HB838

SECTION 1. The legislature finds that virtually all of Hawaii's seniors prefer to age in place at home 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. Over the years, many initiatives have been undertaken to facilitate the needed transformation of the services and programs that support seniors and persons with disabilities in Hawaii, such as Quest-Ex, the expansion of Kupuna Care, the Aging and Disability Resource Center, and the Going Home Program.

The legislature further 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 are entering retirement. As Hawaii's population ages, the number of frail and disabled individuals have 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 further finds that it is necessary to explore public and private sector approaches to support payment for long-term care services, which can assist seniors to age in place and prevent the State from becoming fiscally liable for unsustainable costs under medicaid.

The purpose of this Act is to reestablish the long-term care commission to identify further-needed reforms of the long‑term care system, research program changes and resources necessary to meet the State's long-term care public policy goals, and explore an array of funding options that may help support the provision of long-term care services in the future.

SECTION 2. (a) There is established a long-term care commission that shall be placed within the university of Hawaii college of social sciences public policy center for administrative purposes. The commission shall:

(1) Review and update, as appropriate, the long-term care policy goals and guiding principles expressed in part II of Act 224, Session Laws of Hawaii 2008;

(2) Review the assessments, conclusions, and recommendations contained in the Long-Term Care Reform in Hawaii: Report of the Hawaii Long-Term Care Commission, Final Report, dated January 18, 2012, and update as appropriate, including:

(A) Identifying problems with current long-term care capacity, programs, and services; and

(B) Reviewing and updating public and private financing options and developing recommendations about financial resources, including a mix of public and private financing, necessary to achieve needed state long-term care reforms and state public policy goals;

(3) Develop an updated five-year comprehensive long-term care plan to accomplish long-term care policy goals that, when implemented, will ensure the availability of a full continuum of institutional and community‑based services, including benchmarks to evaluate accomplishments for each year;

(4) Monitor federal legislation for recent changes that may impact the program and adjust the long-term care plan accordingly; and

(5) Collaborate with interested stakeholders, including the executive office on aging and community coalitions or organizations concerned with educating the public regarding long-term care.

(b) The long-term care commission shall consist of:

(1) Five members appointed by the governor;

(2) Five members appointed by the president of the senate;

(3) Five members appointed by the speaker of the house of representatives; and

(4) Five non-voting, ex-officio members, who are the directors of the following departments, or their designees, and who shall collaborate with and support the work of the commission, as requested:

(A) Department of commerce and consumer affairs;

(B) Department of health;

(D) Department of labor and industrial relations; and

(E) Department of taxation.

(c) Each member shall have a background in business, economics, finance, management, health care, long-term care, social services, or public policy development, or be an advocate for or consumer of long-term care services. Members shall be appointed as soon as practicable, but no later than September 30, 2023. Any vacancies occurring in the membership of the commission shall be filled for the remainder of the unexpired term in the same manner as the original appointments.

(d) A simple majority of voting members shall constitute a quorum, whose affirmative vote shall be necessary for all actions.

(e) The members shall serve without compensation, but shall be reimbursed for necessary expenses incurred in the performance of commission duties.

(f) The university of Hawaii college of social sciences public policy center shall convene the first commission meeting as soon as practicable, but no later than November 1, 2023. At this first meeting, the commission shall elect from among its members a chairperson, who shall convene commission meetings, and a vice chairperson, and shall adopt rules for the conduct of its work.

(g) The commission shall:

(1) Submit an interim report to the legislature no later than twenty days prior to the convening of the 2025 regular session, describing the progress made in the development of the five-year plan and preliminary proposed system reforms; and

(2) Submit a final report to the legislature no later than twenty days prior to the convening of the 2028 regular session, which shall include the final five-year plan, an explanation of how the reforms will be prioritized and phased in, and a description and final recommendations regarding the financing of long-term care services, including support for caregivers.

(h) The commission may:

(1) Conduct or initiate studies as it deems necessary; and

(2) Hire staff and contract with third parties to conduct studies, including an actuarial study, as it deems necessary for the purpose of evaluating various options about systems reforms and about how to help State residents pay for needed long-term care and supportive services in the future. Any contract executed pursuant to this subsection shall be exempt from chapter 103D, Hawaii Revised Statutes; provided that any such contract is approved by the commission in an open meeting.

(i) The university of Hawaii college of social sciences public policy center shall provide administrative and policy support to facilitate the work of the commission.

(j) The term of the commission shall terminate on adjournment sine die of the regular session of the 2028 legislature.

SECTION 3. There is appropriated out of the general revenues of the State of Hawaii the sum of $ or so much thereof as may be necessary for fiscal year 2023-2024 and the same sum or so much thereof as may be necessary for fiscal year 2024-2025 for the long-term care commission.

The sums appropriated shall be expended by the university of Hawaii for the purposes of this Act.

SECTION 4. This Act shall take effect on July 1, 2023.

INTRODUCED BY:	_____________________________

HOUSE OF REPRESENTATIVES	H.B. NO.	838
THIRTY-SECOND LEGISLATURE, 2023
STATE OF HAWAII