pg_0001

HB5,HD1,SD2,CD1 - Economic Support for Family Caregivers.doc

HOUSE OF REPRESENTATIVES

HAWAII SILVER LEGISLATURE, 2005

H.D. 1

STATE OF HAWAII

S.D. 2

H.B. NO.

C.D. 1

A BILL FOR AN ACT

RELATING TO A COMPREHENSIVE FAMILY CAREGIVER ASSSITANCE PROGRAM.

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

PART I. INTRODUCTION

SECTION 1. The Silver Legislature finds that significant

changes in Medicare and Medicaid health insurance programs

nationally and locally will impose greater responsibilities upon

individuals and families to be well-informed and astute about long-

term care planning, financing, and the options available to assist

them.

Additionally, Hawaii is facing a growing healthcare worker

shortage, while at the same time health and long-term care needs

continue to rise. As a result of cost-containment policies and

practices, people with healthcare needs are being discharged from

hospitals and other care facilities with complex healthcare

requirements while facing reduced home- and community-based care

options. This puts the responsibility on families, who are

inadequately prepared and trained, to provide such care.

Furthermore, the caregiving tradition in Hawaii is, over time,

challenged by the changes in Hawaii demographics: birth rates,

marriages, single-occupant households, high costs of living, and

family members working outside the home or moving away from Hawaii.

By 2020, more than one in four individuals will be sixty years

old or older. The need for personal care due to physical, sensory,

cognitive, and self-care disabilities increases with age. As

Hawaii's population ages, many more families will be providing

pg_0002

HB5,HD1,SD2,CD1 - Economic Support for Family Caregivers.doc

higher levels of long-term care to frail and disabled older adults

at home.

Finally, Hawaii’s long-term care system is on a collision

course with the day-to-day reality of families coping with caring

for loved ones with chronic conditions. Without attention to this

situation, the $875 million in unpaid supportive services provided

by Hawaii’s family caregivers may well be jeopardized when these

caregivers suffer from the costs that impede their ability to give

care. As this pattern plays itself out, the quality of care

provided to the frail elderly and individuals with disabling or

chronic conditions will diminish, and the costs to Hawaii’s long-

term care system will skyrocket.

The purpose of this Act is to provide assistance to family

caregivers who provide at-home care for their elderly relatives.

PART II. HAWAII FAMILY CAREGIVER GRANT PROGRAM

SECTION 2. There is established a Hawaii Family Caregiver Grant

Program to provide annual grants of up to $1,000 to family

caregivers who provide unreimbursed care to a relative. The

following general requirements shall apply:

(1)

Both the caregiver and the relative receiving care must be

related by blood, marriage, or adoption.

(2)

Both the caregiver and the relative receiving care must

reside in Hawaii.

(3)

A licensed physician must certify that the criteria for

assistance are met.

(4)

Applications must contain an original signature from the

caregiver and the physician who provides certification.

The following caregiver requirements shall apply:

(1)

Provide unreimbursed (unpaid) care for a relative who has a

mental or physical impairment.

(2)

Have an annual Hawaii adjusted gross income of not more than

$50,000.

pg_0003

HB5,HD1,SD2,CD1 - Economic Support for Family Caregivers.doc

(3)

Provide care to the relative for at least six months of the

previous calendar year.

The following relative receiving care requirements shall apply:

(1)

Require assistance with two or more of the following: eating,

dressing, bathing, toileting, transferring, bowel continence,

and bladder continence.

(2)

Require assistance for at least six months out of the

previous calendar year.

(3)

Not be receiving Medicaid-reimbursed long-term care services,

except on a periodic or temporary basis.

PART III. COORDINATION OF STATEWIDE FAMILY CAREGIVER SUPPORT

SERVICES AND POLICIES

SECTION 3. The Executive Office on Aging (EOA) shall

coordinate public and private sector organizations and family

caregivers to establish:

(1)

A one-stop, single entry access point into the long-term care

system and family caregiver support;

(2)

New partnerships to address the needs of family caregivers;

(3)

Greater coordination and support for grandparents and other

relatives who are raising children.

PART IV. RESPITE SERVICES

SECTION 4. The Departments of Health (DOH) and Human Services

(DHS) shall develop respite services for family caregivers so that

families can receive time off from their 24-hour service to have

regular breaks from their caregiving duties. Respite services shall

be based on the DOH’s Developmental Disabilities Division respite

program.

PART V. TRAINING AND EDUCATION

SECTION 5. There is established a training and education

program to:

(1)

Increase the quality and quantity of long-term care workers;

(2)

Improve the support and training of family caregivers in

areas such as lifting, transporting, CPR, bathing, learning

pg_0004

HB5,HD1,SD2,CD1 - Economic Support for Family Caregivers.doc

to deal with loves ones with dementia, psychological skills

and emotional support, and communication skills;

(3)

Promote active aging to enhance the lives of seniors; and

(4)

Develop certification standards for nurses aides.

PART VI. FAMILY CAREGIVER TAX CREDIT

SECTION 6. There is established a refundable $1,000 Family

Caregiver Tax Credit for families who care for a family member at

home, who is categorized as needing help in two of the activities of

daily living, following procedure for granting tax credits for low

income people.

PART VII. CASH AND COUNSELING

SECTION 7. The Departments of Health (DOH) and Human Services

(DHS) shall develop a Cash and Counseling system of providing

financial assistance to family caregivers that combines elements of

financial support with direct services to help consumer make

informed choices about long-term care.

PART VIII. CONCLUSION

SECTION 8. There is appropriated out of the General Revenues

$4 million for the purposes of this Act.

SECTION 9. This Act shall take effect on July 1, 2006.