GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2025

H

HOUSE BILL DRH30158-MG-119

H.B. 349
Mar 10, 2025
HOUSE PRINCIPAL CLERK

D

Short Title:  Update Reqs./Advance Health Care Directives.

(Public)

Sponsors:

Representative Huneycutt.

Referred to:

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A BILL TO BE ENTITLED
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.

The General Assembly of North Carolina enacts:

PART I. HEALTH CARE POWERS OF ATTORNEY

SECTION 1.1.  G.S. 32A-16(3) reads as rewritten:
"(3)  Health  care  power  of  attorney.  –  Except  as  provided  in  G.S. 32A-16.1,  a
written instrument  that substantially meets  the requirements  of this Article,
that  is  signed  in  the  presence  of  two  qualified  witnesses,  and  witnesses  or
acknowledged before a notary public, pursuant to which an attorney-in-fact or
agent is appointed to act for the principal in matters relating to the health care
of the principal. The notary who takes the acknowledgement may but is not
required to  be a paid  employee of the attending  physician or mental  health
treatment provider, a paid employee of a health facility in which the principal
is a patient, or a paid employee of a nursing home or any adult care home in
which the principal resides."

"(a)

SECTION 1.2.  G.S. 32A-25.1(a) reads as rewritten:
The use of the following form in the creation of a health care power of attorney is
lawful and, when used, it shall meet the requirements of and be construed in accordance with the
provisions of this Article:

HEALTH CARE POWER OF ATTORNEY

NOTE:    YOU  SHOULD  USE  THIS  DOCUMENT  TO  NAME  A  PERSON  AS  YOUR
HEALTH  CARE  AGENT  IF  YOU  ARE  COMFORTABLE  GIVING  THAT  PERSON
BROAD  AND  SWEEPING  POWERS  TO  MAKE  HEALTH  CARE  DECISIONS  FOR
YOU.  THERE  IS  NO  LEGAL  REQUIREMENT  THAT  ANYONE  EXECUTE  A
HEALTH CARE POWER OF ATTORNEY.

EXPLANATION:  You have the right to name someone to make health care decisions for you
when you cannot make or communicate those decisions. This form may be used to create a health
care power of attorney, and meets the requirements of North Carolina law. However, you are
not required to use this form, and North Carolina law allows the use of other forms that meet

*DRH30158-MG-119*

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General Assembly Of North Carolina

Session 2025

certain requirements. If you prepare your own health care power of attorney, you should be very
careful to make sure it is consistent with North Carolina law.

This document gives the person you designate as your health care agent broad powers to make
health care decisions for you when you cannot make the decision yourself or cannot communicate
your  decision  to  other  people.  You  should  discuss  your  wishes  concerning  life-prolonging
measures, mental health treatment, and other health care decisions with your health care agent.
Except to the extent that you express specific limitations or restrictions in this form, your health
care agent may make any health care decision you could make yourself.

This form does not impose a duty on your health care agent to exercise granted powers, but when
a power is exercised, your health care agent will be obligated to use due care to act in your best
interests and in accordance with this document.

This Health Care Power of Attorney form is intended to be valid in any jurisdiction in which it
is presented, but places outside North Carolina may impose requirements that this form does not
meet.

If you want to use this form, you must complete it, sign it, and have your signature witnessed by
two qualified witnesses and or proved by a notary public. Follow the instructions about which
choices you can initial very carefully. Do not sign this form until two witnesses and or a notary
public are present to watch you sign it. You then should give a copy to your health care agent
and  to  any  alternates  you  name.  You  should  consider  filing  it  with  the  Advance  Health  Care
Directive  Registry  maintained
State:
http://www.nclifelinks.org/ahcdr/State.

the  North  Carolina

Secretary

by

of

…

By  signing  here,  I  indicate  that  I  am  mentally  alert  and  competent,  fully  informed  as  to  the
contents of this document, and understand the full import of this grant of powers to my health
care agent.

This the _____ day of ______________, 20____.

________________________(SEAL)(SIGNATURE)

I hereby state that the principal, _______________, being  of sound mind, signed (or directed
another  to  sign  on  the  principal's  behalf)  the  foregoing  health  care  power  of  attorney  in  my
presence, and that I am not related to the principal by blood or marriage, and I would not be
entitled  to  any  portion  of  the  estate  of  the  principal  under  any  existing  will  or  codicil  of  the
principal or as an heir under the Intestate Succession Act, if the principal died on this date without
a will. I also state that I am not the principal's attending physician, nor a licensed health care
provider or mental health treatment provider who is (1) an employee of the principal's attending
physician or mental health treatment provider, (2) an employee of the health facility in which the
principal is a patient, or (3) an employee of a nursing home or any adult care home where the
principal resides. I further state that I do not have any claim against the principal or the estate of
the principal.

Box #1
If you elect to have your declaration witnessed, complete the following section:

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DRH30158-MG-119

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General Assembly Of North Carolina

Session 2025

Date:  _____________________________

Witness: ___________________________

Date:  _____________________________

Witness: ___________________________

________________COUNTY, _________________STATE

Sworn to (or affirmed) and subscribed before me this day by _____________________

(type/print name of signer)

______________________
(type/print name of witness)

______________________
(type/print name of witness)

Box #2
If  you  elect  to  have  your  declaration  notarized,  have  the  following  section  completed  by  a
qualified notary public:

Date:  ___________________________

(Official Seal)

______________________________
Signature of Notary Public

__________________, Notary Public
Printed or typed name

My commission expires: __________"

PART II. ADVANCE HEALTH CARE DIRECTIVES

SECTION 2.1.  G.S. 90-321(c)(3) reads as rewritten:
"(3)  Except as provided in G.S. 90-321.1, that has been signed by the declarant in
the presence of a notary public or two witnesses who believe the declarant to
be of sound mind and who state that they (i) are not related within the third
degree to the declarant or to the declarant's spouse, (ii) do not know or have a
reasonable expectation that they would be entitled to any portion of the estate
of the declarant upon the declarant's death under any will of the declarant or
codicil thereto then existing or under the Intestate Succession Act as it then
provides, (iii) are not the attending physician, licensed health care providers
who are paid employees of the attending physician, paid employees of a health
facility  in  which  the  declarant  is  a  patient,  or  paid  employees  of  a  nursing
home or any adult care home in which the declarant resides, and (iv) do not
have a claim against any portion of the estate of the declarant at the time of
the declaration; andor"

SECTION 2.2.  G.S. 90-321(a)(1a) reads as rewritten:
"(1a)  Declaration.  –  Except  as provided in  G.S. 90-321.1, any  signed, witnessed,
dated, and proved signed, witnessed or proved, and dated document meeting
the requirements of subsection (c) of this section."

SECTION 2.3.  G.S. 90-321(d1) reads as rewritten:

"(d1)  The following form is specifically determined to meet the requirements of subsection

(c) of this section:

ADVANCE DIRECTIVE FOR A NATURAL DEATH ("LIVING WILL")

DRH30158-MG-119

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General Assembly Of North Carolina

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NOTE:  YOU  SHOULD  USE  THIS  DOCUMENT  TO  GIVE  YOUR  HEALTH  CARE
OR  WITHDRAW
PROVIDERS
LIFE-PROLONGING MEASURES IN CERTAIN SITUATIONS. THERE IS NO LEGAL
REQUIREMENT THAT ANYONE EXECUTE A LIVING WILL.

TO  WITHHOLD

INSTRUCTIONS

GENERAL INSTRUCTIONS: You can use this Advance Directive ("Living Will") form to give
instructions  for  the  future  if  you  want  your  health  care  providers  to  withhold  or  withdraw
life-prolonging measures in certain situations. You should talk to your doctor about what these
terms mean. The Living Will states what choices you would have made for yourself if you were
able  to  communicate.  Talk  to  your  family  members,  friends,  and  others  you  trust  about  your
choices. Also, it is a good idea to talk with professionals such as your doctors, clergypersons,
and lawyers before you complete and sign this Living Will.

You do not have to use this form to give those instructions, but if you create your own Advance
Directive you need to be very careful to ensure that it is consistent with North Carolina law.

This Living Will form is intended to be valid in any jurisdiction in which it is presented, but places
outside North Carolina may impose requirements that this form does not meet.

If you want to use this form, you must complete it, sign it, and have your signature witnessed by
two qualified witnesses and or proved by a notary public. Follow the instructions about which
choices you can initial very carefully. Do not sign this form until two witnesses and or a notary
public are present to watch you sign it. You then should consider giving a copy to your primary
physician and/or a trusted relative, and should consider filing it with the Advanced Health Care
Directive  Registry  maintained
State:
http://www.nclifelinks.org/ahcdr/State.

the  North  Carolina

Secretary

by

of

My Desire for a Natural Death

I, ____________________, being of sound mind, desire that, as specified below, my life not be
prolonged by life-prolonging measures:

…

I hereby state that the declarant, ______________________, being of sound mind, signed (or
directed  another  to  sign  on  declarant's  behalf)  the  foregoing  Advance  Directive  for  a  Natural
Death in my presence, and that I am not related to the declarant by blood or marriage, and I would
not be entitled to any portion of the estate of the declarant under any existing will or codicil of
the declarant or as an heir under the Intestate Succession Act, if the declarant died on this date
without a will. I also state that I am not the declarant's attending physician, nor a licensed health
care provider who is (1) an employee of the declarant's attending physician, (2) nor an employee
of the health facility in which the declarant is a patient, or (3) an employee of a nursing home or
any  adult  care  home  where  the  declarant  resides.  I  further  state  that  I  do  not  have  any  claim
against the declarant or the estate of the declarant.

Box #1
If you elect to have your declaration witnessed, complete the following section:

Date:  _____________________________

Witness: ___________________________

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General Assembly Of North Carolina

Session 2025

Date:  _____________________________

Witness: ___________________________

________________COUNTY, _________________STATE

Sworn to (or affirmed) and subscribed before me this day by _____________________

(type/print name of declarant)

________________________
(type/print name of witness)

________________________
(type/print name of witness)

Box #2
If  you  elect  to  have  your  declaration  notarized,  have  the  following  section  completed  by  a
qualified notary public:

Date  ___________________________
(Official Seal)

______________________________
Signature of Notary Public

__________________, Notary Public
Printed or typed name

My commission expires: _________"

PART III. ELECTRONIC FILING OF HEALTH CARE POWERS OF ATTORNEY AND
ADVANCE  HEALTH  CARE  DIRECTIVES  WITH  THE  NORTH  CAROLINA
SECRETARY OF STATE

SECTION 3.1.  G.S. 130A-466 reads as rewritten:

"§ 130A-466.  Filing requirements.

(a)

A person may submit any of the following documents and the revocations of these
documents to the Secretary of State in electronic or hard copy format for filing in the Advance
Health Care Directive Registry established pursuant to this Article:

(1)

(2)

(3)

(4)

A health care power of attorney under Article 3 of Chapter 32A of the General
Statutes.
A declaration of a desire for a natural death under Article 23 of Chapter 90 of
the General Statutes.
An advance instruction for mental health treatment under Part 2 of Article 3
of Chapter 122C of the General Statutes.
A declaration of an anatomical gift under Part 3A of Article 16 of Chapter
130A of the General Statutes.
A Health Insurance Portability and Accountability Act (HIPAA) waiver.

(b)

(5)
Any document and any revocation of a document submitted for filing in the registry
shall be notarized regardless of whether notarization is required for its validity. This subsection
does  not  apply  to  a  declaration  of  an  anatomical  gift  described  in  subdivision  (a)(4)  of  this
section.
(c)
document.
(d)
(e)

The person who submits the document shall supply a return address.
The document shall be accompanied by any fee required by this Article."

The  document  may  be  submitted  for  filing  only  by  the  person  who  executed  the

DRH30158-MG-119

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General Assembly Of North Carolina

Session 2025

SECTION 3.2.  G.S. 130A-468 reads as rewritten:

"§ 130A-468.  Filing of documents with the registry.

(a)  When the Secretary of State receives a  hard copy of a document that may be filed
with the registry pursuant to this Article, the Secretary shall create a digital reproduction of that
document and enter the reproduced document into the registry database. When the Secretary of
State receives a document in electronic format that may be filed with the registry pursuant to this
Article, the Secretary shall enter that document into the registry database. The Secretary is not
required  to  review  a  document  to  ensure  that  it  complies  with  the  particular  statutory
requirements applicable to the document. Each document entered into the registry database shall
be assigned a unique file number and password.

(b)

Upon entering the a reproduced hard copy of a document into the registry database,
the Secretary shall return the original hard copy of the document and a wallet-size card containing
the  document's  file  number  and  password  to  the  person  who  submitted  the  document.  Upon
entering  into  the  registry  database  a  document  that  was  received  in  electronic  format,  the
Secretary shall send a wallet-size card containing the document's file number and password to
the person who submitted the document.

(c)  When the Secretary of State receives a revocation of a document that is filed with the
registry and that document's file number and password, or a request to remove that document
from the registry without its revocation, the Secretary shall delete that document from the registry
database.

(c1)  The  Secretary  of  State  may  remove  documents  of  deceased  registrants  from  the

registry upon notification of death in writing in a form acceptable to the Secretary of State.

(d)

The Secretary of State's entry of a document into, or removal of a document from, the

registry database does not do any of the following:

(1)
(2)
(3)

Affect the validity of the document in whole or in part.
Relate to the accuracy of information contained in the document.
Create a presumption regarding the validity of the document, regarding the
accuracy  of  information  contained  in  the  document,  or  that  the  statutory
requirements for the document have been met."

PART IV. EFFECTIVE DATE

SECTION 4.1.  This act becomes effective October 1, 2025.

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