New KCH Protocol Offers Closure for Families, Nurses After Death of Patient

New KCH Protocol Offers Closure for Families, Nurses After Death of Patient

By Tiffany DeMasters
June 14, 2021

Jen Davis still remembers the emptiness she felt the night her fiancé Elvis Sheppard passed away four years ago.

Davis, 39, was walking down a hallway out of Kona Community Hospital’s emergency room toward the dozens of people waiting for an update on Sheppard’s condition following his motorcycle crash.

“I just collapsed in the hallway — I’m crying in the hallway,” Davis told Big Island Now. “Then someone picked me up, we exited and I drove home.”

The grief of her fiancé’s death was compounded by a lack of resources from the hospital aimed at helping people navigate the loss of a loved one.

“It was like here’s the door, exit stage right,” Davis said.

Recognizing a need to extend their dedication of care beyond the loss of life, a group of KCH staff formed the Circle of Life Committee (COL) and put a Code Lavender in place at the facility. Code Lavender helps humanize that empty moment, as well as honor those who have passed and give support to those facing the uncertainties of grief and loss.

“(As a nurse) you have the functions of what you’re supposed to be doing, while you’re trying to read the room and be human about it,” said KCH nurse Valerie Pedrami and member of COL. “Once the patient has passed, there’s a stillness, an emptiness in a way.”

Code Lavender was created out of Pedrami’s passion to turn that moment of emptiness into something meaningful. The catalyst, the nurse said, were a
couple of employees who lost loved ones.

“I felt we weren’t doing enough to show we cared,” Pedrami said.
“We wanted to do more, not just for patients but for cohorts.”

Sheppard’s death — and its impact on Davis — made the need for Code Lavender even more apparent.

“I remember promising (Davis) I would make a change,” Pedrami recalled.


As an experienced critical care nurse, Pedrami can anticipate a patient’s death and mentally prepare herself.

None of it’s easy, she said, for the families or attending nurses.

“It’s always sad,” Pedrami explained. “It’s very emotionally charged, especially if there’s family present. It’s palpable — the emotions, sadness, the anxiety.”

COL, created in 2020, made its mission to create meaningful, respectful experiences for patients and KCH ‘ohana through education and tools relating to traumatic events, end-of-life matters and bereavement. Part of those tools was the adaption of a “Code Lavender,” developed at Santa Barbara Cottage Hospital in California, and tailored to the needs and culture at KCH.

Code Lavender provides support and closure between death and postmortem for both          nurses and families. “As a nurse, you can be stoic, but the reality is you have to zip up a      body bag and go down to the morgue,” Pedrami said. “This (Code Lavender) bridges            the gap. It’s taken a lot of work, but it’s rewarding work.                                                        Code Lavender was activated at KCH for the first time in May. Various elements of the      new protocol include the creation of comfort carts that hold items like stress balls,                aromatherapy, coloring books and books on grief available for a patient’s family.

Images of purple butterflies are now posted outside the door of a dying patient’s room    ensuring people in the area act respectfully and with reverence. After a patient dies,              staff now offer a Lavender Ceremony where a nurse reads a poem memorializing the            deceased. The ceremony is voluntary.

Pedrami performed the Lavender Ceremony for the first time in May. She said she was        nervous to ask them, but her intuition spoke to her and had a feeling the family would        be receptive.

“It was rewarding for my spirit and the family to put into words that we care,” Pedrami said. “Having your moment to kind of say your peace gives you closure and humanizes the moment.”

While the hospital already had literature on grief and some resources, Pedrami said, they did an overhaul of the material, creating an end-of-life resource book. Pedrami said the booklet talks about changes families will see in their loved ones as they come near their deaths.

It’s also a resource as it provides numbers to the mortuary and information on how to get a death certificate. KCH also has a different booklet on grief and the grieving process. Materials were used from Hospice of Kona but tailored to KCH.

The committee also created debriefing champions, who are available for a debrief session three days after Code Lavender has been activated. Pedrami said the hospital does have counseling available to staff, but the debriefing champions allow for staff to address the emotional trauma at the moment.


Code Lavender, Davis said, gives value to the life that’s been lost.

The night Sheppard died, Davis remembers having to sit down with doctors who were trying to explain to her what was going on.

“As a layperson, he was speaking a foreign language,” Davis recalled. “My body was in shock, nothing was registering to me. We were getting married in 28 days. I didn’t understand he was dying.”

After Sheppard’s death, Davis spoke to Pedrami about the lack of support and services and what needed to happen to change it.

“Val (Pedrami) is amazing. All the (KCH) nurses there are all incredible,” Davis said. “There was a need for it and this need has been addressed. It’s so touching to me that they heard me and that someone will be helped through this.”

While Pedrami and KCH staff were working on an adaptation of Code lavender, Davis found ways to support their efforts as well as honor Sheppard.

Davis along with friend and registered nurse Anne Broderson, founded the Elvis Sheppard blood drive in hopes of educating the public about the need for blood donors. It’s been held annually since 2017. In 2019, they broke the state record’s for largest collection in a single-day drive.

During the 2019 blood drive, Broderson and Davis held drawings in an effort to raise funds for the Kona Hospital Foundation’s Trauma Services. The women hoped the money collected would go toward a bereavement program.

“It’s all part of the bigger picture,” Davis said, calling the bereavement program “the best way to honor who he (Sheppard) was to all of us.”

Davis and Broderson raised approximately $30,000 that went toward funding aspects of Code Lavender, including getting materials for the comfort cart.

Broderson and Davis’ vision for a bereavement program was clear. They wanted there to be more education for the staff and effective communication to create fewer problems in the future.

“We wanted something focusing on the staff too,” Broderson said. “It’s extremely hard on the staff to watch someone die. People expect staff to be used to it.”

Davis thinks KCH has done an incredible job creating a bereavement program.

“Everything we were talking about, they addressed it,” Davis said. “It’s good no one will have to do this ever again. People will have help.”

Broderson, who was also friends with Sheppard, was with Davis the night he died. While there was a lot of confusion that night, Davis said, Broderson was there at her side.

A KCH nurse at the time, Broderson was off duty when Sheppard was brought in. She did what she could to help Davis understand what was happening and translated the medical jargon.

“It’s hard to take that extra time to answer questions and address all the things that come up,” Broderson said. “I was in a unique situation; I could be that person to take the extra time to serve in that role.”

Pedrami and COL gave a presentation to Davis and Broderson on Code Lavender and the additional changes to education KCH now provide. Broderson recalls being surprised how powerful the Lavender Ceremony was at providing closure.

Moving forward, both Davis and Broderson are optimistic that Code Lavender will change the experience of losing a loved one from emptiness to feeling supported.

“I think it’s cool to see the loss of someone so loved to carry over and benefit people in the future,” Broderson said. “We know Elvis would be proud of what’s been created in his memory.”

Kanuha named Senate majority leader

Kanuha named Senate majority leader
By Tribune-Herald staff | Thursday, May 6, 2021, 12:05 a.m.



State Sen. Dru Kanuha, a Kona Democrat, was named the new Senate majority leader, it was announced Wednesday.                                                                                                                                  His appointment follows the May 1 retirement of former Sen. J. Kalani English of Maui.

Kanuha, a former Hawaii County Council chairman, has served as the majority caucus leader since being elected to the Senate in 2018.

He’ll continue to maintain caucus leader responsibilities, according to a statement. He’ll also continue to serve as a member of the Ways and Means, Housing and Education committees.

Sen. Lorraine Inouye, a Hilo Democrat, will continue as the body’s majority whip. She’ll also continue to serve as chairwoman of the Water and Land Committee, as vice chairwoman of the Transportation Committee and as a member of the Ways and Means Committee.

Sen. Joy San Buenaventura, a Puna Democrat, will continue to serve as chairwoman of the Human Services Committee and as a member of the Health and Commerce and Consumer Protection committees.

And Sen. Laura Acasio — a Hilo Democrat who was appointed to her seat earlier this year after Kai Kahele was elected to the U.S. House of Representatives — will continue to serve on the Agriculture and Environment, Hawaiian Affairs, Human Services and Judiciary committees.






KCH will cease vaccine clinics at campus, Kekuaokalani Gymnasium on May 28

KCH will cease vaccine clinics at campus, Kekuaokalani Gymnasium on May 28

Kona Community Hospital Wednesday announced it will be wrapping up its public vaccine clinics at both its Kealakekua campus and at Kekuaokalani Gymnasium in Kailua-Kona.

The hospital will cease vaccine operations both sites on Friday, May 28, said hospital spokeswoman Judy Donovan. As of Thursday, Kona Community Hospital has administered 19,940 total vaccine doses.

“We have been honored to play a primary role in this very important public health initiative to provide vaccinations to our community,” said Donovan. “As the numbers of residents receiving the vaccine has increased, the demand for the vaccine has lessened to a manageable level. We are working closely with Premier Medical Group (PMG) as they step in to take administration of the Pfizer vaccination for West Hawaii residents.”

Thursday, May 27 will be the final clinic day at the Kekuaokalani Gymnasium/Kona Aquatic Center for the hospital. First doses will be administered through the final day in May. Second doses will be administered by PMG in June.

Friday, May 28 will be the final clinic day at hospital’s campus on Haukapila Street. First doses will be administered through final day in May, with second doses also being administered by PMG in June.

Thursday, June 17 will be the first clinic day for PMG at the Kona Aquatic Center Gymnasium.

KCH encourages anyone who may be postponing receiving a vaccine to strongly consider making an appointment. Vaccination eligibility is open for all individuals 16 years of age and older.

Contact he KCH Call Center at (808) 322-4451 to make an appointment or email Call Center service hours are 8 a.m. to 2 p.m. on weekdays.

Registration form with instructions can be downloaded online at

HEPA offers two scholarships totaling $6000 to Kona and North Kohala District Students

HEPA offers two scholarships totaling $6000 to Kona and North Kohala District Students

HEPA, the Hawaii Emergency Physicians Associated, Inc., who recently began staffing the emergency rooms at Kona Community Hospital and Kohala Hospital are offering (one) $3000 college scholarship to students in the Kona area and (one) $3000 college scholarship to students in North Kohala District. The scholarships will be awarded $1500 per semester per student.

The goal of the scholarship is to support a graduating high school student, who without financial assistance, is not likely to attend college. The primary criteria for scholarship consideration are financial and familial hardship.

Additional criteria for consideration includes:

  • Must be from West Hawaii Region (Kona area or North Kohala District)
  • Prior academic performance
  • Must be a graduating high school student

Scholarship application forms can be downloaded from the Kona Community Hospital website at Applications can also be requested via email from Judy Donovan at

Completed application forms must be received by Tuesday May 25, 2021.

Interested students should submit the following documents:

  • Application form
  • Photo copy of most recent report card or transcripts
  • Photo copy of SAR report or Free Application for Federal Student Aid (FAFSA) for applicable school year
  • 2 letters of reference from teachers, counselors, employers or other individuals who are familiar with your character and potential. Include this person’s relationship to student.

Mail all required documents to:

Kona Students:                                                     North Kohala District Students:

Judy Donovan                                                       Carmela Rice, RN

Marketing Director                                                 Chief Nurse Executive

Kona Community Hospital                                      Kohala Hospital

79-1019 Haukapila Street                                        54-383 Hospital Road

Kealakekua, HI 96750                                             North Kohala District, HI 96755


For more information, please contact Judy Donovan at 322-6960.

COVID vaccinations now open to all Big Island residents 16 and older

COVID vaccinations now open to all Big Island residents 16 and older

By STEPHANIE SALMONS Hawaii Tribune-Herald | Friday, April 2, 2021, 12:05 a.m.

All Big Island residents 16 and older can now register to receive a COVID-19 vaccine.

The state Department of Health on Wednesday announced that neighbor islands had the ability to expand vaccine eligibility as needed to ensure all vaccination slots are filled.

The Pfizer vaccine has been authorized for individuals 16 and older, while vaccines from Moderna and Johnson & Johnson are approved for adults 18 and older.

“We are strongly committed to accommodating as many community members as possible who are seeking the COVID vaccine,” said Kona Community Hospital spokeswoman Judy Donovan.

KCH has the capacity to administer more than 2,200 vaccines per week.

“As we look at our clinic calendar for later April and early May, our appointment numbers begin to trend down,” Donovan said. “Our goal is to keep all of our vaccine clinics full. Expanding to the broader population will help fill those clinics.”

As it prepares to administer 5,000 doses of the Pfizer vaccine on Saturday, Hilo Medical Center also announced its expanded eligibility Thursday.

“So the coconut wireless among the parents have been fast and furious,” HMC spokeswoman Elena Cabatu said with a laugh. “It went through all the baseball teams, all the basketball teams, soccer teams, the running club.”

Assistant hospital administrator Kris Wilson said a lot of parents are excited to reach this milestone for their children.

Cabatu said parents of college students hoping to return to school on the mainland or to in-person classes also are thrilled about the expanded eligibility.

Wilson said hospitals operating larger PODs, or points of dispensing, are really “driving the vaccine into the community,” but can have trouble filling those slots.

Appointments at HMC’s daily vaccination clinic and local pharmacies, however, are filling up, she said.

“But to do a mass vaccination effort and to make it successful and worth the community’s time … we want to maximize the amount of vaccine that we deliver on that date,” Wilson said.

Cabatu said HMC expects to have 5,000 people registered for Saturday’s clinic.

According to Wilson, HMC also anticipates giving its 25,000th dose on Saturday.

There is a “trickle effect” among previously eligible groups as vaccine hesitancy wanes, but Wilson said as eligibility is rolled out to the next larger group, there will be another push for inoculations.

“We’ll see everybody who really wants it, try to get in early and then those that kind of wait and see for others to get vaccinated, once they see that nothing happened to their friends, nothing happened to their family, they’ll come in and get vaccinated, too,” she said. “We really feel our role, at least for these mass vaccination efforts, is to get through that really excited crowd who wants to get in early, and who wants to be first at the gate when we open up that next group.”

Other providers said they also will begin administering vaccine doses to those 16 or older in the coming days.

Kerri Okamura, director of pharmacy operations for KTA Super Stores, said vaccines will be available for adults 18 and older at an upcoming mass vaccination clinic, scheduled for April 9 at the Edith Kanakaole Multi-Purpose Stadium.

The grocery chain aims to administer about 2,000 first doses of the Moderna vaccine at that clinic.

“I guess it makes it easier as far as screening and I hope there’s enough vaccine so that everyone can get it,” Okamura said. “I hope it wasn’t too early to expand. … It was a pretty big range that we opened up to, so we’ll see how it goes.”

KTA began offering vaccines in its four Big Island pharmacies in February.

“We’re pretty booked in our stores, so we still have our waiting list,” Okamura said.

To schedule an appointment, visit and click on the link for vaccination appointments at KTA’s Puainako location. Those who need assistance should call the pharmacy and press 6 and leave a message for a call back.

Queen’s North Hawaii Community Hospital also will expand its eligibility to those 16 and older starting Monday, said spokeswoman Lynn Scully.

The Waimea hospital still administers about 200 vaccines a day and is scheduled about two weeks out.


Another push for a new hospital in North Kona

Another push for a new hospital in North Kona

By Chelsea Jensen West Hawaii Today | Tuesday, March 9, 2021, 12:05 a.m.

Legislators are pushing forward the conversation about constructing a new hospital in North Kona with a pair of resolutions requesting the Hawaii Health Systems Corporation conduct a feasibility study.

Senate Resolution 53 and Senate Concurrent Resolution 35 were introduced Thursday calling for the Hawaii Health Systems Corporation (HHSC) to convene a task force to assess the practicality of constructing a new hospital in North Kona. Big Island Sens. Dru Kanuha (D-Kona, Ka‘u) and Lorraine Inouye (D-North Hawaii) are among the co-intruders with Sen. Laura Acasio (D-Hilo) as a co-sponsor on both resolutions.

Legislators are pushing forward the conversation about constructing a new hospital in North Kona with a pair of resolutions requesting the Hawaii Health Systems Corporation conduct a feasibility study.

Senate Resolution 53 and Senate Concurrent Resolution 35 were introduced Thursday calling for the Hawaii Health Systems Corporation (HHSC) to convene a task force to assess the practicality of constructing a new hospital in North Kona. Big Island Sens. Dru Kanuha (D-Kona, Ka‘u) and Lorraine Inouye (D-North Hawaii) are among the co-intruders with Sen. Laura Acasio (D-Hilo) as a co-sponsor on both resolutions.

Because the Senate Concurrent Resolution represents the entire Legislature, it must pass a vote on the floor of each chamber to be adopted. The Senate Resolution would only require a single Senate floor vote.

If adopted, the task force would include a representative from the state Senate and House; the director of the Department of Health; the CEO of the West Hawaii Region of the Hawaii Health Systems Corporation; a member of the West Hawaii Regional Health System Board of Directors; and any other representatives of the HHSC West Hawaii Region CEO. The West Hawaii Region CEO would also serve as chairperson of the task force.

The first meeting is requested to be held no later than June 1, 2021, and to submit a report of its findings to the Legislature prior to the opening of the 2022 session.

Jim Lee, CEO of the HHSC’s West Hawaii Region, said hospital leadership and the Board of Directors appreciate the legislators commitment to improving the health care system in West Hawaii.

“Because the needs of our current hospital facility are so great, meeting the future healthcare needs of the community is always at the forefront of our thoughts. Whether data is gathered via a task force, or a community needs assessment, studying the feasibility of building a new hospital is an important step to plan for the future,” said Lee, noting he just learned about and was reviewing S.C.R. No 53 and S.R. No 35.

QNHCH, HMC to being vaccinating seniors 70-74

QNHCH, HMC to being vaccinating seniors 70-74

By STEPHANIE SALMONS Hawaii Tribune-Herald | Friday, March 5, 2021, 12:05 a.m.


Big Island hospitals soon will begin vaccinating individuals over 70 against COVID-19, a move in alignment with the state Department of Health’s decision Wednesday to open inoculations to people 70-74 beginning Monday.

Queens North Hawaii Community Hospital on Monday will begin scheduling vaccinations for those over 70.

The inoculations are by appointment only.

To request an appointment, email, and include your name, date of birth, phone number and employer if you are an essential worker.

Anyone who previously emailed or called while they were ineligible, but are now eligible, are asked to email again.

Hilo Medical Center also will begin registering those over 70 beginning Monday.

For more information, visit

In a post on its website, Kona Community Hospital said it now is accepting appointments for individuals over 70.

For more information, visit

Inoculations from HMC and KCH also are by appointment only.

As of Thursday 380,310 doses of COVID-19 vaccine have been administered statewide, an increase of 8,967 from the previous day.

The state has ordered 507,730 vaccine doses and has so far received 470,150.

According to data from the DOH, 14.7% of Hawaii County’s 201,500 residents have received at least one vaccination dose, while 6.9% have received two doses.

The DOH on Thursday reported 60 new cases of COVID-19 in Hawaii, including four new cases on the Big Island.

Hawaii Island has a 0.4% test positivity rate, compared to a 1% positivity rate statewide.

The number of COVID-related deaths in Hawaii remain at 441.

There have been no COVID-19 clusters under investigation in Hawaii County in the last 14 days, according to a weekly cluster report issued by the DOH.

Inoculations continue: Residents 70 and older eligible for vaccinations starting Monday

Inoculations continue: Residents 70 and older eligible for vaccinations starting Monday

By Laura Ruminski West Hawaii Today | Friday, March 5, 2021, 12:05 a.m.

Pfizer vaccines are ready to be administered at the Kona Community Hospital clinic Thursday at Kekuaokalani Gym. (Laura Ruminski/West Hawaii Today)

Kona Community Hospital held its second COVID-19 vaccine mega clinic Thursday, with more than 600 individuals registered to receive a dose at Kekuaokalani Gymnasium in Kailua-Kona.

With the 615 doses administered Thursday, the hospital has now given more than 7,300 doses of the Pfizer vaccine to Phase 1A front-line workers, and Phase 1B kupuna age 75 and older and essential workers, said Judy Donovan, Kona Community Hospital’s marketing and strategic planning director.

Phase 1B essential workers now include employees in transportation (bus, mass transit and dock workers), agriculture, grocery stores, food suppliers, restaurants, gas stations, skilled trades (mechanics, electricians, plumbers), financial institutions, and hospitality/hotels.

The process begins with those set to get the vaccine entering the gym and being checked in. Next, they headed to a waiting area where their paperwork was verified. Once confirmed, nurses and National Guard medics administered the shot and sent the person for a 15- to 30-minute wait under the watchful eye of medical personnel. The whole process takes about 45 minutes to an hour.

The closed point of dispensing (POD) mega clinic is being put on thanks to a partnership between Kona Community Hospital, Alii Health Center, West Hawaii Community Health Center, state Department of Health, Hawaii County and the Hawaii National Guard. Kona Community Hospital is operating the clinic on Thursdays, the Department of Health on Tuesdays and West Hawaii Community Health Center (WHCHC) on Fridays.

Today, the West Hawaii Community Health Center will host the first walk-in clinic at the gym from 9 a.m. to 3 p.m. for kupuna 75 years of age and older. No pre-registration is needed and vaccination is on a first-come, first-served basis for Hawaii County residents with a valid ID only. Part-time “snowbird” residents are eligible but must provide proof of part-time residency.

Patients of WHCHC may register for the in-clinic vaccination by visiting

Though hundreds pulled up their sleeves Thursday, KCH Medical Director Alistair Bairos said he would like to see more people at the clinic.

“We need more people to sign up and come for our vaccine,” he said.

That hopefully will happen because starting Monday, the eligibility age for vaccine administration will drop to 70 and older for all dispensers, including North Hawaii Community Hospital and the state Department of Health.

Vaccinations are by appointment only at the Waimea facility. To request an appointment, email and include your name, date of birth, phone number, and employer if you are an essential worker.

To schedule an appointment to receive the Moderna vaccine via the Department of Health call (808) 300-1120. Frontline essential workers will receive vaccinations coordinated through their employer or industry organizations. Organizations with frontline essential workers in Phase 1B should complete not more than one online survey available at

To schedule a vaccination with Kona Community Hospital, call (808) 322-4451. Information can also be obtained via email to


Mass COVID Vaccination Clinics Continue Weekly, Walk-Ins Accepted on Fridays

Mass COVID Vaccination Clinics Continue Weekly, Walk-Ins Accepted on Fridays

By Tiffany DeMasters March 4, 2021, 5:44 PM HST

Galen Kawasaki has been waiting to get the COVID-19 vaccine since the pandemic broke out a year ago.

The Safeway cashier got his chance to obtain the shot through Kona Community Hospital’s second mass vaccination clinic on Thursday at the Kona Community Aquatic Center gym. Kawasaki was one of more than 600 people to be inoculated.

“It’s a relief that we can get some protection,” Kawasaki said.

Mass vaccinations have been taking place in Hilo and Kona by appointment only. Up to now, kūpuna ages 75 years or older, essential workers and educators have been the only ones qualified to receive the shot. However, starting March 8, the Department of Health will now offer the vaccine to individuals 70 years of age or older.

Judy Donovan, KCH spokeswoman, said the hospital was unable to handle the number of people requesting appointments for the vaccine. Last week, more than 200 people were vaccinated at KCH.

“Working in collaboration with the Department of Health and West Hawai‘i Community Health Center, we decided to pool our resources and come down to the gym…and open up to a much larger population,” Donovan said.

People were moving through the gym smoothly. With members of the public checking in on the makai side of the building, they filled out paperwork while waiting for the next health care worker available to give the vaccine.

When the health care worker was finishing vaccinating someone, he/she held up a paddle indicating he/she was ready to take the next person waiting.

After getting the shot, people waited in an observation area for 15 minutes to ensure they didn’t have a bad reaction to the vaccine. For those with a history of allergies to vaccines, they were required to stay 30 minutes.

Hawai‘i County has offered the gym as a location to continue the mass clinics until they are no longer needed.

Starting tomorrow, March 5, West Hawai‘i Community Health Center (WHCHC) will offer a walk-in clinic for the community every Friday from 9 a.m. to 3 p.m. Natasha Ala, director of marketing and development at WHCHC, said this week’s clinic will be for kūpuna 75 years or older and essential workers.

“It’ll be first-come-first-serve so come when you can,” Ala said Thursday.

KCH is administering the Pfizer vaccine while WCHC is proving the Moderna vaccine. DOH also announced the single-shot Johnson & Johnson vaccine was now available in the state, however, Donovan and Ala don’t know when their respective facilities will have access to it.

The Kona hospital and clinic aren’t currently having supply issues.

“We have a steady supply of Pfizer…,” Donovan explained. “Right now we’re receiving one tray a week (975 doses).

Donovan added they always want to have enough vaccine on hand to provide the second shot.

For several weeks now, Hawai‘i County has maintained a low number of COVID cases. Donovan believes the reason behind this isn’t just because of the vaccine rollout.

“I’ve been pretty amazed with our community and their compliance with the mask wearing and social distancing,” she added. “Almost everyone I see is willing to do what’s necessary to protect each other.”

The resounding feeling among people waiting for their vaccine during Thursday’s clinic was the importance of protecting not only themselves but those around them from the virus.

“(I’m here) to help prevent it from going further, including ourselves,” said Barbara Cameron who was there with her husband Jim. Both are 75 years or older.

Kawasaki said a lot of his family and friends are at risk or have been affected by COVID-19.

“Just take it — it’s easy,” Kawasaki said. “It’s harmless, painless, quick and simple. Didn’t hurt at all.”

For more information on obtaining a vaccine through KCH, click here.

For more information on obtaining a vaccine through West Hawai‘i Community Health Center, click here.

For more information on obtaining a vaccine through Hilo Medical Center, click here.

Hospitals resist Our Care, Our Choice Act

Hospitals resist Our Care, Our Choice Act

By STEPHANIE SALMONS Hawaii Tribune-Herald | Sunday, February 14, 2021, 12:05 a.m.

Kathleen Katt

Those seeking to access the Our Care, Our Choice Act still face barriers.

Enacted in 2019, the aid-in-dying law allows Hawaii residents 18 years old or older who are diagnosed with a terminal illness and have a prognosis of six months or less to live to obtain a fatal prescription after two separate verbal requests to a physician, a written request with two witnesses and a mental health evaluation to ensure they are capable of making medical decisions for themselves.

But a lack of providers willing to participate and policies implemented by island health care systems are hindering access to aid-in-dying.

The East Hawaii Region of the Hawaii Health Systems Corp., which includes Hilo Medical Center, will not participate in OCOCA-related services on its premises, according to a new policy implemented this month.

That includes the duties required by providers under the law, prescribing or delivering aid-in-dying drugs; and prohibiting patients from self-administering the drug while a patient is in an East Hawaii Region facility.

Under the policy, however, providers can still diagnose or confirm a terminal illness, provide information about the law upon request, refer the patient to another health care provider who does participate, and support the patient and their families through the end-of-life process.

According to the policy, providers won’t be censured, disciplined, lose privileges or face any penalty for participating in OCOCA outside of an East Hawaii Region facility.

Approved by the HMC executive management team this month, the policy applies to all East Hawaii critical access hospitals, long-term care facilities, clinics and the Hilo hospital.

“We really support this, and we’re very glad the Legislature has allowed this service to be provided to our community and the people of Hawaii,” HMC Chief Medical Officer Kathleen Katt said. “We are unable to provide the service at our hospital, because we don’t have the resources that are needed to be able to fulfill all of the requirements.”

“We have providers already stretched thin doing clinic work, seeing their own patients,” hospital spokeswoman Elena Cabatu said. “It would require more care for this one patient that they’re already receiving.”

Katt said the health care system supports patients with terminal illnesses and their families through end of life by supporting patient health care services and providing pastoral and palliative care services.

Providers also could refer patients to other providers in the community who provide aid-in-dying.

A similar policy is in place in North Hawaii.

“Although we respect patients’ dignity and right to choose, QNHC does not participate in Our Care, Our Choice Act activities,” said Lynn Scully, spokeswoman for Queen’s North Hawaii Community Hospital in Waimea.

Kona Community Hospital, however, which is part of the HHSC West Hawaii Region, is in the final stages of adopting a position of “engaged neutrality,” spokeswoman Judy Donovan said.

“KCH supports our patients and their choices regarding the law,” she said. “We will provide appropriate educational resources that allow a patient to make informed end-of-life decisions. However, the hospital does not participate in OCOCA by way of allowing the administration of end-of-life medications on the KCH campus.”

According to Donovan, when a patient requests life-ending medication under the law, KCH providers will participate by offering appropriate resources or support and performing duties that are considered standard care for end-of-life patients.

“For years, KCH providers and the health care team have performed certain aspects of end-of-life processes, such as diagnosing or confirming a terminal disease; providing info to a patient in order to make informed decisions; determining a patient’s capacity, etc.,” she said. “These tasks, along with palliative care, are the standards of care in end-of-life patient care. The determination to provide neutral support of OCOCA was the next step in the evolving standards of care for end-of-life patients.”

Employees are not mandated to participate in OCOCA, but they are educated about KCH’s policy and will arrange for another staff member to provide the requested educational resources, Donovan said.

Donovan said the adoption of this policy is a component of KCH’s inaugural Circle of Life program.

Circle of Life is an employee-based support program that aims to create “meaningful experiences for employees and patients through the use of education and tools relating to traumatic events, end-of-life matters and bereavement.”

Sam Trad, state director for Compassion and Choices, part of a national organization that advocates for end-of-life rights, said finding a provider is the biggest challenge to accessing the law — especially in East Hawaii — and creates a “real barrier.”

“I get a lot of calls from East Hawaii patients who want this option, and currently the only solution is for them to see doctors on the other side of the island,” she said. “I know of at least two patients who died before they were able to complete the process because there’s no doctor in East Hawaii who will support patients. …”

Trad said she encourages health care systems and hospices to have a neutral policy regarding the law.

“If a doctor wants to support the patients in the option, they can,” she said. “We don’t expect any health care systems to be overly supportive of the option but also hope they don’t (oppose) it.”

Calls to Hawaii Care Choices, formerly Hospice of Hilo, were not returned.