HOUSE OF REPRESENTATIVES

H.B. NO.

2224

THIRTY-SECOND LEGISLATURE, 2024

H.D. 2

STATE OF HAWAII

S.D. 1

 

C.D. 1

 

 

 

A BILL FOR AN ACT

 

 

RELATING TO LONG-TERM CARE.

 

 

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

 

     SECTION 1.  The legislature finds that the State is fortunate to have the highest life expectancy in the United States with a record of 80.7 years.  The number of kupuna living to be over eighty, ninety, and even one hundred continues to grow.  As people age, they are more likely to experience differing abilities, with 27.8 per cent of older adults living with a disability.  This likelihood of living with a disability increases to 39.5 per cent for the middle-old (ages seventy-five through eighty-four) and 70.9 per cent for the oldest-old (aged eighty-five years or older).  According to the Centers for Disease Control and Prevention, the ten leading causes of death in the State are heart disease, cancer, stroke, accidents, Alzheimer's disease, chronic lower respiratory disease, coronavirus disease 2019, diabetes, influenza or pneumonia, and kidney disease.  Moreover, three out of ten deaths in the State are due to cardiovascular disease, which is largely preventable.  In addition, there are approximately twenty-nine thousand persons aged sixty-five and older living with Alzheimer's disease in the State who are cared for by fifty-one thousand family caregivers.  According to the Centers for Disease Control and Prevention, one in nine adults forty-five years or older in the State report experiencing subjective cognitive decline, as they notice memory problems that have been getting worse, and within this group, seventy-four per cent have at least one chronic condition.  By 2025, the number of people living with Alzheimer's disease in the State is expected to increase to thirty-five thousand, a more than twenty per cent increase from 2020.

     The legislature further finds that virtually all of the State's seniors prefer to age in place at home, with the option of receiving community-based services, rather than in a care home or institution, and that many seniors will require more intensive services and caregiving at the end of their lives.  Therefore, long-term care of the State's aging population is a matter of statewide concern.

     The legislature also finds that the costs of institutional care have escalated beyond the financial means of most seniors.  The State's portion of medicaid expenditures has increased steadily over the years and is projected to increase significantly as baby boomers enter retirement.  As the State's population ages, the number of frail and disabled individuals has increased, placing a precipitous demand on the need for long-term care services, as well as significant cost pressures on the state budget.  The legislature therefore finds that there is an urgent need to make quality long-term care services as accessible, efficient, and effective as possible.

     The legislature additionally finds that it is necessary to explore public and private sector approaches to support payment for long-term care services, which can assist seniors age in place and prevent the State from becoming fiscally liable for unsustainable costs under medicaid.

     Act 224, Session Laws of Hawaii 2008, established a long‑term care commission within the public policy center of the university of Hawaii college of social sciences to identify needed reforms of the long-term care system.  The commission produced a report entitled "Long-Term Care Reform in Hawaii:  Report of the Hawaii Long-Term Care Commission, Final Report", dated January 18, 2012.  Several bills were introduced during the regular session of 2012 to adopt the commission's recommendations.  However, only one bill was adopted, the kupuna care program, which had been a demonstration project since July 1999, and was codified in statute within the executive office on aging pursuant to Act 238, Session Laws of Hawaii 2012.

     The purpose of this Act is to establish:

     (1)  A comprehensive long-term care plan that incorporates certain essential components of long-term care services; and

     (2)  One long-term care planner position within the executive office on aging to oversee the development and implementation of the long-term care plan.

     SECTION 2.  (a)  The executive office on aging shall coordinate with the state health planning and development agency in the development of a long-term care plan as part of an overall health care system plan.

     (b)  The executive office on aging, in coordination with the state health planning and development agency, shall establish a comprehensive long-term care plan to:

     (1)  Identify essential components to ensure the availability of a full continuum of long-term care services, including homes, skilled nursing institutions, and other institutional and community‑based services;

     (2)  Identify needed reforms to establish a sustainable long-term care system;

     (3)  Research programmatic changes and resources necessary to meet the State's long-term care public policy goals; and

     (4)  Explore funding options to support the provision of long-term care services, including the recruitment, training, and retention of a skilled workforce.

     (c)  The executive office on aging shall submit a report of its findings and recommendations, including any proposed legislation, to the legislature no later than twenty days prior to the convening of the regular session of 2025.

     SECTION 3.  There is appropriated out of the general revenues of the State of Hawaii the sum of $79,872 or so much thereof as may be necessary for fiscal year 2024-2025 to establish and fund one full-time equivalent (1.0 FTE) long‑term care planner position within the executive office on aging to oversee the development and implementation of the comprehensive long-term care plan identified in section 2 of this Act.

     The sum appropriated shall be expended by the executive office on aging for the purposes of this Act.

     SECTION 4.  This Act shall take effect on July 1, 2024.

 

 

Report Title:

EOA; SHPDA; Long-Term Care Plan; Report; Position; Appropriation

 

Description:

Requires the Executive Office on Aging, in coordination with the State Health Planning and Development Agency, to create a comprehensive long-term care plan to accomplish certain long-term care policy goals that ensure the availability of a full continuum of institutional and community-based services.  Establishes and appropriates funds for one long-term care planner position within the Executive Office on Aging to oversee the development and implementation of the long-term care plan.  Requires the Executive Office on Aging to submit a report to the Legislature.  (CD1)

 

 

 

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