Virginia Advance Directives

1. Virginia Advance Directives

2. What is an advance directive • An Advance Directive (AD) is a document that allows you to give directions about your health care instructions and preferences for a time in the future when you may be unable to make informed decisions about your care because of injury or illness. • While traditionally, advance directives were primarily used to dictate medical care, they have grown to include planning for psychiatric care as well. • An AD can be used to cover any or all of these types of health care: • Medical Health Care • Mental Health Care • End-of-life Care

3. History • In 2009, the Virginia General Assembly made significant changes to the Health Care Decisions Act (HCDA).   • The changes were based on recommendations made by the Virginia Supreme Court’s Commission on Mental Health Law Reform.   • The Commission gathered information and suggestions from different groups around the state.   • Some of the changes expanded the use of Advance Directives (ADs) in Virginia.   • Now, it possible for people with chronic health conditions, including serious mental illness (SMI), to make plans for a time in the future when they are unable to make informed decisions about their care.   • People can use ADs to • Write out their instructions and preferences for treatment and/or • Choose someone to make treatment decisions for them.  Advance Directives can also contain specific information about how to prevent crises and how to manage and recover from them.

4. Currently in VA • Virginia is working to bring about the goals envisioned by the HCDA changes.   • Beginning in January 2010, the key stakeholder groups came up with a multi-part, consensus-based strategy to promote the use of Advance Directives among mental health consumers.   • These groups also committed to creating services to help people complete their own ADs.   • This effort was coordinated and overseen by the Commission on Mental Health Law Reform during 2010, and is now coordinated and overseen by a Coordinating Committee for Promoting Use of Advance Directives by People with Mental Illness. 

5. Advance Directives and nrvcs • NRVCS addresses the need for Advance Directives in our Comprehensive Evaluations policy. In the section related to what should be minimally included in a comprehensive evaluation it states, “Advanced Directives (presence of or desire to complete one) and adding this information to the Electronic Health Record and requesting a copy of this document for scanning into the E.H.R.” • If a client of NRVCS has an advance directive, this information is added to the medical record in the demographic section of the EHR and then a copy is scanned into the record as well. • If the client is interested in developing an advance directive, staff should assist them with accessing the needed information and forms on the Virginia advance directives website.

6. Virginia advance directives on the webvirginiaadvancedirectives.org • This website has been created to provide information and resources about Advance Directives, including forms that can be used to create your own advance directive. • This website and corresponding Advance Directive project have grown out of a partnership between two Virginia institutions: • The University of Virginia’s Institute of Law, Psychiatry and Public Policy (UVA ILPPP) and • Virginia’s Department of Behavioral Health and Developmental Services (VA DBHDS)

7. An introduction to advanced directives • To complete this training please click on the link below and watch the corresponding slide show that includes a video. When you are done, you will return here to complete your quiz. • Advance Directives in Virginia by Diamond Walton on Prezi