A Remedy for What Ails Us
By Hawaii State Senator Will Espero
Part I (of a two part series): Long Term Care and Organ Donation
Health care constitutes 26% of all federal spending. While social security is the big talk as the baby boomer generation steps into senior citizen status, their simultaneous entrance into the Medicare system will also take its toll on both federal and state governments.
Senator Suzanne Chun Oakland, Chair of the Senate Human Services Committee, works hard during the legislative interim to keep current on the concerns and needs of our senior citizens. Her Kupuna Caucus brings together many of those who work with, are affected by, or are senior citizens. Over the years the Legislature has undertaken several initiatives to help our elderly: Quest-Ex, Kupuna Care, the Aging and Disability Resource Center, and the Going Home Program.
As the number of frail and disabled elderly increases, so will the demand on the need for long term care and the cost the state will incur for these services. The Legislature is cognizant of the pending long term crisis due to our aging population, and made it a priority to find solutions. The Legislature this year passed SB 3255 to require the State to develop a comprehensive, solid plan for future long term care needs.
The price of institutional care has escalated beyond what most elders can afford. The Legislature finds that public and private collaboration may be necessary to support payment of long term care to both assist senior citizens to receive care at home and prevent the state from becoming fiscally liable for costs it will be difficult to sustain.
SB 3255, sets out the long term care policy goals for Hawaii, to make sure our senior citizens receive the services they need. The state’s plan should:
- (1) Encourage planning and providing for a continuum of care through the end of life;
(2) Coordinate referral, case management, and service delivery;
(3) Strengthen family caregiver support to encourage aging-in-place;
(4) Include workforce development and training to expand the number and capabilities of care providers;
(5) Develop financial mechanisms to help families pay for the care;
(6) Increase public resources to expand home- and community-based care options;
(7) Encourage research and education on aging, long term care, and related subjects; and
(8) Foster public understanding of caregiving issues.
The Legislature also set out these principles to guide the development of a long term care system for Hawaii:
• Families should have as much choice as possible in selecting and using services;
• Patients should be able to gain access to services to achieve the level of self sufficiency desired;
• Programs and services should be accountable, cost effective and of sufficient quality;
• All services should be delivered in a way that minimizes limited state resources; and
• Information should be available to help people make timely, appropriate decisions.
Lastly, the bill establishes a long term care commission in the University of Hawaii College of Social Sciences Public Policy Center, to implement the planning aspects of this state policy.
Many of Hawaii’s elderly prefer to “age at home” rather than in an institution or care home. In-home care, though, does not yet have the financing options that nursing facilities do. The Legislature passed HB 2062 to give our kupuna independence and choice among the service options available, including admittance to a nursing facility, or receiving community- or home-based care. The Department of Human Services, under the bill, would be required to apply to Medicare and Medicaid to allow Medicaid-eligible persons to receive care at home or within the community.
One more issue, organ donation, is addressed in HB 2366, which the Governor signed into law in June. The bill provides for establishing a statewide organ donor registry through the Department of Health. An automated system will make organ donor information available to those who wish to register online. Information in the centralized database will be available to authorized family members and doctors so they can know a person’s wishes with regard to organ donation on a 24/7 basis.
Senator Will Espero represents the 20th Senatorial District (Waipahu, Ewa, Ewa Beach and West Loch) on the Island of Oahu. He also serves as the Chair of the Senate’s Public Safety Committee.