Senate Bill S966

                                 BILL NUMBER:  S966

 TITLE OF BILL :

An act to amend the public health law, in relation to the
establishment of a registry system for medical orders for
life-sustaining treatment (MOLST)

 PURPOSE :

To support the long-term sustainability of the Medical Orders for
Life-Sustaining Treatment (MOLST) program by expressly referencing the
MOLST program in statute, creating an e-MOLST registry, and provide
for mandatory submission to the registry in order to accelerate the
digital transformation of the MOLST program.

 SUMMARY OF PROVISIONS :

Section 1 amends Section 2994-dd of the Public Health Law to expressly
reference and define the MOLST program in statute.

Section 2 amends the Public Health Law to direct the Department of
Health, or a designee of the Department of Health, to establish and
maintain an electronic system for collecting, maintaining, and
transmitting MOLST forms, to be known as the "New York State e-MOLST
Registry".
              

Section 3 amends the Public Health Law to require a health care
provider that completes and signs a medical order form DOH-5003 MOLST
or the electronic version of DOH-5003 MOLST ("eMOLST") to submit a
copy of the completed form to the Registry within fourteen days of
completion.

Section 4 prohibits the imposition of fees on practitioners or
patients that use MOLST or eMOLST to fund the operation of the
Registry.

Section 5 authorizes the Commissioner of Health to promulgate rules
and regulations necessary to establish, operate and maintain the
Registry.

 JUSTIFICATION :

The MOLST program, developed with the assistance of Excellus Blue
Cross Blue Shield and in collaboration with the Department of Health,
has grown into a statewide program that assists physicians and other
health care providers discuss and convey a patient's wishes regarding
cardiopulmonary resuscitation (CPR) and other life-sustaining
treatment. The MOLST form is the only authorized form in New York for
documenting both nonhospital DNR and DNI orders. The form is
beneficial to patients and providers as it provides specific medical
orders and is recognized all health care settings, including the
community. The MOLST program has grown to include a secure web-based
electronic version of the MOLST Form (eMOLST) and an electronic
database centrally housing eMOLST forms to allow 24/7 access in an
emergency.

New York has been a national leader in advanced care planning and
providing patients with opportunities and consumer protections to
ensure their preferences for treatment at the end of life are honored.
Recently, other states have passed legislation and invested
significant resources to further advance and sustain their MOLST
programs. This Bill would enhance the public-private partnership of
the program to ensure that it continues to benefit the residents of
New York.

The goals of the MOLST program align with the Department's development
innovative payment models and the triple aim. Health care policy is
beginning to recognize the importance of advance care planning. CMS
recently began reimbursing health care professionals for providing
advance care planning services to Medicare and Medicaid members. New
York State insurers have reimbursed health care professionals for
MOLST discussions and end of life care planning. Advancement of this
program will allow for more New York residents to ensure their
preferences for treatment at the end of life are honored.

 LEGISLATIVE HISTORY :

S.7883/A.10644 of 2016; Referred to Health

 FISCAL IMPLICATIONS :

Minimal.

 EFFECTIVE DATE :
This act shall take effect immediately.