SB3255 SD1

SECTION 1. While virtually all of Hawaii's elders want to age‑in‑place at home rather than in a care home or institution, many elders will require a more intensive caregiving environment at the end of their lives. However, the costs of institutional care have escalated beyond the financial means of most elders. The State's portion of medicaid expenditures has increased steadily over the years and is projected to increase significantly as baby boomers begin to retire. As Hawaii's population ages, the number of frail and disabled individuals will also increase, placing a precipitous demand on the need for long term care services.

The legislature finds that an array of services are necessary to meet the long term care needs of Hawaii's elders. To make this possible, the following shall be the long term care policy goals of the State of Hawaii: (1) creating a continuum of care, up to and including the end of life;(2) coordinating referral, case management, and service delivery through co-location and other means; (3) strengthening family caregiver support systems, to encourage aging-in-place; (4) stimulating manpower development and training programs, to expand the capacity of long term care service providers; (5) developing financial mechanisms to help Hawaii's families meet the cost of long term care; (6) seeking ways to create a better balance between public expenditures for institutional care and home and community-based care; (7) fostering public understanding of caregiving issues; and (8) encouraging research and education on aging, long term care and related subjects through the University of Hawaii system.

The legislature further finds that it is necessary to develop new funding approaches for long term care services, as well as services to assist elders to age‑in‑place in order to prevent the State from becoming fiscally liable for unsustainable costs under medicaid.

The purpose of this Act is to establish a long term care commission to research what resources are necessary to meet state long term care public policy goals and to recommend a program and funding mechanism that may provide long term care services.

SECTION 2. (a) There is established a long term care commission to research what resources are necessary to meet state long term care public policy goals and to recommend a program and funding mechanism that can provide these services.

(b) The long term care commission shall consist of:

(1) Five members appointed by the governor;

(2) Five members appointed by the president of the senate; and

(3) Five members appointed by the speaker of the house of representatives;

provided that all of the members shall be selected on the basis of their knowledge, interest, and experience in the following: long term care services or aging‑in‑place services, research or education, aging or disability advocacy, public policy development, business, economics or finance, facilities planning and management, medical or health services, and social services, or related experience; provided further that all of the members shall serve for two-year terms beginning on December 1, 2008, and ending on November 30, 2010.

(c) The commission shall elect its chair, who shall commence commission meetings, and vice chair and shall adopt rules for the conduct of its work.

(d) The long term care commission shall:

(1) Review available research, studies, and previously proposed programs relating to the provision of a continuum of long term care services;

(2) Establish a purpose statement to guide the long term care commission in the recommendation of a program to achieve the State's long term care policy goals which are:

(A) Creating a continuum of care, up to and including the end of life;

(B) Coordinating referral, case management, and service delivery through co-location and other means;

(D) Stimulating manpower development and training programs, to expand the capacity of long term care service providers;

(E) Developing financial mechanisms to help Hawaii's families meet the cost of long term care;

(F) Seeking ways to create a better balance between public expenditures for institutional care and home and community-based care;

(G) Fostering public understanding of caregiving issues; and

(H) Encouraging research and education on aging, long term care and related subjects through the University of Hawaii system;

(3) Prepare a five-year plan to accomplish the goals, including the recommendation of benchmarks to evaluate accomplishments for each year;

(4) Monitor federal legislation for changes that may impact the program and adjust the five-year plan accordingly;

(5) Collaborate with interested stakeholders, including community coalitions or organizations concerned with educating the public regarding long term care; and

(6) Submit an interim report to the legislature no later than twenty days prior to the convening of the 2009 regular session, and a final report to the legislature no later than July 31, 2010. The final report shall include, but not be limited to, a description of how the recommended program relates to:

(A) Other components of the State's aging‑in‑place, family caregiver support, and long term care systems;

(B) Related research, education, and training programs;

(D) The care home, adult foster home, nursing home, and assisted living and other retirement facilities in the State.

(e) The long term care commission may:

(1) Conduct or initiate new studies as it deems necessary; and

(2) Contract with consultants to conduct the studies, including an actuarial study, as it deems necessary for the purpose of recommending a program and funding mechanism, and reporting to the legislature. Any contract executed pursuant to this paragraph shall be exempt from chapter 103D, Hawaii Revised Statutes; provided that the long term care commission shall endeavor to ensure transparency in the letting of the contract.

SECTION 3. There is appropriated out of the general revenues of the State of Hawaii the sum of $250,000 or so much thereof as may be necessary for fiscal year 2008-2009 for the long term care commission to research what resources are necessary to provide a continuum of long term care services for Hawaii's aging population and to recommend a program and funding mechanism that can provide these services pursuant to section 2 of this Act.

The sum appropriated shall be allotted as follows:

Senate $125,000

House of representatives $125,000

The sum appropriated shall be expended by the senate and the house of representatives to assist the long term care commission for the purposes of this Act.

SECTION 4. This Act shall take effect upon its approval and shall be repealed on December 1, 2010; provided that section 3 of this Act shall take effect on July 1, 2008.

THE SENATE	S.B. NO.	3255
TWENTY-FOURTH LEGISLATURE, 2008		S.D. 1
STATE OF HAWAII