I am #2 on a POA for Health for my mother. The POA has been enacted. My brother is #1, and must be consulted first. How do I change the POA?

What does your mother's POA actually say? My mother's POA documents state the secondary can function as the attorney in fact anytime the primary is unavailable for any reason. My brother (who is primary on DPOA) has written a letter stating he has directed to me to act as DPOA when he is unavailable due to work or other unnamed reasons so I could manage some property sales. My understanding from our attorney is that he could write a letter authorizing me to do anything the DPOA covers without resigning. I don't want him to resign because I want him to take over the DPOA responsibilities completely when he retires. I'm primary on HCPOA and he's secondary there.

Well all hail the State of Wisconsin! They get the gold medal for writing their forms and guidance notes in plain, intelligible English, and for designing them for practical purposes. Would you look at this! -

"If I am no longer able to make health care decisions for myself, due to my incapacity, I hereby designate (print name, address and telephone number) to be my health care agent for the purpose of making health care decisions on my behalf. If he or she is ever unable or unwilling to do so, I hereby designate
(print name, address and telephone number) to be my alternate health care agent for the purpose of making health care decisions on my behalf."

Which couldn't be much plainer, simpler or more to the point and is straight from the DHS for Wisconsin's own website at https://www.dhs.wisconsin.gov/forms/advdirectives/f00085.pdf

So for instructions on how brother goes about formally indicating his inability (geographical) and/or unwillingness (because it's just not working very well), I'd give the DHS a call and ask them; but as the website is so good you might find the answer by searching without difficulty, I didn't try that far.

For everyone reading this while their parent still has legal capacity--

1. Hire attorney to draw up a durable power of attorney that names you and sibling as equal co-agents permitted to act independently. Most states allow this. Of course, it only works well if you and sibling are on good terms.

2. Get parent to sign three originals in the attorney's presence--one for you, one for sibling, and one for parent.

3. Even if your parent has some level of dementia, if he or she can understand a simple explanation of the legal document--then the parent probably has "capacity" in the legal sense. The bar is kind of low, in other words, for someone to sign most legal documents. Even if they already have an official diagnosis of dementia.

4. Remember that the power of attorney allows you to act, but it does not stop the demented person from acting. Demented dad can go buy a new car if you take away his old car. Demented mom can take out large amounts of cash from the bank for a "friend." Preventing these scenarios takes more than the piece of paper called the POA.

5. Take POA to parent's bank. You and sibling should go together. Probably no need to bring parent. Just make sure the document is on file at the bank. They will probably scan it and give it right back to you.

Alva is correct. Your brother can resign as POA, allowing you to take over as the 2nd named. It's not a big deal, and it is definitely something that seems logical as you are the one doing all the work, yet being inconvenienced by your brother's distant location.

If I were you, I would consult an elder care attorney just to make sure you do things legally.

So the problem is the sheer impracticality as the arrangement is turning out, it isn't any kind of disagreement between you and your brother? Then I agree - suggest he resigns his POA and allows you to take over as secondary. To help soothe his conscience about "giving up the job" so to speak, you might perhaps volunteer to keep him fully informed of developments and reassure your mother on this point (if she's bothered).

I never would have agreed to be the primary care giver if I had no authority to make any decisions.  Either things are shared or they are not.  If you really needed his input about a life or death decision and felt the need to call to get his input, that is one thing, but to have to wait until the next day to make a decision because he is not available is another.  I would talk with your brother and mother (if she is able) and get the POA reworded if it is not set up to allow you to manage her care effectively and in real time.

Wait, I would not have him resign. I would have a letter that states from this date to this date I am unable to fulfill my duties as POA, attach that to the POA and it should be fine.

If he resigns and God forbid, something happens to you then your mom doesn't have a POA.

If the form states unable or unwilling...then a notarized letter stating unable for a set amount of time (I would do 6 months) should default the POA to you.

Please talk to an elder law attorney before making changes that can not be undone.

If your brother is not wanting to resign, or wants to still be required to be contacted, I suggest you both modify the MPOA to state that if either of you cannot be reached, or has not responded within...say 90 minutes...that the need for contact is waived and the available party becomes acting primary.
Talk to hospital staff for assistance in the wording that they will accept & be able to implement. They won't charge you for that advice/clarification. Be sure to have updated copy on file with all local hospitals, LO's doctors and carry a copy. I would also scan to your phone with signatures, dates and Notarized clearly readable. A copy on a flash drive on your car keys is a good idea. You can also put lists of LO RXs, DRs, allergies, & medical conditions.

Many hospitals won't open the flash drive due to cyber security, but you can run to a office supply or copy center and print it out.

Hope this helps. I think it is good to have everyone in the loop. You should also have a time limit provision for treatment even if neither of you can be reached... including acceptance of responsibility to pay!
An ER will only do minimum to save life & limb in immediate danger of loss without someone signing release to bill insurance & responsibility for any balance.

Also be aware of exact rules the insurance has if there are any required or preferred Networks! Know what qualified as a covered exception and have that kept up to date in written Med. Directive & MPOA. This way hospital is directed in writing to make sure care provider is covered!

You didn't ask this, but if in Network Dr/hospital/clinic utilizes an out of Network Provider insurance should pay or the party authorizing the Out of Network Service is responsible for the bill. You put it in writing.

Generally if a in Network hospital, say uses specialist or Radiologist off site, then insurance is supposed to cover it since you went to Network Provider & have no control of whom they contract with. These Surprise Bills are a big problem these days, but mainly that people don't know their rights.

I had to fight this because the Only practice of Specialist needed were associated with OON hospital across the highway. If they are On all or only one available on staff, then they get grandfathered in for emergency or hospital stay. Outpatient they can require you to drive (50 miles in IL). Again know the rules & regs and put it in the documents. That way you are covered in a crisis.

Good Luck!

(I haven't read thru all the responses; apologies if I'm duplicating.) Since there are two of you listed, please do not get the brother eliminated from POA list. What if something happened to you before your mother is gone? Who would be responsible for her then?

My brother finally told the facility to have me contacted first since I "know more of the medical". From their policy, they are supposed to contact the POA first then they call the next family member and that is me. So from now on, if they have any problems, they call me. I am fine with that. I feel that I can handle her a little better than he can. At least in this situation. There are other people that have the same situation like you do. Pray that things get worked out soon.