DOH Patient & Provider Guidance on ‘Our Care, Our Choice Act’

Starting on Jan. 1, 2019, Hawai‘i residents with a terminal illness and six months or fewer to live may request medical-aid-in-dying prescriptions under the Our Care, Our Choice Act, which was signed into law by Gov. Ige earlier this year. To help patients and providers understand the process required by law, the Hawai‘i Department of Health (DOH) launched a new page on its website where all required forms, instructions and frequently asked questions can be accessed.

The law covers strict eligibility criteria and safeguards to ensure a secure, compassionate and patient-centered end-of-life process. There are also additional regulatory requirements to address concerns about misuse.

“We hope these online resources give patients and providers the guidance and tools they need to utilize the Our Care, Our Choice Act,” said Lorrin Kim, chief of DOH’s Office of Planning, Policy and Program Development. “Our goal is to facilitate the process and create a one-stop shop that allows people to navigate the process safely and follow the requirements of the law.”

Guidance for Patients

DOH offers the following recommendations to patients who wish to receive a medical-aid-in-dying prescription in Hawai‘i:

• Concurrently enroll in hospice care. Hospice programs offer the highest level of end-of-life care to effectively manage symptoms and provide assistance to family members of patients.
• Inform and designate a person to follow up on your behalf. The Our Care, Our Choice Act does not require patients to inform family members of their decision; however, after the patient takes the medication, the completed final attestation form must be returned to the attending physician. Additionally, the designated persons should safely dispose of any remaining medications.
• Talk to your health plan about cost and coverage of the prescription. The law is silent on how much medical-aid-in-dying prescriptions will cost and does not address supply and demand issues. Federal laws may prohibit some programs from participating.

Guidance for Providers

DOH encourages providers to be familiar with the forms and processes required by law. Practitioners should have a sound understanding of their organization’s policies so they are equipped to provide their patients with the best and most appropriate care possible.

Several Continuing Medical Education (CME) courses will be made available to educate medical professionals and stakeholders over the next few months. The schedule of upcoming courses is as follows:

• Saturday, Jan. 19, 2019, from 8 to11:30 a.m. Host: Hawai‘i Society of Clinical Oncology at the University of Hawai‘i Cancer Center. More information and registration: https://bit.ly/2Af0Q4Y
• Friday, Feb. 1, 2019, from 1 to 4:45 p.m. at the Queen’s Medical Center.  For more information and registration: email cme@queens.org
• Saturday, Feb. 2, 2019, from 9 a.m. to 12:45 p.m at the University of Hawai‘i John A. Burns School of Medicine. More information and registration: email costaca@hawaii.edu

Other training opportunities and resources for providers will be shared and posted on DOH’s website once they become available.