Legislative Agenda in Hawai‘i

Legislative agenda for the 2024 session

We have heard from our Hawaiʻi hospices that an administrative adjustment is needed in our current POLST law. We have created a bill for the 2024 Legislative session to address the issue. 

This will help to improve access to POLST, especially for some of the most vulnerable patients in hospice care. It will bring us in line with other states and will not decrease the integrity or importance of POLST. Nor will it affect the current wording of our Hawaiʻi POLST Form.

A team from Kōkua Mau has been working on this with Senator Moriwakiʻs office since December. Please visit our legislative webpage for step-by-step details and how you can submit testimony to support this administrative change to make and updated POLST available for all in hospice care.

Kōkua Mau Legislative Activities – 2019

Palliative Care SB 804

Latest news: Governor Ige signed the Support Palliative Care SB 804 on July 2, 2019 at the Governor’s chambers!!

Governor Ige signing the Support Palliative Care SB 804 in Hawaii

Great news and thank you to everyone who wrote supportive testimony. Many thanks to Senator Baker, Representative Belatti and Representative Mizuno for their support in shepherding the bill through.

About the Process Timeline:

May 2019: We are almost there! Our final version SB804 to support Palliative Care has now gone to the Governor’s Office.

This legislative session two bills focused on Palliative Care moved through both houses of the state legislature. This bill is a collaboration with Kōkua Mau, the American Cancer Society – Cancer Action Network (ACS-CAN) and the Department of Health.

On March 20, we joined ACS-CAN  to walk around to visit legislators and talk about the benefit of Palliative Care.

History of SB 804 or the Bills:

  • SB 804 was heard March 28 by the House Finance Committee and 3/20 by the House Consumer Protection and Commerce Committee. It was had been heard by the House Committee on Health on Tuesday 3/11. Initially it was heard 2/25 by the Senate’s Ways and Means Committee and was approved to move forward and cross over to the House.
  • HB 1447 was heard 2/26 by the House Finance Committee and was approved to crossover to the Senate.

THANK YOU to all who submitted testimony!!

Now that the bills are moving, we are asking our members and supporters again to write short testimony on why palliative care is important. These can be personal or professional stories.

They don’t need to be long but should help the legislators understand why we want extra support to expand education, training and access to palliative care. If you want inspiration on what to write, you can read the existing testimony connected to the bill or we can send you examples.

Need help submitting testimony?

Davin Aoyagi from ACS-CAN has agreed to submit your testimony for you! If you send him your testimony, he will make sure that the conference committee and headings are changed for each committee and that it is submitted on time. This is a great service so please utilize his expertise.

You can track these bills on the Legislature Website. You can ask to be notified when the bill will be heard next so you can submit in a timely way. https://www.capitol.hawaii.gov/home.aspx

Questions? Feel free to contact Jeannette or Davin Aoyagi.

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.
POLST Form for Hawaii posted by Kokua Mau

Archives on POLST


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 POLST website

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