THE SENATE                           S.R. NO.              15
TWENTIETH LEGISLATURE, 2000                                
STATE OF HAWAII                                            
                                                             
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                     SENATE RESOLUTION
REQUESTING AN EXAMINATION OF HOW SLIDING-SCALE, HOME- AND
   COMMUNITY-BASED SERVICES AFFECTS THE RISK AND INCIDENCE OF
   INSTITUTIONALIZED CARE.



 1       WHEREAS, eighty-three percent of all caregiving is provided
 2   to persons sixty-five years old and older, and sixty-six
 3   percent of all caregiving is provided to people seventy-five
 4   years old and older; and
 5   
 6       WHEREAS, while the majority of persons receiving long-term
 7   care are older adults, entire families are affected by the
 8   financial, psychological, and social costs of long-term care
 9   provided to those who are limited in the activities of daily
10   living; and
11   
12       WHEREAS, currently, an estimated 12.8 million adults need
13   assistance from others to carry out the activities of daily
14   living such as bathing, feeding, and toileting; and
15   
16       WHEREAS, by 2020, it is estimated that 134 million adults
17   will have chronic health conditions, and of this population,
18   38.8 million, or twenty-nine percent, will have a chronic
19   condition that limits their ability to live independently; and
20   
21       WHEREAS, by 2020, as many as 14 million elderly people will
22   need long-term care, double the number who need it today; and
23   
24       WHEREAS, nursing home care is but one component of an array
25   of long-term care services that have been developed, but due to
26   cost factors, it is likely that home- and community-based
27   services will become more predominant; and
28   
29       WHEREAS, home- and community-based services are provided in
30   and out of the home and are appropriate to those who do not
31   need to be institutionalized--in fact, an important function of
32   home- and community-based services is to prevent
33   institutionalism; and
34   
35       WHEREAS, home- and community-based services consist of a
36   number of different modalities, some or all of which may be
37   used by the individual, and includes adult day health services,

 
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                                  S.R. NO.              15
                                                        
                                                        

 
 1   case management services, environmental modifications,
 2   homemaker services, personal care services, personal emergency
 3   response systems, respite care services, skilled nursing
 4   services, transportation services, and similar services; and
 5   
 6       WHEREAS, home assistance and sliding-scale kupuna programs
 7   are just two types of home- and community-based services that
 8   are based on the individual's ability to pay; and
 9   
10       WHEREAS, while these programs do not provide complete or
11   total care, they alleviate the need for more advanced, acute
12   care; and
13   
14       WHEREAS, there comes a point during an individual's
15   caregiving when the person can no longer maintain oneself at
16   home and is forced to give up individual living, and thus
17   families must resort to placing their loved ones in
18   institutional settings; and
19   
20       WHEREAS, determining the success of sliding-scale, home-
21   and community-based services, such as home assistance and
22   sliding-scale kupuna programs, will help decision-makers reduce
23   the risk and incidence of institutionalized care; now,
24   therefore,
25   
26       BE IT RESOLVED by the Senate of the Twentieth Legislature
27   of the State of Hawaii, Regular Session of 2000, that a study
28   examine how sliding-scale, home- and community-based services
29   affects the risk and incidence of institutionalized care; and
30   
31       BE IT FURTHER RESOLVED that the study determine the number
32   of people who would be prevented from entering
33   institutionalized care by a sliding-scale, home- and community-
34   based strategy; and
35   
36       BE IT FURTHER RESOLVED that expenses for the work be borne
37   by existing budgeted funds for an actuarial study to be done by
38   the Joint Legislative Committee on Long-Term Care Financing,
39   without the necessity for appropriation; and
40   
41       BE IT FURTHER RESOLVED that a report of the findings
42   pursuant to this request be submitted to the Legislature no
43   later than twenty days before the convening of the Regular
44   Session of 2001; and

 
 
 
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                                  S.R. NO.              15
                                                        
                                                        

 
 1       BE IT FURTHER RESOLVED that certified copies of this
 2   Resolution be transmitted to the Co-chairs of the Joint
 3   Legislative Committee on Long-Term Care Financing.
 4 
 5 
 6 
 7                         OFFERED BY:  ____________________________