Recently, the Hawaii State Legislature passed two bills that affect our elderly population and their health care. One was Senate Bill 534, the Kupuna Caregivers Act; the other was House Bill 1396, Relating to Community Care Foster Family Homes, both of which were signed into law by Governor Ige this session.

Kupuna Caregivers: One of the most difficult things that many people here in Hawaii face is trying to provide in-home care for their aging and elderly family members while still holding down a full-time job themselves, raising children, and otherwise maintaining their own lives. I am often asked by clients if there is any government assistance program for their parent who is not quite at the point where they need to go to a nursing home yet, but who needs substantial care and supervision to remain at home.

Although there has been some help available to our Kupuna prior to this new law, thanks to the Kupuna Caregivers Act, now a family member caregiver who works full-time (at least 30 hours per week at one or more jobs) can receive benefits of up to a maximum of $70 per day to hire help to provide transportation, personal care, respite care, adult day care, or chore and homemaker services for their elderly dependents that they would otherwise have to provide themselves. In order to qualify, the elderly dependent care recipient (“Kupuna”) must be a US citizen or legal alien, a Hawaii resident, and over the age of 60. The Kupuna cannot be residing in a skilled nursing facility, assisted living facility, foster care home, or other adult residential care facility yet; and in addition, he or she must be impaired in the performance of at least two activities of daily living or instrumental activities of daily living, or have a cognitive impairment that poses a danger to themselves or others.

Hawaii is the first State to provide this type of support to caregivers who have jobs. This is important because in 2015 there were over 236,000 people over age 65 in Hawaii, and according to the AARP, there are 154,000 unpaid family caregivers in Hawaii. The average caregiver is a 62 year old married woman who cares for a parent or husband while still working. In this Act, the Hawaii Legislature allocated up to $600,000 for this Kupuna Caregivers Program for the 2017-2018 budget year. This doesn’t seem like a lot of money when you consider the number of family member caregivers we have, but it’s a great starting place for a new trial program. The Director of Health and the Executive Office on Aging have not yet established specific rules for the Kupuna Caregiver program, but the funds are already allocated for qualified caregivers with an eligible Kupuna care recipient family member.

Relating to Community Care Foster Family Homes: The State licenses private care homes called Community Care Foster Family Homes (“Foster Homes”) which serve as a family-like home alternative to institutional nursing home settings. These Foster Homes provide 24-hour living accommodations including housing, meals, supervision, personal care, and assistance with activities of daily living. In general, only 2 or 3 residents are allowed per home, only one of which can be a private pay resident at any given time. The other resident or residents must be Medicaid recipients.

This new law allows the Department of Health, working in consultation with the Department of Human Services, to make an exception such that if a husband and wife (or a couple in a civil union) are both private pay patients and neither one is eligible for Medicaid, the Department may allow the couple to occupy two private pay beds in the same Foster Home under certain conditions. Prior to this law being passed, if neither one of the couple were eligible for Medicaid, it was not possible to have the couple both reside together in the same Foster Home as private pay residents.

Both of these two new law changes are helpful for our elderly population and give us greater options for providing quality care to the most vulnerable age-group in our society.


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Ethan R. Okura received his Doctor of Jurisprudence Degree from Columbia University.

Carroll (Cary) D. Dortch received his Doctor of Jurisprudence Degree from the University of New Hampshire School of Law, and clerked for the Honorable Judge David G. Campbell in Arizona.

The lawyers at Okura & Associates focus their practice on Estate Planning to protect assets from nursing home costs, probate, estate taxes, and creditors.

This column is for general information only. The facts of your case may change the advice given. Do not rely on the information in this column without consulting an estate planning specialist.