Senate Bill 1088, sponsored by the Coalition for Compassionate Care of California (CCCC) and authored by Sen. Catherine Blakespear of Encinitas (D-38), is working its way through the Senate with very little opposition. This bill will improve processes around POLST in several ways.
First, the name of POLST will be changed from Physician Orders for Life-Sustaining Treatment to Portable Orders Listing Scope of Treatment. This will acknowledge that signing POLSTs is not limited to physicians, and also remove the somewhat value-laden language of “life-sustaining treatment,” which suggests categorically that doing CPR on a 102-year-old, 79-pound patient will be “life-sustaining.”
Next the bill will explicitly allow for electronic signatures on POLST forms. As the Emergency Medical Services Authority (EMSA) prepares to roll out the statewide POLST registry, it will be important to ensure that electronic signatures are acceptable. The bill also will direct healthcare professionals to honor POLST-type orders from other states, and will standardize the language around who is authorized to sign POLST forms on behalf of incapacitated patients–currently the language is “legally recognized decisionmaker,” which will change to “surrogate.”
Finally, although the directive (often ignored by skilled nursing facilities) that POLST is never mandatory is written prominently on the actual POLST form, that is nowhere in the statute, so SB 1088 will clarify that POLST completion cannot be required for any purpose (such as admission to a skilled nursing facility or residential care facility).
So far, the bill has been heard and voted up in the Senate Health and Senate Judiciary Committees. Jennifer Ballentine, CEO of CCCC, testified at Senate Health, and I was honored to testify at Senate Judiciary–where there was no opposition and the vote was all “Ayes.” Next step was a vote on the Senate floor, also unanimously approved, and now it will go to the Assembly, where the Health and Judiciary Committees will hear testimony and vote. A few non-substantive amendments are expected, but we are hopeful that SB 1088 will sail through the Assembly too.
CALTCM has supported this legislation and looks forward to the improved POLST processes SB 1088 is expected to bring. It’s another example of how our advocacy work can yield meaningful results. If you are interested in getting more involved in legislative and advocacy efforts, please join our Policy & Professional Services Committee! Contact Barbara Hulz ([email protected]) for more information.
Good work, Karl! You are a major LTC dude!!!!