REPORT TITLE:
Long-Term Care


DESCRIPTION:
Extends the sunset date of the joint legislative committee on
long-term care (joint legislative committee) to June 30, 2002.
Extends the submittal deadline of the actuarial study report on
long-term care to the governor and the legislature to November
15, 2001.  Clarifies requirements for the actuarial study.
Provides for the carryover of unexpended and unencumbered funds
to fiscal year 2000-2001 for the actuarial study and the expenses
of the joint legislative committee.  (CD1)

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
                                                        2062
THE SENATE                              S.B. NO.           S.D. 1
TWENTIETH LEGISLATURE, 2000                                H.D. 3
STATE OF HAWAII                                            C.D. 1
                                                             
________________________________________________________________
________________________________________________________________


                   A  BILL  FOR  AN  ACT

RELATING TO LONG-TERM CARE.



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

 1      SECTION 1.  Act 339, Session Laws of Hawaii 1997, as amended
 
 2 by Act 93, Session Laws of Hawaii 1999, is amended by amending
 
 3 section 4 to read as follows:
 
 4      "SECTION 4.  The joint legislative committee shall submit a
 
 5 report of its findings and recommendations to the legislature by
 
 6 December 1, 1998.  The joint legislative committee shall cease to
 
 7 exist on June 30, [2000.] 2002."
 
 8      SECTION 2.  Act 93, Session Laws of Hawaii 1999, is amended
 
 9 by amending section 9 to read as follows:
 
10      "SECTION 9.  (a)  The joint legislative committee on
 
11 long-term care shall contract for [a study on the feasibility and
 
12 advisability] an actuarial study to determine the cost of
 
13 establishing a state-sponsored [universal] program of long-term
 
14 care that offers comprehensive, protective coverage to the
 
15 largest numbers of people as reasonably possible through [either
 
16 a mandatory tax-based or voluntary premium] a funding approach[.]
 
17 that considers factors of expense, ease of administration, and
 
18 actuarial soundness.  The study shall be limited to the number of
 
19 alternatives that can be supported by the funds appropriated.
 

 
Page 2                                                     2062
                                     S.B. NO.           S.D. 1
                                                        H.D. 3
                                                        C.D. 1

 
 1 The study shall [include,] consider, but not be limited to[,]
 
 2 alternative models of:
 
 3      (1)  [Front-end universal] A universal comprehensive program
 
 4           in which coverage [would begin either with:
 
 5           (A)  The first two years of nursing home care or
 
 6                comparable type care; or
 
 7           (B)  One and a half years or other length of time, of
 
 8                community or home care covered by the program,
 
 9           with a reliance upon private insurance for the
 
10           remaining years;] benefits will be capped at the cost
 
11           equivalent to three years of nursing home services;
 
12      (2)  [Back-end] A comprehensive universal program in which
 
13           coverage benefits would begin on the [366th] 91st day
 
14           or 181st day of disability [and include nursing home
 
15           care or comparable care, or community or home care, or
 
16           any combination of these, with the first year to be
 
17           covered out of pocket or by privately purchased long-
 
18           term care insurance; or
 
19      (3)  Comprehensive universal program to provide lifetime
 
20           full coverage, regardless of private insurance
 
21           coverage.] with benefits capped at the cost equivalent
 
22           to three years of nursing home services.
 
23      [The study shall further include an analysis of the
 

 
Page 3                                                     2062
                                     S.B. NO.           S.D. 1
                                                        H.D. 3
                                                        C.D. 1

 
 1 provisions of House Bill No. 31, H.D. 1 and H.D. 2, Regular
 
 2 Session of 1993, that proposed the "Hawaii Family Hope Program
 
 3 Act", and make recommendations on legislation for introduction in
 
 4 the 2000 regular session, including figures for the amount of a
 
 5 tax to be imposed and a premium to be collected.
 
 6      For purposes of this study, the joint legislative committee
 
 7 on long-term care may contract with one or more of the same
 
 8 consultants and advisers, excluding legal consultants, who
 
 9 provided services to the Executive Office on Aging for its
 
10 reports, "Financing Long Term Care, A Report to the Hawaii State
 
11 Legislature", dated January, 1991, and "The Long Term Care
 
12 Advisory Board, Report to the Hawaii State Legislature", dated
 
13 February, 1992; provided that procurement of services from the
 
14 same consultants and advisers shall be exempt from any of the
 
15 provisions of the the Hawaii Public Procurement Code, as provided
 
16 by section 103D-102(b)(6), Hawaii Revised Statutes, on the basis
 
17 that this study is an update of those reports to design a state-
 
18 sponsored universal long-term care model that accounts for
 
19 current statistics and the condition of the State's economy.
 
20 Inasmuch as the groundwork for this follow-up study has been laid
 
21 in those previous reports by the same consultants and advisers,
 
22 the legislature finds that contracting with new consultants and
 
23 advisers would triple the cost of the study and would be
 

 
Page 4                                                     2062
                                     S.B. NO.           S.D. 1
                                                        H.D. 3
                                                        C.D. 1

 
 1 unnecessary duplication of work.  The legislature further finds
 
 2 that the same consultants and advisers are qualified to conduct
 
 3 this follow-up study.] 
 
 4      (b)  The study shall also:
 
 5      (1)  Examine how to integrate a state-sponsored universal
 
 6           program of long-term care with the insurance model of
 
 7           long-term care under this Act, with a goal of
 
 8           supplementing private insurance so as to provide a
 
 9           continuum of care;
 
10      (2)  Include a proposed model for financing a state-
 
11           sponsored universal program of long-term care for a
 
12           target population that cannot afford long-term care
 
13           insurance;
 
14      (3)  Specify the amount of moneys that must be collected
 
15           from each eligible person to adequately finance a
 
16           state-sponsored universal program of long-term care and
 
17           the mechanism for collecting those moneys;
 
18      (4)  Make recommendations on whether a subsidy from the
 
19           general fund or other state revenues is necessary for
 
20           adequate capitalization and reserves, and if so, the
 
21           amount of subsidy; and
 
22      (5)  Make recommendations on the best manner of
 
23           administering a state trust fund for long-term care.
 

 
Page 5                                                     2062
                                     S.B. NO.           S.D. 1
                                                        H.D. 3
                                                        C.D. 1

 
 1      (c)  The study may include an examination of universal long-
 
 2 term care financing models of other countries.
 
 3      (d)  In selecting a contractor by bid for the study, the
 
 4 joint legislative committee on long-term care shall consider,
 
 5 among other things, the knowledge of the contractor of past
 
 6 efforts of the State to establish a universal long-term care
 
 7 program.
 
 8      All state agencies shall cooperate with the contractor for
 
 9 purposes of providing facts, figures, data, projections,
 
10 estimations, and other information to effectuate this study."
 
11      SECTION 3.  Act 93, Session Laws of Hawaii 1999, is amended
 
12 by amending section 10 to read as follows:
 
13      "SECTION 10.  The consultants [hired] contracted under
 
14 section 11 of this Act shall submit a report of findings and
 
15 recommendations to the governor and the legislature not later
 
16 than November 15, [1999.] 2001.  Based on that report, the joint
 
17 legislative committee on long-term care shall draft legislation,
 
18 with the advice of the consultants, for introduction in the
 
19 regular session of [2000;] 2002; provided that the services of
 
20 the consultants for advising in drafting the legislation shall be
 
21 considered as a part of their services under section 11[.] of
 
22 this Act."
 
23      SECTION 4.  Act 93, Session Laws of Hawaii 1999, is amended
 

 
Page 6                                                     2062
                                     S.B. NO.           S.D. 1
                                                        H.D. 3
                                                        C.D. 1

 
 1 by amending section 11 to read as follows:
 
 2      "SECTION 11.  There is appropriated out of the general
 
 3 revenues of the State of Hawaii, the sum of $100,000[,] or so
 
 4 much thereof as may be necessary for fiscal year 1999-2000[,] for
 
 5 the joint legislative committee on long-term care to hire
 
 6 consultants to conduct a study on the feasibility and
 
 7 advisability of establishing a state-sponsored [universal]
 
 8 program of long-term care that offers comprehensive, protective
 
 9 coverage[.] to the largest number of people as reasonably
 
10 possible as specified under section 9(a) of this Act; provided
 
11 that any unexpended or unencumbered funds at the close of fiscal
 
12 year 1999-2000 may be expended or encumbered during fiscal year
 
13 2000-2001, and shall not lapse until June 30, 2001."
 
14      SECTION 5.  Act 93, Session Laws of Hawaii 1999, is amended
 
15 by amending section 12 to read as follows:
 
16      "SECTION 12.  The sum appropriated by section 11 of this Act
 
17 shall be expended by the [joint legislative committee on long-
 
18 term care.] legislature."
 
19      SECTION 6.  Act 93, Session Laws of Hawaii 1999, is amended
 
20 by amending section 13 to read as follows:
 
21      "SECTION 13.  There is appropriated out of the general
 
22 revenues of the State of Hawaii the following sums[,] or so much
 
23 thereof as may be necessary[,] for fiscal year 1999-2000 for
 

 
Page 7                                                     2062
                                     S.B. NO.           S.D. 1
                                                        H.D. 3
                                                        C.D. 1

 
 1 expenses of the joint legislative committee on long-term care to
 
 2 conduct one public briefing each on Oahu, Kauai, and Maui, and
 
 3 two public briefings on Hawaii, on the findings and
 
 4 recommendations of the actuarial study undertaken pursuant to
 
 5 section 11 of this Act[.]:
 
 6      House of Representatives           $5,000
 
 7      Senate                             $5,000;
 
 8 provided that any unexpended or unencumbered funds at the close
 
 9 of fiscal year 1999-2000 may be expended or encumbered during
 
10 fiscal year 2000-2001, and shall not lapse until June 30, 2001."
 
11      SECTION 7.  Statutory material to be repealed is bracketed.
 
12 New statutory material is underscored.
 
13      SECTION 8.  This Act shall take effect upon its approval;
 
14 provided that sections 4, 5, and 6 shall take effect on July 1,
 
15 2000.