SB2269

SECTION 1. The legislature finds that dementia and cognitive impairment are growing public health concerns in Hawaii, particularly among the State's aging population. The impacts of dementia extend beyond individuals to families, caregivers, and communities, placing emotional and financial strain on households and the healthcare system.

The legislature further finds that access to early diagnosis, care planning, and long-term support for individuals with dementia and cognitive impairment is limited, especially in rural areas and on neighbor islands. Many residents face barriers to receiving timely and coordinated care due to geographic isolation, workforce shortages, and fragmented service delivery.

The need for systemic reform for dementia and cognitive impairment treatment cannot be overstated. Alzheimer's disease is estimated to affect one in nine Hawaii residents over age sixty-five. With the older adult population in the State expected to double in the next twenty-five years, the number of individuals living with Alzheimer's disease will exceed sixty-two thousand by 2050. This surge will have devastating financial consequences. Medicaid spending for Alzheimer's care in Hawaii rose from $240,000,000 in 2020 to $309,000,000 in 2025. Without intervention, those costs are projected to approach $1,000,000,0000 annually by 2050, placing an unsustainable strain on the state budget.

The legislature further recognizes that Hawaii's long-term care infrastructure is already at or above capacity, with memory care beds in short supply. Families face crushing financial burdens, paying more than $15,000 per month, or $180,000 per year, for memory care in long-term care facilities. Neighbor islands and rural communities experience even greater challenges, with limited access to diagnosis and treatment leading to delayed care and higher costs. Caregivers lack guidance and support, compounding emotional and financial stress.

The legislature notes that the Alzheimer's Association launched the Hanai Memory Network to address these challenges head-on by ensuring earlier diagnosis, equitable access to care across all counties, and coordination that reduces emergency room visits and hospitalizations. By shifting from crisis-driven care to proactive planning, Hawaii can improve outcomes for kupuna and caregivers while reducing medicaid costs and alleviating pressure on the State's long-term care system.

The legislature additionally finds that a coordinated statewide approach is necessary to ensure equitable access to dementia care services.

The purpose of this Act is to establish a Hanai memory network program to integrate community-based specialists, clinical partnerships, and public education to improve early detection, care coordination, and long-term support for individuals with dementia and their caregivers.

SECTION 2. Chapter 349, Hawaii Revised Statutes, is amended by adding a new part to be appropriately designated and to read as follows:

"Part . Hanai memory network program

§349- Definitions. As used in this part:

"Dementia care specialist" means a trained social worker or allied health professional who provides community-based dementia screening, care planning, and coordination services.

"Memory clinic" means a clinical partnership between the State and a health care provider or health system that provides diagnostic and treatment services for individuals with cognitive impairment, staffed by primary care providers and geriatricians.

§349- Hanai memory network program; established. (a) There is established within the executive office on aging the Hanai memory network program.

(b) The Hanai memory network program shall:

(1) Establish dementia care specialists;

(2) Establish one or more memory clinics;

(3) Ensure coordination between dementia care specialists, memory clinics, and programmatic services;

(4) Develop and maintain a statewide referral network and care options directory for dementia care;

(5) Provide training and technical assistance to participating providers in the program;

(6) Operate a public-facing website to serve as a central hub for education, referrals, and provider listings for dementia care; and

(7) Collect and securely maintain data relevant to the program.

(c) The executive office on aging may enter into contracts or memoranda of agreement with health care providers, health systems, and community-based organizations for the purpose of implementing the Hanai memory network program, including but not limited to the operation of memory clinics, training of dementia care specialists, and provision of community-based services.

(d) The executive office on aging shall:

(1) Administer and oversee the Hanai memory network program;

(2) Collaborate with area agencies on aging, health care providers, and community health centers;

(3) Submit an annual report to the legislature no later than twenty days prior to the convening of each regular session, which shall include:

(A) The number of individuals screened and diagnosed;

(B) The number of care plans created;

(D) Any proposed legislation."

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 2026-2027 to establish and implement the Hanai memory network program, to be allocated as follows:

(1) $ for salaries and fringe benefits for the following positions:

(A) One full-time equivalent (1.00 FTE) memory network program manager; and

(B) One full-time equivalent (1.00 FTE) dementia care specialist; and

(2) $ for equipment, supplies, operational costs, and memory clinic partnerships, including but not limited to:

(A) Clinical infrastructure and support services;

(B) Technology and data systems;

(D) Contracts and memoranda of agreements with health care providers and health systems to establish memory clinics.

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, 2026.

INTRODUCED BY:	_____________________________

THE SENATE	S.B. NO.	2269
THIRTY-THIRD LEGISLATURE, 2026
STATE OF HAWAII