HB 5513, An Act Concerning The Department Of Public Health’s Recommendations Regarding Various Revisions To The Public Health Statutes

TESTIMONY OF THE CONNECTICUT HOSPITAL ASSOCIATION
SUBMITTED TO THE PUBLIC HEALTH COMMITTEE

Friday, March 13, 2026

The Connecticut Hospital Association (CHA) appreciates this opportunity to submit testimony concerning HB 5513, An Act Concerning The Department Of Public Health’s Recommendations Regarding Various Revisions To The Public Health Statutes.  CHA opposes Section 7 of the bill as drafted.

Connecticut hospitals make our state stronger by delivering nationally recognized, world-class care, supporting jobs and economic growth, and serving communities across Connecticut.  Every day, hospitals improve access, affordability, and health equity — providing care to all patients regardless of ability to pay.  At the same time, hospitals invest in their workforce and local communities, even as they navigate significant financial and federal challenges.

Section 7 of HB 5513 would create an unacceptable gap in care by restricting physicians and other providers from entering routine medical orders for any  “life sustaining treatment” for a person who is “approaching the end stage of a serious, life-limiting illness or is in a condition of advanced, chronic progressive frailty” unless the provider is using the Department of Public Health (DPH) approved Medical Order For Life-Sustaining Treatment (MOLST) form. 

Lines 229-232 of Section 7 would cause significant confusion and potentially result in a dangerous departure from current practice and is entirely inconsistent with the MOLST law.  MOLST, by law, is an entirely voluntary program that may only be utilized by providers with specialized training.  It applies in very few circumstances. MOLST is in no way intended to apply to all end stage or terminally ill patients who need or may choose to receive life sustaining care.

We urge that lines 229-232 of the bill, as shown below, be deleted in their entirety.

(d) A medical order for life-sustaining treatment shall not be valid unless it is completed on a form prescribed by the department and executed in accordance with the requirements of this section and any regulations adopted under this section.

If not deleted, this language risks divesting practitioners of the power to write legitimate and routine care orders for patients who happen to be terminally ill unless they are using the MOLST program approach. 

The MOLST program has been underutilized since its inception.  For MOLST to function, there needs to be far greater clarity in what the law means, greater provider flexibility, and better education about how and when the law applies. 

To further ensure that provider and patient rights are not negatively impacted by the MOLST law or program while promoting more flexible use of the MOLST program when appropriate, in addition to deleting lines 229-232, we urge the committee to make two additional changes to Section 7 of HB 5513, as detailed below.

First, amend subsection (a) of Section 19a-580h as follows (double underlining denotes new suggested language) for clarity and to allow physician assistants greater participation in the MOLST process:

Section 19a-580h.

(a) As used in this section: (1) “Medical order for life-sustaining treatment” means a specific set of written medical orders developed by the Department of Public Health specific to the program established in accordance with this section made[order] by a physician, advanced practice registered nurse or physician assistant to effectuate a patient’s request for life-sustaining treatment when the patient has been determined by a physician, physician assistant, or advanced practice registered nurse to be approaching the end stage of a serious, life-limiting illness or is in a condition of advanced, chronic progressive frailty;

Second, add a clear guardrail to the MOLST law as a new subsection (f) of Section 19a-580h, as follows:

(NEW) (f) The use and application of the MOLST program or its forms is entirely voluntary and shall not be required of any provider or patient.  Nothing about the MOLST program shall be construed to impact the ability of a physician, advanced practice registered nurse, or physician assistant to order any type of patient care as permitted under their scope of practice.

Thank you for your consideration of our position.  For additional information, contact CHA Government Relations at (203) 294-7301.