Short Answer

Yes. In North Carolina, you can sign only a Health Care Power of Attorney (medical power of attorney). That document typically authorizes your named health care agent to receive your medical information to make decisions, so a separate HIPAA release is not required for your agent. A standalone HIPAA authorization is useful if you want other people (besides your agent) to get updates or if you want information shared before the power of attorney activates.

Understanding the Problem

You want to know whether, under North Carolina law, you can move forward with only a Health Care Power of Attorney and skip a separate HIPAA authorization while planning for a parent’s incapacity. You’re comparing a bundled fee for multiple documents versus a lower fee for a medical power of attorney alone and need clarity on what each document allows so you can choose the right mix.

Apply the Law

Under North Carolina law, a Health Care Power of Attorney (HCPOA) lets you appoint a health care agent to make medical decisions if you cannot. The statutory HCPOA form generally authorizes your agent to access and disclose protected health information needed to carry out those decisions. A separate HIPAA authorization is optional and typically used to let people who are not your agent (for example, family members) receive information or to allow information sharing before the HCPOA becomes effective. The HCPOA is a private document, not filed with a court; it becomes effective as the document specifies (commonly upon a physician’s determination of incapacity, unless you choose immediate authority).

Key Requirements

• Capacity and age: The principal must be a competent adult at signing.
• Execution formalities: Sign before two qualified witnesses and a notary public.
• Trigger of authority: Typically activates when a physician (or as specified) determines you lack capacity; you may choose immediate authority.
• Access to medical information: Your agent is usually authorized within the HCPOA to receive and disclose medical records needed to decide on treatment.
• When to add HIPAA: Use a separate HIPAA release if you want non‑agents to get updates, or if you want information shared before your HCPOA activates, or to cover specific providers/insurers.
• Guardianship coordination: If a court later appoints a guardian of the person, the court can suspend the agent’s authority for good cause, but it isn’t automatic.

What the Statutes Say

• North Carolina Gen. Stat. § 32A-16 (Execution of health care power of attorney) – Sets signing, witnessing, and notarization requirements.
• North Carolina Gen. Stat. § 32A-19 (Powers of health care agent) – Describes the scope of an agent’s medical decision‑making authority.
• North Carolina Gen. Stat. § 32A-20 (Effective time; duration; limited post‑death authority) – Explains when an HCPOA becomes effective and limited authority that can continue after death for final arrangements.
• North Carolina Gen. Stat. § 90-321 (Right to a natural death) – Governs living wills and end‑of‑life directions, which can complement an HCPOA.

Analysis

Apply the Rule to the Facts: If you choose only a Health Care Power of Attorney for your parent, the agent named in that document can generally access necessary medical records to make decisions, so a separate HIPAA authorization is not required for that agent. If you want additional family members to speak with doctors or receive updates, or you want information shared before the HCPOA activates, add a standalone HIPAA release. A living will and a financial power of attorney address different needs and are not replaced by the HCPOA.

Process & Timing

1. Who files: No court filing. Where: Sign the Health Care Power of Attorney before a notary with two qualified witnesses in North Carolina. What: Use the statutory Health Care Power of Attorney form and, if desired, a separate HIPAA authorization. When: Complete while the principal has capacity; the HCPOA typically activates upon a physician’s determination of incapacity unless made immediate.
2. Provide copies to the health care agent and the parent’s primary providers. Consider carrying a wallet card and, optionally, registering the directive with the North Carolina Advance Health Care Directive Registry.
3. Review documents annually or after major health or family changes. Replace copies with updated versions so providers rely on the most current documents.

Exceptions & Pitfalls

• If the HCPOA activates only upon incapacity, your agent may be blocked from records until a provider certifies incapacity; a separate HIPAA release can allow earlier information sharing.
• Providers sometimes ask for their own HIPAA forms; sign them to avoid delays.
• Want siblings or caregivers to receive updates? Name them on a HIPAA authorization; the HCPOA alone typically covers only the agent.
• If a court appoints a guardian of the person later, the HCPOA does not automatically end; the court must suspend the agent’s authority for good cause, and providers are protected until they get actual notice.
• Your health care agent’s limited authority can continue after death for organ donation, autopsy, or disposition of remains; plan accordingly if you prefer someone else handle final arrangements.

Talk to a Estate Planning Attorney

If you’re deciding which incapacity documents to include and how they work together, our firm has experienced attorneys who can help you understand your options and timelines. Call us today at 919-341-7055.

Disclaimer: This article provides general information about North Carolina law based on the single question stated above. It is not legal advice for your specific situation and does not create an attorney-client relationship. Laws, procedures, and local practice can change and may vary by county. If you have a deadline, act promptly and speak with a licensed North Carolina attorney.