Appropriates funds to provide for the coordination and development of family caregiver support services and to expand the kupuna care services program. (CD1)

A BILL FOR AN ACT

PART I

SECTION 1. On July 1, 1999, the department of health, executive office on aging launched its statewide long-term care program called kupuna care. Kupuna care was developed in partnership with the county area agencies on aging to address the growing numbers of elders with long-term care needs.

Services provided by kupuna care are intended to help meet the needs of older adults who cannot live at home without adequate help from family or formal services and includes services such as adult day care, assisted transportation, attendant care, case management, chore, home delivered meals, homemaker, transportation, and personal care.

Kupuna care was designed to assist, not totally support, Hawaii's older adults to live independently, safely, and healthy for as long as possible. United States citizens or legal aliens sixty years or older who are not receiving other comparable government assistance, who need help with activities of daily living (eating, dressing, bathing, toileting, transferring, mobility) or because they have reduced mental capacity, and who are not residing in an institution, may qualify for the program.

State funds cover the cost of services for those who cannot afford to pay. Kupuna care offers a reduced rate for those who can afford to pay only a portion of the service. Voluntary donations to the service provider are welcomed for any service provided and are used to support the cost of care of additional clients.

The purpose of part I is to ensure that this worthwhile program continues to maintain the quality of life of Hawaii's older adults and their family caregivers by appropriating funds to expand kupuna care services.

SECTION 2. There is appropriated out of the general revenues of the State of Hawaii the sum of $500,000, or so much thereof as may be necessary for fiscal year 2006-2007, to expand the kupuna care services program.

SECTION 3. The sum appropriated in section 2 shall be expended by the department of health, executive office on aging for the purposes of part I of this Act.

PART II

SECTION 4. The legislature finds that families, rather than institutions, are the primary providers of long-term care for older adults in the State. According to the executive office on aging, in 2003, approximately twenty-one per cent of Hawaii's adult population were providing care or assistance to a person age sixty or older, with twenty-nine per cent caring for a parent. Caregivers are motivated to provide care to family members because of their values, the preference of the elderly to remain at home with their families, and the high cost of institutional long-term care.

In Hawaii, the likelihood of becoming a caregiver is similar across different demographic groups and among persons with varied socioeconomic characteristics. Adults of any household income have a similar likelihood of providing care to an elderly person. Married persons in Hawaii are just as likely to provide care to an older adult as their unmarried counterparts.

Among the different ethnic groups in Hawaii, native Hawaiians are most likely to provide regular care to an older adult, followed by Filipinos, Japanese, and Caucasians. Twelve per cent of men and sixteen per cent of women provide care or assistance to someone age sixty or older, according to the executive office on aging. In national studies, women are more likely than men to be primary caregivers, providing higher intensity and frequency of care.

According to the executive office on aging, sixty-five per cent of Hawaii's caregivers are employed. To balance their employment and elder care roles, working caregivers take leaves of absence, report to work late or leave early, change from full-time to part-time employment, change to less demanding jobs, retire early, or give up work completely. As a consequence, caregiving may reduce a caregiver's retirement income since reduced hours on the job or fewer years in the workforce may mean fewer contributions to pensions, social security, and other retirement savings.

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 increase 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.

The purpose of part II is to provide for the coordination and development of family caregiver support services.

SECTION 5. The executive office on aging shall coordinate a statewide system of caregiver support services by, among other things:

SECTION 6. There is appropriated out of the general revenues of the State of Hawaii the sum of $80,000, or so much thereof as may be necessary for fiscal year 2006-2007, for the executive office on aging to coordinate a statewide system of family caregiver support services.

SECTION 7. The sum appropriated in section 6 shall be expended by the department of health, executive office on aging for the purposes of part II this Act.

SECTION 8. This Act shall take effect on July 1, 2006.