Ethan R. Okura
Hawai‘i Herald Columnist

The Hawai‘i state Legislature recently passed two bills that will affect our elderly population and their health care. One was Senate Bill 534, the Kupuna Caregivers Act; the other was House Bill 1396, Relating to Community Care Foster Family Homes. Gov. David Ige signed both bills into law.

Kupuna Caregivers Act. One of the biggest challenges facing many people here in Hawai‘i is trying to provide in-home care for their aging and elderly family members while still holding down a full-time job, raising children and otherwise maintaining their own lives. Clients often ask me if there are any government assistance programs for their parent who is not quite at the point where he or she needs to enter a nursing home, but who needs substantial care and supervision in order to remain at home.

Some help was available to our kupuna (elders) prior to the enactment of the Kupuna Caregivers Act, but not much. The Kupuna Caregivers Act, which the Legislature passed this past session and Gov. David Ige recently signed into law, allows a family member who pulls at least double duty as a family caregiver and works full-time (at least 30 hours per week at one or more jobs) to receive benefits of up to $70 per day to hire help. The $70 can be used for transportation, personal care, respite care, adult day care, or chore and homemaker services for their elderly dependent — tasks they would otherwise have to provide themselves. In order to qualify, the elderly dependent care recipient (“kupuna”) must be a U.S. citizen or a legal alien, a Hawai‘i resident and over the age of 60. The kupuna cannot be residing in a skilled nursing facility, assisted living facility, foster care home or other adult residential care facility at the time. Additionally, he or she must be impaired in the performance of at least two activities of daily living or instrumental activities of daily living, or have a cognitive impairment that poses a danger to themselves or others.

Hawai‘i is the first state in the nation to provide this type of support to caregivers who also have regular day jobs. This is important — in 2015, there were more than 236,000 people over the age of 65 in Hawai‘i. According to AARP, Hawai‘i has 154,000 unpaid family caregivers. The average age of these caregivers — usually married women — is 62. Most of them are caring for a parent or a spouse while still working. The Hawai‘i law allocated up to $600,000 for the Kupuna Caregivers Program for the 2017-2018 fiscal year. While this doesn’t seem like a lot of money given the number of family member caregivers we have, it is a great starting place for a new trial program. The directors of the state Department of Health and the Executive Office on Aging have yet to establish specific rules for the program, but the funds have already been allocated for qualified caregivers with an eligible kupuna care recipient family member.

Relating to Community Care Foster Family Homes. The state of Hawai‘i licenses private care homes called Community Care Foster Family Homes that serve as a family-like home alternative to institutional nursing home settings. These foster homes provide 24-hour living accommodations, including housing, meals, supervision, personal care and assistance with activities of daily living. Generally speaking, each home can house only two or three residents at any given time, only one of which can be a private-pay resident. The other resident or residents must be Medicaid recipients.

The new law allows the Department of Health, in consultation with the Department of Human Services, to make an exception if a husband and wife (or a couple in a civil union) are both private-pay patients and neither is eligible for Medicaid. The Health Department can allow the couple to occupy two private-pay beds in the same foster home under certain conditions. Previously, if neither one of the couple were eligible for Medicaid, the couple could not reside together in the same foster home as private-pay residents.

These two new laws will help for our elderly population and give us more options for providing quality care to the most vulnerable age group in our society.

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Ethan R. Okura received his doctor of jurisprudence degree from Columbia University. The lawyers at Okura & Associates focus their practice on estate planning to protect assets from nursing home costs, probate, estate taxes and creditors.

This column is for general information only. The facts of your case may change the advice given. Do not rely on the information in this column without consulting an estate planning specialist.

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