Don't send your child to college without this

Your 18-year-old is off to college. Clothes? Check. Computer? Check. Health care power of attorney? Well, ummm.

We thought we had bought and supplied everything for our daughter when she went away to college, but we didn’t know how important a health care power of attorney or health proxy was.

When a child turns 18, parents typically have little power to remotely access her medical records or make decisions under federal law. A medical privacy law called HIPAA requires you to have your child’s written permission.

That’s why a health care proxy, a relatively simple legal document that empowers you to make medical decisions and access their records if they’re disabled, is a critical back-to-school item.

The good news is that you can obtain these documents for free and sign them any time -- you don’t need to pay a lawyer to execute them.

I heard about health care proxies for students in a roundabout way. I was attending a seminar on estate planning last year when an attorney mentioned that the documents were essential for college students. Then when a neighborhood attorney offered the documents for free, I jumped at the opportunity.

Another neighbor chimed in that she thought proxies were critically important when one of her children had a health emergency at college.

The first form, called a HIPAA authorization, is really basic. The acronym is short for Health Insurance Portability and Accountability Act, a federal law that protects the privacy of medical records. You can’t casually call your child’s health center at college to get detailed health information without an authorization.

Every state has its own version, but it’s typically only a one-page form that allows access to health records and professionals. You can download one for free.

The health care proxy, however, is more complicated. The person signing it is essentially giving another person the right to make medical decisions for them if the person becomes incapacitated.

An “agent” for health decisions is appointed with the proxy. It covers a broad range of powers. Proxies -- parents or other trusted individuals -- can talk with doctors, approve tests and consult medical records.

You can also do some fine-tuning on proxy forms. You can limit the health agent’s powers and appoint successors in case the agent dies or is unable to act. 

By the way, before you obtain these forms, have a calm, heart-to-heart discussion with your college students on why these documents are important to the family.

In addition to routine information, the proxy goes several steps further into some unpleasant decision making. It can specify action for someone on life support or can withhold further treatment or tests. It can also specify organ donation and other post-mortem issues.

While parents dread the very idea of these horrible end-of-life concerns, there’s some consolation in that the proxy will give them full legal control in this situation.

Some of the more detailed proxies include a survey that helps you through nettlesome end-of-life or advanced “health care directive” decisions. One form I sampled included statements that affirmed final intentions:

“The quality of my life is more important than the length of my life…” begins one proxy statement on deciding whether to continue to prolong life at any cost.

“Staying alive is more important to me no matter how sick I am,” is the other statement, referring to employing life-support technology “in accordance with reasonable medical standards.”

As a parent, this was tough language to wade through, but having been in an end-of-life-situation in an emergency room with my mother nine years ago, I’m glad we had some legal backing to make a decision based on her wishes.

Of course, these are brutally difficult issues to discuss -- even if you’re middle aged or elderly. If there’s an upside, it’s that they do provoke some serious thinking about quality of life in the event of a health emergency.

The key to both documents is understanding what they can and can’t do. They don’t ensure quality care. You’ll still have to consult closely with health professionals and get second opinions on your own.

At the very least, make sure you fully comprehend what these documents mean and how you can change them.

Consult with your family lawyer and appoint trusted family members or friends to make decisions if you or your spouse/partner can’t. A lawyer may charge you a few hundred dollars for the documents, or you can obtain them for free. The American Bar Association has a helpful primer, and you can download these documents fairly easily. 

And while you’re at it, look at your own estate plan. If you don’t have a will, powers of attorney or living trust in place, it’s time to educate yourself on their importance.