Connecticut State Department of Public Health

 

 
History

On June 26, 2017 Governor Malloy signed into law Senate Bill 938, Public Act 17-70 “ Act Concerning the Department of Public Health’s Recommendations for the state-wide adoption of the Medical Orders for Life Sustaining Treatment “ which authorizes the use of these Medical Orders throughout CT.
In 2014 Special Act 14-5 “An Act Concerning the Department of Public Health's Recommendations Regarding Medical Orders For Life-Sustaining Treatment” was passed that gave the CT Department of Public Health (CTDPH) the authority to create a Medical Orders for Life-Sustaining Treatment (MOLST) pilot program in selected areas of the state. The pilot program which was launched on April 16, 2015, National Health Care Decisions Day served 142 individuals in thirteen facilities and hospitals throughout the State.

What is MOLST?
MOLST is a medical order form (similar to a prescription) that relays instructions between health professionals about a patient's care. MOLST is based on an individual's right to accept or refuse medical treatment, including treatments that might extend life. MOLST is not for everyone. In Connecticut patients approaching the end stage of a life limiting illness or in a condition of advance progressive frailty may discuss filling out a MOLST order with their clinician. The patient's decision to use the MOLST form is and must always be voluntary. MOLST is different from a health care representative form. It is recommended that all adults aged 18 and older complete a health care representative form to name the person who can make medical decisions for them in the future event of an unexpected illness or accident. It is also suggested that anyone with a MOLST form also fill out the health care representative form. 
 
 
 
 
The Connecticut MOLST was developed from the national Physician Orders for Life Sustaining Treatment (POLST) Paradigm. The Connecticut MOLST is a voluntary adjunctive planning tool to an advance health care directive. (Some patients may have already completed a living will and may have both documents). MOLST orders are for patients who are at the end stage of a serious life limiting illness or in a condition of advanced chronic progressive frailty as determined by a physician or advance practice registered nurse. The MOLST form documents patients’ decisions in a clear manner that can be quickly understood by all providers, including first responders and emergency medical services (EMS) personnel.

Based upon the ethical principle of respect for patient autonomy and the legal principle of self-determination, A "CT medical order for life-sustaining treatment" is a written medical order by a physician, advanced practice registered nurse, or physician assistant that records a patient’s treatment preferences in writing on a bright green form approved by the CT DPH.

The MOLST form is completed after a conversation or series of conversations have taken place between the patient (and if the patient chooses their loved ones) and the patient’s health care provider or providers. The MOLST is an actionable medical order that reflects the patient’s goals of care for full medical treatment, limited medical treatment or comfort measures only. It is designed to enable patients to document their preferences for medical treatments as they near life’s end, and assists their loved ones and health care providers to better understand the patient’s wishes. The form identifies the patient’s medical condition as well as their treatment preferences and goals and accompanies the patient across all settings. The documentation makes it easier for health providers at one care setting to know the wishes of a patient previously documented in another care setting.

For questions about the MOLST Initiative please contact Barbara Cass at 860-509-7406 or barbara.cass@ct.gov.
 
MOLST Legislation, Policy and Procedures, and Frequently Asked Questions

MOLST Meeting Schedule 

MOLST Advisory Meeting Committee Agenda

MOLST Advisory Meeting Minutes

  

The MOLST Conversation

 
MOLST Resources and Links
 

MOLST Training

Physicians, advanced practice registered nurses or physician assistants who intend to write a Medical Order For Life-Sustaining Treatment

are required to complete training in accordance with CGS §19a-580h. The training is an online self-study program that takes approximately

30-45 minutes to complete and upon successful completion a certificate is issued to the health care provider.

 

How to Access the Online MOLST Course

 

  1. Use Firefox or Internet Explorer as your browser
  2. Go to https://www.train.org/connecticut
  3. Once on the website, select "Create an Account: and the the required information. NOTE: New users must register for a user name and  password.
  4. After creating an account, click on the magnifying glass, type in "MOLST" or enter the Course ID# 1076530, and click on search to bring you to the MOLST course page.
  5. Click on "launch".
  6. Complete the course and short test.
  7. Click on "exit".
  8. Click on "close window".
  9. Once you click on "close window" you are brought back to the MOLST course page.
  10. Click on "print certificate".
  • Hospitals or large facilities that have their own electronic training system (e.g., Healthstream, SABA, or similar) may contact Danny White at 860-509-7557 to access the MOLST training module from an FTP server to download onto their system.
  • Proof of staff completing the training program may be requested by DPH from time to time.

MOLST Forms

  • Health care provider requirements.  (a) An eligible provider that intends to write a MOLST must complete a Department approved training module before writing a MOLST.  (b) Only an eligible provider that has completed such training may write a MOLST. If you are an eligible provider- Please send your request to DPH.MOLST@ct.gov - provide a mailing address and the amount of forms you would like to be mailed.

Documents

Links