If you signed your health care directives with Fleming & Curti, PLC, in the past decade or so, you probably already know about the Arizona advance directive registry. It gives you an easy — and free — way to store your health care power of attorney, living will or pre-hospital medical care directive online.
For almost exactly eleven years, the Arizona Secretary of State’s office has managed the directory. It’s easy: you mail a copy (not the original) of your advance directives to the office. They scan the document(s) and send them back. They also send you a card telling you how to download your directives.
Now you have a wallet-sized card to keep with your insurance and other medical-related cards. Headed to the hospital? Just show them the card; they can download your health care power of attorney and your living will.
So why are they changing it?
Fleming & Curti, PLC, clients (and everyone else who uses the Arizona advance directive registry) started receiving notices this month about upcoming changes. Do you need to do something about it? No. But the change might confuse (and even alarm) some of our clients. There’s no need to worry.
The initial law ordering creation of an online registry for advance directives was actually passed in 2004. In classic Arizona style, the legislature ordered the creation of a registry, but prohibited anyone from using state money to set it up or maintain it.
Hospice of the Valley, a Phoenix-based hospice organization, stepped up. They estimated that the annual cost of maintaining the directory would probably be about $60,000, and they committed to find the funds. And they did.
The registry didn’t actually get underway until 2010. Shortly after that, we at Fleming & Curti, PLC, realized it would help clients maintain their advance directives — and make them available to health care providers. We began encouraging clients to sign up when they signed new health care powers of attorney, mental health care powers, living wills or pre-hospital medical care directives. We even signed up for our own directive storage.
The new registry — two years in the making
In 2019, the Arizona legislature passed a new law. It ordered the Department of Health Services to find a different registry arrangement. The registry had originally been housed at the Secretary of State’s office. That was partly because of concerns that the Health Department might use advance directives to limit medical care resources to patients. That might seem like a quaint and old-fashioned concern today (in fact, you might have thought it odd twenty years ago). But setting up an outside entity seemed like a way to get around any concern.
It has taken two years for the Department of Health Services to come up with a different arrangement. They have now begun to roll out their agreement with Health Current. That organization is part of Contexture, which (in turn) is a combination of similar organizations from Arizona and Colorado. Health Current was a $15 million (revenue) Arizona non-profit in 2020, so presumably has sufficient resources to keep the Arizona advance directive registry going.
In the meantime, documents filed with the Secretary of State remain available. The link is actually hard to find; the back of your card takes you almost there. The correct site to download your existing advance directives is still on the Secretary of State’s website. The link on the back of your registry card will take you to a site with that link, but not prominently displayed.
Are there alternatives?
There are. A number of private organizations make similar registry services available online. One, the U.S. Advance Care Plan Registry, has different charges depending on your health care provider and possibly other considerations. Probably the best-known and most widely-used, DocuBank, charges $55/year or $175 for a five-year registration. DocuBank can also keep other documents — like your financial power of attorney, your trust, and a copy of your will — online. We know of no free alternative like the Arizona advance directive registry, however.
We anticipate continuing to recommend the (free) Arizona advance directive registry system for our clients’ documents. But we’re keeping an eye on the changes.