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MOLST in Massachusetts

History of Massachusetts MOLST Implementation

2008 - MA legislature enacts Chapter 305 of the Acts of 2008, Sections 41–43 to require the establishment of an MA MOLST demonstration program in at least one area of the Commonwealth. 

2009 - MOLST Demonstration planning begins.  The greater Worcester area is selected for the demonstration due to its size, number and diversity of health care providers, and ongoing community-based efforts to improve end of life care. 

2010 - In February, MA DPH Circular Letter: DHCQ 10-02-529 supports MOLST use to meet the “standard of care for communicating patient preferences regarding life-sustaining treatment options.”

2010 - In April, the MOLST Demonstration program is implemented involving two acute care hospitals; five skilled nursing facilities, home health and hospice providers; one primary care home-visiting program; and regional emergency medical services.

2010 - The Massachusetts Expert Panel on End-of-Life Care Report recommends that "full statewide implementation of MOLST should be achieved no later than January 1, 2014."

2011 - MOLST Demonstration Report recommends statewide expansion of MOLST, stating that, "as a result of the overwhelmingly positive findings from the MOLST Demonstration Program, the MOLST Steering Committee holds the vision that in Massachusetts: 1. Every suitable patient will be offered the opportunity to utilize a MOLST form in concert with that patient’s clinician to communicate life-sustaining treatment preferences across health care settings; 2. Every emergency medical technician will receive MOLST training and be authorized to honor valid MOLST forms; 3. Every major hospital system and health care plan will implement policies and procedures to facilitate the appropriate utilization of MOLST by clinicians and patients; 4. Every clinician will seek to improve communications skills with patients nearing the end of life; have access to MOLST education; and be encouraged by professional organizations and regulatory bodies (e.g. Boards of Registration, Massachusetts Medical Society) to utilize MOLST correctly; and 5. MOLST forms as well as education and outreach materials will be uniform; linguistically appropriate; culturally relevant; easily available; accessible to persons with disabilities; and recognized by health professionals and consumers alike." 

2012 - MOLST statewide expansion announced in MA DPH Circular Letter: DHCQ 12-3-560 and statewide expansion of MOLST use begins.

2014 - MOLST form in use in clinical care institutions statewide.