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Key Facts About the Our Care, Our Choice Act For Patients & Families
- The Our Care, Our Choice Act (OCOCA) went into effect on January 1, 2019 and was updated in 2023. View the Our Care, our Choice act in its entirety here. (You can read the PDF file by clicking here)
- Under this law, only Hawaiʻi residents who are 18 years of age or older who have received a terminal diagnosis of six months or less can begin the process of requesting a prescription for aid-in-dying medication.
- Participation in the Our Care, Our Choice Act is voluntary every step of the way – for patients, health care providers, health systems, pharmacists and insurers. No one can be forced to participate.
- A request for the OCOCA prescription must come directly from the terminally-ill patient. No one can request the medication on behalf of the patient.
- Patients must be able to make their own medical decisions and speak for themselves.
- The OCOCA prescription request cannot be written in to an advance directive, living will or Provider Orders for Life Sustaining Treatment (POLST). Learn more about POLST in Hawaii here.
- The law requires patients and their provider to go through several steps before the writing an OCOCA prescription, including verbal requests, a written request, consultation with a second participating provider, consultation with qualified counselor, and completion of several forms.
- The law requires that your provider talk with you about the importance of informing family and significant others, however, you are not required to inform your family or significant others.
- The law requires that your provider discuss with you feasible alternatives or additional treatment opportunities, including but not limited to hospice care, pain management, and palliative care.
- Patients who go through all the steps to obtain the OCOCA prescription can ultimately decide NOT to take the medication. National data show that, more than one-third of people who fill the OCOCA prescription never take the medication.
- A terminally-ill patient must be physically and mentally able to take the medication themselves, without assistance.
- Hawaiʻi law does not require insurance plans to cover the OCOCA prescription. Contact your health plan for details.
- Hawaiʻi Med-QUEST, the state’s program for people who qualify for Medicaid, covers the cost of OCOCA-related care and medication. Medicare, the federal program for people over 65, will not cover the cost of the medication.
- Under Hawaiʻi law, patients cannot be denied health insurance, life insurance or annuities because they are participating in the Our Care, Our Choice Act.
Under the law, taking a medical aid-in-dying prescription will not be viewed as suicide, assisted suicide, homicide, mercy killing, or other criminal conduct under the law. If all of the requirements of the Our Care, Our Choice Act are followed, the patient’s death certificate will list the terminal disease as the immediate cause of death.
Our Care Our Choice Act in Hawaii OCOCA Information for Providers
DOH webpage: Patients, Family Members, and Care Support Resources
DISCLAIMER: Nothing on this web page is intended to be, and should not be interpreted as, specific medical or legal advice regarding this complex piece of legislation and related medical issues. This information may serve as a guideline for providers who are seeking general information about participation in the Our Care, Our Choice Act (OCOCA).