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Legislative Changes

The 2018 New York State legislative session ended in June. Legislation signed by Governor Cuomo has resulted in amendments to the Health Care Proxy Law as outlined in the Authority of Nurse Practitioners under Current NYS Law. The proposed legislation is critical to the MOLST program and will be reintroduced in 2019.

Proposed Legislation

Combined Health Care Proxy and eMOLST Registry Bill

Patients deserve a statewide registry for health care proxies and MOLST. To recognize why this is critically important, read this article.

Assemblyman Joseph Morelle introduced new legislation (A9063) in 2018 related to the eMOLST Registry, combining the prior eMOLST Registry legislation with a proposal to require the Department of Health (DOH) to develop a health care proxy registry.  The bill defines “Medical Orders for Life Sustaining Treatment (MOLST)” under the Public Health Law and directs the Department to establish an electronic registry for health care decision medical orders and documents, placing both the eMOLST program and registry for health care proxies under one Health Care Decisions Document Registry. The bill was referred to the Assembly Health Committee with 14 co-sponsors, including a number of members on the Assembly Health Committee.  Unfortunately, it never moved out of the Assembly Health Committee and was not introduced in the Senate.

This legislation is critical to the continued success of the MOLST Program. New sponsors for an Assembly and parallel Senate bill are needed, as former Assemblyman Morelle is now a member of the US Congress.

In addition, we need volunteers willing to educate your local Senators and Assembly members about MOLST and share the value of eMOLST in improving quality & patient safety, ensuring accessibility in an emergency and achieving the quadruple aim. We need to introduce and pass legislation during the 2019 session. If interested, please contact Dr. Patricia Bomba

The bill introduced in 2018 contains a critical provision that would require practitioners who complete a MOLST form to submit to the Registry within 14 days.  By requiring health care professionals to submit completed MOLST forms to the registry, the bill will ensure the most current MOLST form is accessible in an electronic format, allowing for a patient’s end-of-life preferences to be followed as he or she moves through the health care system, facility to facility, physician to physician.  Other states that have established MOLST (or POLST) registries have included mandatory submission as a necessary component of operating the registry.   In efforts to support the submission of MOLST forms, the MOLST program has already developed optical scanning recognition system that simplifies the process for practitioners to submit paper versions of the MOLST to eMOLST.

Requiring the DOH to create a health care proxy registry is an important step. Promoting early advance care planning discussions and completion of health care proxies for all New Yorkers 18 years of age and older complements the thoughtful MOLST discussions and completion of the MOLST for seriously ill patients who might die in the next year. Access to a properly completed health care proxy is vital in completing a MOLST for patients who lack the capacity to make decisions that are well informed using a shared decision making model. It assures that end-of-life decisions are being made by the person the incapacitated patient trusts and is made by known wishes.

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The MOLST Update is a Newsletter dedicated to providing up-to-date information on advance care planning, MOLST and eMOLST.