SB2440

Report Title:

Comprehensive Family Caregiver Assistance

Description:

Appropriates $4,000,000 for a comprehensive family caregiver assistance program. Requires director of taxation to submit proposed legislation and projections of effect on tax revenues by a $1,000 tax credit for family caregivers before convening of 2007 regular session.

THE SENATE	S.B. NO.	2440
TWENTY-THIRD LEGISLATURE, 2006
STATE OF HAWAII

A BILL FOR AN ACT

relating to a comprehensive family caregiver assistance program.

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

Part I. Introduction

SECTION 1. The legislature finds that significant changes in medicare and medicaid health insurance programs nationally and locally will impose greater responsibilities upon individuals and families to be well-informed and astute about long-term care planning, financing, and the options available to assist them. In addition, Hawaii is facing a growing health care worker shortage while at the same time health and long-term care needs continue to rise. As a result of cost-containment policies and practices, people with health care needs are being discharged from hospitals and other care facilities with complex health care requirements while facing reduced home- and community-based care options. This puts the responsibility on families, who are inadequately prepared and trained, to provide such care.

Furthermore, the caregiving tradition in Hawaii, over time, is being challenged by the changes in Hawaii demographics: birth rates, marriages, single-occupant households, high costs of living, and family members working outside the home or moving away from Hawaii. By 2020, more than one in four individuals will be sixty years old or older. The need for personal care due to physical, sensory, cognitive, and self-care disabilities increases with age. As Hawaii's population ages, many more families will be providing higher levels of long-term care to frail and disabled older adults at home.

Finally, Hawaii's long-term care system is on a collision course with the day-to-day reality of families coping with caring for loved ones with chronic conditions. Without attention to this situation, the $875,000,000 in unpaid support services provided by Hawaii's family caregivers may well be jeopardized when these caregivers suffer from the costs that impede their ability to give care. As this pattern plays itself out, the quality of care provided to the frail elderly and individuals with disabling or chronic conditions will diminish and the costs to Hawaii's long-term care system will skyrocket.

The purpose of this Act is to provide assistance to family caregivers who provide at-home care for their elderly relatives.

Part II. Hawaii Family Caregiver Grant Program

SECTION 2. Chapter 346D, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"§346D-A Hawaii family caregiver grant program. (a) There is established the Hawaii family caregiver grant program within the department of human services to provide annual grants of up to $1,000 to family caregivers who provide unreimbursed care to a relative. The following general requirements shall apply:

(1) Both the caregiver and the relative receiving care must be related by blood, marriage, or adoption;

(2) Both the caregiver and the relative receiving care must reside in Hawaii;

(3) A physician licensed under chapter 453 or 460 must certify that the criteria for assistance are met; and

(4) Applications must contain an original signature from the caregiver and the physician who provides certification.

(b) Caregivers shall comply with all of the following requirements:

(1) Provide unreimbursed care for a relative who has a mental or physical impairment;

(2) Have an annual Hawaii adjusted gross income of not more than $50,000; and

(3) Have provided care to the relative for at least six months of the previous calendar year.

(1) Require assistance with two or more of the following: eating, dressing, bathing, toileting, transferring, bowel continence, and bladder continence;

(2) Have required assistance for at least six months out of the previous calendar year; and

(3) Not be receiving medicaid-reimbursed long-term care services, except on a periodic or temporary basis."

Part III. Coordination of Statewide Family Caregiver

Support Services and Policies

SECTION 3. Chapter 346D, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"§346D-B Coordination of family caregiver support service. The executive office on aging shall coordinate public and private sector organizations and family caregivers to establish:

(1) A one-stop, single entry access point into the long-term care system and family caregiver support;

(2) New partnerships to address the needs of family caregivers; and

(3) Greater coordination and support for grandparents and other relatives who are raising children."

Part IV. Respite Services

SECTION 4. Chapter 346D, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"§346D-C Respite services. The departments of health and human services shall develop respite services for family caregivers so that families can receive time off to have regular breaks from their twenty-four-hour caregiving duties. Respite services shall be based on the department of health's developmental disabilities division respite program."

Part V. Training and Education

SECTION 5. Chapter 346D, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"§346D-D Long-term care; training and education. There is established a training and education program to:

(1) Increase the quality and quantity of long-term care workers;

(2) Improve the support and training of family caregivers in areas such as lifting, transporting, cardiopulmonary resuscitation, bathing, learning to deal with loves ones with dementia, psychological skills and emotional support, and communication skills;

(3) Promote active aging to enhance the lives of seniors; and

(4) Develop certification standards for nurse aides."

Part VI. Cash and Counseling

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

"§346D-E Cash and counseling program. The departments of health and human services shall develop a cash and counseling system of providing financial assistance to family caregivers that combines elements of financial support with direct services to help consumers make informed choices about long-term care."

Part VII. Family Caregiver Tax Credit

SECTION 7. (a) The director of taxation shall develop proposed legislation to establish a refundable $1,000 family caregiver tax credit for families who care for a family member at home and who is determined to require help in two of the activities of daily living, in a manner similar to granting tax credits for low-income individuals.

(b) The director of taxation shall develop projections as to the effect on state tax revenues as a result of implementing the tax credit.

(c) The director of taxation shall submit a report to the legislature including proposed legislation and projections on the effect of state tax revenues no later than twenty days prior to the convening of the regular session of 2007.

Part VIII. Appropriations

SECTION 8. There is appropriated out of the general revenues of the State of Hawaii the sum of $4,000,000, or so much thereof as may be necessary for fiscal year 2006-2007, for the purposes of this Act.

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

SECTION 9. In codifying the new sections added by sections 2 to 6 of this Act, the revisor of statutes shall substitute appropriate section numbers for the letters used in designating the new sections in this Act.

SECTION 9. This Act shall take effect upon its approval, except that section 8 shall take effect on July 1, 2006.

INTRODUCED BY:	_____________________________