State and federal statutes protect the rights of every adult to make their own health care decisions, including what treatments to accept, decline, or discontinue. In Alaska, the Alaska Health Care Decisions Act (AHCDA) is the statute that governs our Advance Directive (AD) laws and Do Not Resuscitate (DNR) statewide protocols. Alaska POLST is now replacing the Alaska Comfort One program and is a legal medical order indicating the patient’s preferences for emergency and/or life-sustaining treatments when seriously ill or at the end of life.

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The Alaska POLST form was signed into regulation May 2021 and is now in use. The orders on a POLST are required to be honored by all health care professionals.

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Advanced Practitioner Registered Nurses (APRN), and Physician Assistants (PA) are now granted legal authority to sign the Alaska POLST form.  This change was made possible by House Bill 392 with an Effective Date of 11/8/2022.  HB392 amended AS 13.52.65, authorizing Alaska licensed APRNs and PAs to sign Do-Not-Resuscitate (DNR) orders, despite the fact that Alaska Regulation, 7 AAC 16.010 does not currently reflect this change.

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This site is developed and maintained in collaboration with DHSS, AHHA, and the members of the Alaska State POLST workgroups to provide the POLST form and resources to support its use and implementation.  Future planned resources include an archive of webinar recordings for education and training, a policy share for facilities, and a best practice guide.  Check back soon for updated content! 

Overview of the Comfort One to POLST Transition:

• Clinicians and institutions are working to adapt their practice and policies to using Alaska POLST, while continuing to recognize and honor the Comfort One form.

• Comfort One forms will no longer be resupplied by the state EMS office.

• Comfort One forms will continue to be honored and the most recently signed Comfort One or POLST order is the legal medical order.

• Patients can be given the opportunity to voluntarily update their Comfort One form to the Alaska POLST form, if POLST better communicates their wishes.

• DHSS will support POLST forms to be faxed, in a HIPPA-compliant manner, to patient’s local EMS/dispatch when the form indicates DNR.
   

How does the Alaska POLST form affect the Alaska MOST form?

It is recommended that clinicians and health care facilities  transition from MOST to Alaska POLST, too. The Alaska MOST form was developed to address the deficiencies of the Comfort One (needing a way to document pre-arrest life-sustaining treatment preferences.) However, the form was never legislated as a state-wide medical order so there are no protocols instructing health care professionals to follow the MOST orders and no provisions for immunity from civil and criminal liability for health care professionals following the order. For clinicians and facilities that are utilizing the MOST form, it is recommended to transition to using the Alaska POLST form instead.