BILL ANALYSIS
AB 3000
Page 1
CONCURRENCE IN SENATE AMENDMENTS
AB 3000 (Wolk)
As Amended July 2, 2008
Majority vote
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|ASSEMBLY: |76-0 |(May 1, 2008) |SENATE: |35-0 |July 10, 2008 |
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Original Committee Reference: JUD.
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.
The Senate amendments add helpful clarifications to the bill
including:
1)Adding legislative intent that it is important for people to
make health care decisions before it is necessary.
2)Adding language that health care planning is a process, rather
than a single decision, that helps individuals think about the
kind of care they would want if they become seriously ill or
incapacitated, encouraging them to talk with their loved ones
and physicians.
3)Noting that a legally recognized health care decision maker
may execute the POLST form only if and when the individual
lacks capacity, or the individual has designated that the
decision maker's authority is effective pursuant to Probate
Code Section 4682.
4)Clarifying that the POLST form shall be completed by a health
care provider based on patient preferences, and medical
indications, and signed by a physician
5)Specifying that a physician may conduct an evaluation of the
individual and, if possible, in consultation with the
AB 3000
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individual, or the individual's legally recognized health care
decision-maker, issue a new order consistent with the most
current information available about the individual's health
status and goals of care.
6)Reiterating that an individual with capacity may, at any time,
request alternative treatment to that treatment that was
ordered on the form.
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.
AS PASSED BY THE ASSEMBLY , this bill was substantially similar
to the version approved by the Senate.
FISCAL EFFECT : None
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
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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
(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).
Analysis Prepared by : Drew Liebert / JUD. / (916) 319-2334
FN: 0005939