Cynthia Elledge, Ph.D.
Advance Directive Implementation Coordinator
DBHDS & UVa Institute of Law, Psychiatry and Public Policy
Cynthia@virginia.edu
(434) 297-7879​

Facilitation Training

Comprehensive facilitation of Advance Directives for individuals with mental illness requires knowledge and practices beyond what is typically employed for wills and estate planning.  In order to provide the best assistance possible, the facilitator must have a thorough understanding of the nuances that characterize the public mental health service delivery system, crisis response protocol, physician treatment decisions, and capacity determination, among other topics.  Because of these intricacies, we recommend that attorneys who are interested in facilitating ADs seek additional training through relevant mechanisms, such as Virginia Advance Directive CLE program or the University of Virginia’s Facilitator Training.

Pro Bono Opportunities


There are many individuals around Virginia who have expressed interest in completing an Advance Directive but do not have the ability to pay for assistance.  If you or your firm are interested in receiving training on facilitating ADs and being connected with individuals in your area who need assistance, please contact:

Advance Directives and Attorneys

How ADs are Related to Prior Health Care Decision-Making Tools

In short, prior Virginia laws concerning living wills and health care powers of attorney have been repealed.  Statutory powers to write instructions about end-of-life care and appoint a health care power of attorney are now subsumed in the Health Care Decisions Act (Va. Code § 54.1-2981 et seq.).

What is more, revisions to the HCDA in 2009 and 2010 expanded the coverage of ADs to cover all major domains of health care: general medical care, mental health care, and end-of-life care.

Available Forms

The HCDA does not prescribe what form an AD must take (§ 54.1-2984) beyond requiring a few procedural formalities (§54.1-2983).

Many agencies, health systems, and facilities have drafted AD forms.  Three representative versions of the form can be found on our “Picking an AD Form” page.

Relevant Statutes

Some highlights of the HCDA (and related statutes) are included here for easy access and review.