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37.10.101   DEFINITIONS

(1) "POLST" means Provider Orders for Life-Sustaining Treatment, a comprehensive statewide method of identifying a patient's wishes for providing palliative care, medical interventions, or withholding resuscitative measures to terminally ill patients who have a declaration governing the withholding or withdrawal of life-sustaining treatment or for whom a do-not-resuscitate (DNR) order has been issued pursuant to 50-10-101, et seq., MCA.

(2) "POLST form" means a uniform, single form for statewide use, approved by the department and Board of Medical Examiners, indicating either that a valid and current declaration pursuant to 50-9-103, MCA, has been executed and that the declarant is a qualified patient as defined in 50-9-102, MCA, or that a provider has issued a DNR order for the patient pursuant to 50-10-101, et seq., MCA.

(3) "Provider" means a physician, or advanced practice registered nurse. A physician assistant with a valid agreement with a supervising physician who has delegated the authority to sign DNR orders may also be considered a provider.

 

History: 50-9-110, MCA; IMP, 50-9-102, 50-9-106, MCA; NEW, 1989 MAR p. 2232, Eff. 12/22/89; TRANS, from DHES, 1997 MAR p. 1462; AMD, 2008 MAR p. 2356, Eff. 11/7/08; AMD, 2022 MAR p. 1881, Eff. 9/24/22.

37.10.104   LIVING WILL PROTOCOL FOR EMS PERSONNEL

(1) The living will protocol may also be designated the "POLST protocol". Providers may use POLST to implement DNR orders, or the end of life treatment decisions by a patient expressed through a living will or otherwise.

(2) For a patient who has completed a POLST form, emergency medical services personnel must follow the POLST protocol for providing palliative care or withholding life-sustaining procedures from a patient if a patient meets the following criteria:

(a) The identity of the patient has been clearly established and the personnel have been presented with any one of the following:

(i) a POLST form for the patient; or

(ii) a written DNR order signed and dated by a provider.

(b) An unresponsive person is wearing a POLST necklace or bracelet (no further identification is necessary).

 

History: 50-9-110, MCA; IMP, 50-9-102, 50-9-103, MCA; NEW, 1989 MAR p. 2232, Eff. 12/22/89; TRANS, from DHES, 1997 MAR p. 1462; AMD, 2009 MAR p. 86, Eff. 11/7/08; AMD, 2022 MAR p. 1881, Eff. 9/24/22.

37.10.105   SOURCES OF POLST IDENTIFICATION

(1) POLST forms, cards, necklaces, and bracelets may be obtained only through:

(a) physicians;

(b) licensed hospice programs;

(c) licensed home health agencies;

(d) hospitals;

(e) skilled nursing facilities;

(f) long term care facilities; and

(g) any other entity specifically approved by the department.

 

History: 50-9-110, MCA; IMP, 50-9-102, MCA; NEW, 1989 MAR p. 2232, Eff. 12/22/89; TRANS, from DHES, 1997 MAR p. 1462; AMD, 2008 MAR p. 2356, Eff. 11/7/08; AMD, 2022 MAR p. 1881, Eff. 9/24/22.

37.10.108   DO-NOT-RESUSCITATE PROTOCOL

(1) POLST is the system used by medical professionals to identify and administer appropriate care, including DNR orders, to terminally ill patients.

(2) When issuing a DNR order for a patient with a terminal condition, medical professionals are encouraged to use the POLST form and follow the DNR/POLST protocol approved by the Board of Medical Examiners and the department. The department adopts and incorporates by reference the Montana Provider Orders for Life-Sustaining Treatment (POLST) protocol (last revised September 2019), which is accessible at the Board of Medical Examiner's website. A copy of the POLST protocol may also be obtained by contacting the department's EMS and Trauma System Section, 1400 Broadway, Room C303A, P.O. Box 202951, Helena, MT 59620-2951, 406-444-3895.

 

History: 50-10-105, MCA; IMP, 50-10-101, MCA; NEW, 2008 MAR p. 2356, Eff. 11/7/08; AMD, 2022 MAR p. 1881, Eff. 9/24/22.