H.B. NO.



















     SECTION 1.  The legislature finds that Hawaii's aging population, similar to the rest of the United States, is rapidly increasing as more and more residents born during the baby-boom era of 1946-1964 turn sixty years of age.  Between 1980 and 2010, the number of adults in Hawaii over the age of sixty grew by 139.8 per cent, eclipsing the growth of the general population, which increased by 34.2 per cent during the same period.  The increase in the number of adults in Hawaii over the age of eighty-five during this period is even more extreme at 431.5 per cent.  In addition, it is projected that Hawaii's adult population over the age of sixty will comprise 29.7 per cent of the total population by 2035.

     This significant increase in Hawaii's elder population and the concomitant increase in demand for services, particularly those that allow for aging in place, will require an ongoing commitment to ensure that Hawaii's kupuna are adequately cared for.

     The legislature finds that the kupuna care program was enacted in 1999 to help frail and vulnerable persons over the age of sixty age in place by leading independent, meaningful, and dignified lives in their own homes and communities.  One of the principles of the program is that long-term care should be available to everyone, regardless of government or private insurance coverage or eligibility for other assistance programs, such as Medicaid and supportive and nutrition services under Title III of the federal Older Americans Act.  The kupuna care program is considered to be an alternative to traditional long-term care options and uses state funds to provide a continuum of home and community based supports that form a safety net for all kupuna and their caregivers.

     Access to the kupuna care program for all seniors is necessary to maintain a consistent continuum of care for vulnerable older persons, particularly as individuals' access to resources, support systems, and capacity change over time.  The most successful programs for aging-in-place recognize and build upon integrated health and social services.  Kupuna care is comprised of nine core services that support individuals in need of assistance to perform some of the basic activities of daily living and instrumental activities of daily living.  Basic activities of daily living include transferring from bed to chair, moving about within the home, bathing, dressing, toileting, and eating.  Instrumental activities of daily living include preparing a meal, shopping, managing medications, laundry, using the telephone, managing money, housekeeping, and using available transportation.  Kupuna care also provides core services, including personal care, homemaking, chores, home delivered meals, adult day care, case management, assisted transportation, regular transportation, and attendant care.

     In addition to the foregoing services, kupuna care clients may select services from a contracted provider or have the option for a participant-directed approach to home and community based services.  Individuals who are assessed and deemed eligible for kupuna care core services will have services authorized based on the needs identified within their respective individual support plan.  In the participant-directed model, an individual exercises decision-making authority to use an allotment of public funds to purchase and manage a wide array of supports that meet the individual's unique needs that complement the ongoing efforts of family caregivers and the individual's personal and financial resources.

     The legislature further finds that funding for the kupuna care program is critical as the population aged sixty and older is increasing rapidly.  The additional funding provided by this Act would enable the executive office on aging to target and triage additional clients according to each individual's vulnerability by utilizing the comprehensive person-centered intake and assessment tools developed statewide for targeting public supports to persons in greatest need.

     The purpose of this Act is to make an appropriation to the department of health for the kupuna care program.

     SECTION 2.  There is appropriated out of the general revenues of the State of Hawaii the sum of $4,145,695 or so much thereof as may be necessary for fiscal year 2017-2018 and the same sum or so much thereof as may be necessary for fiscal year 2018-2019 for the kupuna care program; provided that any funds appropriated pursuant to this section shall be in addition to and shall not supplant any portion of the base budget of the executive office on aging.

     The sums appropriated shall be expended by the department of health for the purposes of this Act.

     SECTION 3.  This Act shall take effect on July 1, 2017.








Report Title:

Kupuna Caucus; Kupuna Care; Appropriation



Makes an appropriation to the department of health for the kupuna care program.




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