Advance health care directives; creating the Uniform Health Care Decisions Act of 2026; establishing requirements for certain health care directives; effective date.
HB 1687 establishes Oklahoma's "Uniform Health Care Decisions Act of 2025," creating a clear framework for advance health care directives. It defines key terms like "advance health care directive" (including mental health directives), "agent" (someone appointed to make decisions), and "default surrogate" (a family member or cohabitant who can act if no directive exists). The bill specifies how directives are created, updated, or revoked, outlines duties for health care professionals, and details procedures for resolving conflicts between directives. This directly affects Oklahomans planning for future medical decisions, their families, and health care providers across the state.
The bill was updated from the House version to the Senate floor version, changing the effective year from 2025 to 2026 and updating the list of repealed statutes to reflect recent legislative changes. The core definitions and structure of the Uniform Health Care Decisions Act remain consistent, but the Senate version includes specific repeals of prior health care directive laws to ensure the new act is the sole governing authority.
Scope change
The bill's scope remains the same regarding health care directives, but the applicability date is shifted to 2026, and the list of repealed laws was expanded to include more recent amendments.
TIMELINE
The act's name was changed from the 'Uniform Health Care Decisions Act of 2025' to the 'Uniform Health Care Decisions Act of 2026', indicating a one-year delay in the effective date.
REQUIREMENT
The summary of the act's contents was updated to include 'providing short title' and 'defining terms' more explicitly, and the list of repealed statutes was expanded to include sections from the Oklahoma Advance Directive Act and the Oklahoma Health Care Agent Act as amended in 2025 and 2023.
TECHNICAL
The header was changed from 'HOUSE OF REPRESENTATIVES' to 'SENATE FLOOR VERSION', and the byline was updated to 'COMMITTEE SUBSTITUTE FOR ENGROSSED HOUSE BILL NO. 1687', reflecting the bill's progression through the legislative process.
The document transitioned from a Senate committee draft to the House Floor version, resulting in the removal of specific amendment instructions and the addition of the bill's full title and statutory definitions. This change establishes the foundational legal terms for the new 'Uniform Health Care Decisions Act of 2025', defining key concepts like 'advance health care directive' and 'default surrogate' to guide future application of the law.
Scope change
The bill's scope is now explicitly defined as the 'Uniform Health Care Decisions Act of 2025', covering advance directives, powers of attorney, and mental health care decisions.
DEFINITION
Added a comprehensive list of statutory definitions including 'advance health care directive', 'agent', 'capacity', 'cohabitant', 'default surrogate', 'family member', and 'health care institution' to standardize legal terminology.
TECHNICAL
Removed Senate-specific amendment instructions, committee headers, and draft metadata that were not part of the final enacted text.
SCOPE
Added the formal title and summary of the act, clarifying that it covers health care instructions, powers of attorney, and mental health care directives.
The document version was updated from a final draft (FA) to a working draft (WDFA), accompanied by a timestamp change from April 27 to April 29, 2026. No substantive policy changes, such as new laws, funding amounts, or eligibility criteria, were introduced in this specific diff.
TECHNICAL
The file metadata was updated to reflect a later revision date and a change in document status from Final (FA) to Working Draft (WDFA).
The amendment shifts the effective dates for different parts of the bill and changes the sponsor from Senator Rosino to Senator Howard. It extends the implementation timeline for the new sections by moving the effective date from November 1, 2026 to November 1, 2027, while keeping an earlier date for the first 32 sections. This change delays when the new provisions in the bill become active law.
Scope change
The scope of the bill's applicability remains the same, but the timeline for when the new rules take effect has been extended by approximately eight months for the later sections.
TIMELINE
The effective date for Sections 33 and 34 was changed from November 1, 2026 to November 1, 2027, delaying their implementation.
REQUIREMENT
New text was added to explicitly define the effective dates for different sections of the act, separating the first 32 sections from the remaining ones.
TECHNICAL
The bill sponsor was updated from Senator Rosino to Senator Howard, and the document version was updated to reflect the new floor amendment.
The bill was amended to expand eligibility by explicitly including physician assistants alongside nurses in a specific provision. Additionally, the effective date for the legislation was delayed from November 1, 2026, to July 1, 2027, giving more time for implementation.
Scope change
The bill's scope was expanded to include physician assistants in a provision previously limited to nurses.
ELIGIBILITY
Added physician assistants to the list of eligible healthcare providers in a specific section.
TIMELINE
Delayed the effective date of the bill from November 1, 2026, to July 1, 2027.
The only change to the bill is a minor update to the document's timestamp, reflecting a revision made on April 15, 2026, rather than the original April 14, 2026. There are no substantive policy changes, and the bill's scope, requirements, or eligibility criteria remain exactly the same.
TECHNICAL
Updated the document revision timestamp from April 14 to April 15, 2026.
The bill text was reorganized to include Senate floor amendments, adding a new definition for 'physician assistant' and a clause allowing individuals to defer to another person's judgment. The effective date of the law was delayed from November 1, 2026, to July 1, 2027.
Scope change
The scope of the bill was expanded to explicitly include physician assistants in the list of eligible health care professionals.
DEFINITION
Added 'physician assistant' to the list of health care professionals eligible to make decisions.
ADDED
Added a new provision allowing individuals with capacity to defer to the judgment of another person, including their named agent.
TIMELINE
Changed the effective date of the act from November 1, 2026, to July 1, 2027.
The bill was finalized and updated from the 2025 version to the 2026 version, incorporating significant policy expansions. The most critical change is the addition of a repeal section that removes previous advance directive laws to prevent conflicts with the new rules. The scope of the bill was expanded to include specific procedures for objecting to capacity findings and clarifying the definition of 'health care decision' to explicitly include withholding nutrition and hydration.
Scope change
The bill's scope was expanded to include explicit procedures for objecting to and appealing capacity findings, and the definition of health care decisions was broadened to specifically cover the withholding of nutrition and hydration.
ENFORCEMENT
Added a repeal section to remove and replace previous advance directive laws to ensure legal consistency.
TIMELINE
Updated the effective year of the act from 2025 to 2026.
REQUIREMENT
Added specific requirements for objecting to and seeking judicial review of capacity findings.
DEFINITION
Expanded the definition of 'health care decision' to explicitly include directions to withhold or withdraw artificially administered hydration or nutrition.
Amended And Engrossed→Engrossed·5 edits·May 5, 2026
MODERATE
The bill was amended to transition from the 'Uniform Health Care Decisions Act of 2026' to the 'Uniform Health Care Decisions Act of 2025', bringing the effective date forward by one year. The amendment also updated the bill's title and summary to reflect new provisions, including the establishment of an 'advance mental health care directive' and expanded definitions for key terms like 'health care institution' and 'person interested in the welfare of the individual'.
Scope change
The bill now applies to the 2025 legislative year instead of 2026, and its scope was expanded to explicitly include mental health care directives and broader definitions for surrogates and interested parties.
TIMELINE
Changed the effective date of the act from 2026 to 2025.
SCOPE
Added explicit authorization for 'advance mental health care directives' alongside standard health care directives.
DEFINITION
Expanded the definition of 'person interested in the welfare of the individual' to include public entities providing case management and individuals with ongoing educational or support relationships.
Updated the definition of 'health care institution' to align with specific federal Social Security Act definitions for nursing and skilled nursing facilities.
TECHNICAL
Removed the repeal of previous statutes (Oklahoma Advance Directive Act and Oklahoma Health Care Agent Act) that were included in the original text.
Introduced→Amended And Engrossed·3 edits·May 5, 2026
MINOR
The bill was amended to update the effective year from 2025 to 2026 and to include a comprehensive repeal of previous advance directive laws, ensuring the new Uniform Health Care Decisions Act fully replaces outdated statutes. The amendment also standardizes the formatting of the bill title and summary to align with current legislative procedures.
Scope change
The bill's scope expanded to explicitly repeal and replace multiple prior sections of the Oklahoma Statutes related to advance directives, clearing legal conflicts with older laws.
TIMELINE
Changed the act's title from 'Uniform Health Care Decisions Act of 2025' to 'Uniform Health Care Decisions Act of 2026', indicating a one-year delay in the effective date.
REQUIREMENT
Added a detailed list of repealed statutes (Sections 3101.1 through 3102.5 and others) to formally invalidate previous advance directive laws and prevent conflicts with the new act.
TECHNICAL
Reformatted the bill header and summary text to correct the designation from 'As Introduced' to 'Engrossed Senate Amendment' and updated the sponsor's name to reflect Senate involvement.
Floor votes · Senate May 5, 2026 · House Mar 26, 2025
How they voted
49–0
Passed · 1 other
Total votes 50
May 5, 2026
D
Democratic9
9 Yea
100% Yea
R
Republican41
40 Yea1
97% Yea
Your representatives
Vote distribution
All YeaAll NayMixedNo data
88–6
Passed · 6 other
Total votes 100
Mar 26, 2025
D
Democratic19
18 Yea1
94% Yea
R
Republican81
70 Yea6 Nay5
86% Yea
Your representatives
Vote distribution
All YeaAll NayMixedNo data
Full legislative history
Actions timeline
Total actions
28
Key actions
10
Committee
7
Amendments
2
May 12, 2026
Signed into law
Approved by Governor 05/11/2026
lower
May 6, 2026
Executive-Receipt
Sent to Governor
lower
May 6, 2026
Other
Enrolled measure signed, returned to House
upper
May 6, 2026
Other
Enrolled, signed, to Senate
lower
May 6, 2026
Committee
Referred for enrollment
lower
May 6, 2026
Lower · Passed
Fourth Reading, Measure passed: Ayes: 77 Nays: 3
lower
May 6, 2026
Lower · Passed
SA's read, adopted
lower
May 5, 2026
Other
SA's received
lower
May 5, 2026
Upper · Passed
Engrossed to House
upper
May 5, 2026
Committee
Referred for engrossment
upper
May 5, 2026
Upper · Passed
Measure passed: Ayes: 47 Nays: 0
upper
May 5, 2026
Introduced
General Order, Amended
upper
Apr 13, 2026
Other
Placed on General Order
upper
Apr 8, 2026
Upper · Passed
Reported Do Pass, amended by committee substitute Health and Human Services committee; CR filed
upper
Apr 1, 2025
Reading-2
Second Reading referred to Health and Human Services
upper
Mar 27, 2025
Introduced
First Reading
upper
Mar 27, 2025
Lower · Passed
Engrossed, signed, to Senate
lower
Mar 26, 2025
Committee
Referred for engrossment
lower
Mar 26, 2025
Lower · Passed
Third Reading, Measure passed: Ayes: 87 Nays: 6
lower
Mar 26, 2025
Introduced
Amended by floor substitute
lower
Mar 26, 2025
Other
General Order
lower
Feb 27, 2025
Other
Authored by Senator Rosino (principal Senate author)
lower
Feb 27, 2025
Lower · Passed
CR; Do Pass Judiciary and Public Safety Oversight Committee
lower
Feb 6, 2025
Lower · Passed
Policy recommendation to the Judiciary and Public Safety Oversight committee; Do Pass Civil Judiciary
lower
Feb 4, 2025
Committee
Referred to Civil Judiciary
lower
Feb 4, 2025
Reading-2
Second Reading referred to Judiciary and Public Safety Oversight
