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With the introduction of California Assembly Bill 1234, CCCC took an important step forward in our efforts to bring advance care planning into the electronic age and our longstanding efforts to make POLST information available to healthcare providers statewide.

AB 1234 would:

  • Enact the California POLST eRegistry Act, which would require the California Health and Human Services Agency to create a statewide electronic POLST registry system.
  • Require the agency to promulgate regulations necessary for the operation of the POLST eRegistry and set timelines for implementation.
  • Explicitly allow an electronic representation of a POLST form and the electronic communication of the information contained in a POLST form to have the same legal standing as a paper hardcopy of a POLST form.
  • Explicitly allow an electronic signature to be used for the purposes of an advance health care directive and POLST form.

CCCC was fortunate to secure Assemblymember Joaquin Arambula (D-Fresno) as the bill’s author and legislative champion. As an emergency room physician, Dr. Arambula has first-hand experience with the value of POLST in delivering goal-oriented, person-centered care.

“It’s vital that we establish a reliable, uniform, and modernized electronic system that provides clarity and immediate availability of patients’ treatment preferences,” said Assemblymember Arambula. “My experiences as an emergency room doctor for 10 years showed me the importance of having this information in hand as quickly as possible. At its core, this improvement puts our patients’ interests and care at the forefront, where it should be.”

CCCC believes that this is the right moment in time to introduce this legislation because:

  • COVID-19 has heightened the need for advance care planning while, at the same time, social distancing and other efforts to reduce disease spread make it harder to complete, sign, and access POLST and advance directive forms.
  • The increase in use of telehealth and other forms of virtual care has highlighted a critical need to update state statute with regard to use of electronic forms of POLST and electronic signatures, and ensure that patient treatment wishes are honored.
  • Leadership by the State of California is needed for the POLST registry effort in California. Local POLST registries have already begun to pop up organically in California – four are operating independently in the state. While this is a good sign of interest and support for a registry, it also points to the need for state leadership and consistent registry standards to support quality and statewide interconnectivity.
  • Establishing a statewide POLST registry will require a financial investment. Given that California expects to have a budget surplus this year, a POLST registry would be an important and valuable capital investment.

“We believe that our work over the past few years with POLST and POLST registry stakeholders has created a solid foundation of support for the development of a statewide POLST registry,” said CCCC’s CEO Judy Thomas, JD. “Creating a statewide POLST registry in a state the size of California is a huge undertaking, but I think we’re ready now to take that next big step with this legislation.”

How You Can Help

AB 1234 will make its first stops in the legislative process in hearings before the Assembly’s Health and Judiciary committees. Due to COVID-19 restrictions, legislative committee hearings are being conducted virtually, but supporters will still have an opportunity to weigh in on AB 1234. The hearing dates and times have not yet been set, but will likely be announced in early April. CCCC members are encouraged to write letters of support, as well as attend the virtual hearing.

Please watch your email for CCCC’s announcement of how to write a letter of support, the hearing dates, and instructions for participating in grassroots support for AB 1234.

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