Report Title:

End of Life Care

 

Description:

Makes an appropriation for research and analysis etc. of end of life care.

THE SENATE

S.B. NO.

2436

TWENTY-FIRST LEGISLATURE, 2002

 

STATE OF HAWAII

 


 

A BILL FOR AN ACT

 

Making an appropriation for 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 and university 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 deaths are of people age sixty and older with heart disease, cancer, and stroke as the leading causes of death. 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 leadership team consists of the executive office on aging, St. Francis Healthcare System’s International Center for Healthcare Ethics, the Hawaiian Islands Hospice Organization (consisting of all hospices in the State), and the Center on Aging at the John A. Burns School of Medicine. Leadership and funding are shared among the four lead organizations, assisted by multiple working committees and a statewide coalition of 265 organizations and individuals dedicated to improving care at the end of life.

Funding has been provided by the State, Robert Wood Johnson Foundation, Archstone Foundation, Atherton Family Foundation, Cooke Foundation, Freer Eleemosynary Trust, G.N. Wilcox Trust, S.W. Wilcox Trust, Hawaii Medical Services Association Foundation, Hawaii Association of Broadcasters, Hawaii Community Foundation, McInerny Foundation, Project on Death in America (SOROS Foundation), and St. Francis Healthcare System Foundation. Substantial amounts of pro bono time have been provided by professionals and concerned citizens.

Since its baseline year of 1998, this group has: established a professional speakers bureau that has reached at least 15,000 members of the public and professionals; increased hospice referrals by as much as forty per cent and admissions by approximately twenty per cent; added end-of-life curriculum for all medical and nursing students in the State; improved advance healthcare directive completion; provided the The Complete Life Course, a series of practical workshops for churches and temples across the State; and 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.

Funding for one year will enable the Kokua Mau coalition to progress in public and professional education and provide policy research and analysis. Funding will also enable planning to transition from a short term project and establishment of a center for end-of-life care that will provide information and referral services for the public as well as public and professional education and support resources.

SECTION 2. There is appropriated out of the general revenues of the State of Hawaii the sum of $100,750, or so much thereof as may be necessary for fiscal year 2002-2003, for improving end-of-life care through:

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

(2) Planning the establishment of a resource center for end-of-life care; and

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

The sum appropriated shall be expended by the department of health, executive office on aging, for the purposes of this Act.

SECTION 3. This Act shall take effect on July 1, 2002.

INTRODUCED BY:

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