Facilitator 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 determinations, among other things.  Because of these intricacies, we recommend that attorneys who are interested in facilitating Advance Directives seek additional training through relevant mechanisms, such as CLEs 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 Advance Directives for individuals with mental illness and being connected with individuals in your area who need assistance with their AD, please contact: 

 


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


Heather Zelle, J.D., Ph.D.

Post-Doctoral Research Associate

Institute of Law, Psychiatry, and Public Policy

University of Virginia

Zelle@virginia.edu

(434) 924-8321



Code provisions relevant to ADs

Virginia’s Health Care Decisions Act can be found in the Virginia Code §§ 54.1-2981 thru 54.1-2996.  Some particularly relevant provisions are noted and linked below:

  • ​Va. Code § 54.1-2983 outlines the requirements of Advance Directives in the Commonwealth.  These stipulations note that the AD:
  1. Must be signed by the individual and two individuals who witness the declarant’s signature.
  2. Does not have to be on a particular form.
  3. Does not have to be completed with the assistance of an attorney.
  4. Does not need to be notarized.


  • Va. Code § 54.1-2984 lists powers of the agent in the statutory form and other model forms, which allows the individual to tailor the document to his/her wishes.  This is something that lawyers should take the time to do with each client.
  • Va. Code § 54.1-2986.2 highlights how certain health care decisions are made in the event that the patient is protesting a particular treatment or course of action.
  • Va. Code § 54.1-2988 covers immunity from liability.  This provision also notes that the distribution of, and assistance in completing, an Advance Directive by health care providers does not constitute unauthorized practice of law (The definition of “health care provider” can be found in Va. Code § 8.01-581.1).
  • Va. Code §§ 32.1-291.1 thru 32.1-291.25 contains information regarding anatomical gifts.  In particular, § 32.1-291.4 defines who may make an anatomical gift on behalf of an individual before his/her death, and § 32.1-291.21 notes the specific effect that an AD has on organ donation.​

Advance Directives and Attorneys