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Home & Community-Based Services: State-Only Funded Programs in Hawaii

States may be required to contribute match funding to some federally funded long-term care (LTC) programs and to different extents. In FY 2003 states spent 21.4% of total state expenditure on Medicaid (NASBO, 2004). Total expenditures for HCBS are increasing and totaled $16.4 billion in FY 2001, with states paying between 1.7% and 13.3% of total health care expenditures on HCBS in FY 2001 (Milbank 2003). Medicaid spending grew quickly in the early 2000s, forcing state legislatures and officials to investigate ways to contain Medicaid costs rather than expanding services (Coleman et al 2003).

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Program Name: Kupuna Care³,⁴,⁴⁷

Administrative Agency: Executive Office on Aging

Population Served: Elderly 60+

Annual Expenditure: $4,854,305 FY02 Appropriation

Funding Source: General Revenue

Number of People Served: 6,333 FY05

Eligibility Criteria: Ability of caregiver to provide care. Individuals who are financially &/or functionally ineligible for Medicaid, individuals waiting Medicaid HCBS or nursing home placement. No income or asset limit.

Further Information: Cost control: cost cap $1000/mth. No service limits. Co-pay required on sliding scale except for case management & meals. Individuals with income at/below $1,107.mth (150% FPL) are not charged. Those with incomes between $1,108-1,845/mth pay 1/3 of service cost, those with incomes between $1,845-2,583/mth (250-350%FPL) pay 2/3 of service cost, individuals with incomes above 350% FPL pay the full cost. Out of pocket health care expenses are deductible. Quality control: program monitoring by AAA staff, client satisfaction surveys, caregiver surveys.

Abbreviations:

AAAs - Area Agencies on Aging.

ADL - Activities of Daily Living.

AT - Assistive Technology. Dept - Department.

FY - Financial Year.

HCBS - Home & Community-Based Services.

LTC - Long Term Care. Mth - month. Rehab - Rehabilitation.

Mth - month.

Rehab - Rehabilitation.

SCI - Spinal Cord Injury.

SSBG - Soical Services Block Grant.

TBI - Traumatic Brain Injury.

Wk - week.

Yr - year.

Footnotes:

(a) Note that some figures listed are the yearly appropriation, not expenditure.

(b) Sources of funding are listed in the language with which they are reported.

(c) The figures for number of participants are not necessarily figures for unduplicated participants.

Notes:

(1) The definitions of the services provided in programs may differ between states.

(2) Unless otherwise stated, programs are statewide.

(3) Programs where it is known that funding may come from a variety of sources, including non-state only funds (e.g. Older Americans Act) are indicated by the program name in italics.

(4) The table does not include Mental Health Services programs.

(5) All information is the most up-to-date found from secondary sources noted in the references.

(6) N/A means the information has not been found (not available).

(7) all programs primarily aim to support people to live in the community, therefore there may be additional state only funded programs but these are not directly to support HCBS.

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