The MOLST Demonstration Project was implemented in Massachusetts pursuant to a mandate in the Commonwealth Acts of 2008. 

Preparation began in 2009 with the following activities:

• Formation of MOLST Steering Committee and Work Groups
• Selection of the Greater Worcester area for the demonstration* 
• Recruitment and selection of demonstration sites
• Interviews and meetings with health professionals and other stakeholders to create a Massachusetts MOLST form
• Consumer focus groups and interviews to inform the development of outreach and education strategies and materials
• Demonstration site training for MOLST signers (clinicians), other health professionals and staff
• MOLST education for other local health providers, stakeholders and consumer groups 
• Feburary 2010 MOLST launch event for Worcester area and state-level stakeholders
• MOLST website created for public access to MOLST information, resources and materials
• Development of evaluation activities for the demonstration and to inform decisions about statewide MOLST expansion

Use of the MOLST demonstration form began in April 2010 in the eight demonstration sites and local emergency medical services: 

• Acute care hospitals (2):  UMass Memorial Medical Center; St. Vincent Hospital
• Managed primary care provider (1):  Fallon Clinic Home Run Program
• Nursing homes, home health care and hospice care settings (5): Jewish Healthcare Center and Hospice; Notre Dame Long Term Care Center and Hospice; Shrewsbury Nursing and Rehabilitation Center; UMass Memorial Home Health and Hospice; VNA Care Hospice
• Worcester area EMS services

The MOLST demonstration continued through December 2010. A final report documented lessons learned and recommended statewide expansion of MOLST in Massachusetts by 2014.