Health Net and its participating providers are required to comply with the PSDA for all new and renewing members. Health Net's policy is that any adult member has the right to make an advance directive concerning health issues. Additionally, in accordance with Title 22 of the California Code of Regulations and 422.128(b)(1)(ii)(E) of the Code of Federal Regulations, providers must document in a prominent place in the member's medical records (adult members only), whether the member has been informed of, or has executed, an advance directive.

An advance directive is a written document signed by a member, such as a durable power of attorney for health care (DPAHC), a declaration pursuant to the Natural Death Act, or a living will that explains the member's wish concerning a given course of medical care should a situation arise where they is unable to make these wishes known. The member may specify guidelines for care or delegate the decision-making authority to a family member, close friend, or other representative.

According to AB 2805 (ch.579, 2006), a written advance health care directive is legally sufficient if all the following requirements are satisfied:

• The advance directive contains the date of its execution
• The advance directive is signed either by the member or in the member's name by another adult in the member's presence and at the member's direction
• The advance directive is either acknowledged before a notary public or signed by at least two witnesses who satisfy the requirements of Sections 4674 and 4675 of the California Probate Code
• If the advance directive is acknowledged before a notary public, and a digital signature is used, the digital signature must meet all of the following requirements:
  • It either meets the requirements of Section 16.5 of the Government Code and Chapter 10 (commencing with Section 22000) of Division 7 of Title 2 of the California Code of Regulations, or the digital signature uses an algorithm approved by the National Institute of Standards and Technology
  • It is unique to the person using it
  • It is capable of verification
  • It is under the sole control of the person using it
  • It is linked to data in such a manner that if the data are changed, the digital signature is invalidated
  • It persists with the document and not by association in separate files
  • It is bound to a digital certificate

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Provider Responsibilities and Procedures