SB927 CD1

Report Title:

Adult Day Health Care; Research Corp. of UH; Rehabilitation

Description:

Allows the governor to contract with the Research Corporation of the University of Hawaii to develop an adult day health care program and a research center and to study their effectiveness in lowering medicaid costs for the frail and elderly. (CD1)

THE SENATE	S.B. NO.	927
TWENTY-FIRST LEGISLATURE, 2001		S.D. 1
STATE OF HAWAII		H.D. 1
		C.D. 1

A BILL FOR AN ACT

RELATING TO ADULT DAY HEALTH CARE CENTERS.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

SECTION 1. The legislature finds that due to the institutionalization of frail, elderly persons into nursing homes, the continuing hospitalization of elderly persons, and their development of severe chronic illnesses, medical costs continue to rise for the care of the frail and elderly on medicaid. To address this issue in a manner that minimizes social, economic, and public dysfunction, the State needs to help keep frail and elderly persons more independent in their own homes or in a similar environment that creates the least amount of dysfunction as possible.

The legislature further finds that innovative solutions must be sought to address the major underlying factors which may lead to a loss of independence and ensuing dysfunction. New strategies are required to minimize attendant social, economic, and public costs. This requires appropriate and innovative programs to address the underlying problems of disease and dysfunction, both mental and physical.

An adult day health care program would provide a place for rehabilitation and wellness that has the potential to address the underlying problems of loss of independence, chronic disease, and dysfunction. The department of health has supported the concept of an adult day health care center as an alternate means to lower all costs in the long-term care of the frail and elderly population. The department has indicated its willingness to examine ways of allowing those who are currently ineligible under the medicaid program to become participants at an adult day health care center.

Accordingly, the legislature further finds that these strategies for providing a wellness and adult day health care center are particularly well-suited for complex projects that need to be completed efficiently and effectively.

The strategy to provide programs for the poor, frail, and elderly is essential to the success of innovative approaches to the problems of rising institutionalization and physical and mental illness rates. This strategy is to provide innovative programs to address the underlying causes of disease by developing research and rehabilitation programs to reduce the number of hospitalizations, institutionalizations, and severe chronic illnesses. This would eliminate the necessity to continue building additional skilled nursing facilities and will allow capital funds to be used for other innovative programs in the care of the elderly. This strategy includes the following:

(1) Development of a nonprofit research center to collect and analyze data from adult day health care participants to be used in developing individualized treatment programs;

(2) Research on the relationship between nutrition and behavior patterns in the frail and elderly population;

(3) Research on the effects of proper balanced nutrition and exercise on adult day health care participants with diabetes, heart disease, obesity, and mental disabilities; and

(4) Follow-up testing of adult day health care participants to provide data on program effectiveness.

The legislature further finds that the State has an opportunity to take advantage of these innovative strategies for research and rehabilitation that include programs addressing the underlying causes of morbidity and dysfunction. The State also has the opportunity to develop programs to change behavior and programs to effectively keep the frail and elderly independent, thereby substantially reducing hospitalization, institutionalization, and severe physical and mental disabilities.

The purpose of this Act is to authorize the governor to enter into a contract with the research corporation of the University of Hawaii to take advantage of these and similar innovative strategies to develop an adult day health care program and to conduct research and develop programs to provide effective support, and when possible, rehabilitation.

SECTION 2. The research corporation of the University of Hawaii may negotiate, upon approval and on behalf of the governor, for the development of a program to provide for the development of adult day health care centers capable of providing day health care services to all frail and elderly persons as well as physically and mentally disabled adults of all ages. The person or organization chosen by the University of Hawaii and the governor to develop the program shall have at least five years' experience in treating medicaid recipients in adult day health care centers. The center established under this section shall:

(1) Have a capacity to accommodate a minimum of forty frail and elderly participants;

(2) Offer extensive health and treatment programs;

(3) Have sufficient space to accommodate these programs;

(4) Be a free standing facility that sits on its own foundation;

(5) Offer a variety of educational programs to ensure that participants will successfully incorporate healthy life habits into their everyday lives, whether at the center or at home; and

(6) Include a research center that may be located at the facility or at another appropriate location to provide for the nonprofit research corporation to conduct research into the behavior of adult day health care participants and the effectiveness of the programs. The research center should include professional personnel as well as scientific researchers and medical personnel qualified to conduct research utilizing the most innovative, state-of-the-art methodologies and technology. The research center shall provide:

(A) For the collection of test and chart data;

(B) Research equipment and test material;

(D) Quarterly reports to the State on testing progress and findings from chart reviews.

The rehabilitation center's annual operating budget shall not exceed the highest annual cost per day to operate existing adult day health care centers in the State.

SECTION 3. There is appropriated out of the general revenues of the State of Hawaii the sum of $300,000 or so much thereof as may be necessary for fiscal year 2001-2002 and the sum of $300,000 or so much thereof as may be necessary for fiscal year 2002-2003 for the development of a private research center and an adult day health care program as provided in this Act.

The sums appropriated shall be expended by the University of Hawaii at Manoa for the purposes of this Act.

SECTION 4. This Act shall take effect upon its approval; provided that section 3 shall take effect on July 1, 2001.