Test Drive Our New Site! We have some improvements in the works that we're excited for you to experience. Click here to try our new, faster, mobile friendly beta site. We will be maintaining our current version of the site thru the end of 2024, so you can switch back as our improvements continue.
Legislation Quick Search
06/15/2024 10:02 AM
Pennsylvania House of Representatives
Home / House Co-Sponsorship Memoranda

House Co-Sponsorship Memoranda

Subscribe to PaLegis Notifications

Subscribe to receive notifications of new Co-Sponsorship Memos circulated

By Member | By Date | Keyword Search

House of Representatives
Session of 2021 - 2022 Regular Session


Posted: April 20, 2021 12:58 PM
From: Representative Paul Schemel
To: All House members
Subject: Pennsylvania Orders for Life Sustaining Treatment (POLST)
In the near future, I plan on introducing legislation (Prior HB 987) that would amend Title 20 (Decedents, Estates and Fiduciaries) of the Pennsylvania Consolidated Statutes to update and revise Pennsylvania law to include the codification of Pennsylvania Orders for Life Sustaining Treatment (POLST) to be used by medical professionals across all health care settings for patients who voluntarily wish to execute a POLST order. POLST orders are different from advance directives in that POLST orders convert an individual’s wishes regarding health care into a medical order that is immediately actionable and applicable across all health care settings. In contrast, advance directives often only name a surrogate decision-maker to make health care decisions for the individual or often lack specificity as to the individual’s goals and preferences for a medical condition that subsequently develops because it was not foreseen by the individual.

POLST legislation has been offered previously in both the House and Senate, but has continuously failed to gain the support of all parties engaged in providing healthcare for the elderly, specifically, it did not have the support of the 44 Catholic hospitals and nursing facilities in Pennsylvania. This legislation includes a compromise, which should suit the objectives of all parties. The compromise language clarifies that a POLST is only appropriate for an individual with a life limiting and irreversible condition.

Speaker Cutler offered the 2017-18 POLST legislation and his co-sponsorship memo provided a detailed explanation of what a POLST is and how it is used by medical providers. The description below in bold is taken from the Speaker’s memo of that session.

In 2006, Title 20 was amended by Act 169 to update the procedures for living wills, health care powers of attorney and out-of-hospital do not resuscitate (OOH-DNR) orders. In addition, Act 169 created a committee to assist the Department of Health (DOH) in determining the advisability of using a standardized form containing orders by qualified physicians that detail the scope of medical treatment for patients’ life-sustaining wishes. However, Act 169 did not mandate the use of a POLST form as a medical order. My legislation will codify a POLST form that may be used by individuals wishing to designate end of life wishes and discontinue the use of OOH-DNR orders following the effective date of my legislation.

The first part of our legislation will update Chapter 54 of Title 20 to include the recognition of POLST orders. The majority of our legislation creates new Subchapter F known as the Pennsylvania Order for Life Sustaining Treatment Act. New Subchapter F will:
  • Make clear that POLST forms are not to be used to advance or support euthanasia, suicide or health care practitioner-assisted suicide.
  • Health insurer prohibitions: Prohibit insurers from certain actions regarding POLST orders, including requiring an individual to consent to a POLST order or to have a POLST order as a condition for being insured, prohibit insurers from charging an individual a different rate whether the individual consents to a POLST order or has a POLST order, and prohibit an insurer from requiring a health care provider to have a policy to offer a POLST order to any individual.
  • Health care provider restrictions: Prohibit health care providers from adopting policies that require individuals to have a POLST order as a condition for treatment or admission to a facility.
  • DOH responsibilities: Create a POLST Advisory Committee headed by the Secretary of Health to advise DOH on POLST-related matters, including but not limited to the format and content of the POLST form and education about POLST orders. DOH would be required to adopt and update a POLST form as needed; develop and update basic education materials on POLST orders; and make the POLST form and its educational materials available and accessible through the Internet.
  • Requirements for a valid POLST order: Require specific information be provided on the POLST form, including: completion of the medical order section regarding CPR, the individual and health care practitioner’s signatures, and procedures when a verbal POLST order shall be accepted as a valid POLST order.
  • Portability and transfer requirements: Ensure that POLST orders are valid anywhere within the Commonwealth, including health care facilities, the individual’s residence, vehicle transits from one health care facility to another and other care settings outside of a health care facility. My bill will also require a health care facility that transfers an individual to another health care facility to provide a copy of the POLST order to the receiving health care facility.
  • Emergency medical services: Set forth requirements for EMS providers in complying with POLST orders.
  • Immunity: Provide immunity for health care providers and other persons for complying with a POLST order based upon a good faith assumption that the order was valid.
 I have attached the current legislation and I hope you will consider joining me as a cosponsor. 


View Attachment

Introduced as HB2394