Report Title:

Elderly Services Programs; Adult and Community Care Services

Description:

Makes appropriations to the department of human services for home and community-based programs for the elderly.

HOUSE OF REPRESENTATIVES

H.B. NO.

2014

TWENTY-SECOND LEGISLATURE, 2004

 

STATE OF HAWAII

 


 

A BILL FOR AN ACT

 

relating to elderly services.

 

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

SECTION 1. The legislature finds that the cost of providing long-term care in an institution can be prohibitive; as a result, the department of human services’ adult and community care services branch seeks alternative community-based treatment that provide individuals with appropriate levels of care at a cost savings of about fifty per cent per person per year. The residential alternative community care program (RACCP) under the department of human services provides qualified individuals with placements in community-based residential facilities, including adult foster homes, adult residential care homes, and assisted-living facilities, as a less costly alternative to institutional care. These individuals are medicaid-eligible adults who require nursing-facility level care and are not able to benefit from in-home services because they have no caregiver or residence. RACCP provides a broad array of services, including personal care, homemaker services, transportation, respite, and day health services. RACCP is a federally-approved medicaid home and community-based waiver program that is jointly funded by the federal government and the State.

The legislature further finds that the lack of state match dollars has resulted in the State's inability to provide services to the maximum approved client limits, leaving a portion of the federal funding unused. The RACCP has grown rapidly and the current number of individuals on the wait list is two hundred thirty with no projected increase in state funding. The additional funds would allow RACCP to provide services to additional one thousand two hundred seven individuals, thereby satisfying the waiver client limits, maximizing federal reimbursements, and negating potential litigation resulting from unnecessary institutionalization.

The legislature also finds that another federally-approved medicaid home and community-based waiver program is in need of increased state funding in order utilize the maximum amount of funding provided by the federal government. There are three hundred individuals on the wait list for the nursing home without walls program (NHWW). The NHWW is a particularly innovative care system for the elderly that allows individuals to remain in the comfort of their homes.

The legislature further finds that the department of human services administers the chore services program (program) that provides essential housekeeping services to enable eligible disabled clients to remain living in the community. Clients employ their own service providers who are paid minimum wage. The program is funded on a matching basis with federal moneys.

Increases in the minimum wage has resulted in unanticipated program costs without a concomitant increase in funding levels. As a result, the program has been closed to new admissions since August 2001. Because no new clients have been admitted to the program, an estimated eight hundred forty-five individuals are now on the wait list for chore services. These individuals may be forced to utilize more costly care options, including utilizing medical and hospital services or institutionalization. The legislature believes that it is imperative for the State to provide its share of matching dollars to enable the program to continue and to serve new applicants.

The purpose of this Act is to appropriate funds for the residential alternative community care, nursing home without walls, and chore services programs.

SECTION 2. There is appropriated out of the general revenues of the State of Hawaii the sum of $1,494,708, or so much thereof as may be necessary for fiscal year 2004-2005, for the residential alternative community care program.

SECTION 3. There is appropriated out of the general revenues of the State of Hawaii the sum of $2,448,122, or so much thereof as may be necessary for fiscal year 2004-2005, for the nursing home without walls program.

SECTION 4. There is appropriated out of the general revenues of the State of Hawaii the sum of $3,424,942, or so much thereof as may be necessary for fiscal year 2004-2005, for the chore services program.

SECTION 5. The sums appropriated shall be expended by the department of human services for the purposes of this Act.

SECTION 6. This Act shall take effect on July 1, 2004.

INTRODUCED BY:

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