Nurse practitioners; authorize certain to sign physician orders for sustaining treatment (POST).

H. B. No. 1030 *HR26/R1430* ~ OFFICIAL ~ G1/2
26/HR26/R1430
PAGE 1 (RF\KW)

To: Public Health and Human
Services
MISSISSIPPI LEGISLATURE REGULAR SESSION 2026

By: Representative Currie

HOUSE BILL NO. 1030

AN ACT TO AMEND SECTION 41-41-302, MISSISSIPPI CODE OF 1972, 1
TO AUTHORIZE THE NURSE PRACTITIONER PRIMARILY RESPONSIBLE FOR 2
ATTENDING TO THE CARE OF THE INDIVIDUAL TO SIGN A PHYSICIAN ORDER 3
FOR SUSTAINING TREATMENT (POST) FOR THE INDIVIDUAL; TO AMEND 4
SECTION 41-41-303, MISSISSIPPI CODE OF 1972, TO CONFORM TO THE 5
PRECEDING PROVISION; AND FOR RELATED PURPOSES. 6
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI: 7
SECTION 1. Section 41-41-302, Mississippi Code of 1972, is 8
amended as follows: 9
41-41-302. (1) A physician order for sustaining treatment 10
(POST) directing health care in the standardized form provided by 11
this section may be executed by the primary physician of an 12
individual or by the nurse practitioner primarily responsible for 13
attending to the care of the individual, and: 14
(a) The individual, if an adult or emancipated minor 15
with capacity; or 16
(b) The agent, guardian, or surrogate having authority 17
to make health care decisions on behalf of the individual if the 18
individual is: 19
(i) An unemancipated minor; or 20
H. B. No. 1030 *HR26/R1430* ~ OFFICIAL ~
26/HR26/R1430
PAGE 2 (RF\KW)

(ii) An adult or emancipated minor who lacks 21
capacity. 22
(2) The physician order for sustaining treatment shall be 23
executed, implemented, reviewed, and revoked in accordance with 24
the instructions on the form. 25
(3) The State Board of Medical Licensure shall promulgate a 26
standardized physician order for sustaining treatment form in 27
accordance with the provisions in this section, adhering to the 28
sequence in those provisions and using checkboxes to indicate the 29
various alternatives. The board shall consult with appropriate 30
professional and advocacy organizations in developing the 31
physician order for sustaining treatment form, including the 32
Mississippi Hospital Association, the Mississippi State Medical 33
Association, Mississippians for Emergency Medical Services, the 34
Mississippi Health Care Association, the Mississippi Independent 35
Nursing Home Association, the Louisiana-Mississippi Hospice and 36
Palliative Care Organization, Disability Rights Mississippi, 37
Mississippi Right to Life, the Mississippi Bar Association and the 38
Mississippi Section of American Congress of Obstetricians and 39
Gynecologists. 40
The physician order for sustaining treatment form shall begin 41
with an introductory section containing the name "POST, Physician 42
Orders for Sustaining Treatment," the patient's name, patient's 43
date of birth, the effective date of the form followed by the 44
statement "Form must be reviewed at least annually.", and 45
H. B. No. 1030 *HR26/R1430* ~ OFFICIAL ~
26/HR26/R1430
PAGE 3 (RF\KW)

containing the statements "HIPAA permits disclosure of POST to 46
other health care professionals as necessary" and "This document 47
is based on this person's current medical condition and wishes and 48
is to be reviewed for potential replacement in the case of a 49
substantial change in either. Any section not completed indicates 50
preference for full treatment for that section." 51
(a) Section A of the form shall direct provision or 52
withholding of cardiopulmonary resuscitation to the patient when 53
he or she has no pulse and is not breathing by selecting one (1) 54
of the following: 55
(i) Attempt Resuscitation (CPR); or 56
(ii) Do Not Attempt Resuscitation (DNR); and 57
include the statement "When not in cardiopulmonary arrest, follow 58
orders in B, C, and D." 59
(b) Section B of the form shall direct the sustaining 60
treatment when the patient has a pulse or is breathing by 61
selecting one (1) of the following: 62
(i) Full Sustaining Treatment, including the use 63
of intubation, advanced airway interventions, mechanical 64
ventilation, defibrillation or cardio version as indicated, 65
medical treatment, intravenous fluids, and comfort measures. This 66
option shall include the statement "Transfer to a hospital if 67
indicated. Includes intensive care. Treatment Plan: Full 68
treatment including life support measures"; 69
H. B. No. 1030 *HR26/R1430* ~ OFFICIAL ~
26/HR26/R1430
PAGE 4 (RF\KW)

(ii) Limited Interventions, including the use of 70
medical treatment, oral and intravenous medications, intravenous 71
fluids, cardiac monitoring as indicated, noninvasive bi-level 72
positive airway pressure, a bag valve mask, and comfort measures. 73
This option excludes the use of intubation or mechanical 74
ventilation. This option shall include the statement "Transfer to 75
a hospital if indicated. Avoid intensive care. Treatment Plan: 76
Provide basic medical treatments"; or 77
(iii) Comfort Measures, including keeping the 78
patient clean, warm, and dry; use of medication by any route; 79
positioning, wound care, and other measures to relieve pain and 80
suffering; and the use of oxygen, suction, and manual treatment of 81
airway obstruction as needed for comfort. This option shall 82
include the statement "Do not transfer to a hospital unless 83
comfort needs cannot be met in the patient's current location 84
(e.g., hip fracture)," and include a space for other instructions. 85
(c) Section C of the form shall direct the use of oral 86
and intravenous antibiotics by selecting one (1) of the following: 87
(i) Antibiotics if life can be sustained; 88
(ii) Determine use or limitation of antibiotics 89
when infection occurs; 90
(iii) Use antibiotics only to relieve pain and 91
discomfort; and include a space for other instructions. 92
(d) Section D of the form, which shall have the heading 93
"Medically Administered Fluids and Nutrition: Administer oral 94
H. B. No. 1030 *HR26/R1430* ~ OFFICIAL ~
26/HR26/R1430
PAGE 5 (RF\KW)

fluids and nutrition if physically possible," shall include the 95
following options: 96
(i) Directing the administration of nutrition into 97
blood vessels if physically feasible as determined in accordance 98
with reasonable medical judgment by selecting one (1) of the 99
following: 100
1. Total parenteral nutrition long-term if 101
indicated; 102
2. Total parenteral nutrition for a defined 103
trial period, which option shall be followed by "Goal:" and a 104
blank line; or 105
3. No parenteral nutrition; 106
(ii) Directing the administration of nutrition by 107
tube if physically feasible as determined in accordance with 108
reasonable medical judgment by selecting one (1) of the following: 109
1. Long-term feeding tube if indicated; 110
2. Feeding tube for a defined trial period, 111
which option shall be followed by "Goal:" and a blank line; or 112
3. No feeding tube; 113
and shall include a space for other instructions; or 114
(iii) Directing the administration of hydration, 115
if physically feasible as determined in accordance with reasonable 116
medical judgment, by selecting one (1) of the following: 117
1. Long-term intravenous fluids if indicated; 118
H. B. No. 1030 *HR26/R1430* ~ OFFICIAL ~
26/HR26/R1430
PAGE 6 (RF\KW)

2. Intravenous fluids for a defined trial 119
period, which option shall be followed by "Goal:" and a blank 120
line; or 121
3. Intravenous fluids only to relieve pain 122
and discomfort. 123
(e) Section E of the form, which shall have the heading 124
"Patient Preferences as a Basis for this POST Form," shall include 125
the following: 126
(i) A direction to indicate whether or not the 127
patient has an advance health-care directive as defined in Section 128
41-41-203 and if so, the date of the advance directive's 129
execution, and, a certification that the physician order for 130
sustaining treatment is in accordance with the advance directive, 131
followed by the printed name, position, and signature of an 132
individual so certifying; 133
(ii) If the patient is an unemancipated minor, an 134
indication of by which one or more of the following directions 135
were given in accordance with Section 41-41-3: 136
1. Minor's guardian or custodian; 137
2. Minor's parent; 138
3. Adult brother or sister of the minor; 139
4. Minor's grandparent; or 140
5. Adult who has exhibited special care and 141
concern for minor; and 142
H. B. No. 1030 *HR26/R1430* ~ OFFICIAL ~
26/HR26/R1430
PAGE 7 (RF\KW)

(iii) If the patient is an adult or an emancipated 143
minor, by which one or more of the following directions were given 144
in accordance with Section 41-41-205, 41-41-211 or 41-41-213: 145
1. Patient; 146
2. Agent authorized by patient's power of 147
attorney for health care; 148
3. Guardian of the patient; 149
4. Surrogate designated by patient; 150
5. Spouse of patient (if not legally 151
separated); 152
6. Adult child of the patient; 153
7. Parent of the patient; 154
8. Adult brother or sister of the patient; or 155
9. Adult who has exhibited special care and 156
concern for the patient and is familiar with the patient's values. 157
(f) A signature portion of the form, which shall 158
include lines for the printed name, signature, and date of signing 159
for: 160
(i) The patient's primary physician or the nurse 161
practitioner primarily responsible for attending to the care of 162
the individual; 163
(ii) The individual or individuals described in 164
paragraph (e)(ii) or (iii) of this subsection; and 165
H. B. No. 1030 *HR26/R1430* ~ OFFICIAL ~
26/HR26/R1430
PAGE 8 (RF\KW)

(iii) The health care professional preparing the 166
form, if other than the patient's primary physician or nurse 167
practitioner, with contact information. 168
(g) A section entitled "Information for patient or 169
representative of patient named on this form," which shall include 170
the following language: 171
"The POST form is always voluntary and is usually for persons 172
with advanced illness. POST records your wishes for medical 173
treatment in your current state of health. Once initial medical 174
treatment is begun and the risks and benefits of further therapy 175
are clear, your treatment wishes may change. Your medical care 176
and this form can be changed to reflect your new wishes at any 177
time. However, no form can address all the medical treatment 178
decisions that may need to be made. An advance health-care 179
directive is recommended for all capable adults and emancipated 180
minors, regardless of their health status. An advance directive 181
allows you to document in detail your future health care 182
instructions and/or name a health-care agent to speak for you if 183
you are unable to speak for yourself. 184
If this form is for a minor for whom you are authorized to 185
make health-care decisions, you may not direct denial of medical 186
treatment in a manner that would make the minor a "neglected 187
child" under Section 43-21-105, Mississippi Code of 1972, or 188
otherwise violate the child abuse and neglect laws of Mississippi. 189
In particular, you may not direct the withholding of medically 190
H. B. No. 1030 *HR26/R1430* ~ OFFICIAL ~
26/HR26/R1430
PAGE 9 (RF\KW)

indicated treatment from a disabled infant with life-threatening 191
conditions, as those terms are defined in 42 USCS Section 5106g or 192
regulations implementing it and 42 USCS Section 5106a.". 193
(h) A section entitled "Directions for Completing and 194
Implementing Form," which shall include the following four (4) 195
subdivisions: 196
(i) The first subdivision, entitled "Completing 197
POST," shall have the following language: 198
POST must be reviewed and prepared in consultation with the 199
patient or the patient's representative. 200
POST must be reviewed and signed by a physician or nurse 201
practitioner to be valid. Be sure to document the basis for 202
concluding the patient had or lacked capacity at the time of 203
execution of the form in the patient's medical record. The 204
signature of the patient or the patient's representative is 205
required; however, if the patient's representative is not 206
reasonably available to sign the original form, a copy of the 207
completed form with the signature of the patient's representative 208
must be placed in the medical record as soon as practicable and 209
"on file" must be written on the appropriate signature on this 210
form. 211
Use of original form is required. Be sure to send the 212
original form with the patient. 213
There is no requirement that a patient have a POST. 214
H. B. No. 1030 *HR26/R1430* ~ OFFICIAL ~
26/HR26/R1430
PAGE 10 (RF\KW)

(ii) The second subdivision, entitled 215
"Implementing POST," shall have the following language: 216
If a health care provider or facility is unwilling to comply 217
with the orders due to policy or personal objections, the provider 218
or facility must not impede transfer of the patient to another 219
provider or facility willing to implement the orders and must 220
provide at least requested care in the meantime unless, in 221
reasonable medical judgment, denial of requested care would not 222
result in or hasten the patient's death. 223
If a minor protests a directive to deny the minor 224
life-preserving medical treatment, the denial of treatment may not 225
be implemented pending issuance of a judicial order resolving the 226
conflict. 227
(iii) The third subdivision, entitled "Reviewing 228
POST," shall have the following language: 229
This POST must be reviewed at least annually or earlier if; 230
The patient is admitted or discharged from a health care 231
facility; 232
There is a substantial change in the patient's health status; 233
or 234
The patient's treatment preferences change. 235
If POST is revised or becomes invalid, draw a line through 236
Sections A-E and write "VOID" in large letters. 237
(iv) The fourth subdivision, entitled "Revocation 238
of POST," shall have the following language: 239
H. B. No. 1030 *HR26/R1430* ~ OFFICIAL ~
26/HR26/R1430
PAGE 11 (RF\KW)

This POST may be revoked by the patient or the patient's 240
representative. 241
(i) A section entitled "Review of POST," which shall 242
include the following columns and a number of rows determined by 243
the State Board of Medical Licensure: 244
(i) Review Date; 245
(ii) Reviewer and Location of Review; 246
(iii) MD/DO Signature (Required); and 247
(iv) Signature of Patient or Representative 248
(Required). 249
(j) A section entitled "Outcome of Review," which shall 250
include descriptions of the outcome in each row by selecting one 251
(1) of the following: 252
(i) No Change; 253
(ii) FORM VOIDED, new form completed; or 254
(iii) FORM VOIDED, no new form. 255
SECTION 2. Section 41-41-303, Mississippi Code of 1972, is 256
amended as follows: 257
41-41-303. (1) A physician, nurse practitioner or other 258
health-care provider acting in good faith and in accordance with 259
generally accepted health-care standards applicable to the 260
physician, nurse practitioner or health-care provider is not 261
subject to civil or criminal liability or to discipline for 262
unprofessional conduct for: 263
H. B. No. 1030 *HR26/R1430* ~ OFFICIAL ~
26/HR26/R1430
PAGE 12 (RF\KW)

(a) Executing a physician order for sustaining 264
treatment in compliance with a health-care decision of a person 265
apparently having authority to make a health-care decision for a 266
patient, including a decision to provide, withhold or withdraw 267
health care; 268
(b) Declining to execute a physician order for 269
sustaining treatment in compliance with a health-care decision of 270
a person based on a belief that the person then lacked authority; 271
or 272
(c) Complying with an apparently valid physician order 273
for sustaining treatment on the assumption that the order was 274
valid when made and has not been revoked or terminated. 275
(2) A health-care provider or institution that intentionally 276
violates Section 41-41-302 is subject to liability to the 277
aggrieved individual for damages of Five Hundred Dollars ($500.00) 278
or actual damages resulting from the violation, whichever is 279
greater, plus reasonable attorney's fees. 280
(3) A person who intentionally falsifies, forges, conceals, 281
defaces, or obliterates an individual's physician order for 282
sustaining treatment or a revocation of a physician order for 283
sustaining treatment without the individual's consent, or who 284
coerces or fraudulently induces an individual to give, revoke, or 285
not to give a physician order for sustaining treatment, is subject 286
to liability to that individual for damages of * * * Two Thousand 287
H. B. No. 1030 *HR26/R1430* ~ OFFICIAL ~
26/HR26/R1430
PAGE 13 (RF\KW)
ST: Nurse practitioners; authorize certain to
sign physician orders for sustaining treatment
(POST).
Five Hundred Dollars ($2,500.00) or actual damages resulting from 288
the action, whichever is greater, plus reasonable attorney's fees. 289
(4) On petition of a patient, the patient's agent, guardian, 290
or surrogate, a health-care provider or institution involved with 291
the patient's care, or surrogate for the patient as described in 292
Section 41-41-211(2) or (3), any court of competent jurisdiction 293
may enjoin or direct a health-care decision related to a physician 294
order for scope of treatment, or order other equitable relief. A 295
proceeding under this section shall be governed by the Mississippi 296
Rules of Civil Procedure. 297
SECTION 3. This act shall take effect and be in force from 298
and after July 1, 2026. 299