California’s program for Physician Orders for Life-Sustaining Treatment (POLST) has received the highest level of recognition from the National POLST Paradigm, which establishes and oversees national standards for POLST.
The National POLST Paradigm
announced today that California’s POLST program has achieved Mature status, a level reserved solely for programs in which POLST is implemented in every region of a state, and is used by 50 percent or more hospitals, nursing homes, and hospices. In addition, more than 75 percent of Emergency Medical Services (EMS) must have POLST protocols for a state to achieve Mature status.
In California, the POLST Paradigm program is run by the Coalition for Compassionate Care of California
under the direction of CEO Judy Thomas, JD. The Coalition for Compassionate Care of California sponsored the legislation which established POLST in California. AB 3000 (Wolk) was passed unanimously and went into effect in January 2009.
“We’re excited to join Oregon and West Virginia as the only states recognized as having a Mature POLST program,”
said Judy Thomas during an address at the Coalition for Compassionate Care of California 8th Annual Summit.
“Mature status would not be possible without the many volunteers who supported POLST legislation in California, and the grassroots efforts of the 27 local POLST coalitions who worked with us to design and spread the POLST education curriculum now used by many POLST programs around the country.”
POLST is a medical order signed by both a patient and physician, nurse practitioner or physician assistant that specifies the types of medical treatment a patient wishes to receive toward the end of life. POLST is also a tool that encourages conversation between providers and patients about their end-of-life treatment options, and helps patients make more informed decisions and communicate their wishes clearly. As a result, POLST can prevent unwanted treatment, reduce patient and family suffering, and help ensure patient wishes are followed.
“The Coalition for Compassionate Care of California was successful at implementing POLST because they built a strong implementation model by forming coalitions comprised of stakeholders representing a diverse array of interests,” said Amy Vandenbroucke, executive director of the National POLST Paradigm. “We are pleased to recognize California’s POLST program, particularly since Judy Thomas has been so willing to mentor other developing states by sharing the California model.”
In 2015, the Coalition for Compassionate Care of California sponsored two POLST-related bills and both were signed by Governor Jerry Brown. AB 637 (Campos) allows nurse practitioners and physician assistants – under the supervision of a physician and within their scope of practice – to sign POLST forms and make them actionable medical orders. SB 19 (Wolk) requires the State to establish and operate a statewide digital registry for the purpose of collecting POLST forms received from health care providers.
“Compared with the rest of the country, Judy Thomas and the Coalition for Compassionate Care of California championed POLST legislation in a relatively short period of time by being able to get the nation’s most populous, diverse and arguably most complicated state to pull in one direction,” said Susan Tolle, MD, professor of medicine at the Center for Ethics in Healthcare at the Oregon Health & Science University. Tolle is also a founding member of the Oregon and National POLST task forces. “The Coalition’s ability to bring people together, form consensus, and develop models for education and training are on the leading edge.”
Currently, there are 47 states throughout the country which have received some level of formal acknowledgement from the National POLST Paradigm.