Service Line 6: Health Care Surrogate Designation & Notarization Support (Florida-Compliant MPOA Assistance)
Caring Connections Alliance offers a Community Health Worker (CHW)-led service to support the completion and notarization of Health Care Surrogate Designation forms in accordance with Florida law (Chapter 765, Florida Statutes). All CHWs providing this service are licensed Florida notaries, enabling them to guide patients through the full process of appointing a legal health care decision-maker and to notarize the document in the same encounter—at home, in-clinic, or in the community.
This service is critical for medically vulnerable Floridians—especially those living with chronic illness, cognitive impairment, or limited access to legal or digital services—ensuring they have a documented surrogate in place before a crisis occurs.
Clinical and Operational Benefits:
• Facilitates compliance with Florida’s legal requirements for medical decision-making when patients lose capacity
• Improves hospital and emergency room workflow by ensuring surrogate information is on file and accessible in the EHR
• Reduces the likelihood of family conflict, treatment delays, or inappropriate interventions
• Enhances care alignment in patients with complex or progressive disease
• Increases documented advance directive rates for accreditation and value-based care reporting
Cost Abatement & Reimbursement Alignment:
• Prevents avoidable ICU stays, readmissions, and non-beneficial procedures at end of life
• Supports Advance Care Planning reimbursement through:
- o CPT 99497 (Initial 16+ min discussion)
o CPT 99498 (Each additional 30 min)
o Medicaid Managed Care Plan incentives for documented advance planning
- o 99490/99487/99489 (CCM billing codes)
o Florida Medicaid’s Long-Term Care Program and MMA Plan requirements
- o Florida-specific Health Care Surrogate Forms
o Living Will language (optional add-on service)
o Z66 (Do Not Resuscitate) and Z51.5 (Palliative care encounter) codes