MOLST Updates
March 4, 2010
Following the meeting with Reps. Garland and Lehner and interested parties on January 12, it appeared that a consensus had been achieved to permit this legislation to move forward. Since then, there have been concerns expressed by Ohio Right to Life that center mainly on the issue of who can create and/or change a MOLST for an incapacitated patient. National POLST Paradigm consultants have reported that a common point of challenge or confusion in other states centers on a confusion of the intention of advance directives compared with a MOLST/POLST form that are medical orders and not advance directives, per se. A third version of the bill was recently sent to Rep. Garland, the sponsor, for her review.
December 11, 2009
Ohio Right to Life (ORTL) submitted nine amendments to HB 241. Rep. Garland, the bill's sponsor, has hosted several meetings that have included ORTL and representatives from the Honoring Wishes Task Force to attempt some agreements and accommodations. One result of these conversations has been a sub-bill to incorporate several ORTL concerns. There is a follow up meeting planned on Jan. 12 with Rep. Garland and the same interested parties.
September 11, 2009
Ohio Right to Life (ORTL) has submitted 9 amendments to HB 241 that are similar in focus to the amendments they put forth re: HB 601 in the fall of ‘08. Their concerns include details about the granting of immunity and the process of initiating and changing a MOLST. On August 12, a meeting was held with ORTL and several members of the task force along with Rep. Nancy Garland (D) and Rep. Peggy Lehner (R) to attempt to arrive at areas of agreement. The task force has responded to the amendments and concerns of ORTL and are open to changes and accommodations. The next step is a follow-up meeting on September 17 to continue our discussion. Hopefully, this will result in the creation of a substitute bill that will include areas of compromise. After HB 241 is passed in the House, a MOLST bill will need to be created for consideration by the Senate.
Contact Rep. Garland to thank her for her sponsorship and to voice your support! She can be contacted at district20@ohr.state.oh.us.Several revisions of the bill were written. One change called for the removal of the age requirement that previously stipulated that one had to be 18 years of age or older in order to complete a MOLST. The pediatric community requested that change so that the pediatric population could benefit from MOLST. Representative Lynn Wachtmann offered to sponsor the bill and it was introduced in July and assigned House Bill 601.Back to Top
June 23, 2009
The MOLST bill was introduced by Rep. Nancy Garland (R), 20th District, on June 24, 2009 and is HB 241. Rep. Garland, the sponsor of this legislation, was joined by a bipartisan group of 15 representatives as co-sponsors. It has been referred to the Health Committee for hearings.
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February 4, 2009
The second half of 2008 witnessed the following activity related to Medical Orders for Life Sustaining Treatment (MOLST) legislation:
It initially appeared that HB 601 could move out of the Health committee and might pass during the lame duck session before the end of the year. There were three hearings before the health committee. At the first hearing, several interested parties expressed support for the bill. During the second hearing, Ohio Right to Life (ORTL) offered testimony in opposition to the bill and proposed eight amendments. During the third hearing, ORTL was joined in their opposition by Agudath Israel, a group representing some in the Orthodox Jewish community. Much of the concern centered on their perception that the legislation, in its current form, would reduce some of the protections offered to persons currently through advance directives. The Honoring Wishes Task Force has met to discuss the issues raised by ORTL and Agudath Israel and have developed responses to the eight amendments.
MOLST, while having some resonance with advance directives, is a medical order and not formally an advance directive. During the course of discussing the intention of MOLST and its use in other states, one challenging aspect of this initiative has been identified: how to create a vehicle that has fluidity and can be modified to match the treatment needs of patients with advancing chronic illness while honoring their changing preferences. The future plan is for the task force to seek a sponsor to reintroduce the legislation during early 2009.There is a legislative initiative currently in process that addresses the issues of resuscitation preferences along with specifying other treatment decisions. Medical Orders for Life Sustaining Treatment (MOLST) is modeled after the national POLST Paradigm (Physician Orders for Life Sustaining Treatment) that is currently in use in nearly twenty states, including neighboring West Virginia. See www.polst.org for more details about this nationally recognized program that has resulted in significant, positive patient outcomes.
Introduction of this MOLST legislation in the Ohio General Assembly is anticipated soon. If adopted by the General Assembly, an Advisory Council will work together with ODH to develop rules associated with the program's implementation and to design the MOLST order form. The orders will be portable across sites of care and are specifically intended for use by those persons with chronic illnesses, those who are terminally ill, frail elders and others seeking to specify their future treatment preferences. The POLST Paradigm offers a range of treatment options from full aggressive measures to limited interventions.
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May 31, 2008
There have been two postings of proposed drafts of revised DNR rules on the Ohio Dept. of Health website. The second draft was posted in December, 2007 and resulted in opposition to the proposed changes. Ohio Dept. of Health (ODH) is prepared to forgo instituting any changes at present in view of the difficulty achieving consensus.
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