SB2320 SD2.DOC

PART I

SECTION 1. In 1965, the Older Americans Act established a system to provide services and supports for older adults. With guidance from the United States Administration on Aging and the Centers for Medicare and Medicaid Services, the department of health's executive office on aging and the county offices on aging are currently making sweeping changes to transform the system in Hawaii to reflect current and future needs of older adults, including those with disabilities.

The purpose of this Act is to build a statewide system of support for Hawaii's older adults and their family caregivers by:

(1) Enhancing the delivery of home- and community-based services through the kupuna care program;

(2) Statutorily establishing the kupuna care program under the executive office on aging; and

(3) Engaging seniors in community activities, encouraging healthy aging, and assisting older adults living with Alzheimer's disease and related dementia.

PART II

SECTION 2. According to the executive office on aging, the elderly population in Hawaii is one of the fastest growing segments of the population in the country. Between 1990 and 2000, the number of persons aged sixty and older increased by nineteen per cent, compared to a nationwide increase of nine per cent. Studies conducted by the executive office on aging and the four county agencies on aging have indicated that the elderly in Hawaii have a significant need for assistance in various areas and this need is outpacing the ability to provide assistance. Significant issues that arise with elderly people include health status, changes in family structure (caregivers), social security stability for the future, fear of health care burdens (financial stability), and changes in public responsibility. Case management and needs assessments of older adults are required to develop programs and services that meet the needs of the elderly. As Hawaii's culture and values revolve around the family, caregiving of the elderly in Hawaii is often provided by family members, which poses financial hardships for family members. Financial stability and burden are the main issues for the elderly and their caregivers and families. Long-term care services are expensive and the high cost of services may lead to changes in living arrangements and family households, especially in Hawaii.

The State's kupuna care program (kupuna care) was established in 1999 to address the needs of the aging population and the issues arising from those needs. The program is home- and community-based, designed to address the increasing need for affordable long-term care and the desire of the elderly to age in place. The program provides funding for services to populations who are not eligible for medicaid, but cannot afford services or insurance on their own. The program has no financial eligibility criteria and services are free to clients, although clients are asked to make voluntary donations to the service provider. The kupuna care program is an alternative to traditional long-term care options and fills an important gap in assistance for the elderly in Hawaii.

The purpose of this part is to statutorily establish the kupuna care program within the executive office on aging and appropriate funds for the program.

SECTION 3. Chapter 349, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"§349- Kupuna care program. (a) There is established the kupuna care program within the executive office on aging. The kupuna care program shall provide affordable and quality home- and community-based services that are person-centered and consumer-directed for adults that are sixty years of age and older and family caregivers.

(b) The kupuna care program shall be available in every county as a function of the aging and disability resource centers.

"Aging and disability resource centers" means an entity established by the State as part of the state system of long-term care, serving as a highly visible and trusted source, where people of all incomes and ages can get information on the full range of long-term support options, and a single point of entry for access to public long-term support programs and benefits.

"Family caregivers" means a spouse, adult child, other relative, partner, or friend who has a personal relationship with, and provides a broad range of unpaid assistance for, an older adult with a chronic or disabling condition.

(d) The director shall adopt rules pursuant to chapter 91 necessary for the purposes of this section."

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 2012-2013 for the kupuna care program; provided that the sum appropriated shall be in addition to the executive office on aging's base budget.

The sum appropriated shall be expended by the department of health for the purposes of this part.

PART III

SECTION 5. The legislature finds that multi-service senior centers offer a wide selection of daily events and activities, classes, intergenerational opportunities, computer education, cultural activities, fitness and health programs, and social services for Hawaii's older adults. Senior centers are a venue for older adults to socialize in a safe and healthy environment, thus enabling participants to remain active and engaged in the community.

Another opportunity to engage seniors is through health promotion activities. Hawaii's healthy aging partnership program is a statewide coalition established in 2003 to improve the well-being of older adults by adapting evidence-based health promotion programs to the State's multi-cultural population.

Hawaii's elderly commonly battle Alzheimer's disease and related dementia. Six out of ten people with Alzheimer's disease and related dementia will wander during the course of their illness. Wandering can be dangerous and sometimes fatal, and causes stress among caregivers and family members.

The legislature finds that there are registration services through which individuals who wander can be more easily located, identified, and returned safely to their families. These services also aid police and other first responders to secure the safe return of the elderly who are found but who cannot remember essential contact information.

The purpose of this part is to appropriate funds for the following:

(1) The healthy aging partnership program;

(2) Senior centers; and

(3) The support and promotion of elder registration services.

SECTION 6. 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 2012-2013 for the healthy aging partnership program of the department of health's executive office on aging

The sum appropriated shall be expended by the department of health for the purposes of this part.

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 2012-2013 to provide funding for grants, pursuant to chapter 42F, Hawaii Revised Statutes, for senior centers and to be distributed as follows:

(1) Catholic Charities Hawaii for the Lanakila multi-purpose senior center $

(2) Moiliili Community Center for the Moiliili senior center $

(3) Waikiki Community Center $

The sum appropriated shall be expended by the department of health for the purposes of this part.

SECTION 8. 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 2012-2013 as a grant, pursuant to chapter 42F, Hawaii Revised Statutes, to the Alzheimer's Association, Aloha Chapter, to:

(1) Establish a wanderer's registration service to protect individuals with Alzheimer's disease and related dementia;

(2) Conduct targeted outreach throughout the State to increase enrollment in the national wanderer's registry and offer scholarships and subsidies to low-income families, as defined by the United States Department of Health and Human Services' 2011 poverty guidelines for Hawaii, who want to enroll in the registry;

(3) Conduct annual training for first responders and other community members to increase awareness and provide ongoing education on best practices for search and rescue efforts for people with dementia; and

(4) When authorized by the family, issue customized updates and information through social media to provide alerts to the community and assist with search and rescue efforts.

The sum appropriated shall be expended by the department of health for the purposes of this part.

PART IV

SECTION 9. New statutory material is underscored.

SECTION 10. This Act shall take effect on July 1, 2012.

THE SENATE	S.B. NO.	2320
TWENTY-SIXTH LEGISLATURE, 2012		S.D. 2
STATE OF HAWAII