An act to amend Section 4675 of the Probate Code, relating to advance health care directives.
Summary
SB 1189 would amend California Probate Code Section 4675, which governs advance health care directives for patients in skilled nursing facilities. Under current law, such a directive is not effective unless it is witnessed by either a patient advocate or an ombudsperson designated by the Department of Aging. This bill would remove the patient advocate from that role, leaving an ombudsperson as the required witness for a skilled nursing facility patient’s advance directive.
The bill keeps the existing framework that is intended to protect vulnerable residents by ensuring their directives are executed voluntarily and with special oversight. It does not change the general rules for advance health care directives outside skilled nursing facilities, nor does it alter the ability of witnesses to rely on facility staff or family members for identification purposes when reasonable.
Impact
SB 1189 would narrow the class of authorized witnesses for advance health care directives executed by skilled nursing facility residents, making an ombudsperson the sole designated witness under Probate Code Section 4675. In practical terms, this changes the process for validating these directives and may affect skilled nursing facilities, ombudsperson programs, patients, families, and staff involved in end-of-life planning. The bill amends a specific section of the Probate Code and does not create an appropriation, fiscal committee referral, or local program mandate.
Sentiment
The available voting history suggests broad support and little opposition. The bill passed a Senate committee vote 12-0 and later passed on the Senate floor 38-0 on the consent calendar, indicating a largely noncontroversial measure. No committee transcript objections are available, and the bill’s progression to third reading further suggests favorable legislative sentiment.
Contention
The main substantive issue is the removal of the patient advocate as an authorized witness, which could raise questions about whether narrowing the witness pool affects access or administrative flexibility for skilled nursing facility residents. Supporters appear to favor a cleaner, more uniform witness requirement centered on the ombudsperson role, while any concern would likely come from those who view the patient advocate as an additional safeguard or a useful alternative when an ombudsperson is unavailable. The bill text itself preserves the underlying protection for vulnerable patients, so the dispute appears limited to who may perform the witnessing function rather than whether the safeguard should exist at all.
Advance health care directives; creating the Uniform Health Care Decisions Act of 2026; establishing requirements for certain health care directives; effective date.
Advance health care directives; Uniform Health Care Decisions Act of 2025; definitions; capacity; presumption of capacity; overcoming presumption; notice; judicial review; power of attorney; advance mental health care directive; conflicting health care directives; default surrogate; disqualification; revocation; validity; conflict of law; duties; powers; coagents; responsibilities; immunity; conduct; damages; judicial relief; effective date.