SB2228 SD1.DOC

PART I

SECTION 1. The legislature finds that falls and fall-related injuries among the elderly impact individuals, families, the community, and the State's health care system. Fall prevention is a major concern for the safety and well-being of the State's elderly residents, the fastest-growing segment of Hawaii's population.

Among the elderly in Hawaii, falls are the leading cause of fatal injuries (an average of forty-four per cent) and injury-related hospitalizations (an average of eighty-three per cent). On average, every five hours in Hawaii an elderly person is injured so severely in a fall that hospitalization is necessary. Falls among Hawaii's elderly also result in a yearly average of eighty-two deaths and nearly one thousand eight hundred hospitalizations.

The legislature further finds that hospital costs associated with fall-related injuries average over $65,000,000 a year. This total does not include the additional significant costs associated with skilled nursing care and rehabilitation. Among Hawaii seniors hospitalized for a fall, forty-three per cent are discharged to skilled nursing facilities for additional care, and twelve per cent are moved to rehabilitation facilities.

The legislature additionally finds that access to fall prevention services and programs would significantly reduce these costs. In addition, the early detection of fall occurrences would reduce both costs and suffering by expediting treatment, minimizing serious long-term consequences, reducing the extent of the injury, and in some instances, avoiding death.

Falls among the elderly are a significant public health issue. Yet, currently, there are insufficient resources to develop a coordinated statewide approach to reduce and promptly detect falls among the elderly. The legislature therefore finds that the department of health's emergency medical services and injury prevention system branch should be permitted to establish and maintain a program dedicated to fall prevention and early detection for the elderly. This program shall serve as a focal point for statewide injury prevention and detection efforts to ensure multidisciplinary support, coordination of prevention and detection efforts, and continuity of implementation and accountability.

The purpose of this part is to establish a fall prevention and early detection coordinator within the emergency medical services and injury prevention system branch to coordinate the provision of public and private fall prevention and early detection services for the elderly.

SECTION 2. Chapter 321, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"§321- Fall prevention and early detection coordinator. There is established within the emergency medical services and injury prevention system branch a fall prevention and early detection coordinator to coordinate the provision of public and private fall prevention and early detection services for the elderly."

SECTION 3. There is appropriated out of the trauma system special fund the sum of $78,555 or so much thereof as may be necessary for fiscal year 2014-2015 to establish and fill one full-time equivalent fall prevention and early detection coordinator position.

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

PART II

SECTION 4. Section 349-3.2, Hawaii Revised Statutes, is amended to read as follows:

"[[]§349-3.2[]] Alzheimer's disease and related dementia services coordinator. There is established within the executive office on aging an Alzheimer's disease and related dementia services coordinator to coordinate the provision of public and private Alzheimer's disease and related dementia services. [~~The coordinator shall be appointed by the director in accordance with chapters 76 and 89.~~]"

SECTION 5. There is appropriated out of the general revenues of the State of Hawaii the sum of $70,000 or so much thereof as may be necessary for fiscal year 2014-2015 for the Alzheimer's disease and related dementia services coordinator position.

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

SECTION 6. There is appropriated out of the general revenues of the State of Hawaii the sum of $4,200,000 or so much thereof as may be necessary for fiscal year 2014-2015 for the kupuna care program; provided that the sum appropriated shall be in addition to the base budget of the 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 $427,937 or so much thereof as may be necessary for fiscal year 2014-2015 for the aging and disability resource 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 $335,000 or so much thereof as may be necessary for fiscal year 2014-2015 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 $185,000;

(2) Kapahulu Center $40,000;

(3) Moiliili Community Center for the Moiliili senior center $50,000; and

(4) Waikiki Community Center $60,000.

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

SECTION 9. There is appropriated out of the general revenues of the State of Hawaii the sum of $476,772 or so much thereof as may be necessary for fiscal year 2014-2015 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.

PART III

SECTION 10. The legislature finds that Americans with multiple, chronic health conditions and increased rates of disability in old age are living longer now than in the past. Furthermore, the aging of the population in Hawaii guarantees that there will be a greater need for long-term care in the future. Between 2007 and 2030, the population aged eighty-five and older, which has the greatest need for long-term care, will increase by almost two-thirds.

The legislature further finds that many people in Hawaii have limited knowledge on long-term care issues, and some of what they know may be incorrect. For example, although long-term care is not covered by medicare or regular private health insurance, a 2011 survey of Hawaii members of the Association of American Retired Persons found that twenty-nine per cent of respondents said they expected medicare to pay for their long-term care if needed.

The legislature additionally finds that unless people have basic information about long-term care, including the different types and providers of long-term care services, the statistical risk of needing long-term care, and the cost of long-term care, they are unlikely to be motivated to establish long-term care plans or pay significant amounts of money for long-term care insurance.

The legislature also finds that a long-term care education and awareness campaign will educate people about their risks of needing long-term care and motivate people to begin planning for their potential long-term care needs.

The purpose of this part is to appropriate funds to the executive office on aging of the department of health to administer a public education and awareness campaign on long-term care and obtain an independent evaluation of the campaign.

SECTION 11. (a) The department of health's executive office on aging shall conduct a long-term care education and awareness campaign.

(b) The campaign goals shall include:

(1) Informing the public on the likelihood of needing long-term care at some point in life;

(2) Educating the public on the risks of not planning for long-term care and on maximizing the length of independent living;

(3) Building awareness that long-term care is not covered by medicare or regular private health insurance;

(4) Educating the public about the cost of long-term care, including the limits of medicaid eligibility and benefits;

(5) Informing the public on the value and availability of current financing and delivery options to obtain long-term care; and

(6) Providing the public with resources to navigate the complexities of planning for long-term care and the agencies that provide these services.

(c) The executive office on aging may develop a public-private partnership to fund and administer the campaign and may invite broad participation from multiple interested stakeholders in the State.

(d) The director of the executive office on aging shall have the campaign independently evaluated for its effectiveness.

(e) The director of the executive office on aging shall submit the report of the evaluation's findings and recommendations, if any, to the legislature no later than twenty days prior to the convening of the 2017 regular session.

SECTION 12. 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 2014-2015 for the executive office on aging of the department of health to conduct an education and awareness campaign on long-term care and to have an independent evaluation performed on the campaign.

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

PART IV

SECTION 13. Chapter 349, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"§349‑ Elder justice coordinator; establishment; duties. (a) There is established within the executive office on aging an elder justice coordinator to plan and implement statewide initiatives to prevent seniors from elder abuse and fraud.

(b) The elder justice coordinator shall:

(1) Promote collaborative efforts in the development of elder justice programs at the state and local levels;

(2) Support and protect elder victims by improving identification of elder abuse and enhancing response and outreach to victims;

(3) Work to improve the recognition, detection, and awareness of elder abuse, neglect, and exploitation by the general public and health care professionals;

(4) Facilitate the development, implementation, and continuous improvement of a coordinated, multidisciplinary elder justice system in Hawaii;

(5) Establish a clearinghouse to collect and disseminate information concerning best practices and resources for training and technical assistance to carry out evidence-based programs to prevent and address elder abuse, neglect, and exploitation;

(6) Work to improve the ability of first responders to screen for diminished capacity, vulnerability to financial abuse, and victimization; and

(7) Establish a multifaceted public awareness campaign, including public service announcements and social media, with clear messaging to raise awareness of elder abuse and existing prevention efforts."

SECTION 14. There is appropriated out of the general revenues of the State of Hawaii the sum of $70,000 or so much thereof as may be necessary for fiscal year 2014-2015 for the executive office on aging to establish an elder justice coordinator position.

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

PART V

SECTION 15. Chapter 349, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"§349‑ Long-term supports and services system and resource development coordinator; establishment; duties. (a) There is established within the executive office on aging a long-term supports and services system and resource development coordinator.

(b) The long-term supports and services system and resource development coordinator shall:

(1) Collaborate with each aging and disability resource center or area agency on aging to facilitate their social entrepreneurship by developing and implementing a business plan for each respective county's aging and disability resource center or area agency on aging. The goal of each business plan is to improve the aging and disability resource center or area agency on aging's operational efficiency and diversify their funding, thereby decreasing the organization's reliance on allocations and grants, and to encourage business market competition, which will subsequently strengthen services for Hawaii's older adults and their families into the future;

(2) Research the fiscal, policy, and operational changes necessary to integrate new ways of doing business within the aging and disability resource center and area agency on aging systems, and assist in developing new business partnerships;

(3) Promote increased operational efficiency of the aging and disability resource centers and area agencies on aging by facilitating a corporate culture change that aligns with their respective organization's business plan;

(4) Research and explore other funding sources for aging and disability resource centers and area agencies on aging;

(5) Develop and refine mechanisms for collaboration among aging and disability resource centers and area agencies on aging regarding information sharing, new business partners' policies, practices, interactions, and outcomes of each line of business developed within the aging network;

(6) Facilitate the development of a full array of services that can be offered by each aging and disability resource center and area agency on aging to potential business partners that will result in sustainable funding sources for the aging and disability resource center and area agency on aging that are more independent of direct state government funding;

(7) Support the development of pricing long-term supports and services which will be offered by each aging and disability resource center and area agency on aging to potential business partners;

(8) Develop and expand each aging and disability resource center and area agency on aging's capacity to bill and receive payments from a variety of funding sources;

(9) Facilitate the development of marketing materials to advertise the array of services available through each aging and disability resource center and area agency on aging in Hawaii;

(10) Initiate and facilitate contact with new business partnerships and market services available by the aging and disability resource centers and area agencies on aging to potential new partners;

(11) Assume the responsibility of being the liaison and interface between business partners, the aging and disability resource centers and area agencies on aging, and the executive office on aging;

(12) Collaborate with other executive office on aging vendors and contractors where appropriate;

(13) Collect and analyze data from the aging and disability resource centers and area agencies on aging regarding outcomes of each line of business; and

(14) Enable the capacity of each aging and disability resource center and area agency on aging to collect outcome information that makes a business case for the value of aging and disability resource center and area agency on aging services."

SECTION 16. There is appropriated out of the general revenues of the State of Hawaii the sum of $70,000 or so much thereof as may be necessary for fiscal year 2014-2015 for the executive office on aging to establish a position for a long-term supports and services system and resource development coordinator to increase the sustainability of Hawaii's aging network.

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

PART VI

SECTION 17. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 18. This Act shall take effect on July 1, 2014.

THE SENATE	S.B. NO.	2228
TWENTY-SEVENTH LEGISLATURE, 2014		S.D. 1
STATE OF HAWAII