Report Title:

End of Life Care

Description:

Appropriates $255,074 for FY 2003-2004 and FY 2004-2005 to fund the creation of an end of life center. Creates end of life center within executive office on aging.

HOUSE OF REPRESENTATIVES

H.B. NO.

612

TWENTY-SECOND LEGISLATURE, 2003

 

STATE OF HAWAII

 


 

A BILL FOR AN ACT

 

RELATING TO IMPROVING END-OF-LIFE CARE.

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

SECTION 1. Across almost all cultures, it is taboo to talk about death and dying. These taboos create a public and professional culture in which many people die alone, in pain, in unfamiliar institutional settings, and with their families exhausted and impoverished. This assessment is confirmed by the SUPPORT Study, a landmark national investigation involving 9,105 dying patients, and echoed by findings of Hawaii's 1998 governor's blue ribbon panel on living and dying with dignity. Hawaii's Kokua Mau project was initiated by the executive office on aging, the University of Hawaii, and private sector partner organizations to address these issues.

Kokua Mau's goal is to support all Hawaii's people in dying well. In Hawaii, approximately eight thousand people die each year. Approximately seventy per cent of Hawaii deaths are of people aged sixty and older with heart disease, cancer, and stroke. These are long-term conditions for which improved care at the end of life, including hospice and palliative care services, has the potential to greatly relieve suffering for those nearing the end of life and their families and caregivers.

Kokua Mau's current management team consists of the executive office on aging, the Hawaiian Islands Hospice Organization (consisting of all hospices in the State), the Center on Aging and the Department of Geriatric Medicine at the John A. Burns School of Medicine. Leadership and funding is shared among the four lead organizations, assisted by multiple working committees and a statewide coalition of two hundred sixty-five organizations and individuals dedicated to improving care at the end of life. Substantial amounts of pro bono time have been provided by professionals and concerned citizens.

Since its baseline year of 1998, this group has:

(1) Established a professional speakers bureau that has reached at least seventeen thousand members of the public and professionals;

(2) Increased hospice referrals by as much as forty per cent and admissions by approximately twenty per cent;

(3) Added end of life curriculum for all medical and nursing students in the State;

(4) Improved advance healthcare directive completion;

(5) Provided The Complete Life Course, a series of practical workshops for churches and temples across the State; and

(6) Organized workshops across the State for professionals who work with older adults.

For its work with Kokua Mau, the executive office on aging received Harvard's 2001 Innovations in American Government award as one of the top fifteen most innovative government programs in the nation. However, people's deep-seated reluctance to deal with these topics continues to be a serious barrier for both the public and professionals in talking about and dealing with death and dying.

SECTION 2. There is established within the executive office on aging a center for end of life care that will provide information and referral services for the public, professional education, and support resources. The center shall:

(1) Conduct policy research and analysis on hospice and palliative care, pain management, and advance health care planning;

(2) Establish a resource center for end of life care; and

(3) Coordinate related public and professional education with Kokua Mau, Hawaii's end of life care coalition.

SECTION 3. There is appropriated out of the general revenues of the State of Hawaii the sum of $255,074, or so much thereof as may be necessary for fiscal year 2003-2004, and the same sum, or so much thereof as may be necessary for fiscal year 2004-2005, for establishment of an end of life center to improve end of life care. The sums appropriated shall be expended by the department of health, executive office on aging, for the purposes of this Act.

SECTION 4. This Act shall take effect on July 1, 2003.

INTRODUCED BY:

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