End-of-Life Options Act Materials
Proposition 106 – Colorado End-of-Life Options Act (“the Act”) – was approved by voters in November 2016 and took effect Dec. 16, 2016. The Act allows Colorado residents with a terminal illness to request and self-administer medical aid-in-dying medication from a physician under certain conditions. In 2024, the General Assembly passed legislation updating the medical aid-in-dying law.
Senate Bill (SB) 24-068: Medical Aid-in-Dying – A health care provider may continue to choose whether to participate in providing medical aid-in-dying medication to an individual. In addition, health care providers – including hospitals – can prohibit physicians employed or under contract from participating in the Act in specific circumstances. Learn more here.
To ensure hospitals and hospital employees are in full compliance, CHA advises all Colorado hospital leaders to work quickly to fully understand how the law may impact their hospital, discuss with their respective boards whether the hospital will participate (opt-in) or not participate (opt-out) under the Act, and develop and adopt policies and procedures.
Effective Aug. 7, 2024, the bill makes the following changes to Colorado’s End-of-Life Options Act:
- Allows advance practice nurses the same prescribing authority as physicians;
- Reduces the waiting period between oral requests for medical aid-in-dying from 15 days to seven days and eliminates the waiting period to access the medication if the prognosis is less than 48 hours;
- Limits self-administration of medical aid-in-dying medication to ingestion only;
- If a provider is unable or unwilling to offer medical aid-in-dying services, they must disclose this to the patient and transfer, upon request, a copy of the individual’s relevant medical records to a new health care provider.
- Disallows facilities to prohibit providers from providing information to patients on the feasible end-of-life care and treatment options for the individual’s terminal disease and the individual’s right to withdraw a request for medical aid-in-dying;
- If any of the medical aid-in-dying requirements are found to be in conflict with federal requirements for the receipt of federal funds, the conflict part is solely inoperative and the conflict does not affect the operation of the remaining medical aid-in-dying rights and requirements; and,
- Codifies health and life insurance requirement to prohibit the denial or alteration medical aid-in-dying benefits to a covered individual with a terminal disease based on the availability of medical aid-in-dying and prohibits health insurance carriers from attempting to coerce a request for medical aid-in-dying.
To help member hospitals and health systems come into compliance with the law, CHA developed an issue brief and toolkit with a variety of resources, all available here:
- SB 24-068 Issue Brief
- A Hospital Guide to the Colorado End-of-Life Options Act
- Model Hospital Policies to Opt-In or Opt-Out
- Frequently Asked Questions
- Non-Participating Hospitals Memorandum
- Educational PowerPoint Presentation
- Sample Website Copy for Patient Notification
- Proposition 106
- CHA Comment Letter – CDPHE Reporting and Collecting Medical Aid-in-Dying Medication Information
CHA also presented a webinar with additional details, and those materials are available here:
CDPHE released guidance on reporting and collecting medical aid-in-dying medication information, which includes:
- 6 CCR 1009-4, Reporting and Collecting Medical Aid-in-Dying Medication Information (emergency rule adopted in January 2017)
- Attending/Prescribing Physician Form
- Medication Dispensing Form