MARYLAND DEPARTMENT OF HEALTH Maryland MOLST Program Office

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MARYLAND DEPARTMENT OF HEALTH Maryland MOLST Program Office of Health Care Quality Margie Heald,

MARYLAND DEPARTMENT OF HEALTH Maryland MOLST Program Office of Health Care Quality Margie Heald, Deputy Director, Federal Programs Ranada Cooper, Program Manager, Long Term Care August 5, 2019

Maryland MOLST Initiative • Seven years after our 2012 submission for an AHFSA Best

Maryland MOLST Initiative • Seven years after our 2012 submission for an AHFSA Best Practices Award for the Maryland MOLST initiative, it remains one of OHCQ’s top priorities • Our efforts have increased the likelihood that an individual’s wishes to accept, limit, or decline treatment are honored across Maryland’s health care continuum 2

State Survey Agency’s Role • OHCQ remains the driving force of the process, partnering

State Survey Agency’s Role • OHCQ remains the driving force of the process, partnering with the Maryland Attorney General’s Office, Maryland Institute for Emergency Medical Services Systems (MIEMSS), and a diverse group of stakeholders • All involved recognize the value of MOLST and of on-going education about health care decision making 3

Outcomes of the Initiative • Empowers individuals to communicate their wishes about health care

Outcomes of the Initiative • Empowers individuals to communicate their wishes about health care • Increases understanding of Maryland’s Health Care Decisions Act • Raises awareness about State and federal regulatory requirements, as well as standards of care 4

Training Since 2012 • Over 300 hours of training to a diverse group of

Training Since 2012 • Over 300 hours of training to a diverse group of stakeholders • Annually provide 8 – 12 hours of training to OHCQ and other State employees • Trained 14 individuals to provide over 100 educational programs across the State to providers, consumers, and other stakeholders 5

Other Activities Since 2012 • OHCQ continues to consistently cite noncompliance with State and

Other Activities Since 2012 • OHCQ continues to consistently cite noncompliance with State and federal laws protecting an individual’s right to have their wishes for health care honored • Respond to 800 – 1, 100 email and phone inquiries annually to clarify requirements, regulations, and laws related to MOLST and health care decision making • Maintain a Maryland MOLST website 6

CMP Grant for Maryland MOLST Research • In 2017, OHCQ awarded a civil money

CMP Grant for Maryland MOLST Research • In 2017, OHCQ awarded a civil money penalty funded grant to a university to study the performance of the Maryland MOLST form in clinical practice • This study resulted in an article in a peer-reviewed palliative medicine journal 7

Sustainability • The costs continue to be absorbed as part of the budgets of

Sustainability • The costs continue to be absorbed as part of the budgets of OHCQ, the Attorney General’s Office, and MIEMSS • Gathered together on this common ground, the State agencies and stakeholders continue to advocate that an individual’s wishes regarding care honored across the health care continuum 8

Questions Paul Ballard, Assistant Attorney General Counsel for Health Decisions Policy 410 -767 -6918

Questions Paul Ballard, Assistant Attorney General Counsel for Health Decisions Policy 410 -767 -6918 paul. ballard@maryland. gov Tricia Tomsko Nay, MD, Executive Director 410 -402 -8055 tricia. nay@maryland. gov 9