HAWAII
Hawaii broke new ground in 2002 with a long-term care financing program that is intended to ensure universal coverage, but the failure to fund the program left it in limbo until a study is completed about needed tax revenues. An 18-month planning process involving state agencies and consumers resulted in a broad range of recommendations to increase access to home and community-based care.
Long-Term Care Insurance
Hawaii became the first state to create a long-term care financing program when then-Governor Benjamin Cayetano signed legislation on July 1, 2002, establishing the Hawaii Long-Term Benefits Fund to provide a system of universal long-term care in the state. The legislation calls for long-term care taxes to be deposited into the fund to cover benefit payments and administrative costs. People would qualify for coverage if they needed assistance with at least two activities of daily living or were suffering from Alzheimer's disease.
However, a proposal to fund the program through a $10 tax on all Hawaii workers was defeated in the Legislature. Instead, a board of trustees is to conduct a study to determine the amount of tax revenue that the state should place into the fund.
Governor Linda Lingle said in her state-of-the-state address in January 2003 that she would seek a 30 percent tax credit to be phased in over three years to encourage Hawaiians to purchase private long-term care insurance. The 2003 Legislature considered several tax credit measures for those who buy long-term care insurance.
Planning and Reports
The state's Department of Health and Human Services and Department of Health and the Hawaii Centers for Independent Living issued a long-term care planning document on September 13, 2002 after 18 months of work. Individuals with disabilities, advocates, providers, and businesses and government agencies that assist people with disabilities also participated in the planning process. The document, The Olmstead Plan: State of Hawaii, describes five goals.
- To inform and educate consumers about their choices and rights involving community living opportunities and services.
- To support individuals in finding appropriate, affordable and accessible housing in a timely manner. This goal involves improving the assessment process, including assessing residents of nursing homes to determine if they should remain in such facilities or move to community settings.
- To facilitate the access of individuals to financial resources for their long-term care and to increase the flexibility available to them in how funds are used, including allowing consumers to direct their own care.
- To ensure adequate housing, transportation and employment for people with disabilities. This goal includes developing and maintaining a suitable work force to assist people with disabilities to live in the community.
- To coordinate a quality assurance program to monitor and assess the state's progress in meeting the goals of the plan.
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