Clarifies the distinction between the Department's authority to require an agreement that future grants of assistance will constitute an agreement or lien against a claimant's interest in real property, and the agreement or lien against real property where a claimant is an inpatient. Makes an appropriation for respite care services. Establishes a welfare safety net program called, "Keeping Hope Alive." (SD1)

A BILL FOR AN ACT

PART I.

SECTION 1. The legislature finds there is a need to clarify the law with respect to the requirement that the department of human services annually update the actual amount of the medical assistance liens recorded in the bureau of conveyances. Consequently, one of the purposes of this Part is to clarify that the update is an internal departmental accounting measure intended to track expenditures by the department and not burden the bureau of conveyances by essentially recording the same lien against the same property year after year. Filing the same lien annually does not attach more interest in the real property than claimed in the first recorded or filed lien, and the issue of an increase in the amount of the lien is already addressed in section 346-29.5(c), Hawaii Revised Statutes (HRS).

This Part further clarifies that in addition to an agreement that future grants of assistance constitute a real property lien, there is a statutory provision for the placement of real property liens.

In the enforcement of a lien as a claim under section 346-37, HRS, against the estate of a recipient, there are instances the department may need to initiate probate proceedings. Therefore, the proposed amendment clarifies that the department may initiate probate proceedings.

Finally, other technical and grammatical corrections have been made.

SECTION 2. Section 346-29.5, Hawaii Revised Statutes, is amended by amending subsections (b), (c), and (d) to read as follows:

"(b) The department may also place a lien against the real property of any recipient receiving medical assistance who is an inpatient in a nursing facility, intermediate care facility for the mentally retarded, or other medical institution, after a state determination, pursuant to notice and hearing requirements of chapter 91, that the recipient cannot reasonably be expected to be discharged from the medical institution and returned home. There is a rebuttable presumption that the recipient cannot reasonably be expected to be discharged from the facility and return home if the recipient or a representative of the recipient declares that there is no intent to return home or if the recipient has been institutionalized for six months or longer without a discharge plan.

is lawfully residing in the home.

(c) The agreement in subsection (a) or the lien in subsection (b) shall be recorded in the bureau of conveyances, or filed in the office of the assistant registrar of the land court. When the agreement [for the] or lien is recorded in the bureau of conveyances, the registrar shall forthwith cause the same to be indexed in the general indexes of the bureau of conveyances. From and after the recording in the bureau of conveyances the [lien] liens shall attach to all interests in real property then owned by the person and not registered in the land court, and from and after the filing thereof in the office of the assistant registrar of the land court, the [lien] liens shall attach to any such interest in land then registered therein. The [lien] liens shall be for all amounts of assistance, unless otherwise provided by rules adopted pursuant to chapter 91, then or thereafter paid in accordance with the programs from which the person receives assistance. The department shall be obligated to annually update, as an accounting measure, the actual amount of the [lien] liens recorded in the bureau of conveyances.

(d) The department shall issue certificates of release or partial release upon satisfaction or partial satisfaction of the [lien.] liens. Certificates of release or partial release of any real property lien issued by the director [of the department] or the director’s authorized representative shall be recorded in the bureau of conveyances. The director shall consider issuing conditional certificates of release in cases of extreme hardship as set out in rules adopted under chapter 91. The registrar shall forthwith cause the same to be indexed in the general indexes in a like manner as the original [lien.] liens. No fee shall be charged for any of the recording. The [lien] liens herein provided for shall take priority over any other lien subsequently acquired or recorded except tax liens and except that, in the estate of a beneficiary, the actual funeral expenses, the expenses of the last sickness, the cost of administration of the estate, and any allowance made to the surviving spouse and children for their support during administration of the estate, shall have priority and preference over the [lien] liens herein imposed, and over any claim against an estate filed under section 346-37.

The [lien] liens shall be enforceable by the department by suit in the appropriate court or shall be enforceable as a claim against the estate of the recipient under section 346-37, having priority over all other debts except taxes, the actual funeral expenses, the expenses of last sickness, the cost of administration of the estate, and any allowance made to the surviving spouse and children for their support during administration of the estate.

The [lien] liens shall be enforceable as a claim under section 346-37 against the estate of a recipient under any circumstances if the estate is admitted to probate at the instance of any interested party [other than the department].

Whenever the department is satisfied that the collection of the amount of assistance paid a recipient will not be jeopardized or that the release or waiver of the priority of the [lien] liens against the recipient’s property, in whole or in part, is necessary to provide for the maintenance or support of the recipient, the recipient’s spouse, or any minor or incapacitated child, it may release or waive the priority of the [lien] liens with respect to all or any part of the real property.

The recipient, the recipient’s heirs, personal representatives, or assigns may discharge the [lien] liens at any time by paying the amount thereof to the department which shall execute a satisfaction thereof. The department may at its discretion compromise the collection of any such [lien,] liens, but such compromise shall be made only when the recipient, the recipient’s heirs, personal representatives, or assigns prove that the collection of the full amount of the [lien] liens or claim would cause undue hardship or the [lien] liens or claim [is] are otherwise uncollectible.

The proceeds from the enforcement, payment, or compromise of the [lien] liens shall be paid into the treasury of the State. If the amount of assistance reflected by the proceeds was paid in part by federal funds, the proper portion of these funds shall be paid by the director of finance to the treasury of the United States. The director of finance shall thereupon report such payment to the department. If the federal funds are not paid directly into the treasury of the United States, these federal funds shall be credited by the director of finance to the department for expenditure for assistance without need for further appropriation.

If at any time the federal government, or any agency or instrumentality thereof, requires, as a condition to any grant of assistance, the performance of conditions inconsistent with this section, or desisting from actions provided by this section, the governor may suspend, upon a finding to that effect and to the extent of such requirement, any provisions of this section to the end that such federal assistance may be received.

The department shall submit an annual report to the legislature, which shall include a list of liens held by the department on real property. This report shall include[,] but not be limited to a description of the value of the liens, the legal status of the liens, and when the liens were initiated.

The department shall adopt rules pursuant to chapter 91 necessary for the purposes of this section."

PART II.

SECTION 3. The legislature finds that family members and informal caregivers are the backbone for providing long-term care services. According to a survey conducted by the Family Caregiver Alliance, over fourteen million working Americans are providing care for someone with a disability or chronic health problem. The time-consuming role of being a caregiver often creates enormous emotional, physical, and financial hardships. As a result, caregivers commonly experience a tremendous sense of burden, fair-to-poor physical health, and high rates of depression.

In addition, the legislature finds that the stress of providing long-term care has been found to increase the mortality rates of caregivers. A study on caregivers reported in the 1999 Journal of the American Medical Association showed that older spousal caregivers had mortality risks that were sixty-three per cent higher than the non-caregiving control subjects.

Respite care provides family members with temporary relief or rest from the daily stress and strain of caring for a loved one. Respite care allows families to visit friends, enjoy leisure time, take a vacation, run errands, or do other chores. The time provided when using respite care reduces stress on families by allowing caregivers to spend more time together with spouses or children.

The purpose of this Part is to preserve and strengthen families by appropriating funds to provide respite care services for family caregivers of individuals who are ill or disabled or families providing home care to a family member with special needs.

SECTION 4. 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 2001-2002 and the sum of $ or so much thereof as may be necessary for fiscal year 2002-2003 for the provision of respite care services to relieve family stress for family caregivers of individuals who are ill or disabled.

The sums appropriated shall be expended by the department of human services for the purposes of this Act.

PART III.

SECTION 5. The purpose of this Part is to create a welfare safety net program called "Keeping Hope Alive" that will utilize a system of vouchers to assist children from families that will stop receiving public assistance with housing, child care, clothing, and school supplies.

SECTION 6. Chapter 346, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"§346-    Welfare net safety program; department of human services; voucher system; case management; rules (a) The department of human services may create a welfare safety net program entitled "Keeping Hope Alive" to assist children in families that will be disqualified from receiving further public assistance as a consequence of reaching the five-year time limit set by the federal Personal Responsibility and Work Opportunity Act of 1996. The department shall create a voucher system wherein children in these families may exchange vouchers issued by the department to obtain a set dollar amount of assistance with housing, child care, clothing, and school supplies.

(b) The department shall also provide these families with case management to assist these families to obtain employment after their loss of public assistance benefits.

(c) The department of human services shall adopt rules in accordance with chapter 91 to implement the voucher system, including the process of identifying children who may be eligible, setting eligibility standards, determining the amount of voucher assistance, the operation of the voucher system, the provision of case management, and any other relevant matters that the department believes are necessary to implement this section."

SECTION 7. 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 2001-2002 for the welfare safety net program established in section 346-   , Hawaii Revised Statutes, to be funded from excess moneys in the temporary assistance to other needy families program.

The sum appropriated shall be expended by the department of human services for the purposes of this Act.

SECTION 8. New statutory material is underscored.

SECTION 9. This Act shall take effect upon its approval; provided that sections 4 and 7 shall take effect on July 1, 2001.