Our Care, Our Choice Act (End of Life Option)

The Hawai‘i Department of Health has made steady progress over the past several months to prepare healthcare providers for the implementation of the “Our Care, Our Choice Act,” which goes into effect Jan. 1, 2019.

The progress can be attributed to the Our Care, Our Choice Act advisory group and collaboration with community partners to ensure a smooth implementation of the law.

Our Care, Our Choice Act
Under the new law, Hawai‘i residents 18 years old or older who are diagnosed with a terminal illness and have a prognosis of six months or fewer to live may obtain aid-in-dying prescription after two separate verbal requests to two physicians, a written request with a witness, and a mental health assessment to ensure the patients are capable of making medical decisions for themselves.

Healthcare Providers Critical to Implementation
As with any new law, preparing for implementation is challenging, especially in a relatively short timeframe. Healthcare providers are critical to the implementation of the law.

“The Department of Health has made it a priority to inform healthcare providers about their role and responsibilities under the law because, ultimately, patients will turn to their doctors first for information and questions as well as requests for aid-in-dying prescriptions,” said Lorrin Kim, Chief, Office of Planning, Policy and Program Development.

At this early stage, the department urges interested patients to begin conversations with their health care provider as early as possible, starting from now, and to concurrently explore supportive services provided by hospice care.

Participating in the Our Care, Our Choice Act is strictly voluntary for healthcare providers; however, the Department of Health has urged all providers statewide to anticipate patient needs.

Extensive Outreach Efforts
In October, the Department of Health encouraged providers to develop policies and procedures that inform patients about the full spectrum of alternatives, including palliative care and hospice care for symptom management, and to establish workflows for timely referrals and clinical support. Click here to view news release.

There have been extensive education, communication and outreach efforts by the Department of Health to inform healthcare providers, first responders, and others across the state about the law. The Department of Health is supporting a Continuing Medical Education event in early 2019, in addition to clinical education events from other stakeholders happening throughout late 2018 and into the new year. The law requires physicians to make known to patients all available alternatives, which is a particular focus for the department’s education efforts.

Patient-Doctor Conversations
Communicating with patients is equally as important for the Department of Health.

“We are also encouraging patients to have a conversation about the Our Care, Our Choice Act with their doctor now to better understand the complexities of the law and to consider enrolling in a hospice program for pain management and to take control of their lives,” Kim added.

Dedicated Web Resources
The Department of Health is preparing online resources for the public. Now under construction is a dedicated section on the Office of Planning, Policy and Program Development website with downloadable checklists and forms relating to the Our Care, Our Choice Act that can be easily accessed by providers and patients. The provider forms and documentation will be required for submission to the Department of Health to ensure annual reporting is met according to the new law.

As more information becomes available it will be posted on this site. You may also view the Our Care, Our Choice Act in its entirety here.