After repeated pushes at the state Capitol, Hawaii’s AARP chapter and others are cheering the CARE (Caregiver Advise, Record, Enable) Act, which took effect Saturday, and this year’s passage of House Bill 607, which drafts framework for a Kupuna Caregivers program — respite support for people caring for elders while remaining in the workforce.
With the CARE Act, Hawaii is 27th among states to give family caregivers opportunity to receive instructions when loved ones are discharged from the hospital. And with HB 607, the Aloha State is the first to pass legislation that aims to provide eligible caregivers with a financial voucher that could be applied to bills for home care aids and others who can provide adult day care, transportation, personal care and various homemaking services.
Hawaii has good reason to move to the forefront on senior issues. We have the fastest-aging population and the most people over age 65 per capita in the nation.
The latest U.S. Census Bureau data finds that 17 percent of the state’s 1.4 million residents are age 65 or older — a bump up by almost 3 percent since 2010. The oldest of some 333,550 baby boomers, those born between 1946 and 1964, are now in their early 70s.
The careAct is needed to ensure that family caregivers are part of a patient’s care team. It allows an acute-care hospital patient to designate a family caregiver on their medical record, and that caregiver must be notified before discharge or transfer elsewhere; and requires explaining and demonstrating medical and nursing duties to the family caregiver.
Two years ago, the idea of boosting training for lay caregivers pitted some of the state’s hospitals against the AARP, with health care industry representatives worried about liability issues and adding to the workload of already-stretched-thin health care personnel. In the end, common sense prevailed. Adequately informed family caregivers taking on potentially complex services — injections, tube feedings, wound care and medication management, among other tasks — will result in fewer cases of hospital re-admission and associated charges.
The desire among kupuna to live at home for as long as possible and avoid the often-exorbitant price tag tied to other types of assisted-care prompts the call for a voucher program.
A study slated for this year will be followed by $6 million in 2018-19 for implementation. If all goes as planned, people who work at least 30 hours a week but also have caregiver responsibilities could get $70 a day to spend on bills for home care aids and others who can provide adult day care, transportation, personal care and homemaking services.
A social services handout? Hardly. While the state pitches in for respite services, it draws economic benefits, such as tax revenue, from the caregiver’s continued employment. Plus, all of this unpaid caregiving in Hawaii adds up to a critically important service.
AARP says the average caregiver in this bracket is a 62-year-old woman. And she may well be struggling to make financial ends meet. A recent University of Hawaii study finds that more than 9 percent of women here included in the so-called silver tsunami headcount are living below the poverty line.
That should sound an alarm for our lawmakers to confront other emerging senior issues, ranging from affordable housing to transportation. In Hawaii, our lifespan expectancy is 81.3 years, topping the national average by 2.3 years. Now is the time to grapple with aging-population challenges and make careful plans to address them.