Budget Amendment ID: FY2023-S4-626
EHS 626
Portable Orders for Life Sustaining Treatments (POLST)
Mr. Cyr, Ms. Jehlen, Ms. Lovely and Messrs. Feeney and Hinds moved that the proposed new text be amended moves to amend the bill by adding the following sections:-
SECTION X. Chapter 19A of the General Laws is hereby amended by adding the
following section:- Section 44. (a) To facilitate the effective and efficient use of portable medical orders across care settings, the department shall, notwithstanding any general or special law to the contrary, develop, implement, and administer a program governing the statewide use of Portable Orders for Life Sustaining Treatment (POLST) in Massachusetts. The POLST program shall transition from the use of Medical Orders for Life-Sustaining treatment (MOLST) to the national POLST model. The department shall consult with the department of public health and the executive office of health and human services in the development and implementation of the POLST program.
(b) Any patient information submitted to or held by the POLST program shall be kept confidential and shall be exempt from disclosure under clause Twenty-sixth of section 7 of chapter 4 and chapter 66 and shall be governed by the provisions of chapter 66A.
(c) The department may develop, implement, and administer a secure electronic system as part of the POLST program. The electronic POLST (ePOLST) system shall be a secure electronic database or other similar secure software or information system that enables automated query and retrieval of POLST program information by a health care professional. The department shall promulgate regulations governing the protection of and access to POLST information. POLST Program (patient) information includes, but is not limited to, POLST forms, health care proxy forms, guardianship documentation, and clinical notes documenting conversations that led to the creation of POLST forms.
(d) The department shall establish and maintain procedures to ensure that POLST patient information that may be collected, recorded, transmitted and maintained is not disclosed to persons except as provided for in regulations promulgated in accordance with this chapter.
(e) The department may contract with another agency or private vendor, as necessary, to ensure the effective operation of ePOLST. Any such contractor shall be bound to comply with, at a minimum, the provisions regarding confidentiality of POLST program information and the regulations promulgated in accordance with this chapter.
(f) The department may enter into reciprocal agreements with other states that have compatible ePOLST systems to facilitate access to POLST program information.
(g) The secretary may establish an advisory committee to provide advice regarding POLST program issues, including but not limited to, appropriate user training, policies governing the use of POLST, and aspects of program implementation to facilitate the effective and efficient use of portable medical orders across care settings.
(h) The department shall promulgate regulations necessary to implement the requirements of this chapter.
SECTION X: Chapter 29 of the General Laws is hereby amended by adding after section 2 QQQQQ the following new section:-
Section 2RRRRR. (a) There shall be established and set up on the books of the commonwealth a separate fund to be known as the Portable Order for Life Sustaining Treatment Trust Fund. The secretary of health and human services shall be the trustee of the fund and shall expend the fund to: (i) develop, implement and operate a program governing the statewide use of a Portable Order for Life Sustaining Treatment (POLST) program administered by the department of elder affairs; (ii) support the transition from the use of the Medical Order for Life Sustaining Treatment (MOLST) program in the department of public health to the POLST program in the department of elder affairs; (iii) develop, implement and operate a statewide electronic POLST (ePOLST) program administered by the department of elder affairs; and (iv) provide for any other program purpose related to the transition from MOLST to POLST, or the establishment, maintenance or operation of the POLST or ePOLST program.
(b) There shall be credited to the fund an amount equal to: (i) any revenues under Section 9817 of the American Rescue Plan Act of 2021, Pub. L. No. 117-2 designated for the purposes described in subsection (a); (ii) any federal financial participation revenues claimed and received by the commonwealth for eligible expenditures made from the fund; (iii) any appropriations or other money authorized by the general court and specifically designated to be credited to the fund; (iv) interest earned on any money in the fund; and (v) any other grants, premiums, gifts, reimbursements, or other contributions received by the commonwealth from any source for or in support of for the purposes described in subsection (a).
(c) Amounts credited to the fund may be expended without further appropriation. For the purpose of accommodating timing discrepancies between the receipt of revenues and related expenditures, the fund may incur expenses, and the comptroller shall certify for payment, amounts not to exceed the most recent revenue estimate as certified by the secretary of elder affairs, as reported in the state accounting system. Any moneys remaining in the fund at the end of a fiscal year shall not revert to the General Fund and shall be available for expenditure in a subsequent fiscal year.
SECTION X. Notwithstanding any general or special law to the contrary, the secretary of health and human services may expend from the Health Information Technology Trust Fund, established pursuant to section 35RR of chapter 10 of the General Laws, any grants, premiums, gifts, reimbursements, or other contributions received by the commonwealth for the purposes described in subsection (a) of the Portable Order for Life Sustaining Treatment Trust Fund, established under section 2RRRRR of chapter 29 of the General Laws, provided that any grants, premiums, gifts, reimbursements, or other contributions received by the commonwealth for said purposes remaining in the Health Information Technology Trust Fund as of the effective date of this act shall be transferred to the Portable Order for Life Sustaining Treatment Trust Fund.