Legislative Agenda POLST in Hawai‘i

Kōkua Mau Legislative Activities – 2014

Congratulations to all of us!

Governor Abercrombie signed the new expanded POLST legislation on June 30 and it goes into effect on July 1, 2014.  Kōkua Mau spearheaded the successful coalition that  pushed the bill forward.

Many thanks to everyone who helped to make this possible especially Senator Roz Baker who introduced the bill and Senator Josh Green and Representative Della Au Belatti who helped move it through the process.

The Kōkua Mau POLST Task Force is made up of Drs. Cherylee Chang and Daniel Fischberg, Queen’s Medical Center; Dr. Libby Char; Ken Zeri, Hospice Hawaii; Keith Ridley, DOH; and Jeannette Koijane, Kōkua Mau.  Additionally we had great support from Malia Espinda, QMC, and Kathleen Yokouchi and Valisa Saunders, Hawaii State Center for Nursing and the expert advice from Jim Pietsch, Director, University of Hawaiʻi Elder Law Program.

There was support for the legislation from a wide variety of organizations who submitted supportive testimony and attended hearings throughout the process including Healthcare Association of Hawaii, The Queen’s Medical Center, Hawaii Pacific Health, HMSA, The Department of Health, the Executive Office on Aging, UHA, the Hawaii Association of Health Plans, the Hawaii Association of Professional Nurses, Hawaii State Rural Health Association, the American Organization of Nurse Executives, American Association of Nurse Practitioners, UH Manoa School of Nursing and Dental Hygiene, Maui County Office on Aging, Hawaii Medical Association, Hawaii Island Family Medicine Residency, Lanai Community Health Center, and a cadre of individual well-spoken nurses, many of whom are Kōkua Mau members.

We are now working on revising the forms, updating the website and developing support material.  We will also be developing training materials so if you are interested in a POLST training, please let Jeannette know.

class=”rtecenter”>POLST Form for Hawaii posted by Kokua Mau


Archives on POLST

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POLST or Physician Orders for Life Sustaining Treatment is now Act 186 in Hawai‘i – July 2009.

Congratulations to the POLST team for their success and thank you to everyone who helped make it possible!

On July 16, 2009 POLST introduced as HB1379 HD2 SD2 CD1 became law without the Governor’s signature as Act 186, (Gov. Msg. No. 543)

As this legislation took effect, this website became the repository for POLST related information and questions and the bill’s implication for people living in Hawai‘i. 

During the 2009 Legislative session, our legislative agenda had focused on the passage of a bill to implement a POLST system (Physician Orders for Life Sustaining Treatment).  A coalition of healthcare providers, the Department of Health, and Kōkua Mau had been working on this legislation. Thank you to everyone who contributed testimony and helped this bill move forward and become law. Hawai‘i was the seventh State to pass a POLST. Please visit POLST.org to see if, and what form of POLST is or might be offered in other States.


Read the Honolulu Advertiser Article “Hawaii bill gives patients a voice – Document tells health workers how far to go in treating gravely ill” from June 15, 2009

What is POLST?

The Physician Orders for Life-Sustaining Treatment (POLST) is designed to improve the quality of care people receive at the end of life. It is based on the effective communication of patient wishes, documentation of medical orders on a brightly colored form and a promise by health care professionals to honor these wishes.

POLST complements an advance health care directive by taking the individual’s wishes regarding life-sustaining treatment, such as those set forth in the advance health care directive, and converting those wishes into a medical order. The hallmarks of a physician orders for life sustaining treatment form are that:

  1. The orders contained in the standardized form are immediately actionable, signed medical orders;
  2. The orders address a range of life sustaining interventions as well as the patient’s preferred intensity of treatment for each intervention;
  3. The form is clearly identifiable and is available in an electronic form;
  4. The form is recognized, adopted, and honored across various treatment settings.
  5. The form will be recognized by the Emergency Medical System, replacing the Comfort Care Only / Do Not Resuscitate Bracelet (the bracelet remains valid!)

The POLST form is particularly useful for individuals who are frail and elderly or who have a compromised medical condition, a prognosis of one year of life, or a terminal illness. The purpose of the bill currently in the legislature is to implement the use of a standardized form that states an individual’s wishes regarding end-of-life treatment in all pre-hospital and health care settings.

For more information on POLST, please visit the national website http://www.ohsu.edu/ethics/polst/

Please click here to track the POLST bill.

Please click here for a pdf of HB1379

Hawaii Revised Statutes Title 19 Health Chapter 327K Physician Orders for Life-Sustaining Treatment