SB 1088 updates portable life-sustaining treatment orders
Oct 4, 2026 edition · GC-2026-0223 · Published 2026-10-04 · Version 2 · Final
SB 1088 updates POLST terminology, authorized execution and recognition of orders signed electronically or outside California. The law expressly preserves voluntary completion, patient preferences and specified signer qualifications, with revised acknowledgment language for forms printed after January 1, 2027.
What happened
California enacted SB 1088 on September 27 to update requests regarding resuscitative measures, including POLST, now defined as Portable Orders Listing Scope of Treatment. Probate Code section 4780 permits execution by the individual with capacity or an authorized health care agent, conservator or surrogate, together with a physician, a nurse practitioner practicing under the specified independent-practice provisions, or a physician assistant or nurse practitioner under physician supervision. An agent, conservator or surrogate may execute a POLST only when the individual lacks capacity or has made the surrogate’s authority effective under the cited statute. A provider must explain the form and complete it based on patient preferences and medical indications. Completion or refusal is entirely voluntary and cannot be a condition of care or admission. The enactment is the event reported here; the applicable commencement of these provisions must be confirmed separately.
The amended section 4783 makes an electronic signature sufficient for a required signature and recognizes a substantially similar out-of-state or other-jurisdiction request that complies with that jurisdiction’s law or California law, to the same extent as a California POLST. A provider without knowledge to the contrary may presume a request is valid and unrevoked. Forms printed after January 1, 2027 must carry the revised representative acknowledgment about the individual’s known desires and best interests. Other provisions preserve a capable person’s ability to revoke a POLST or request alternative treatment, the most recent instruction rule for a direct conflict, and the exception for medically ineffective care or care contrary to generally accepted standards.
Scope and timing
- Authority status
- Final
- Applicability
- Potentially applicable
- Audience
- Health systems, Provider networks, Health-tech
- Jurisdiction
- California
Why it matters
Intake and emergency workflows need to distinguish a portable medical order from an advance directive and identify the actual signer’s authority. Electronic or out-of-state execution is not itself a reason to reject an otherwise qualifying order. Equally, a form requirement in an admission checklist could undermine the law’s express voluntary-choice protection.
Recommended action
Confirm the applicable commencement before treating the new provisions as current duties. Prepare the following for implementation at that commencement: Review POLST templates and the acknowledgment for forms printed after January 1, 2027. Check authorized clinician and representative signatures, electronic acceptance and out-of-state recognition workflows. Train intake staff that neither completing nor refusing an order can condition care or admission, and preserve escalation for changed preferences, conflicting instructions or ineffective treatment.
Sources
- SB1088 enacted final textOfficial · California Legislature · 2026-09-27 · Source review 2026-10-05
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