SB 1088 updates portable life-sustaining treatment orders
Oct 11, 2026 edition · GC-2026-0223 · Published 2026-10-11 · Version 3 · Final
SB 1088 updates POLST to Portable Orders Listing Scope of Treatment and clarifies signers, electronic signatures, and recognition of qualifying out-of-state requests. Orders remain voluntary, with capacity and clinical limitations preserved and a specific acknowledgment for forms printed after January 1, 2027.
What happened
California enacted SB 1088 on September 27 as Chapter 677. The amended POLST framework requires patient preferences and medical indications, with signatures from the patient or authorized representative and a qualifying clinician. Specified independently practicing nurse practitioners may sign under their cited authority; physician assistants and other referenced nurse practitioners sign under physician supervision and lawful scope. Representative execution is limited by capacity or the specified effective-authority designation. A POLST is distinct from an advance health care directive, and neither care nor admission may depend on completing or refusing a POLST or prehospital DNR order.
Electronic signatures suffice for required signatures. Qualifying requests executed under another jurisdiction's law or California law are enforceable to the same extent as valid California requests, and providers without contrary knowledge may presume validity and nonrevocation. The framework retains the medically ineffective or contrary-to-accepted-standards exception, capacity-based revocation and alternative-treatment rights, and the rule favoring the most recent conflicting order or instruction. Forms printed after January 1, 2027 must contain the specified representative acknowledgment about known desires and best interests. This express printing milestone is separate from ordinary statutory effectiveness.
Scope and timing
- Authority status
- Final
- Applicability
- Potentially applicable
- Audience
- Health systems, Provider networks, Health-tech
- Jurisdiction
- California
- Recorded date
- 2027-01-01
- Date type
- effective
Why it matters
Forms and intake practices must preserve informed, voluntary treatment choices.
Recommended action
Review POLST forms, signer qualifications, electronic workflows and out-of-state recognition; confirm staff do not require an order as an admission condition.
Sources
- SB1088 enacted final textOfficial · California Legislature · 2026-09-27 · Source review 2026-10-11
- California Constitution, Article IV section 8(c), official Assembly 2023–24 editionOfficial · California State Assembly · Source review 2026-10-14
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