Island Voices
Three cheers for Kokua Mau
By Gail C. Christopher and Stephen Goldsmith
Recently our nation watched as the powers of patriotism and the human spirit reached new heights. Responding to the tragic events of Sept. 11, thousands of citizens and civil servants banded together in unprecedented moments of heroism and teamwork.
The spirit of America shines brightest during times of crisis, but all of us should be encouraged to know it also glows strong every day of the year. On a much less dramatic scale, dedicated, resourceful people throughout the public sector are working together to improve lives of others and help communities flourish, day in and day out.
The Innovations in American Government Awards were created 15 years ago to identify and celebrate outstanding examples of creative problem-solving in local, state and federal government. And this year, we are pleased to recognize a Hawai'i program for its unique and thoughtful approach to improving end-of-life care.
The Executive Office on Aging's Kokua Mau project joins 15 finalists eligible for a national award and a $100,000 prize. As a finalist, the program has already earned a $20,000 grant for its innovative achievements.
Meaning "continuous care," Kokua Mau weaves a lei of community support that brings together government, university and nonprofit organizations. The goal? To ensure that Hawai'i's citizens are able to die in the place of their choice, free from pain and according to their beliefs.
Gov. Ben Cayetano brought the topic of dying — taboo in many cultures — to the forefront in Hawai'i when he created the Blue Ribbon Panel on Living and Dying with Dignity. In 1998, the executive office and other partners established Kokua Mau as a direct response to the panel's recommendations. The program addresses pain management, hospice and palliative care, spiritual counseling, advance directives, and educating healthcare professionals and the general public.
The results have been impressive. Hawai'i citizens are using hospice care services more frequently — admissions have risen 20 percent since 1998. And today, all medical residents and nursing students in Hawai'i receive training on how to help patients and their families cope with the dying process.
Moreover, there has been a marked increase in the number of citizens over 60 who outline their advance directives — meaning that family members and health officials will know their healthcare wishes should they become incapacitated. Kokua Mau participants even helped spark a new law that enables citizens to include advance directive designations on their state identification cards.
An independent panel of prestigious judges will select five winners of the Innovations in American Government Award and announce them in December. Regardless of the outcome, everyone involved with Kokua Mau deserves to be commended for exceptional work. Hawai'i citizens should be very proud.
Kokua Mau has created an example of public- and private-sector collaboration that governments nationwide would be well-served to follow. This program's creative thinking and impressive achievements exemplify the power of innovation, so vital to good government and so central to the everyday vigor of the American spirit.
Gail C. Christopher is the executive director of the Institute for Government Innovation, Kennedy School of Government, Harvard University. Stephen Goldsmith is faculty director of the Innovations in American Government Program there.
