Long-Term Care; Actuary Study

Amends Act 93, SLH 1999, to extend actuarial study on long-term
care from November 15, 1999, to November 15, 2001; to extend
sunset date of joint committee from June 30, 2000, to June 30,
2002; to clarify requirements for the actuarial study; and to
make unspecified appropriations for the study and JLC expenses.

HOUSE OF REPRESENTATIVES                H.B. NO.           
TWENTIETH LEGISLATURE, 2000                                
STATE OF HAWAII                                            

                   A  BILL  FOR  AN  ACT



 1      SECTION 1.  Act 339, Session Laws of Hawaii 1997, as amended
 2 by Act 93, Session Laws of Hawaii 1999, is amended by amending
 3 section 4 to read as follows:
 4      "SECTION 4.  The joint legislative committee shall submit a
 5 report of its findings and recommendations to the legislature by
 6 December 1, 1998.  The joint legislative committee shall cease to
 7 exist on June 30, [2000.] 2002."
 8      SECTION 2.  Act 93, Session Laws of Hawaii 1999, is amended
 9 by amending section 9 to read as follows:
10      "SECTION 9.  (a)   The joint legislative committee on
11 long-term care shall contract for a study on the feasibility and
12 advisability of establishing a state-sponsored universal program
13 of long-term care that offers comprehensive, protective coverage
14 to the largest numbers of people as reasonably possible through
15 [either a mandatory tax-based or voluntary premium] a funding
16 approach[.] that is the least expensive, easiest to administer,
17 and actuarially sound.  The study shall include, but not be
18 limited to, alternative models of:
19      (1)  Front-end universal program in which coverage would

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 1           begin either with:
 2           (A)  The first two years of nursing home care or
 3                comparable type care; or
 4           (B)  One and a half years or other length of time, of
 5                community or home care covered by the program,
 6           with a reliance upon private insurance for the
 7           remaining years; 
 8      (2)  Back-end universal program in which coverage would
 9           begin on the 366th day of disability and include
10           nursing home care or comparable care, or community or
11           home care, or any combination of these, with the first
12           year to be covered out of pocket or by privately
13           purchased long-term care insurance; or
14      (3)  Comprehensive universal program to provide lifetime
15           full coverage, regardless of private insurance
16           coverage.
17      (b)  The study also shall:
18      (1)  Examine how to integrate a state-sponsored universal
19           program of long-term care with the insurance model of
20           long-term care under this Act, with a goal of
21           supplementing private insurance so as to provide a
22           continuum of care;
23      (2)  Include a proposed model for financing a state-

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 1           sponsored universal program of long-term care for a
 2           target population that cannot afford long-term care
 3           insurance;
 4      (3)  Specify the amount of moneys that must be collected
 5           from each eligible person to adequately finance a
 6           state-sponsored universal program of long-term care and
 7           the mechanism for collecting those moneys;
 8      (4)  Make recommendations on whether a subsidy from the
 9           general fund or other state revenues is necessary for
10           adequate capitalization and reserves, and if so, the
11           amount of subsidy; and
12      (5)  Make recommendations on the best manner of
13           administering a state trust fund for long-term care.
14      (c)  The study may include an examination of universal long-
15 term care financing models of other countries.
16      [The study shall further include an analysis of the
17 provisions of House Bill No. 31, H.D. 1 and H.D. 2, Regular
18 Session of 1993, that proposed the "Hawaii Family Hope Program
19 Act", and make recommendations on legislation for introduction in
20 the 2000 regular session, including figures for the amount of a
21 tax to be imposed and a premium to be collected.
22      For purposes of this study, the joint legislative committee
23 on long-term care may contract with one or more of the same

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 1 consultants and advisers, excluding legal consultants, who
 2 provided services to the Executive Office on Aging for its
 3 reports, "Financing Long Term Care, A Report to the Hawaii State
 4 Legislature", dated January, 1991, and "The Long Term Care
 5 Advisory Board, Report to the Hawaii State Legislature", dated
 6 February, 1992; provided that procurement of services from the
 7 same consultants and advisers shall be exempt from any of the
 8 provisions of the the Hawaii Public Procurement Code, as provided
 9 by section 103D-102(b)(6), Hawaii Revised Statutes, on the basis
10 that this study is an update of those reports to design a state-
11 sponsored universal long-term care model that accounts for
12 current statistics and the condition of the State's economy.
13 Inasmuch as the groundwork for this follow-up study has been laid
14 in those previous reports by the same consultants and advisers,
15 the legislature finds that contracting with new consultants and
16 advisers would triple the cost of the study and would be
17 unnecessary duplication of work.  The legislature further finds
18 that the same consultants and advisers are qualified to conduct
19 this follow-up study.]
20      (d)  In selecting a contractor by bid for the study, the
21 joint legislative committee on long-term care shall consider,
22 among other things, the knowledge of the contractor of past
23 efforts of the State to establish a universal long-term care

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 1 program.
 2      The departments of taxation and budget and finance shall
 3 cooperate with the contractor for purposes of providing facts,
 4 figures, data, projections, estimations, and other information to
 5 effectuate this study."
 6      SECTION 3.  Act 93, Session Laws of Hawaii 1999, is amended
 7 by amending section 10 to read as follows:
 8      "SECTION 10.  The consultants [hired] contracted under
 9 section 11 of this Act shall submit a report of findings and
10 recommendations to the governor and the legislature not later
11 than November 15, [1999.] 2001.  Based on that report, the joint
12 legislative committee on long-term care shall draft legislation,
13 with the advice of the consultants, for introduction in the
14 regular session of [2000;] 2002; provided that the services of
15 the consultants for advising in drafting the legislation shall be
16 considered as a part of their services under section 11[.] of
17 this Act."
18      SECTION 4.  Act 93, Session Laws of Hawaii 1999, is amended
19 by amending section 11 to read as follows:
20      "SECTION 11.  There is appropriated out of the general
21 revenues of the State of Hawaii, the sum of [$100,000,]
22 $          , or so much thereof as may be necessary for fiscal
23 [year 1999-2000,] biennium 2000-2002, for the joint legislative

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 1 committee on long-term care to hire consultants to conduct a
 2 study on the feasibility and advisability of establishing a
 3 state-sponsored universal program of long-term care that offers
 4 comprehensive, protective coverage[.], as specified under section
 5 9 of this Act."
 6      SECTION 5.  Act 93, Session Laws of Hawaii 1999, is amended
 7 by amending section 13 to read as follows:
 8      "SECTION 13.  There is appropriated out of the general
 9 revenues of the State of Hawaii the following sums, or so much
10 thereof as may be necessary, for fiscal year [1999-2000] 2001-
11 2002, for expenses of the joint legislative committee on long-
12 term care to conduct one public briefing each on Oahu, Kauai, and
13 Maui, and two public briefings on Hawaii, on the findings and
14 recommendations of the actuarial study undertaken pursuant to
15 section 11 of this Act.
16      House of Representatives           $5,000
17      Senate                             $5,000"
18      SECTION 6.  Statutory material to be repealed is bracketed.
19 New statutory material is underscored.
20      SECTION 7.  This Act shall take effect upon its approval;
21 provided that sections 4 and 5 shall take effect on July 1, 2000.
23                           INTRODUCED BY:  _______________________

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