Long-Term Care Commission

Establishes the long-term care commission within the Joint
Legislative Committee on Long-Term Care Financing.  (SB2320 HD1)

THE SENATE                              S.B. NO.           S.D. 1
TWENTIETH LEGISLATURE, 2000                                H.D. 1
STATE OF HAWAII                                            

                   A  BILL  FOR  AN  ACT



 1      SECTION 1.  The legislature finds that the future of long-
 2 term care for Hawaii's senior and adult disabled population is
 3 one of the most critical health and fiscal issues facing Hawaii
 4 in the 21st century.  The rapid growth of the elderly and
 5 disabled populations will result in extraordinary demands on
 6 long-term care financing and delivery of services.
 7      The purpose of this Act is to create a temporary long-term
 8 care commission composed of a panel of experts who will prepare
 9 recommendations for the establishment of an integrated, cost-
10 effective, and responsive long-term care delivery system to
11 provide quality care to all of Hawaii's citizens who need long-
12 term care services.
13      SECTION 2.  There is established the Hawaii long-term care
14 commission (commission) within the Hawaii's state legislature's
15 joint legislative committee on long-term care financing.  The
16 commission shall be a temporary agency established to implement
17 the purpose of this Act.               
18      SECTION 3.  The commission shall consist of fifteen members
19 to be appointed jointly by the president of the senate and the

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 1 speaker of the house of representatives no later than October 1,
 2 2000.  The chairperson shall be selected by a majority vote of
 3 the members of the commission.  The senate president and the
 4 speaker of the house of representatives shall appoint no fewer
 5 than one person from each of the categories under section 5 of
 6 this Act.  The director of human services and the director of
 7 health, or their respective designees, shall be ex-officio voting
 8 members of the commission.  Heads of state agencies, department
 9 divisions, or members of state commissions are not prohibited
10 from serving as members.
11      No act of the commission shall be valid except by
12 concurrence of a majority of its members.
13      SECTION 4.  Members of the Hawaii long-term care commission,
14 except the chairperson, shall serve without compensation but
15 shall be reimbursed for expenses, including travel expenses,
16 necessary for the performance of their duties.
17      SECTION 5.  The president of the senate and the speaker of
18 the house of representatives shall jointly appoint at least one
19 person with background or experience from each of the following
20 categories:
21      (1)  Administrators of health plans, including prepaid
22           health plans;

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 1      (2)  Health care professionals such as physicians and
 2           nurses;
 3      (3)  County offices on aging, collectively;
 4      (4)  Hospital administrators;
 5      (5)  Institutional long-term care providers;
 6      (6)  Disabilities services providers;
 7      (7)  Community-based long-term care providers; and
 8      (8)  Consumer representatives;
 9 provided that no fewer than two persons shall be consumer
10 representatives and there shall be statewide representation on
11 the commission.
12      SECTION 6.  The commission may contract for consultation
13 services without regard to chapter 103D, Hawaii Revised Statutes.
14      SECTION 7.  The commission shall make findings and
15 recommendations relating to:
16      (1)  Developing and prioritizing goals for a long-term care
17           program for Hawaii including but not limited to:
18           (A)  Development of coordinated policies and programs
19                among executive departments and agencies;
20           (B)  Facilitation of an adequate amount of home and
21                community-based services and minimally sufficient
22                institutional services for long-term care;

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 1           (C)  Maximization of both public and private funds for
 2                long-term care;
 3           (D)  Assurance of accessibility to appropriate services
 4                in the least restrictive environment;
 5           (E)  Assurance of quality care for persons receiving
 6                long-term care which includes disability services;
 7           (F)  Treatment of chronic disabilities to optimize
 8                individual function and assure dignity and well-
 9                being;
10           (G)  Promotion of consumer choice as much as possible;
11           (H)  Encouragement of continuing involvement of family
12                members of persons receiving long-term care;
13           (I)  Increasing the sense of personal responsibility
14                and awareness of Hawaii's seniors and the young
15                adult population regarding their future long-term
16                care needs; and
17           (J)  Innovation and development of programs that
18                facilitate integrated care delivery and the long-
19                term care goals of the State;
20      (2)  Assessment of the long-term care needs of the State's
21           population; establishment of a system of quality
22           assurance for long-term care; delineation of different
23           levels of long-term care; and standardization of:

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 1           (A)  Pertinent terminology in the administrative rules
 2                of the various departments; and
 3           (B)  Assessment instruments of eligibility for
 4                different levels of long-term care;
 5      (3)  Review of administrative rules of the various executive
 6           departments to achieve standardization, consistent with
 7           the State's goals, and to achieve integration to reduce
 8           fragmentation and achieve cost-effectiveness;
 9      (4)  Establishment and expansion of a single-point entry
10           system, with a standardized pre-admission screening for
11           the determination of the appropriate level and setting
12           of care;
13      (5)  Establishment of a comprehensive assessment planning
14           and management system to encourage home- and community-
15           oriented services;
16      (6)  Financing alternatives for a long-term care system in
17           this State including but not limited to participation
18           in any manner by the public and private sectors and
19           insurance companies, including tax incentives to build
20           long-term care facilities and to support home-based
21           care; and
22      (7)  Workforce requirements of the long-term care industry
23           with particular attention to paraprofessional workers.

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 1      In making its findings and recommendations, the commission
 2 members must agree to be guided by the principles of creating a
 3 high quality, integrated, and cost-effective long-term care
 4 system, including the protection of clients and emphasis on the
 5 optimal use of all public funds in a reasonable manner.      
 6      SECTION 8.  The commission shall report to the joint
 7 legislative committee on long-term care financing before the
 8 convening of the regular session provided below, on the status of
 9 its progress toward its objectives and interim findings and
10 recommendations, as follows:
11      (1)  The first report for 2002 shall relate to objectives in
12           paragraphs (1), (2), and (3) under section 7 of this
13           Act;
14      (2)  The second report for 2003 shall relate to objectives
15           in paragraphs (4) and (5) under section 7 of this Act;
16           and
17      (3)  The third report for 2004 shall relate to objectives in
18           paragraphs (6) and (7) under section 7 of this Act, and
19           include a final report on all the objectives.
20      Each report shall contain an explanation of the impact of
21 relevant sources of funding on the recommendation.
22      SECTION 9.  For purposes of section 8 of this Act, the
23 commission shall:

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 1      (1)  Review relevant past state studies, reports, and
 2           experience of other states; and
 3      (2)  Serve as a centralized database for collecting state
 4           demographic data on aging and long-term care to
 5           facilitate the ongoing monitoring of the State's long-
 6           term care system by the executive, legislative, and
 7           judicial branches; provided that the department of
 8           business, economic development, and tourism shall
 9           assist the commission upon request in obtaining the
10           data; and provided further that upon repeal of this
11           Act, the database shall be transferred to the
12           department of human services.
13      SECTION 10.  There is appropriated out of the general
14 revenues of the State of Hawaii the sum of $           or so much
15 thereof as may be necessary for fiscal year 2000-2001 for the
16 expenses of the Hawaii long-term care commission, including the
17 contracting of consultation services.
18      SECTION 11.  The sum appropriated shall be expended by the
19 legislature for the purposes of this Act.
20      SECTION 12.  This Act shall take effect on July 1, 2000, and
21 shall be repealed on December 31, 2004.