Report Title:

Unified Entry System for Long-term Care Services



Requires the executive office on aging to establish a coordinated and unified system of long-term care that provides multiple entry points for long-term care and related services; makes appropriation.



H.B. NO.









relating to long-term care.



SECTION 1. Current long-term care services are characterized by fragmentation and uncoordination, according to a 1995 legislative reference bureau report recommending the creation of a coordinating committee to plan the creation and implementation of a single entry point system. Unfortunately, little has been done, despite the report's recommendations, to remedy the situation.

The legislature finds that Act 301, Session Laws of Hawaii 1996, required the department of human services to formulate a plan for a single entry point system. The department reported to the legislature in 1997 with a proposed single entry point model and flow chart, which would have provided for a coordinating agency and an advisory council to adopt a plan for implementing single entry point model.

The legislature further finds that potential long-term care recipients currently enter the system of care from various service points and from different Islands. For example, an individual could enter the system through an adult residential care home, home care agency, or nursing home on any of the Islands. Every person entering the system from any point on any island deserves to be placed in an appropriate setting with adequate services.

The legislature further finds that the vast majority of the elderly in Hawaii are not eligible for the full array of long-term care services provided by the Medicaid program. Medicaid recipients are serviced by the department of human services, in accordance with federal law that preempts state laws. The intent of the legislature is not to jeopardize federal Medicaid funding to the State by imposing any requirements pertaining to recipients of long-term care services funded by Medicaid.

The purpose of this Act is to establish a coordinated and unified system of long-term care for the non-Medicaid elderly that provides multiple entry points; information and referral services; intake and needs assessment; preadmission screening for institutional care; and a comprehensive service plan.

SECTION 2. Chapter 349, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"349-   System of long-term care services; coordinated and unified system. (a) This section shall not apply to elders who receive Medicaid funded long-term care services.

(b) The executive office on aging shall establish a coordinated and unified system of long-term care for the elderly and disabled persons of any age that provides:

(1) Multiple entry points;

(2) Information and referral services;

(3) Needs assessment at the time of intake;

(4) Preadmission social and medical screening for institutional care; provided that medical screening shall be provided within the limits of available resources;

(5) Placement of the individual into the appropriate setting; and

(6) A comprehensive service plan for each individual that is subject to change as the individual's needs change.

(c) The executive office on aging may enter into a small purchase contract with a private, nonprofit entity in accordance with section 103D-305, to implement the services under subsection (b); provided that the contract amount shall be $1 per year.

(d) The nonprofit entity shall be incorporated under chapter 451B for the specific purpose of acting as a coordinating agency for purposes of this section. The board of directors shall be advised by a panel of representatives of the department of human services, department of health, providers of long-term care services, and recipients of long-term care services, as chosen by the board."

SECTION 3. There is appropriated out of the general revenues of the State of Hawaii the sum of $1, for fiscal year 2002-2003, for creating a coordinated and unified system of long-term care as specified in section 2 of this Act.

The sum appropriated shall be expended by the executive office on aging.

SECTION 4. New statutory material is underscored.

SECTION 5. This Act shall take effect on July 1, 2002.