The dream of a statewide POLST registry in California took a huge step toward becoming a reality late Monday when Governor Gavin Newsom signed the main 2021-2022 state budget bill (SB 129) which includes a $10 million appropriation for the California Emergency Medical Services Authority (EMSA) to develop a POLST eRegistry in consultation with the Coalition for Compassionate Care of California (CCCC) and other stakeholders.
SB 129 provides the overall architecture of the 2021-22 state budget, which includes an unprecedented $196 billion in general fund spending and relies on an estimated $80 billion surplus. It also puts more than $25 billion into reserves, including $15 million in the state’s Rainy Day Fund. Other budget bills, known as trailer bills, will provide more detail on the spending and are expected to make it to the Governor’s desk for signature before the legislature adjourns for its annual Summer Recess on July 16.
In addition to a one-time allocation of $10 million in state funding for the POLST registry, trailer bill language currently includes an additional $750,000 per year in ongoing spending to strengthen the POLST ecosystem and prepare patients and providers for the future registry.
The budget allocations are the culmination of years of effort spearheaded by CCCC to support electronic exchange of POLST information whenever and wherever it is needed to support person-centered care.
“We are incredibly excited and thankful to the Governor and Legislature for recognizing the value a statewide POLST registry will bring to California, particularly for seriously ill individuals who express their treatment wishes through POLST and the licensed medical providers who rely on POLST to support them in delivering care that aligns with patients’ goals and wishes,” said CCCC CEO Judy Thomas.
As the operational home of the California POLST program since its inception in 2008, CCCC has worked collaboratively with other stakeholders to advance POLST in California through education and advocacy. The work has been largely funded through philanthropic grants to CCCC from the California Health Care Foundation, charitable donations, and CCCC membership dues.
EMSA is the state administrative authority in charge of the POLST form, and will take the lead in the POLST registry project and contracting. This will be the first time the state has invested significant time and resources into POLST, and CCCC hopes to work closely with EMSA to provide education and lead quality improvement efforts.
The 2021-2022 budget negotiations were like no other. COVID-19 limited face-to-face meetings and changed the way budget details were negotiated. And, despite a year of pandemic-related business closures and costly wildfires, California built an $80 billion budget surplus going into the 2021-2022 fiscal year, thanks largely to Silicon Valley and the surging stock market. With a huge surplus on the table, legislators and advocacy organizations like CCCC saw a rare opportunity to get a piece of the surplus pie to fund special projects and restore funds lost due to previous cutbacks.
“I don’t think we’ll ever see this kind of opportunity again. The stars were aligned for securing state funding for the POLST registry and ecosystem, so CCCC went all in with our advocacy,” said Thomas. “Thankfully, we had the support of Assemblymember Dr. Joaquin Arambula, who submitted our proposal to the Legislature and administration and shepherded it through the budget process. We also had great engagement from POLST champions and stakeholder organizations who responded to CCCC’s requests for letters of support to the budget committees and Newsom administration. That grassroots support really helped raise awareness of our issues during the tumultuous budget process.“
“This budget represents the largest recovery plan in the nation – a plan that will not only sustain California’s recovery, but accelerate it by providing immediate relief to those that need it most and tackling some of California’s most persistent and stubborn challenges,” said Governor Newsom. “From providing stimulus checks to middle class Californians and immediate relief for small businesses, to transforming our public schools, addressing the homelessness crisis head-on, and making major investments in nation-leading climate change actions, this budget represents a once-in-a-generation opportunity to reimagine what California’s future can look like.”
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Join us for an exclusive CCCC MEMBERS ONLY webinar as Judy Thomas, JD, discusses CCCC’s recent efforts to shape public policy, and the many opportunities still open for driving change in the movement to transform serious illness care, including the California Master Plan for Aging; the State Budget allocation for the POLST Registry; CalAIM; and current legislation.
Special guests include Assemblymember Dr. Joaquin Arambula, and Amanda Lawrence, Master Plan for Aging Project Director, California Department of Aging.
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