BILL ANALYSIS
AB 3000
Page 1
Date of Hearing: April 22, 2008
ASSEMBLY COMMITTEE ON JUDICIARY
Dave Jones, Chair
AB 3000 (Wolk) - As Amended: February 22, 2008
PROPOSED CONSENT
SUBJECT : RESUSCITATIVE MEASURES: OPTIONAL FORMS
KEY ISSUE : SHOULD CALIFORNIA ADOPT THE PHYSICIAN'S ORDER FOR
LIFE SUSTAINING TREATMENT?
SYNOPSIS
This non-controversial bill seeks to offer the helpful
"Physician's Order for Life Sustaining Treatment" (POLST) order
to the whole of California. The POLST order has shown itself to
help direct what resuscitative means, if any, a patient would
like used in an emergency. These standardized orders are
designed specifically to assist individuals in fragile or frail
health or those diagnosed with a terminal illness. Unlike broad
advanced health care directives, which often are not easily
available to health care personnel, these model forms allow for
specific instructions for what if any resuscitative means are to
be employed. In support of the bill, the bill's health care
entities note the measure can be very helpful for all involved
to make sure the right levels of intervention are employed in
emergency situations that meet the patient's wishes. There is
no known opposition to the measure.
SUMMARY : Seeks to offer and encourage use of the "Physician's
Order for Life Sustaining Treatment" (POLST) order, to help
direct what resuscitative means, if any, a patient would like
used in an emergency. Specifically, this bill would amend the
Probate Code to reflect a broader vision of resuscitative or
life sustaining requests and to encourage the use of POLST
orders to better handle resuscitative or life sustaining
treatment consistent with patients' wishes.
EXISTING LAW currently provides the requirements for the
execution of an advance health care directive, an oral
designation of a surrogate decision maker, and how an advanced
health care directive should be implemented by health care
providers. (Probate Code sections 4600 to 4805.)
AB 3000
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FISCAL EFFECT : As currently in print this bill is keyed
non-fiscal.
COMMENTS : This non-controversial bill would add the
"Physician's Order for Life Sustaining Treatment" (POLST) form
as another helpful statewide mechanism for a patient to disclose
his or her wishes about what if any life sustaining or
resuscitative measures she or he would desire in a
life-threatening situation. This bill does not remove any of
the currently recognized advanced health care directives; rather
it merely seeks to include POLST orders as a helpful option.
Previously, most advanced health care directives focused on "do
not resuscitate" orders. Thus our current body of law refers to
"requests to forego resuscitative measures." However, POLST is a
more specific form which allows more detailed instructions as to
when and to what level resuscitative measures should be employed
on the given individual.
Many advanced health care directives are designed simply to name
a decision-maker for the individual if they become
incapacitated. The named person then makes health care
decisions for the other. These forms are often locked away in
files or safe deposit boxes, and may not be available to health
care providers when the need arises to ensure the patient's
wishes are followed. POLST orders, experience has shown, help
those individuals who are in frail or fragile health or have
been diagnosed with a terminal illness. Additionally, POLST
provides for more detailed instructions. A patient using POLST
may consequently provide more specific and detailed instructions
regarding when, where, to what extent, and under what
circumstances life sustaining resuscitative measures should be
employed.
Most importantly, this measure does not require health care
providers to use POLST. Rather it requires that health care
providers honor POLST orders.
Currently, fifteen states have adopted POLST (Florida, Georgia,
Hawaii, Louisiana, Michigan, Missouri, Nebraska, New Hampshire,
New York, Ohio, Oregon, Tennessee, Texas, Utah, and Washington).
Communities within five other states have also adopted POLST
(Pennsylvania, Minnesota, Nevada, North Dakota, and Wisconsin.)
Additionally, three more states have similar pending legislation
AB 3000
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(Idaho, North Carolina, and West Virginia).
Finally, efforts are already underway in eight California
communities to establish POLST as a recognized and commonly used
tool in their local areas (Alameda, Humboldt, Mendocino,
Riverside, Sacramento, Santa Clara, Ventura, and Woodland).
REGISTERED SUPPORT / OPPOSITION :
Support
California American College of Emergency Physicians
California Association of Health Facilities
California Medical Association
Opposition
None on file
Analysis Prepared by : Drew Liebert and Kent Gray / JUD. / (916)
319-2334