The OMNIBUS Budget Reconciliation Act (OBRA) of 1990 requires that states provide advanced directives as options for clients.

Advanced directives:

• document that allows clients to make legal decisions about how they wish to receive future medical treatment.

• may indicate who the client wishes to make medical decisions in situations in which the client is unable to do so.

• needs to be signed and witnessed and copies kept on file in the physician's office and the hospital.

• witness to this document should not be a hospital employee who gives direct care, relative or heir to the clients estate - medical social workers are acceptable as witnesses in many states.

• vary among states.

• a living will is a type of advanced directive.