A new law (Assembly Bill 637) recently signed by Gov. Jerry Brown will allow nurse practitioners (NP) and physician assistants (PA), under the direction of a physician and within their scope of practice, to sign Physician Orders for Life-Sustaining Treatment (POLST) forms and make them actionable medical orders. The law goes into effect on January 1, 2016.

The POLST form is a legally recognized document that outlines a plan of care reflecting patients’ wishes concerning medical treatment and interventions toward the end of their lives.

The California Medical Association (CMA) co-sponsored AB 637, citing the importance of POLST as a tool for honoring end-of-life care preferences. The new law will result in increased use of POLST orders by allowing nurse practitioners and physician assistants the ability to sign the document so that it legally goes into effect immediately. Therefore, patients can exercise more control over the medical treatment they receive.

End-of-life conversations are never simple, but POLST is a powerful tool for physicians to use to help patients consider the level of care they want and need at the end of life. Thoughtful end-of-life planning can make a patient’s last few weeks, months, or even years far more satisfying.

CMA publishes a POLST Kit, which includes legal forms and wallet identification cards, and answers frequently asked questions about end-of-life issues. Physicians are encouraged to keep a supply of forms in their offices for use when having end-of-life discussions with patients.

For more information on POLST, see CMA On-Call document #3451, "Decisions Regarding Life-Sustaining Treatment: Advance Directives and POLST."

POLST Kits can be purchased from CMA’s online store. Single copies are $5 for members ($6 for nonmembers). Significant discounts are available on bulk purchases. For bulk purchase inquiries, please call CMA Publications at (800) 882-1262.