document is acceptable if it meets legal requirements. To be valid, an AHCD must be in writing and signed by you (or by another person at your direction and in your presence), and it must be either:
- Signed by two adult witnesses who meet statutory requirements, or
- Acknowledged before a notary public.
Witness restrictions and statements appear in the statutory form, including who may not serve as a witness (e.g., your health care provider or agent) and the requirement that at least one witness be disinterested. If you reside in a skilled nursing facility, an ombudsman or patient advocate must also sign as a special witness to the directive. See OAG guidance; Probate Code § 4701 (witness and special SNF provisions); and the Health Care Decisions Law.
When Your Directive Takes Effect
You may state that your agent’s authority begins immediately or only if a health care provider determines you lack capacity. Your written instructions generally apply whenever the conditions you contemplated arise. You retain the right to make your own decisions as long as you have capacity. See OAG guidance.
Changing or Revoking Your Directive
You may change or revoke your AHCD at any time while you have capacity. Revocation can be done by a signed writing, by destroying the document, or by telling your health care provider or agent that you revoke it. After any change, share updated copies with your agent, alternates, primary doctor, and health systems so your most recent directive is on file. See OAG guidance and the Health Care Decisions Law.
Making Your Directive Available
Provide copies to your agent(s), your primary care clinician, and regular specialists. Bring a copy to hospital admissions and ask that it be scanned into your electronic medical record. Consider carrying an agent contact card, and consider secure digital storage your providers can access.
Practical Tip
At your next annual checkup, bring your AHCD and ask your clinic to confirm it is scanned into your chart and that your agent’s phone number is current.
Quick Checklist: California AHCD
- Clarify your goals and values for medical care.
- Choose a primary agent and at least one alternate.
- Complete the statutory form or a compliant custom document.
- Decide when your agent’s authority begins.
- Address organ donation and end-of-life preferences if desired.
- Sign with two qualified witnesses or a notary.
- If in a skilled nursing facility, obtain the required ombudsman/patient advocate signature.
- Share copies with your agent(s) and doctors; upload to your patient portal.
- Review annually and after major health changes; revoke/update as needed.
POLST vs. Advance Directive
A POLST (Physician Orders for Life-Sustaining Treatment) is a set of medical orders for people with serious illness or frailty. It translates current goals of care into actionable orders for first responders and clinicians. An AHCD is broader planning appropriate for all adults; it names an agent and records values and preferences. Many people appropriately have both: the AHCD for values and decision-making authority, and a POLST for immediate treatment orders when clinically appropriate. See California POLST information and OAG guidance.
How We Can Help
We guide clients through clarifying values, discussing options, and preparing a California-compliant AHCD tailored to your needs. We can coordinate with your medical team, ensure proper execution (including witness and notarization options), and help you keep your directive current as circumstances evolve. Ready to get started? Contact us.
FAQs
Do I need both a POLST and an AHCD?
Most healthy adults only need an AHCD. A POLST is typically appropriate if you have a serious illness or frailty and want current treatment orders.
Can I name co-agents to act at the same time?
California’s statutory form allows it, but naming a single primary agent with alternates often avoids delays or disagreements.
Are copies or scans valid?
Yes, copies are generally acceptable in practice. Keep the original in a safe but accessible place and share electronic copies with your providers.
Does my AHCD expire?
No, but review it yearly and after major life or health changes to ensure it still reflects your wishes.
Who cannot be my witness?
Generally, your health care provider, your agent, and employees of certain care facilities should not witness. At least one witness must be disinterested.
How do I revoke my AHCD?
By a signed writing, physically destroying the document, or telling your provider or agent you revoke it. Then distribute updated versions.
Where can I find the California form?
See the Attorney General’s page and Probate Code § 4701.
Key Sources
- California Office of the Attorney General – Advance Health Care Directives
- California Probate Code § 4701 (Statutory AHCD Form)
- California Probate Code, Division 4.7 (Health Care Decisions Law)
- Coalition for Compassionate Care of California – POLST
Disclaimer
This blog post is for general informational purposes only and is not legal advice. Reading it does not create an attorney-client relationship. Laws change and vary based on specific facts. Consult a qualified California attorney about your situation. For help with your directive, contact us.