An act to amend Sections 1799.103 and 1861 of the Health and Safety Code, to amend Sections 4780, 4781.2, 4781.4, 4781.5, 4782, and 4783 of the Probate Code, and to amend Section 9270 of the Welfare and Institutions Code, relating to health care.
SB 1088 updates California law governing POLST forms and other requests regarding resuscitative measures, which are medical orders used to communicate a patient’s wishes about CPR and other life-sustaining treatment. The bill replaces the longer term “Physician Orders for Life Sustaining Treatment” with “POLST,” and expands who may complete or sign these forms to include a patient with capacity or, when appropriate, a health care agent, conservator, or surrogate, together with a physician, nurse practitioner, or physician assistant acting under physician supervision.
The bill also makes the POLST process more flexible and portable. It states that completion of a POLST or do-not-resuscitate order is entirely voluntary and cannot be required as a condition of care or facility admission. It allows electronic signatures, requires a date on the form but does not invalidate a form if the date is missing, and provides that valid out-of-state POLSTs or similar orders are enforceable in California. It also clarifies that providers may presume a POLST is valid and unrevoked unless they know otherwise, and it makes conforming changes across the Probate Code, Health and Safety Code, and Welfare and Institutions Code.
SB 1088 would amend multiple sections of the Health and Safety Code, Probate Code, and Welfare and Institutions Code to standardize and broaden the legal treatment of POLST forms in California. It would update definitions, authorize additional signers and health care professionals, recognize electronic signatures, preserve validity despite certain clerical omissions, and require California providers to honor qualifying out-of-state orders. The bill also reinforces that patients cannot be pressured into completing a POLST and preserves provider immunity when acting in good faith reliance on a valid order.
The available voting history suggests broad support and little opposition. The bill passed committee unanimously in both recorded votes, first 11-0 and then 12-0, indicating a strong consensus that the changes are administrative and patient-centered rather than controversial. No committee transcript excerpts were provided, so the record available here shows favorable treatment without documented floor or committee debate.
The main policy issues embedded in the bill are procedural rather than ideological: who may sign POLST forms, whether electronic signatures should count, how to treat missing dates, and whether California should recognize out-of-state orders. The bill also touches on the balance between honoring patient wishes and allowing providers or facilities to refuse medically ineffective or nonstandard treatment. Because the votes were unanimous and no transcript objections are available, there is no clear evidence of organized opposition in the materials provided, though the recognition of surrogate authority and out-of-state forms could be the most likely points of legal or clinical concern.