General WV Center for End-of-Life Care FAQs
Forms and Advance Care Planning FAQs
WV e-Directive Registry FAQs
General WV Center for End-of-Life Care FAQs
What is the WV Center for End-of-Life Care?
The West Virginia Center for End-of-Life Care is a nonprofit, state agency created with the purpose of educating and assisting WV residents (Patients) and health care providers with advance care planning.
When was the WV Center for End-of-Life Care formed and what is the mission statement?
Established in 2002 by the WV Legislature, the West Virginia Center for End-of-Life Care provides coordination, education, and resources so that West Virginians will 1) have their preferences for care at the end of life identified and respected through advance care planning, 2) die in the setting of their choice with the option of palliative care and hospice, and 3) die comfortably with the availability of appropriate pain and symptom management.
Why are non-health care professionals referred to as "Patients" by the WV Center for End-of-Life Care and e-Directive Registry?
To avoid confusion, the WV Center for End-of-Life Care and e-Directive Registry separate education materials and resources into two general categories based on health care provider status. Non-health care providers are referred to as "Patients" simply because not all of the individuals who utilize the WV Center for End-of-Life Care's resources are WV residents; some out-of-state individuals also seek the WV Center for End-of-Life Care for information. By separating the general population into "Patients" and "Providers," it is easier for individuals to find the resources that directly apply to them.
Is the WV Center for End-of-Life Care hospice, health care, body/organ donation, home health care, or another health related organization?
No. The WV Center for End-of-Life Care is a nonprofit state agency focused on coordination, education, and resources. No part of the organization involves treating patients in health care related tasks. To locate health care related services near you, contact your local National 2-1-1 hotline for more assistance.
Forms and Advance Care Planning FAQs
Do I have to sign an advance directive or medical order to receive health care treatment?
No. A health care provider cannot require you to complete an advance directive or medical order as a condition for you to receive services. Completing an advance directive or medical order is always voluntary.
I'm in good health and consider myself young, do I still need to do advance care planning?
Yes! Advance care planning, or the process of creating advance directives and/or medical orders (when appropriate), is recommended for everyone 18 years of age and older including mature and emancipated minors. Advance care planning allows you to outline what you do and do not want in your medical care in the event you are unable to speak for yourself. We never know when an accident or serious illness will leave us incapable of making our own health care decisions. It is best to plan early and prepare for these decisions early.
Can I still make my own health care decisions once I have created an advance directive?
Yes! Your advance directive does not go into effect until you are no longer able to state your own wishes. As long as you can do this, you make your own decisions. If you regain decision-making capacity, your advance directive is no longer in effect.
Do I need a lawyer to create an advance directive?
No. Anyone can create a WV advance directive without the assistance of a lawyer. Visit our "Forms and Resources" page or call the Center at 877-209-8086 to obtain free WV advance directive forms.
Who should witness my signature on my advance directive?
Your witnesses must be at least 18 years of age and not related to you by blood or marriage. Choose individuals who will not inherit any of your property. Do not choose the person you named as your representative or your successor representative on your Medical Power of Attorney or your health care provider as your witness.
How can I find a Notary Public to notarize my advance directive?
Businesses such as banks, insurance agents, government offices, hospitals, physicians’ offices, and automobile associations have or can direct you to a notary public. Contact your local National 2-1-1 hotline for more assistance and location of a Notary Public.
What forms can I find through the WV Center for End-of-Life Care for advance care planning?
You can find WV advance directives on our website under the "Forms and Resources" tab. We have the West Virginia-based versions of the Living Will, Medical Power of Attorney, Combined Living Will and Medical Power of Attorney, and Mental Health Advance Directive forms. We also have a Frequently Asked Questions packet with all of these advance directive forms included as well as the e-Directive Registry Opt-In form and the e-Directive Registry Revocation form.
If you live or receive medical care outside of West Virginia, we recommend completing both the WV forms as well as the state-approved forms for your other state. Please contact your local, non-West Virginian, state agency to locate advance directive forms.
What is a Living Will?
A Living Will is a legal document, a type of advance directive, that tells your health care provider how you want to be treated if you are terminally ill or permanently unconscious and cannot make decisions for yourself. A Living Will says that life-prolonging medical interventions that would serve only to prolong your dying should not be used. A Living Will only applies if you are terminally ill or permanently unconscious AND too sick to make decisions for yourself.
If my heart should stop, I want to be resuscitated in my current condition. Can I request CPR on my Living Will?
No, CPR is not consistent with the purpose of a Living Will. A Living Will is for patients who want to avoid life-sustaining interventions, such as CPR, when they are dying or permanently unconscious and unable to speak for themselves. Under state law, a request for CPR in the "Special Directives or Limitations" of a Living Will is invalid, because it is contradictory to the purpose of the Living Will. Requests for CPR in the "Special Directives or Limitations" section of a Combined Medical Power of Attorney and Living Will form are permissible, as the CPR request will be applied in accordance when the Medical Power of Attorney half of the document is in effect but NOT when the Living Will half of the document is in effect.
What is a Medical Power of Attorney?
A Medical Power of Attorney is a legal document, a type of advance directive, that allows you to name a person(s) to make health care decisions for you if you are unable to make them for yourself. The Medical Power of Attorney only goes into effect if you are too sick to make decisions for yourself. If you regain decision-making ability, the Medical Power of Attorney is no longer in effect, and you will be able to speak for yourself again.
The Medical Power of Attorney allows your representative to respond to medical situations that you might not have anticipated and to make decisions for you with knowledge of your values and wishes. Medical Power of Attorney representatives (i.e., the people you choose to make health care decisions for you) can never override your written, expressed wishes.
How is the Medical Power of Attorney different from the Living Will?
A Living Will is only in effect if you are terminally ill or permanently unconscious AND too sick to make decisions for yourself. A Living Will tells your physician what treatment you do and do not want if you are unable to speak for yourself. A Living Will is a written record of decisions that you have made yourself.
The Medical Power of Attorney allows you to give specific instructions to your Medical Power of Attorney representative(s) and health care provider about the type of care you would or would not want if you are unable to speak for yourself.
On all WV advance directive forms, including the Living Will and Medical Power of Attorney, you can write specific instructions in the Special Directives section of the form to further explain your wishes in your own words. You can also give your Medical Power of Attorney representative(s) the authority to make decisions for you about funeral arrangements or cremation by writing something such as “I authorize my representative to make decisions regarding my funeral arrangements or cremation.”
What if I already have a Living Will? Do I need to create a Medical Power of Attorney?
Most West Virginians complete both a Medical Power of Attorney and a Living Will. Since the Medical Power of Attorney is a more flexible document and allows you to name a representative(s) to make decisions for you, it is advisable to create a Medical Power of Attorney even if you have already completed the Living Will or decided not to complete a Living Will. If you lose the ability to speak for yourself due to a medical condition or incapacity, your Medical Power of Attorney representative(s) can speak on your behalf.
If you do not have someone you trust to make medical decisions on your behalf or who knows your values and preferences for medical care, you should consider creating a Living Will so that you can leave specific directions about their end-of-life treatment. If you lose decision-making capacity, your health care provider will assign a Health care Surrogate representative to make decisions on your behalf. This representative can use the instructions and wishes you described in your Living Will to make health care decisions on your behalf.
If you choose to sign both documents, you should store them in the same place to help assure that your representative(s) will know all of your wishes. You may also complete a Combined Living Will and Medical Power of Attorney form which combines both documents into one form.
Will another state honor my advance directive?
Laws differ somewhat from state to state, but in general, a patient’s expressed wishes will be honored. No law or court has invalidated the concept of advance directives, and an increasing number of statutes and court decisions support it. Many, if not most, states will honor your advance directives. We recommend contacting your specific non-WV health care provider or organization to confirm whether they will honor your advance directive or not.
If I decide to create a Medical Power of Attorney, how should I choose my representative(s)?
Choose someone who knows your values and wishes, and whom you trust to make decisions for you. Do the same for a successor representative. Have a discussion with your intended representative(s) to make sure they understand your wishes and agree to be your representative.
You may, but do not have to, choose a family member to be your representative. Regardless of your choice, your representative should be someone who will be available if needed and who will make decisions the way you would decide.
Do not choose your health care provider, or another person who is likely to be your future health care provider, as your representative or successor representative.
What instructions should I give my representative(s) concerning my health care?
You may give very general instructions and preferences or be quite specific. It would be helpful to your representatives to have directions from you about medical conditions in which you would NOT want life-prolonging intervention, particularly medically administered food and water (tube feedings), cardiopulmonary resuscitation (CPR), and the use of machines to help you breathe. You should also tell your representative if you want to be an organ and tissue donor. Talk with your representative(s) about your choices and personal values and beliefs. Make sure they know what is important to you. This information will help them make the decisions that you would make if you were able to speak for yourself.
Some people choose to write their representative(s) a letter and attach it to their Medical Power of Attorney form stating their personal values and wishes, their feelings about life and death, and any specific instructions.
What if my health care provider and/or my loved ones do not agree with my treatment choices or health care decisions?
You should begin by talking with your family and health care providers about your decisions and personal values and beliefs. If others understand your choices and the reasons for them, there is a smaller chance that they will challenge them later.
If you have made your wishes known in an advance directive and a disagreement does occur, by law, your health care provider and your representative(s) must respect your wishes. You have a right to refuse or consent to health care. If your health care provider refuses to respect your wishes, they must transfer your care to another physician.
The consent or refusal to medical care by your Medical Power of Attorney representative(s) is as meaningful and valid as your own. The wishes of your Medical Power of Attorney representative(s) other family members will not override your own clearly expressed wishes and choices or those made by your representative on your behalf in accordance with your own wishes.
I completed advance directives and/or medical orders previously. Do I have to do anything else?
It is highly recommended that advance directives and medical orders are reviewed regularly to ensure they still match your wishes for medical care. You also want to make sure there are no inconsistencies between your advance directives and medical orders. These inconsistencies could be requesting "CPR" in your advance directive but also having a "DNR" order or "DNR" selected on a POST form.
Should I complete a new Living Will and/or Medical Power of Attorney form if I completed one before June 11, 2000?
On June 11, 2000, a new West Virginia law went into effect that made several changes to the Living Will and Medical Power of Attorney forms. Most importantly, the new law requires only one physician to decide whether you are able to make your own health care decisions. Forms completed prior to the new law required two physicians to determine your ability to make your own health care decisions. The new forms also are written in clearer, easy-to-understand language. If you want to take advantage of these changes, you should complete a new Living Will and/or Medical Power of Attorney form. The most current forms can be found on our "Forms and Resources" page.
I reviewed my advance directives and/or medical orders, and I need to make changes. How do I update these forms?
It is common for wishes to change over time as different events and priorities occur in your life. If you have a minor change, such as updating your address the address of a Medical Power of Attorney representative, you can make the change on your original document if you have enough room to make the change neatly. Initial and date the update. For larger changes, such as changing a Medical Power of Attorney representative, changing the special directives or limitations section on your advance directive(s), changing the CPR/DNR status on medical orders, or changing the level of treatment on your POST form, you should complete a new form. Be sure to notify everyone who has a copy of your old advance directive and/or medical order so they may destroy these copies and replace them with the new form.
Remember to submit your new advance directive to the WV e-Directive Registry by faxing it to 844-616-1415 or mailing a copy to the WV e-Directive Registry, 64 Medical Center Drive, PO Box 9022, Health Sciences North, Morgantown, WV 26506-9022.
I reviewed my advance directives and/or medical orders, and everything is consistent with my wishes. What do I do now?
Great! It is so important to make sure your documents are as updated and accurate as possible by reviewing them regularly. Make sure your advance directive is signed, witnessed, notarized and reflects your wishes. Make sure your medical order is signed and reflects your wishes as well. If you are happy with your documents, it is recommended that you give a copy to your loved ones, Medical Power of Attorney representative(s), and health care providers and store your original documents in a safe place where they can still be easily accessed in the event you become incapacitated. A copy of your advance directive is legally valid.
We also recommend submitting a copy of your documents to our e-Directive Registry. This Registry is available to treating health care providers 24/7 through the West Virginia Health Information Network to make your documents immediately available in an emergency. Learn more about the e-Directive Registry on our e-Directive Registry page. If you would like to have your forms included in the registry, you must indicate in the "Opt-In" box to grant your permission for the forms to be stored on the e-Directive Registry. The opt-in box is located on the top left corner of all WV advance directives obtained through the WV Center for End-of-Life Care and located on the bottom half of the WV Physician Orders for Scope of Treatment (POST) form. There is no opt-in box on the WV Do Not Resuscitate (DNR) card; these forms are automatically "opted-in" if submitted to the Registry. If your form does not have an opt-in box, simply complete the WV e-Directive Registry sign up form and submit it with your documents to the Registry.
WV e-Directive Registry FAQs
What is the e-Directive Registry and why should I submit my documents to it?
The West Virginia Center for End-of-Life Care through the WV Health Information Network established the WV e-Directive Registry. With the permission of patients or their legal agents, this electronic Registry houses and makes available to treating health care providers West Virginians’ advance directive forms, do not resuscitate (DNR) cards, and Physician Orders for Scope of Treatment (POST) forms. The Registry makes patients’ treatment wishes known to their treating health care providers so that these wishes can be respected.
You can submit your (or a patient’s) advance directive, do-not-resuscitate (DNR) card or Physician Orders for Scope of Treatment (POST) form to the e-Directive Registry by faxing your forms to 844-616-1415 or mailing them to PO Box 9022, 64 Medical Center Drive, Morgantown, WV 26506. If you have questions about the forms, call us at 877-209-8086.
Do I have to pay anything to have my forms housed on the e-Directive Registry?
No! We will never charge patients for submitting their advance directives and/or medical orders on the e-Directive Registry. We created the e-Directive Registry as a resource for West Virginians, and beyond, to help ease the advance care planning process and ensure accurately-completed documents are available in medical emergencies.
I have submitted my advance directives and/or medical orders to the Registry, but I also have other forms that are not medical advance directives or medical orders. Can I submit these to the Registry?
Depending on the form, yes. We can accept Durable Power of Attorneys, body or organ donation papers, and other similar documents on the Registry. Please make sure you submit these with enough demographic information (i.e., name, address, date of birth, last 4 of your SSN) so the forms can be matched to your patient profile. We DO NOT accept psychological evaluations or court documents containing psychological information on the Registry. If you want these documents available for your health care providers, please contact them directly.
Can my forms end up on the Registry even if I didn't submit them myself?
Yes! As the central hub for advance directives and medical orders in WV, most law offices, individuals, and health care providers automatically send documents to our e-Directive Registry so that health care providers can access these important documents in times of need. Most personnel with knowledge of the e-Directive Registry will submit these documents on your behalf.
How can I check to see what forms are on the Registry for myself?
Right now, there is no portal for patients to be able to see their own documents online. If you would like to know what forms are on the Registry, you can call at 877-209-8086 to ask. If you'd like to obtain copies of your documents from the Registry, you must submit a Release of Information request with a copy of your photo ID to our offices. We will then process the request and send forms back to you if appropriate. We cannot send forms to people other than the patient whom are not listed as Medical Power of Attorney representatives on documents on the Registry.
West Virginia Health Information Network (WVHIN) members can gain access to the Registry to search for documents 24/7 by clicking the link below. Search for the patient through the Unified Landing Page (ULP). The e-Directive Registry is listed to the left on the patient's Snapshot page under "Advance Directives Vault."
Login to the WVHIN
If you or your organization is not a member of WVHIN, you can sign up to become a member by visiting WVHIN's website and completing the "Participation Agreement" under "Resources." A WVHIN representative will reach out to you.
You can always request forms directly from the e-Directive Registry by completing a Release of Information request (linked below) and submitting it to the WVCEOLC offices Monday through Friday 8:30 AM - 4:00 PM. Requests will only be completed during business hours.
Release of Information Request for Health Care Providers
I am the MPOA representative or Health Care surrogate for someone with forms on the e-Directive Registry. The patient has passed away. Can I still submit a Release of Information request to access these forms?
No. All powers of the MPOA representative and Health Care surrogate end upon the patient's death. Deceased patients' documents are also no longer available for health care providers following the patient's death.
I want to remove my documents from the e-Directive Registry. How do I do that?
If you want to remove your documents from the e-Directive Registry, you can submit a Revocation form to the Registry and indicate the forms you want removed. This Revocation form is only used internally and will not be released to treating health care providers.
I received a letter in the mail. What is this?
If you received a letter and wallet card in the mail, this is the information you are looking for. That letter is just confirming that we received an advance directive (medical power of attorney, living will, combined medical power of attorney and living will, etc.) or medical order (POST form or DNR card) for you to our e-Directive Registry. This will allow your document to be available to health care providers in emergencies. These forms were likely either submitted by you or by health care providers on your behalf as part of standard protocol.
If you received an error letter with directions on how to update your forms, that letter will alert you to problems preventing your advance directive (medical power of attorney, living will, combined medical power of attorney and living will, etc.) or medical order (POST form or DNR card) from being accessible to treating health care providers.