Colorado’s End of Life Options Act at Denver Health

Colorado's End-of-Life Options Act (EoLOA), adopted in December 2016, permits terminally ill adults to request and receive prescribed medication for the purpose of ending their life in a peaceful manner. Qualifying patients must meet stringent requirements and must go through a mandated process outlined by this act. The act allows health care providers to opt in or opt out of participation in EoLOA activities; however, providers who opt out of participation must refer the patient to a provider who can support the request. Two out of three voters in Colorado voted in favor of the EoLOA. The EoLOA was updated in the 2024 legislative session to include SB24-068, which shortens the waiting time between visits and allows APRNs the ability to participate.

Denver Health supports its patients' right to access medical aid in dying services and has opted to allow medical aid-in-dying (MAiD) services at Denver Health under certain conditions.

Frequently asked questions

What should a patient do if they want medical aid in dying services via Denver Health’s MAiD program?

  • The patient or their next of kin should call Denver Health’s MAiD service line with questions or requests at 303-602-8044.
  • Leave a brief message including the patient’s name and a call back number. The call will be returned by a member of our team within one business day.

How long does the process take to access MAiD at Denver Health?

The law requires the patient attends two visits with two different providers separated by seven days.

Denver Health’s MAiD program holds clinic for first requests on Tuesdays, and clinic for second requests occur on Wednesdays. To reserve an appointment, all documentation must be submitted the Thursday prior to the appointment date.

Updates to the Colorado End of Life Options Act also allow the prescribing clinician the discretion to waive the seven-day waiting period if a patient is imminently dying. Please note that the two visits and written request still need to be completed in order to access the medication.

Does Denver Health’s MAiD program have a fax number for documents/referrals?

It is the preference of the program that all documents be sent via email to maidprogram@dhha.org.

If an agency prefers to fax records, they must first call the program to collect the appropriate medical record number for a patient to ensure records are received.

Will Denver Health determine if a patient is terminally ill?

No. A patient must receive a terminal diagnosis as well as a prognosis of six months or less from their community provider. Documentation of this prognosis is required prior to the first appointment with Denver Health MAiD.

Who is eligible to request and receive medical aid-in-dying medication?

Per the law, a Colorado resident who is 18 or older may request MAiD medication if/when:

  • They have a terminal illness with a prognosis of six months or less to live if the disease takes its natural course.
  • They have the mental capacity to make this medical decision.
  • They have voluntarily expressed this request for a prescription for medical aid-in-dying medication.

Does an individual have to be a current Denver Health patient to make a request to the MAiD program?

No pre-existing relationship with Denver Health is required to utilize the services of Denver Health’s MAiD program. Inquiries can be made for further information and clarification at 303-602-8044.

Are health care providers required to participate?

No, the law allows for any individual to opt out of participating in providing medical aid-in-dying services. Patients whose providers choose not to participate in these services can contact Denver Health’s MAiD program at 303-602-8044.

Please note that the legislation does require that if a provider has opted out of supporting a patient in accessing MAiD, that provider is obligated to refer the patient to a provider or program who can support the patient’s access of MAiD. For more information, please review the Colorado legislation.

Do other options exist for terminally ill patients?

Denver Health’s MAiD program strongly suggests all prospective patients research and enroll in hospice services prior to booking their first MAiD appointment to offer additional support for the end-of-life experience.

Denver Health’s palliative care team provides specialized medical care for patients with serious or life-threatening illnesses to improve symptoms, provide patient and family support, and facilitate end-of-life decision-making through its interdisciplinary team. Denver Health offers several options to terminally ill patients that provide support and comfort.

Where does an individual self-administer the medical aid-in-dying medication?

Each patient should discuss the manner and setting for self-administering medications and are encouraged to choose a private, secure, and home-like setting. Many patients choose to take the medication in their homes or private residences. The ingestion of medical aid-in-dying medication is not permitted at any Denver Health facility.

If a patient is living in an assisted living facility or a skilled nursing facility, it is encouraged to have a discussion with the administrators regarding the building’s policy regarding ingestion of MAiD medication on their property.

Does a physician or medical provider have to be present when the medication is taken?

EoLOA does not require the presence of a physician or medical provider when a patient takes the medical aid-in-dying medication. It is permissible for physicians to be present at the self-administration of the medication if requested by the patient and if the medical provider’s agency allows their presence during MAiD ingestion. The patient must self-administer the medication.

What is an informed decision?

An informed decision, as defined by EoLOA, is:

  • Made by a qualified individual to request and receive medical aid-in-dying medication which the individual may decide to self-administer to end their life in a peaceful manner.
  • The individual must be fully informed by the attending physician of:
    • Their medical diagnosis and prognosis of six months or less to live if the disease takes its natural course.
    • The potential risks associated with taking the medical aid-in-dying medication including the probable result of death following ingestion of the medical aid-in-dying medication.
    • All additional feasible treatment alternatives and opportunities, including comfort care, palliative care, and/or hospice services.
    • The patient’s right to not take MAiD medications at any point in their end of life journey.

How does a patient demonstrate residency?

A patient demonstrates Colorado residency by providing any of the following:

  • A Colorado driver’s license or identification card
  • A Colorado voter registration card or other documentation showing the individual is registered to vote in Colorado
  • Evidence that the individual owns or leases property in Colorado
  • A Colorado income tax return for the most recent tax year

NOTE: Denver Health requires a Colorado state issued identification card prior to booking the first MAiD appointment.

Can a non-resident move to Colorado to receive medical aid-in-dying services?

Qualified individuals must demonstrate current residency in Colorado and meet the requirements as outlined in EoLOA before receiving medical aid-in-dying services. The law does not explicitly prevent an individual from moving to Colorado for this purpose, however, patients must ultimately show proof of state residency to qualify.

If a patient’s primary care physician is located in another state, can that physician write a prescription for a patient?

No. According to EoLOA, only physicians licensed to practice medicine by the Board of Medical Examiners for the State of Colorado can write a valid prescription for medical aid-in-dying medication.

Will this be covered by insurance?

EoLOA does not specify who must pay for services. Individual insurers determine whether the medical aid-in-dying professional services (a minimum of three medical visits) and medication are covered. Federal law prevents the use of any federal funds to support these services, including federally-funded Medicare and Medicaid insurance.

How much will participation cost?

The costs associated with participation in EoLOA include the cost of the physician services and the prescribed medication. At this time, MAiD is an out of pocket expense. There are no other specific fees for participating in EoLOA.

If the costs are prohibitive, please speak with the program coordinator about financial assistance.

Can donations be made to support people accessing MAiD at Denver Health?

Yes! If you wish to support others wanting to pursue the Colorado End of Life Options Act at Denver Health, we welcome donations to Denver Health Foundation, designating the donation to “MAiD Program.” Such donations can be submitted via check or via the Foundation website. Thank you for your consideration.

Checks

Please make checks payable to “Denver Health Foundation” noting “MAiD Program” in the memo section. Checks can be sent to:

DH Foundation: 601 Broadway, MC 0111, Denver, CO 80203

Online donations

Please enter the website listed below, and when donating select “Other” for designation and write in “MAiD Program” for the description so that your contribution can support future patients.

www.denverhealthfoundation.org/donate/