A package of bills sponsored by Assembly Democrats Annette Quijano, Connie Wagner, Herb Conaway, Jr., M.D. and L. Grace Spencer to make end-of-life care decisions easier for New Jersey families has received final legislative approval and now heads to the Governor’s desk.
The first measure (A-3475/S-2197), sponsored by Quijano, Wagner and Conaway, would require the state to create a form called the Physician Orders for Life-Sustaining Treatment (POLST) to enable New Jersey patients to indicate their preferences for health care. The bill was approved by a vote of 60-6-10.
According to POLST.org, the POLST Paradigm program is designed “to improve the quality of care people receive at the end of life. It is based on effective communication of patient wishes, documentation of medical orders on a brightly colored form and a promise by health care professionals to honor these wishes.”
“This bill would help ensure that people receive the medical treatment they desire toward the end of their lives,” said Quijano (D-Union). “The POLST form is a simpler, easier way for families to know what type of medical decisions their loved one would prefer, especially when they’re incapacitated.”
The POLST form would serve as a complementary measure to the use of an advance directive for health care, or in lieu of an advance directive if the patient has not executed such a document. Unlike an advanced directive, which varies in nature and is the responsibility of a patient to have prepared, the POLST form would be a standardized printed document made available to health care professionals and facilities to use with their patients.
“The POLST paradigm is a smart, efficient way for individuals to communicate their medical wishes,” said Wagner (D-Bergen). “It not only helps physicians understand the wishes of their patients, but eases the burden on families who might be overwhelmed during understandably emotional circumstances.”
Under the bill, the Commissioner of DHSS would be responsible for instituting the program and charged with, among other things:
– promoting awareness among health care professionals and the general public;
– encouraging ongoing training of health care professionals about the POLST form; and
– prescribing additional requirements for the completion of a POLST form applicable to a patient with mental illness or a developmental disability;
“This bill would ensure that those individuals receive the care they desire and the dignity they deserve during critical times,” said Conaway (D-Burlington/Camden). “This directive employs a compassionate, yet efficient, model for administering care to vulnerable residents.”
Health care professionals and institutions would be required to treat a patient who has a completed POLST form in accordance with the information contained in the form.
The second bill (A-3839/S-2199), sponsored by Spencer, would establish the New Jersey Advisory Council on End-of-Life Care in the Department of Health and Senior Services. The bill was approved by a vote of 71-4.
The advisory council would be charged with conducting a thorough and comprehensive study relative to the quality and cost-effectiveness of, and access to, end-of-life care services for all residents in New Jersey. The council would also be required to develop and present policy recommendations relating to state agencies, policymakers, health care providers, and third party payers.
“End of life care decisions are often very difficult for loved ones to make, and even more difficult for many to discuss,” said Spencer (D-Essex). “Hopefully this council will help offer the necessary guidance to make this process easier for families.”
In developing its recommendations, the advisory council’s overriding concern would be to promote an end-of-life care paradigm in which patients’ wishes are paramount and they are provided with dignified and respectful treatment that seeks to alleviate their physical pain and mental anguish as much as possible.
The advisory council would be comprised of 21 members, including: the Commissioners of Health and Senior Services and Human Services, or their designees; two members each from the Senate and the General Assembly to be appointed by the President of the Senate and the Speaker of the General Assembly, respectively, who in each case are to be members of different political parties; the Ombudsman for the Institutionalized Elderly or his designee; and 14 public members who are residents of New Jersey, to be appointed by the Governor with the advice and consent of the Senate, with a wide variety of specified backgrounds related to end of life care.
The advisory council would be required to report to the Governor and the Legislature no later than 18 months after the date of its organization on the results of its activities.