AGING AND DISABILITY SERVICES ADMINISTRATION
July 31, 2000
AASA: BH 2000-015
RE: POLST Pilot Project
Dear Boarding Home Provider:
The purpose of this letter is to provide information about a significant pilot project in Spokane and Whitman Counties related to Physician’s Orders for Life Sustaining Treatment (POLST). Although this pilot project is limited in scope at this time, we believe that providers not directly involved may hear about the project, admit persons who possess a completed POLST form, and/or have questions or concerns related to this project.
Q. Was this pilot project initiated by the Department of Social and Health
Services (DSHS)?
A. No. The pilot project is the work of a group in Washington State known as
Regional Ethics Network of Eastern Washington (RENEW). DSHS was recently invited
to participate with the work group.
Q. What is the purpose of the pilot project?
A. The pilot project is designed to provide a way for an individual’s
decisions about life sustaining treatment choices to be communicated from one
setting to another through a form that is a summary of physician orders for
medical treatment. The physician’s order form is entitled, “Physicians
Orders for Life Sustaining Treatment (POLST)”. This form is not an advance
directive, but should accurately summarize and reflect the resident’s
advance directives (if any).
Q. Are there any new regulations for nursing homes, adult family homes, or
boarding homes?
A. No. The pilot project does not change any regulations. Nursing homes, adult
family homes and boarding homes must continue to comply with their own licensing
regulations.
Q. When will the pilot project begin?
A. August 1, 2000.
Q. How long will the pilot project last?
A. At least 6 months, possibly longer.
Q. Where will the pilot project take place?
A. The RENEW committee has sent the POLST form only to physicians in Spokane
and Whitman Counties. These physicians have been encouraged to use the form
with their patients.
Q. Which long term care providers will be part of the pilot project?
A. Only nursing homes in Spokane and Whitman Counties are a part of the pilot
project at this time.
Q. Is a nursing home in Spokane and Whitman Counties required to participate
in the pilot?
A. No, a provider may choose to participate.
Q. Are adult family homes and boarding homes in Spokane and Whitman Counties
part of the pilot project?
A. No.
Q. What do nursing homes in the pilot project need to know?
A. Nursing homes in Spokane and Whitman counties need to know basic information
about the purpose of this project and be ready to admit individuals who may
bring with them a completed Physician’s Orders for Life Sustaining
Treatment (POLST). See also next three questions.
Q. Is the use of the POLST form optional for residents in nursing homes in
the pilot project?
A. Yes
Q. Will nursing homes in the pilot project need to develop draft policies
and procedures to use with the POLST physician order form?
A. Yes. Sample draft policies and procedures will be available to nursing homes
in the pilot project at the time of training. See next question.
Q. Will training on the POLST physician order form and related policies and
procedures be provided to nursing homes in Spokane and Whitman Counties?
A. Yes. The training will take place on August 10, 2000 in Spokane. Nursing
homes in Spokane and Whitman Counties will receive details on location and
time of sessions. At the training, these providers will receive sample POLST
draft policies and procedures to assist them in using the physician order form
appropriately. It is very important that nursing homes in the pilot project
develop and follow draft policies and procedures to use with the POLST form.
Q. What do nursing home, adult family home and boarding home providers not
in the pilot project need to know?
A. Providers that are not part of the pilot project need to have basic information
about the project, such as that it is limited to Spokane and Whitman counties;
that nursing homes in these counties are the only long term care facilities
that are part of the project; and that acute care hospitals, emergency rooms
and emergency personnel in these counties are also part of the project. Until
the pilot is completed, the POLST physician order form will not be widely distributed.
However, you may have occasion to admit an individual who has a completed POLST
form, because the form may accompany the individual moving from one setting
to another.
Q. Will nursing homes, adult family homes and boarding homes not in
the pilot project implement the completed POLST physician’s order form?
A. No.
Q. What should a nursing home not in the pilot project do if they admit an
individual with a completed POLST physician order form?
A. If a nursing home not in the pilot project admits an individual with a completed
POLST physician order form, you must notify the physician and the resident
that you are not part of the pilot project (limited to nursing homes in Spokane
and Whitman Counties); have not been trained on the POLST form; and therefore
are not prepared to implement it. You will continue to follow current regulations.
Q. What should an adult family home or boarding home provider do if they admit
an individual with a completed POLST physician order form?
A. If an adult family home or boarding home admits an individual with a completed
POLST physician order form, you must notify the physician and the resident
that you are not part of the POLST pilot study (limited to nursing homes in
Spokane and Whitman Counties); have not been trained on the POLST form; and
therefore are not prepared to implement it. You will continue to follow current
regulatory requirements.
Q. Where should I direct questions about the pilot project and the POLST form?
A. All providers with questions about regulatory requirements related to the
POLST pilot project should contact Sheldon Plumer at (360) 725-2403. For
other questions about the pilot project, contact Dr. Jim Shaw with RENEW
at (509) 474-3097.
Sincerely,
Patricia K. Lashway, Director
Residential Care Services
cc: Jim Shaw, M.D., Medical Director – Providence for Faith and Healing
Alice Anderson, Administrator – St. Joseph’s Care Center
Janet Griffith, Director – Office of Emergency Medical and Trauma
