,i  #aad? ,,congress  #b;d ,session  ,h4
 ,r4 #eeee  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,june #bb1 #bjaf,mr4  
,blum5au] 7= himself & ,mr4 ,roe (      
,t5nessee7 introduc$ ! foll[+ bill2 :i* 
0 ref]r$ to ! ,committee on ,en]gy &    
,comm]ce1 & 9 addition to ! ,committee  
on ,ways & ,means1 = a p]iod to be      
subsequ5tly det]m9$ by ! ,speak]1 9 ea* 
case = consid]ation ( su* provisions z  
fall )9 ! jurisdiction ( ! committee    
conc]n$  ,a ,,bill  ,to am5d titles     
,,xviii & ,,xix ( ! ,social ,security   
,act to improve end-(-life c>e & advanc$
 illness managem5t4  #a4 ,%ort title2   
f9d+s2 table ( cont5ts  7a7 ,%ort title 
,?is ,act may be cit$ z ! ,p]sonalize   
,y\r ,c>e ,act #b4j4  7b7 ,f9d+s        
,congress f9ds ! foll[+3  7#a7 ,all     
individuals %\ld be af=d$ ! opportunity 
to fully p>ticipate 9 decisions relat$  
to _! heal? c>e4  7#b7 ,c>e ne> ! end ( 
life %\ld be p]son- & family-ori5t$ &   
evid5ce-bas$4  7#c7 ,to ensure          
high-quality1 p]son-c5t]$ c>e ne> ! end 

( life1 c>e mu/ align ) an individual's 
goals1 values1 & /at$ pref]5ces4  7#d7  
,advance c>e plann+ plays a valuable    
role 9 a*iev+ quality c>e by in=m+      
provid]s & family memb]s ( an           
individual's treatm5t pref]5ces4  7#e7  
,all cl9icians :o c>e = p ) advanc$     
s]i\s illness %\ld demon/rate compet5ce 
9 basic advance c>e plann+ & palliative 
c>e1 includ+ communication skills1      
int]-pr(essional collaboration1 &       
symptom managem5t4  7#f7 ,m %\ld be done
 to e/abli% specific policies & programs
 to assi/ p ) s5sory1 m5tal1 & o!r      
disabilities 9 ord] to maximize ! degree
 to :i* !y are active p>ticipants 9 !   
decisions relat$ to _! heal? c>e1       
includ+ tra9+ heal? c>e provid]s h[ to  
communicate ) p ) developm5tal1         
psy*iatric1 spee*1 & s5sory             
disabilities4  7#g7 ,includ+ complet$   
advance c>e plann+ docum5ts )9 a        
pati5t's electronic heal? record c      
increase ! likelihood ^! docum5ts are   
kept curr5t & available at ! "r place at

 ! "r "t4  7#h7 ,a decade ( rese>* has  
demon/rat$ t physician ord]s =          
life-su/a9+ treatm5t effectively convey 
pati5t pref]5ces & guide m$ical p]sonnel
 t[>d m$ical treatm5t align$ ) pati5t   
wi%es4  7#i7 ,pati5ts1 c>egiv]s1        
families1 & heal? pr(essionals w\ld     
b5efit f an au?oritative1 validat$ li/ (
 core compon5ts to ! deliv]y            
high-quality end-(-life c>e4  7#aj7     
,palliative c>e1 hospice1 & v>i\s c>e   
models t integrate heal? c>e &          
supportive s]vices provide high-quality 
end-(-life c>e & r$uce ! use ( avoidable
 hospital- & in/itution-bas$ s]vices t !
 pati5t does n want4  7c7 ,table (      
cont5ts ,! table ( cont5ts ( ?is ,act is
 z foll[s3 ,sec4 #a4 ,%ort title2 f9d+s2
 table ( cont5ts4 ,sec4 #b4 ,advanc$    
illness managem5t & *oices c>e model    
demon/ration program4 ,sec4 #c4 ,grants 
= programs = ord]s = life-su/a9+        
treatm5t & simil> provid] or m$ical     
ord]s4 ,sec4 #d4 ,advance c>e plann+    
/&>ds = electronic heal? records4 ,sec4 

#e4 ,portability ( advance directives4  
,sec4 #f4 ,application ( quality        
measures "u ,m$ic>e relat+ to end-(-life
 c>e4 ,sec4 #g4 ,annual report on       
,m$ic>e dec$5ts4 ,sec4 #h4 ,grants to   
increase public aw>5ess ( advance c>e   
plann+4 ,sec4 #i4 ,advance c>e plann+ & 
palliative c>e education & tra9+4 ,sec4 
#aj4 ,advance ,c>e ,plann+ ,advisory    
,c\ncil4  #b4 ,advanc$ illness managem5t
 & *oices c>e model demon/ration program
  7a7 ,9 g5]al ,! ,secret>y ( ,heal? &  
,human ,s]vices 79 ?is section ref]r$ to
 z ! ,secret>y7 %all e/abli% a #c-ye>   
demon/ration program 79 ?is section     
ref]r$ to z ! demon/ration program7 to  
te/ ! use ( advanc$ illness managem5t & 
e>ly use ( palliative c>e "u ! ,m$ic>e  
program4 ,! ,secret>y may ext5d !       
program to a duration ( #d or #e ye>s1 z
 det]m9$ necess>y by ! ,secret>y 9      
coord9ation ) ! ,c5t]s = ,m$ic>e &      
,m$icaid ,innovation4  7b7 ,demon/ration
 program design ,"u ! demon/ration      
program ! ,secret>y %all e/abli% a      

capitat$ paym5t = ! paym5t ( advanc$    
illness managem5t s]vices & ! e>ly use (
 palliative c>e consi/5t ) ! foll[+3    
7#a7 ,! s]vices & c>e are furni%$ to    
individuals :o-- 7,a7 reside at home or 
9 an in/itutional sett+2  7,b7 h a      
docum5t$ m$ical prognosis t !           
individual's life expectancy is #bd     
mon?s or less2 &  7,c7 h ! ne$ =        
assi/ance ) two or m activities ( daily 
liv+ or meet su* o!r crit]ia z !        
,secret>y may specify4  7#b7 ,! s]vices 
& c>e are furni%$ concurr5tly ) !       
receipt ( s]vices relat$ to ! treatm5t (
 ! individual's condition ) respect to  
:i* a diagnosis ( t]m9al illness has be5
 made4  7#c7 ,! s]vices & c>e include at
 lea/ hospice c>e 7z def9$ 9 section    
#ahfa7;dd77#a7 ( ! ,social ,security    
,act71 a functional assessm5t ( !       
individual & ( ! family c>egiv] 7z      
appropriate71 9-home s]vices & supports1
 #bd-;h\r1 #g-;day-a-week em]g5cy       
supports1 c>e coord9ation &             
communication across sett+s & provid]s1 

& su* o!r palliative c>e s]vices z !    
,secret>y deems necess>y4  7#d7 ,!      
s]vices & c>e are furni%$ by an         
int]discipl9>y team t includes prim>y   
c>e provid]s1 palliative m$ic9e         
speciali/s1 palliative nurses1 social   
work]s1 *apla9s1 ph>maci/s1 dieticians1 
physical !rapi/s1 occupational !rapi/s1 
psy*o!rapi/s1 & su* o!rs z ! ,secret>y  
deems necess>y & appropriate4  7c7      
,timely implem5tation ,! ,secret>y (    
,heal? & ,human ,s]vices %all implem5t a
 capitat$ paym5t model = ! paym5t (     
advanc$ illness managem5t s]vices "u    
subsection 7a7 n lat] ?an #b ye>s aft] !
 date ( ! enactm5t ( ?is ,act4  #c4     
,grants = programs = ord]s = life-su/a9+
 treatm5t & simil> provid] or m$ical    
ord]s  7a7 ,9 g5]al ,! ,secret>y (      
,heal? & ,human ,s]vices %all make      
grants to eligible entities = ! purpose 
( develop+1 exp&+1 & enhanc+ programs = 
ord]s = life-su/a9+ treatm5t 7z def9$ 9 
subsection 7c77#b774  7b7 ,au?oriz$     
activities ,activities fund$ ?r\gh a    

grant "u ?is section = an area may      
include-- 7#a7 develop+ su* a program = 
! area t includes hospitals1 home c>e1  
hospice1 long-t]m c>e1 community &      
assi/$ liv+ resid5ces1 skill$ nurs+     
facilities1 & em]g5cy m$ical s]vices )9 
a ,/ate2  7#b7 exp&+ an exi/+ program = 
ord]s reg>d+ life-su/a9+ treatm5t to    
s]ve m pati5ts or enhance ! quality (   
s]vices1 includ+ educational s]vices =  
pati5ts & pati5ts' families1 tra9+ (    
heal? c>e pr(essionals1 or e/abli%+ an  
ord]s = life-su/a9+ treatm5t regi/ry2 & 
7#c7 te*nical assi/ance & pr(essional   
tra9+4  7c7 ,def9itions ,9 ?is section3 
7#a7 ,! t]m eligible entity includes--  
7,a7 an academic m$ical c5t]1 a m$ical  
s*ool1 a ,/ate heal? dep>tm5t1 a ,/ate  
m$ical association1 a multi/ate task    
=ce1 a hospital1 or a heal? sy/em       
capable ( adm9i/]+ a program = physician
 ord]s reg>d+ life-su/a9+ treatm5t = a  
,/ate2 or  7,b7 any o!r heal? c>e ag5cy 
or entity z ! ,secret>y det]m9es        
appropriate4  7#b7 ,! t]m program =     

ord]s = life-su/a9+ treatm5t means a    
program t1 reg>dless ( its "n--  7,a7   
implem5ts a cl9ical process design$ to  
facilitate %>$1 in=m$ m$ical            
decisionmak+ & communication betwe5     
heal? c>e pr(essionals & pati5ts )      
s]i\s1 progressive illness or frailty & 
results 9 a set ( m$ical ord]s t are    
sub/antially consi/5t ) ! national /&>d 
& t--  7i7 are portable & honor$ across 
c>e sett+s2 &  7ii7 address key m$ical  
decisions consi/5t ) ! pati5t's goals ( 
c>e2 &  7,b7 is guid$ by a coalition (  
/akehold]s1 su* z pati5t advocacy gr\ps 
& repres5tatives f across ! cont9uum (  
heal? c>e s]vices1 disability rights    
advocates1 s5ior advocates1 em]g5cy     
m$ical s]vices1 long-t]m c>e1 m$ical    
associations1 hospitals1 home heal?1    
hospice1 nurs+ associations1 ! ,/ate    
ag5cy responsible = s5ior & disability  
s]vices1 fai?-bas$ gr\ps1 & ! ,/ate     
dep>tm5t ( heal?4  7#c7 ,! t]m ,secret>y
 means ! ,secret>y ( ,heal? & ,human    
,s]vices4  7d7 ,au?orization (          

appropriations ,to c>ry out ?is section1
 !re are au?oriz$ to be appropriat$     
#ce1jjj1jjj = ! #e-;fiscal-ye> p]iod    
beg9n+ ) fiscal ye> #bjag1 to rema9     
available until exp5d$4  #d4 ,advance   
c>e plann+ /&>ds = electronic heal?     
records  7a7 ,9 g5]al ,not)/&+ section  
#cjjd7;b77#c7 ( ! ,public ,heal? ,s]vice
 ,act 7#db ,u4,s4,c4                    
#cjj;jj-#ad7;b77#c771 n lat] ?an #d ye>s
 aft] ! date ( ! enactm5t ( ?is ,act1 ! 
,secret>y ( ,heal? & ,human ,s]vices    
%all adopt1 by rule1 /&>ds = a qualifi$ 
electronic heal? record 7z def9$ 9      
section #cjjj7ac7 ( su* ,act 7#db       
,u4,s4,c4 #cjj;jj7#ac771 ) respect to   
organiz+ pati5t communications ) heal?  
c>e provid]s ab\t c>e goals & to provide
 "o-click access to ! foll[+3  7#a7 ,!  
pati5t's curr5t advance directive 7z    
def9$ 9 section #ahff7;f77#c7 ( !       
,social ,security ,act 7#db ,u4,s4,c4   
#acie;cc7f77#c771 z applicable4  7#b7 ,!
 pati5t's curr5t ord] = life-su/a9+     
treatm5t 7describ$ 9 section            

#c7;c77#b77;,a771 z applicable4  7#c7   
,docum5tation ( advance c>e plann+      
discussion betwe5 ! pati5t & ! provid]4 
7b7 ,treatm5t ( /&>ds ,a /&>d adopt$ "u 
subsection 7a7 %all be treat$ z a /&>d  
adopt$ "u section #cjjd ( ! ,public     
,heal? ,s]vice ,act 7#db ,u4,s4,c4      
#cjj;jj-#ad7 = purposes ( c]tify+       
qualifi$ electronic heal? records       
pursuant to section #cjja7;c77#e7 ( su* 
,act 7#db ,u4,s4,c4                     
#cjj;jj-#aa7;c77#e774  #e4 ,portability 
( advance directives  7a7 ,9 g5]al      
,section #ahff7;f7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4 #acie;cc7f77 is    
am5d$ by add+ at ! end ! foll[+ new     
p>agraph3  7#e7  7,a7 ,an advance       
directive validly execut$ outside !     
,/ate 9 :i* su* directive is pres5t$ mu/
 be giv5 effect by a provid] ( s]vices  
or organization to ! same ext5t z an    
advance directive validly execut$ "u !  
law ( ! ,/ate 9 :i* x is pres5t$4  7,b7 
,9 ! abs5ce ( k to ! contr>y1 a         
physician or o!r heal? c>e provid] or   

organization may presume t a writt5     
advance heal? c>e directive or simil>   
in/rum5t1 reg>dless ( :]e execut$1 is   
valid4  7,c7 ,9 ! abs5ce ( a validly    
execut$ advance directive1 any au!ntic  
expression ( a p]son's wi%es ) respect  
to heal? c>e %all be honor$4  7,d7 ,!   
provisions ( ?is p>agraph %all preempt  
any ,/ate law on advance directive      
portability to ! ext5t su* law is       
inconsi/5t ) su* provisions4 ,no?+ 9 !  
p>agraph %all be con/ru$ to au?orize !  
adm9i/ration ( heal? c>e treatm5t       
o!rwise prohibit$ by ! laws ( ! ,/ate 9 
:i* ! directive is pres5t$4  4  7b7     
,,gao /udy on heal? c>e decisionmak+    
laws & b>ri]s to ! use ( advance        
directives  7#a7 ,/udy ,! ,comptroll]   
,g5]al ( ! ,unit$ ,/ates %all conduct a 
/udy t exam9es ! use1 portability1 &    
electronic /orage ( advance directives &
 t id5tifies b>ri]s t[>ds adopt+1 us+1 &
 foll[+ advance directives 9 ! cl9ical  
sett+4 ,su* exam9ation %all include     
issues t rema9 unresolv$ aft] ! ,/age #c

 ,mean+ful ,use f9al rule1 includ+      
b>ri]s & solutions to f9d+ & access+    
advance c>e plann+ docum5ts1 be/        
practices = al]t+ eligible provid]s to !
 pres5ce ( an advance c>e plan1 & be/   
practices = transmitt+ advance c>e plans
 across sites ( c>e4  7#b7 ,report ,n   
lat] ?an #a ye> aft] ! date ( ! enactm5t
 ( ?is ,act1 ! ,comptroll] ,g5]al %all  
submit to ,congress a report on ! /udy  
conduct$ "u p>agraph 7#a7 & %all include
 9 ! report su* recomm5dations reg>d+   
improv+ advance heal? c>e plann+ z !    
,comptroll] ,g5]al deems appropriate4   
#f4 ,application ( quality measures "u  
,m$ic>e relat+ to end-(-life c>e  7a7   
,incorporat+ end-(-,life c>e subdoma9s  
)9 quality doma9s "u ,m$ic>e physician  
fee s*$ule ,section #ahdh7s77#a7 ( !    
,social ,security ,act 7#db ,u4,s4,c4   
#aciew-#d7s77#a77 is am5d$ by add+ at ! 
end ! foll[+ new subp>agraph3  7,g7     
,end-(-life subdoma9s relat+ to quality 
doma9s ,)9 "o or m appropriate quality  
doma9s1 ! ,secret>y %all e/abli%        

subdoma9s relat+ to end-(-life c>e1     
includ+ subdoma9s relat+ to ea* ( !     
foll[+3  7i7 ,! process ( elicit+ &     
docum5t+ goals1 pref]5ces1 & values ( ! 
pati5t 7&1 :]e relevant & appropriate1  
family c>egiv]7 reg>d+ end-(-life c>e f 
! pati5t or f a legally au?oriz$        
repres5tative1 includ+ ! articulation ( 
goals t accurately reflect h[ ! pati5t  
wants to live4  7ii7 ,! effectiv5ess1   
pati5t-c5t]$ness 7&1 :]e relevant1      
family c>egiver-c5t]$ness71 & accuracy (
 end-(-life c>e plans1 includ+          
docum5tation ( individual goals1        
pref]5ces1 & values4  7iii7 ,agreem5t & 
consi/5cy ) respect to end-(-life c>e   
among-- 7,i7 pati5t's goals1 values1 &  
pref]5ces2  7,,ii7 any docum5t$ c>e     
plan2 &  7,,iii7 ! c>e deliv]$4  4  7b7 
,incorporat+ quality measures on        
end-(-,life c>e = po/-,acute c>e 7,,pac7
 ,section #ahii;,b ( ! ,social ,security
 ,act 7#db ,u4,s4,c4 #acielll7 is       
am5d$-- 7#a7 9 subsection               
7a77#b77;,e77i7--  7,a7 by /rik+ & at ! 

end ( subclause 7,,iv72  7,b7 by /rik+ !
 p]iod at ! end ( subclause 7,v7 &      
ins]t+ 2 &2 &  7,c7 by add+ at ! end !  
foll[+ new subclause3  7,,vi7 ) respect 
to ! doma9 describ$ 9 subsection        
7c77#a77;,f7 7relat+ to end-(-life      
c>e7--  7aa7 = ,,pac provid]s describ$ 9
 clauses 7ii71 7iii71 & 7iv7 ( p>agraph 
7#b77;,a71 ,octob] #a1 #bjah2 &  7bb7 = 
,,pac provid]s describ$ 9 clauses 7i7 ( 
su* p>agraph1 ,janu>y #a1 #bjai4  2 &   
7#b7 9 subsection 7c77#a71 by add+ at ! 
end ! foll[+ new subp>agraph3  7,f7 ,!  
effectiv5ess1 pati5t-c5t]$ness 7&1 :]e  
relevant1 family c>egiver-c5t]$ness71 & 
accuracy ( end-(-life c>e plans &       
communications relat+ to su* plans1     
includ+--  7i7 docum5tation ( a pati5t's
 goals1 pref]5ces1 & values2 &  7ii7    
agreem5t & consi/5cy ) respect to       
end-(-life c>e among--  7,i7 pati5t's   
goals1 values1 & pref]5ces2  7,,ii7 any 
docum5t$ c>e plan2 &  7,,iii7 ! c>e     
deliv]$4  4  #g4 ,annual report on      
,m$ic>e dec$5ts ,! ,secret>y ( ,heal? & 

,human ,s]vices %all issue = ea* fiscal 
ye> 7beg9n+ no lat] ?an fiscal ye>      
#bjah7 an annual report t analyzes !    
circum/ances ( ,m$ic>e b5efici>ies :o   
di$ dur+ ! fiscal ye> cov]$ by su*      
report4 ,su* analysis %all include at   
lea/ ! foll[+ ) respect to su* dec$5ts3 
7#a7 ,in=mation on ! c>e or payor sett+s
 7su* z "u "p ,a or "p ,c ( ,m$ic>e7 at 
! "t ( dea?4  7#b7 ,in=mation on !      
demographic *>act]i/ics ( su* dec$5ts4  
7#c7 ,in=mation on ! geographic         
di/ribution ( su* dec$5ts4  7#d7 ,an    
evaluation ( ! ,m$ic>e claims data = su*
 dec$5ts = s]vices furni%$ 9 ! la/ ye> (
 life1 includ+ an analysis ( ! sett+ (  
c>e = dec$5ts :o _h m ?an "o *ronic     
illness at ! "t ( dea?4  7#e7 ,su* o!r  
in=mation z ! ,secret>y deems           
appropriate4  #h4 ,grants to increase   
public aw>5ess ( advance c>e plann+  7a7
 ,9 g5]al ,! ,secret>y ( ,heal? & ,human
 ,s]vices %all aw>d grants to increase  
public aw>5ess ( advance c>e plann+4    
,su* grants %all be aw>d$ "u su* t]ms & 

conditions z ! ,secret>y %all specify4  
7b7 ,types ( grants ,grants "u ?is      
section may provide = ! developm5t (--  
7#a7 decision support tools &           
in/ructional mat]ials = individuals1    
family c>egiv]s1 & heal? c>e provid]s t 
include ! importance ( plann+ = treatm5t
 decisions1 discuss+ values & goals     
relat$ to cata/rophic injury or illness1
 & complet+ an advance directive2 &     
7#b7 mat]ials = individuals t pres5ts ! 
importance ( articulat+ goals ( c>e1    
und]/&+ disease diagnosis & prognosis1  
evaluat+ treatm5t options1 & develop+ a 
plan ( c>e1 & docum5t+ ! treatm5t plan4 
7c7 ,au?orization ( appropriations ,!re 
are au?oriz$ to be appropriat$ to c>ry  
out ?is section = ! #e-;fiscal-ye> p]iod
 beg9n+ ) fiscal ye> #bjag #bj1jjj1jjj1 
to rema9 available until exp5d$4  #i4   
,advance c>e plann+ & palliative c>e    
education & tra9+  7a7 ,9 g5]al ,!      
,secret>y ( ,heal? & ,human ,s]vices    
%all aw>d grants to eligible entities to
 develop & implem5t programs &          

initiatives to tra9 & educate           
individuals to provide advance c>e      
plann+1 advance illness c>e1 hospice    
c>e1 & palliative c>e 9 hospital1       
hospice1 home1 community1 & long-t]m c>e
 sett+s4  7b7 ,eligible entities ,=     
purposes ( ?is section1 eligible        
entities may be a m$ical s*ool1 a nurs+ 
s*ool1 a heal? c>e sy/em1 non-pr(it     
organization1 or o!r entity ! ,secret>y 
deems appropriate4  7c7 ,use ( funds    
,fund+ "u grants aw>d$ "u ?is section   
%all be us$-- 7#a7 to provide tra9+ &   
cont9u+ education to individuals :o w   
provide advance c>e plann+ s]vices or   
palliative c>e 9 ! hospital1 hospice1   
home1 community1 & long-t]m c>e sett+s2 
&  7#b7 to develop curricula or tea*+   
mat]ials relat$ to advance c>e plann+ or
 palliative c>e 9 su* sett+s4  7d7      
,au?orization ( appropriations ,!re are 
au?oriz$ to be appropriat$ to c>ry out  
?is section = ! #e-;fiscal-ye> p]iod    
beg9n+ ) fiscal ye> #bjag #bj1jjj1jjj1  
to rema9 available until exp5d$4  #aj4  

,advance ,c>e ,plann+ ,advisory ,c\ncil 
7a7 ,e/abli%m5t ,n lat] ?an #ahj days   
aft] ! date ( ! enactm5t ( ?is ,act1 !  
,secret>y ( ,heal? & ,human ,s]vices 79 
?is section ref]r$ to z ! ,secret>y7    
%all e/abli% )9 ! ,(fice ( ! ,secret>y  
an advisory committee to be kn[n z !    
,advance ,c>e ,plann+ ,advisory ,c\ncil 
79 ?is section ref]r$ to z ! ,c\ncil74  
7b7 ,duties  7#a7 ,mission ,! ,c\ncil   
%all advise ! ,secret>y reg>d+ !        
compilation1 developm5t1 & dissem9ation 
( res\rces = individuals fac+ advanc$ & 
t]m9al illness4  7#b7 ,responsibilities 
,responsibilities ( ! c\ncil include !  
foll[+3 7,a7 ,ensur+ t res\rces provid$ 
conta9 non-bias$ in=mation ab\t ! range 
( options available to individuals )    
advance & t]m9al illness1 includ+       
in=mation ab\t conv5tional1 curative    
treatm5ts1 palliative c>e1 & hospice    
c>e4  7,b7 ,develop+ /rategies =        
increas+ public und]/&+ ab\t advanc$    
illness & ! important role advance c>e  
plann+ c play 9 docum5t+ an individual's

 wi%es = m$ical c>e = lov$ ones 9 ! ev5t
 t individual _c communicate !          
individual's 8 or h] wi%es4  7,c7       
,compil+ in=mation = dissem9ation reg>d+
 exi/+ advance c>e plann+ models includ+
 ,,pol/1 ,,mol/1 advance directives1 &  
heal?c>e proxies4  7,d7 ,promot+        
int]ag5cy coord9ation & m9imiz+ ov]lap  
reg>d+ advance c>e plann+1 includ+      
opportunities to coord9ate ef=ts betwe5 
! ,f$]al ag5cies & ext]nal /akehold]s4  
7,e7 ,id5tify+ & evaluat+ cross-cutt+   
issues su* z p]9atal end-(-life c>e &   
advance c>e plann+ access issues4  7c7  
,memb]%ip  7#a7 ,9 g5]al ,! ,c\ncil %all
 be compos$ ( up to #ae memb]s appo9t$  
by ! ,secret>y f among qualifi$         
individuals :o are n (fic]s or employees
 ( ! ,f$]al ,gov]nm5t4  7#b7 ,gr\ps ,!  
memb]s ( ! ,c\ncil %all include !       
foll[+3 7,a7 ,at lea/ #c memb]s )       
cl9ical tra9+ & an exp]tise 9 advanc$   
illness or end-(-life c>e4  7,b7 ,at    
lea/ #c memb]s f pati5t & family        
advocacy gr\ps4  7,c7 ,at lea/ #c memb]s

 f religi\s or spiritual organizations4 
7,d7 ,o!r memb]s f int]e/$ /akehold]    
gr\ps ) a prov5 exp]tise 9 *ronic1      
advanc$1 & end-(-life c>e4  7d7         
,applicability ( ,,faca ,! ,c\ncil %all 
be treat$ z an advisory committee       
subject to ! ,f$]al ,advisory ,committee
 ,act 7#e ,u4,s4,c4 ,app474