Health care decisions: life-sustaining treatment

It expands who may help execute these orders, permits electronic signatures, and recognizes qualifying out-of-state forms. It also reinforces that POLST and do-not-resuscitate decisions are voluntary.

What the law does ​

• Renames Physician Orders for Life Sustaining Treatment as POLST, also meaning Portable Orders Listing Scope of Treatment.
• Allows a patient with capacity, or an authorized health care agent, conservator, or surrogate in specified circumstances, to sign a POLST or other resuscitation request with a physician, qualifying nurse practitioner, or qualifying physician assistant.
• Requires providers to explain the POLST and its treatment options, base it on patient preferences and medical indications, and distinguish it from an advance health care directive.
• Bars providers and facilities from conditioning care or admission on completing or declining a POLST or prehospital do-not-resuscitate order.
• Allows electronic signatures for required resuscitation-request signatures.
• Treats qualifying resuscitation orders made in other states or jurisdictions as valid in California and lets providers presume an order is valid and unrevoked unless they know otherwise.
• Requires forms printed after January 1, 2027, to include an acknowledgment by an agent, conservator, or surrogate that the request reflects the patient’s known wishes and best interests.

Who it affects ​

• Patients making decisions about resuscitation or life-sustaining treatment.
• Health care agents, conservators with health care decisionmaking authority, surrogates, and facility care teams acting for patients without capacity.
• Physicians, nurse practitioners, physician assistants, emergency responders, health care providers, and health care facilities.
• Public patient representatives participating in reviews of POLST, do-not-resuscitate, comfort-care, or hospice decisions.