1. As used in this section, the following terms mean:

(1) “Adult”, an individual who is eighteen years of age or older;

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Terms Used In Missouri Laws 459.250

  • Contract: A legal written agreement that becomes binding when signed.
  • following: when used by way of reference to any section of the statutes, mean the section next preceding or next following that in which the reference is made, unless some other section is expressly designated in the reference. See Missouri Laws 1.020
  • person: may extend and be applied to bodies politic and corporate, and to partnerships and other unincorporated associations. See Missouri Laws 1.020
  • Power of attorney: A written instrument which authorizes one person to act as another's agent or attorney. The power of attorney may be for a definite, specific act, or it may be general in nature. The terms of the written power of attorney may specify when it will expire. If not, the power of attorney usually expires when the person granting it dies. Source: OCC
  • User fees: Fees charged to users of goods or services provided by the government. In levying or authorizing these fees, the legislature determines whether the revenue should go into the treasury or should be available to the agency providing the goods or services.

(2) “Advance health care directive”, a power of attorney for health care or a declaration signed or authorized by an adult, containing the person‘s direction concerning a health care decision;

(3) “Declaration”, a record, including but not limited to a living will or a do-not-resuscitate order, signed by an adult specifying the circumstances under which a life support system may be withheld or withdrawn;

(4) “Department”, the department of health and senior services;

(5) “Health care decision”, any decision regarding the health care of the person;

(6) “Intake point”, any licensed health care provider or licensed attorney.

2. The department shall issue a request for proposal* and contract with a third party for the establishment of a secure online central registry for individuals to be known as the “Advance Health Care Directives Registry” to store advance health care directives and to give authorized health care providers access to such directives.

3. An adult declarant may submit an advance health care directive or declaration and the revocations of such documents to the registry established under subsection 2 of this section.

4. Any document and any revocation of a document submitted for filing in the registry shall be submitted electronically at an intake point and signed electronically with a unique identifier, such as a Social Security number, a driver’s license number, or another unique government-issued identifier. The electronic submission of the document shall be accompanied by a fee not to exceed ten dollars.

5. All data and information contained in the registry shall remain confidential and shall be exempt from the provisions of chapter 610.

6. The third party awarded a contract pursuant to subsection 2 of this section shall be solely responsible for all issues applicable to the registry, including, but not limited to, the development and operation of the registry; educating the general public, licensed health care providers, and legal professionals about the registry; responding to questions; providing technical assistance to users; and collection of user fees not to exceed ten dollars.

7. The department may promulgate rules to carry out the provisions of this section which may include, but not be limited to:

(1) A determination of who may access the registry, including physicians, other licensed health care providers, the declarant, and his or her legal representatives or designees; and

(2) A means for the contracting third party to annually remind registry users of which documents they have registered.

8. Any rule or portion of a rule, as that term is defined in section 536.010, that is created under the authority delegated in this section shall become effective only if it complies with and is subject to all of the provisions of chapter 536 and, if applicable, section 536.028. This section and chapter 536 are nonseverable and if any of the powers vested with the general assembly pursuant to chapter 536 to review, to delay the effective date, or to disapprove and annul a rule are subsequently held unconstitutional, then the grant of rulemaking authority and any rule proposed or adopted after August 28, 2017, shall be invalid and void.

9. Failure to register a document with the registry maintained under this section shall not affect the document’s validity. Failure to notify the registry of the revocation of a document previously filed with the registry shall not affect the validity of a revocation that meets the statutory requirements for such revocation to be valid.