CONTRACT FOR CARE · RIGHTS, CONSENT & GOVERNMENT POWER
Our Legal Case
A patient’s need for medicine should not become the pressure used to obtain a criminal admission. Examine compulsory disclosures, penalties for silence, coerced rights waivers, and the circumstances behind the signature.
Use this state record to trace the legal requirement, then compare it with the terms an office adds. The full work explains the constitutional case, consent analysis, evidence needed, and protections to demand.
Apply the constitutional and consent review to this record
- Government responsibility: Which law, binding rule, agency instruction, or public-provider policy requires the particular disclosure or consequence? Separate it from provider-added terms.
- Potential criminal admission: Identify the exact spoken answer, written history, certification, or explanation and the real criminal risk it creates.
- Penalty for silence: Record what happens if the patient invokes the privilege or refuses a rights waiver, including denial, discharge, or interruption of treatment.
- Consent and pressure: Preserve the circumstances of signing, severity of pain, accessible alternatives, and whether the patient could honestly accept the prospective obligations.
- Criminal-use protection: Identify legally sufficient immunity and limits on use of both the answer and evidence derived from it. A privacy assurance is a separate protection.
Read the precedents, evidence framework, clause review, and remedies and reform demands. The work develops a proposed constitutional challenge; applying it to a particular condition requires its facts and legal authority.
Hawaii · 22 selected conditions
Separate the state requirement from the office’s terms
18 selected practice-document and access-policy conditions, plus four insurer-form conditions. These sources have different evidentiary limits; read each label before attributing a term to your care.
HRS §386-28 requires an informed-consent agreement for qualifying injured employees under workers’ compensation: opioid treatment beyond three months, opioids together with benzodiazepines, or a dose exceeding 90 morphine-equivalent doses. The broader §329-38.5 is repealed. Do not treat its older requirements as current law for every Hawaii patient.
The Board’s pain-management guidance discusses one physician/pharmacy when possible, agreements for higher-risk patients, testing and possible refill/discontinuation terms. Guidance that permits a term is different from a statute requiring that exact term. Read the source hierarchy and full comparison baseline.
WorkStar Injury Recovery Center
Historical agreement — current use unconfirmed
Two-page Pain Management Agreement, older 2021 upload path; indexed text reviewed. Original source URL — currently unavailable · Practice / publisher source
The original PDF URL now returns 404. Indexed text preserves an older Ewa Beach form; the current website lists six different office locations. These records do not establish that any current branch uses that form. Request the current signed packet before relying on these terms.
| Selected condition / source | Government baseline | Document or policy provision | Stated consequence |
|---|---|---|---|
| Privacy authorization · p. 2 | HRS §386-28 does not specify this condition. | Law-enforcement cooperation and waiver of privacy/privilege for the stated authorizations. | General breach clause: pain medicines stopped; taper may be offered. |
| Lost or stolen medicine · p. 1 | The Board guidance discusses this option; it does not impose this exact term universally. | No replacement. | Patient goes without replacement under this term. |
| Other prescribers · p. 1 | Board guidance favors one physician when possible. | No seeking controlled medicines from another doctor. | General breach clause applies. |
| Unused medicine · p. 2 | HRS §386-28 does not specify this condition. | Bring remaining pain medicine to every visit. | General breach clause applies. |
| Refill timing · p. 1 | The Board guidance discusses this option; it does not impose this exact term universally. | Office visit/business hours; no evenings, weekends or before next appointment. | Refill unavailable outside those limits. |
| Marijuana · p. 1 | HRS §386-28 does not specify this condition. | Listed among prohibited substances during pain-medication treatment. | General breach clause applies. |
Office records: Kapolei · Honolulu · Mililani · Kahului · Lihue · Kailua-Kona
Hawaii Institute for Pain
Intake reviewed — medication policy text needed
Seven-page New Patient Packet, revision 02/2021, currently linked. Document / policy source · Practice / publisher source
The packet names a Prescription Medication Policy but does not supply its terms in the seven downloaded pages. A question about another prescriber’s opioid agreement is not itself this practice’s opioid contract. Obtain the referenced policies before comparing refill, testing or termination terms.
| Selected condition / source | Government baseline | Document or policy provision | Stated consequence |
|---|---|---|---|
| Intake completion · p. 1 | HRS §386-28 does not specify this condition. | All pages completed and required signatures dated before evaluation. | Packet says patient cannot be seen until completed. |
| Policy acknowledgement · p. 2 | HRS §386-28 does not specify this condition. | Signature acknowledges medication, cancellation, courtesy and financial policies. | Specific medication-policy consequences cannot be established from this packet. |
Office records: Honolulu / East Oʻahu · Waipahu / West Oʻahu · Kahului / Maui
Spine & Pain Center of Kauai
Public intake and refill policies reviewed
17-page New Patient Packet, filename dated 02/2018, currently linked. Document / policy source · Practice / publisher source
The website says patients sign a medication agreement at arrival. The reviewed packet contains refill and other policies, but not the complete opioid agreement. Its separate chronic-care-management consent can be revoked; it is not evidence that patients must purchase those services to obtain opioids.
| Selected condition / source | Government baseline | Document or policy provision | Stated consequence |
|---|---|---|---|
| Refill/medication changes · p. 11 | The Board guidance discusses this option; it does not impose this exact term universally. | Requires an appointment for refills, new prescriptions and changes. | These services only occur at an appointment under the form. |
| Cancellation · p. 7 | HRS §386-28 does not specify this condition. | 24-hour notice; signed acceptance of cancellation charges. | $75 cancellation charge under the form. |
| Urinalysis · p. 17 | The Board guidance discusses this option; it does not impose this exact term universally. | A urine test may be required during a visit. | No specific refusal penalty stated here. |
Office records: Koloa
Vally Medical Group
Published policy — opioid-free service stated
Public article describing four agreement provisions; full signed agreement not located. Document / policy source · Practice / publisher source
Current location pages describe an opioid-free practice, while an article describes medication agreements. The article is policy evidence, not proof of current opioid prescribing. Applicability to current patients and the operative agreement version need confirmation.
| Selected condition / source | Government baseline | Document or policy provision | Stated consequence |
|---|---|---|---|
| One pharmacy · article, pillar 1 | Board guidance favors one pharmacy when possible. | Designate one pharmacy for all prescriptions. | No specific penalty stated. |
| Pill counts · article, pillar 2 | HRS §386-28 does not specify this condition. | Practice reserves on-demand pill counts. | No precise response deadline or penalty stated. |
| Drug testing · article, pillar 3 | The Board guidance discusses this option; it does not impose this exact term universally. | Regular/random urine testing; unexpected findings treated as breach. | Article says relevant parties are notified; recipients and stopping procedure are unspecified. |
| Other prescribers · article, pillar 4 | Board guidance favors one physician when possible. | Outside pain prescriptions require the practice’s prior knowledge. | No specific penalty stated. |
Office records: Hilo · Kealakekua · Kihei · Lihue
Hawaii Pain Center
Published non-opioid and attendance policies
Current website FAQ and No-Show Policy updated January 1, 2025. Document / policy source · No-show form
The website expressly says opioids have not been offered to new or existing patients since 2025. These are access and attendance policies, not an opioid agreement.
| Selected condition / source | Government baseline | Document or policy provision | Stated consequence |
|---|---|---|---|
| Opioid availability · FAQ | The agreement statute does not require a practice-wide opioid exclusion. | No opioid treatment offered since 2025. | Opioid treatment unavailable under the posted policy. |
| Referral · FAQ | HRS §386-28 does not specify this condition. | Referral and records review before scheduling, including self-pay. | Appointment depends on that review. |
| No-show · January 2025 form | HRS §386-28 does not specify this condition. | Missed visit or cancellation with less than one business day’s notice; case-by-case excuses. | Discontinuation of care stated; no no-show fee. |
Office records: Honolulu
UHA Health Insurance — payer form
Public payer agreement reviewed
Three-page Long Term Opioid Therapy Consent and Medication Agreement, code HCR-0689-122415. Document / policy source · Practice / publisher source
This insurer-hosted form is a separate comparison layer. It is not attributed to any listed clinic, and its online availability does not establish current coverage criteria or required use by all UHA members.
| Selected condition / source | Government baseline | Document or policy provision | Stated consequence |
|---|---|---|---|
| Signature · p. 3 | §386-28 requires informed-consent agreements only within its defined workers’ compensation scope. | Form makes consent signature a condition of long-term opioid treatment. | Treatment under this form requires agreement to the plan. |
| Lost/early medicine · p. 3 | The Board guidance discusses this option; it does not impose this exact term universally. | Provider might decline early refills or replacement of lost/stolen doses. | Discretionary refusal, not an absolute prohibition. |
| Testing response · pp. 1, 3 | The Board guidance discusses this option; it does not impose this exact term universally. | Urine testing; results or refusal prompt discussion of the plan. | Discussion may lead to changed or discontinued medication. |
| Single prescriber · p. 3 | Board guidance favors one physician when possible. | Opioid prescriptions only from the primary pain-management provider. | No separate automatic penalty stated for this bullet. |
Insurer document only: no office location is counted for this source.
Oʻahu Pain Care: agreement text needed
No contract provisions inferred. See the Honolulu and Hilo records.
Reviewed October 13, 2026. We have not verified each office’s current patient packet, actual enforcement, appointment availability or prescribing decisions. Shared organization documents are not separate agreements for each branch. A condition beyond the cited statute is not automatically unlawful.