Report Title:

Elder wellness

 

Description:

Appropriates funds to the executive office on aging for collaborative programs with private agencies relating to elder wellness and to contract an independent evaluation of these elder wellness programs. (HB780 HD1)

 

HOUSE OF REPRESENTATIVES

H.B. NO.

780

TWENTY-FIRST LEGISLATURE, 2001

H.D. 1

STATE OF HAWAII

 


 

A BILL FOR AN ACT

 

relating to the elderly.

 

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

SECTION 1. The legislature finds that throughout the Asia-Pacific region, including Hawaii, profound demographic changes are occurring. Populations are aging as a result of longer life expectancies. In Hawaii, the elderly population is growing at about two and one-half times the national elderly growth rate. Although Hawaii has traditionally been a state with a large youth population, the percentage of elderly residents in the year 2000 exceeded the national average for the first time in history.

The aging of Hawaii's population is accompanied by a greater prevalence of chronic degenerative conditions and disabilities for which individuals require assistance. It is becoming increasingly difficult for families to provide the traditional care for their elderly family members, as the dynamics of families are changing nationally and in Hawaii.

Family size is shrinking, and there are fewer multigenerational households today, with many extended families separated geographically. Additionally, there is a general decrease in family living space, and more and more families have both parents in the workplace, with nobody in a traditional homemaker/caregiver role. All of these trends affect the ability of families to provide the necessary care to their elder members.

Hawaii's elder support system is currently not equipped to handle the increasing numbers of elderly residents. Hawaii has approximately thirty nursing home beds per one thousand elderly residents compared to the national average of about fifty-four beds per one thousand elderly residents. Because of this shortage, only the most severely disabled of our elderly population can be accommodated by our nursing homes. Hawaii's nursing home patients have the most acute disabilities, on average, of any State in the country. This creates a great deal of pressure on acute care facilities in hospitals, and on the families of elderly persons who are unable to receive care.

In recent decades, many new kinds of services have emerged to address the long-term care needs of the elderly, with over two hundred different organizations operating on Oahu alone. Unfortunately, these programs are fragmented, and are not adequate to handle Hawaii's needs. Furthermore, our medical system is designed and financed to provide a rather narrow range of treatments, and does not provide the comprehensive system of services required by those with chronic debilitating conditions. The range of services that is required for a typical progression of elder care is as follows:

(1) Wellness and prevention;

(2) Early onset and adaptation;

(3) Informal assistance;

(4) Formal community-based services; and

(5) Institutional care.

Those who receive intervention early can often forestall the progression, and can improve their quality of life immeasurably. There is a need for a comprehensive and cost-efficient system of long-term care that is created with an understanding of this continuum of care. It must focus on the early stages of long-term care needs to minimize the reliance on institutional care which presents an immense burden to families and the State as a whole.

Some of the key elements of a functional elder wellness system, as identified by various private health care organizations, would be:

(1) Volunteer service banking, in which the volunteer efforts of seniors and others helping seniors are documented and rewarded;

(2) Pilot projects that seek to develop preventive, wellness-oriented, cost-effective, nonmedical service teams for home-based seniors that operate in specific communities;

(3) Intergenerational programs that match independent senior volunteers with school-age children; and

(4) The development of support programs and funding for family caregivers of the elderly to ensure that home care can continue as long as possible.

The purpose of this Act is to provide funding for targeted resources to encourage and facilitate the development, implementation, and documentation of key components of future community-based elder wellness support systems that will meet the needs of Hawaii's growing elderly population. Specifically, these funds will be used to develop handbooks and operational manuals for the implementation of service banking and community wellness outreach programs that can be utilized by various organizations.

SECTION 2. The executive office on aging shall submit reports to the legislature no later than twenty days prior to the convening of the regular sessions of 2003 and 2004 on the progress and findings of the following programs:

(1) A model program of volunteer elder service banking, including the evaluation and selection of various computer volunteer documentation and tracking systems, and the development of a handbook on elder service banking; and

(2) A service delivery system model and pilot project including the development of an operating manual on service delivery.

SECTION 3. There is appropriated out of the general revenues of the State of Hawaii the sum of $1 or so much thereof as may be necessary for fiscal year 2001-2002 and the sum of $1 or so much thereof as may be necessary for fiscal year 2002-2003 to be expended as follows:

(1) $1 for fiscal year 2001-2002 and $1 for fiscal year 2002-2003 for the development, documentation, implementation, and analysis of a model program of volunteer elder service banking that actively engages seniors in the service of other seniors, and rewards volunteers for their efforts. The program shall include the evaluation and selection of various computer volunteer documentation and tracking systems, and the development of a handbook on elder service banking to assist organizations in the future;

(2) $1 for fiscal year 2001-2002 and $1 for fiscal year 2002-2003 for the planning, development, implementation, documentation, and evaluation of a service delivery system model and pilot project, including;

(A) The development of an operating manual for the recruitment of a team;

(B) The development of a client base of over one hundred seniors;

(C) The logistics of providing services to a client base; and

(D) Other relevant lessons that could be useful to organizations in the future;

and

(3) $1 for fiscal year 2002-2003 to contract with the University of Hawaii's social service research institute to conduct independent program integrated evaluations and assessments of the projects in (1) and (2) above, and provide a final report to the executive office on aging.

The sums appropriated shall be expended by the executive office on aging for the purposes of this Act.

SECTION 4. This Act shall take effect on July 1, 2001.