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Senate committee advances bill to modernize POLST and DNR rules
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Summary
SB 1088 would modernize POLST and prehospital DNR rules (recognize NP/PA signatories, allow electronic signatures, clarify voluntariness and reciprocity), aiming to reduce confusion and improve advanced care planning across settings.
Sen. Blakespear introduced SB 1088 to update the Portable Orders for Life‑Sustaining Treatment (POLST) and prehospital DNR statutes. The proposal allows physician assistants and nurse practitioners to sign POLST and DNR forms, clarifies that POLST completion is voluntary and cannot be a condition of care, permits recognition of out‑of‑state POLST forms and authorizes electronic signatures to ease use in electronic medical records.
Jennifer Ballantine, CEO of the Coalition for Compassionate Care of California, cited a statewide survey showing confusion about the forms and errors in practice and supported narrow, operational changes. Several clinical nurse specialists testified that the bill could be improved by authorizing clinical nurse specialists to sign POLST forms in recognition of their expertise and to improve access in underserved areas; the author said that expansion of signatory authority for CNSs would be a separate scope‑of‑practice conversation.
Senators praised efforts to reduce confusion and update statutes but noted professional‑scope concerns raised by some witnesses. The committee moved SB 1088 and placed it on call for procedural completion.
