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.

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