New York State Department of Health revises medical orders for life-sustaining treatment form to improve patient care coordination

Albany, New York – In a move that underscores New York’s commitment to patient-centered care, the New York State Department of Health has released a revised version of the Medical Orders for Life-Sustaining Treatment (MOLST) form, a crucial document that helps ensure patients’ preferences are honored in critical healthcare situations. The update marks a significant step forward in aligning medical care with individuals’ values, particularly in moments when they may not be able to speak for themselves.

The MOLST form, used statewide to record medical decisions related to interventions such as CPR, intubation, artificial hydration, and other life-sustaining treatments, has long been an essential component of healthcare planning, especially for those facing serious illness or advanced age. The revision of this form was the result of an extensive collaboration involving the Department of Health, the Office for People with Developmental Disabilities (OPWDD), the Office of Mental Health (OMH), and the MOLST Statewide Implementation Committee.

According to health officials, this revision ensures the form better reflects patients’ medical conditions and aligns treatment options with their individual goals and values. In addition to streamlining the paper version of the MOLST, Excellus, the nonprofit health plan that manages the electronic MOLST (eMOLST), has also updated its digital counterpart to match the changes.

Though Excellus has stopped accepting new applications for the eMOLST registry, providers with existing agreements can continue using the system. Moreover, officials clarified that older versions of both paper and electronic MOLST forms remain valid and enforceable.

Read also: New housing initiative brings hope by supporting homeownership in Rochester neighborhoods with a history of disinvestment

“The release of the revised Medical Orders for Life-Sustaining Treatment forms and eMOLST are important because they ensure that a patient’s current medical condition, values, and treatment preferences are communicated and respected across all healthcare settings,” said State Health Commissioner Dr. James McDonald. “I thank everyone involved in this revision and who is committed to confirming patients’ current health status is reflected, their wishes are honored, and unwanted or inappropriate interventions are prevented.”

The revised form not only modernizes how preferences are documented but also enhances clarity and accessibility for both healthcare professionals and patients. New instructions and supporting materials accompany the update, offering clearer guidance for clinicians when initiating end-of-life discussions and completing the form accurately.

The importance of these updates was echoed by Kara Travis, Director of the State Health Department’s Center for Hospice & Palliative Care, who emphasized the ongoing effort to build awareness around end-of-life planning.

“The release of a revised MOLST and eMOLST has been an important part of our foundational work as a Center for Hospice & Palliative Care,” said Travis. “While we are charged with increasing awareness and access to end-of-life care options as well as Advance Care Planning, making sure there is a consistent, collaborative, patient-centered conversation happening at the bedside or in living rooms across the care continuum will always be a critical component of our mission to encourage all New Yorkers to live their best life as they age or combat chronic illness.”

The MOLST form is unique because it is not limited to one care setting. It follows patients from their homes to hospitals, nursing facilities, or hospice care. It is legally binding and must be honored by emergency responders, home health aides, and hospital staff. As explained by Jonathan Karmel, Esq., of the State Health Department’s Division of Legal Affairs, this legal aspect reinforces the importance of the document.

“Emergency medical services personnel, home care services agency personnel, hospice personnel, and hospital emergency services personnel are required to honor nonhospital Do Not Resuscitate and Do Not Intubate orders that are issued using the MOLST form,” Karmel stated. “The MOLST form, instructions, and additional guidance materials will ensure that physicians, nurse practitioners, and physician assistants issue end-of-life medical orders to withhold or withdraw life-sustaining treatment in accordance with their patients’ wishes.”

Special attention was given during the revision process to ensure inclusivity, particularly for individuals with developmental disabilities. The form’s updated instructions offer more detailed explanations and wider options, helping to ensure dignity, respect, and autonomy for all patients, regardless of cognitive ability.

Read also: Governor Hochul announces the successful completion of the $22 million renovation of Dietz Stadium as a major milestone in the revitalization of downtown Kingston

“End-of-Life preferences are very personal decisions and come at the hardest time for a family,” said Willow Baer, Acting Commissioner of OPWDD. “Updates to the MOLST form and its instructions provide more detailed explanations and choices regarding end-of-life care, making it easier to provide dignity for and choice by people with developmental disabilities, together with their families and loved ones. OPWDD appreciates the working partnership between the NYS Department of Health and Office for Mental Health to further develop and clarify this vital legal document for the people we support.”

The Office of Mental Health also highlighted the significance of these updates, emphasizing that honoring a person’s wishes, especially in times of emotional and physical vulnerability, is an essential part of quality care.

“OMH was pleased to partner with DOH on the revisions of the MOLST and the eMOLST forms,” said Dr. Ann Sullivan, Commissioner of the Office of Mental Health. “The MOLST and eMOLST forms provide that patients choices about their care are readily and easily available across treatment settings, ensuring their wishes are respected.”

The newly updated MOLST form comes at a time when there is growing national awareness around the importance of advance care planning. For many families, conversations about end-of-life treatment are difficult to initiate, yet critical to ensure that medical interventions align with personal values. This latest revision offers a more approachable tool for healthcare providers and families alike to guide those conversations and ensure patients are treated in accordance with their wishes.

New Yorkers are encouraged to speak with their healthcare providers about completing or updating their MOLST forms, particularly if their medical condition or treatment preferences have changed. The form is available in both paper and electronic formats, and its use remains voluntary but highly recommended.

With this latest revision, New York State takes another meaningful step toward compassionate, patient-driven care—placing individual choice at the center of even the most difficult medical decisions.