Hawaiians Say ‘Aloha’ to Home Care Services Funding

Hawaiian families can say “aloha” to funding to help pay for home care services for a family member, after Gov. David Ige signed the Kupuna Caregivers Program into law. Kupuna is the Hawaiian word for elderly.

The new program gives eligible families up to $70 per day to help pay for in-home care services to better enable seniors living at home who have trouble with activities of daily living (ADLs), and could have national implications. The bill, which is deemed the first of its kind, will give financial relief to family caregivers and provide a boost for families to pay for professional in-home care services.

The funding helps bridge a gap in care services for seniors living at home, but who are not qualified for Medicaid home care services or Medicare home health care services .


The bill provides the funding for families who have one member who works outside the home for at least 30 hours per week and also takes care of a relative at home. It is not intended to meet all the needs of seniors aging at home in need of care, but to provide some relief to family caregivers and boost professional services. It is also not intended to provide funding to cover a stay in a long-term care facility such as a skilled nursing home or an assisted living community.

“This act will help Hawaii’s family caregivers balance their responsibilities to both their employers and their kupuna,” State Senator Roz Baker said in a statement. “Nobody should lose their job or their own retirement benefits in order to take care of their aging loved ones. For me, and I hope for all our state legislators, it is a source of pride to know that Hawaii is at the forefront of long-term care legislation.”

The program will be implemented through Hawaii’s Executive Office on Aging, attached to the state’s Department of Health.


“Essentially, the state re-prioritized within its overall budget to now put some more resources toward care and caregiving,” Kevin Simowitz, political director for Caring Across Generations, told Home Health Care News. “This is not financed through Medicaid.” The advocacy group Caring Across Generations was an instrumental force behind the legislation.

Families can put the funding toward a number of needed services.

“It is designed to be as flexible as caregiving needs are diverse,” Simowitz said during a tele briefing on the program on Monday.

The flexibility means families can pay for a number of services related to taking care of loved ones at home.

“This measure is just one more extension of what we believe is fundamentally important to ensure we can take care of our kupuna going forward,” Gov. Ige said when he signed the program into law. “[The program] provides up to $70 per day for transportation services, personal care, respite care and homemaker services to help facilitate and allow our families to take care of their loved ones at home.”

National Implications

The bill, which had strong backing from the advocacy group Caring Across Generations, is being touted as a model financing solution for other states around the country.

The program comes at the same time as the United States is embroiled in a contentious health care debate over Republicans’ plan to repeal and replace the Affordable Care Act (ACA), also known as Obamacare. Published drafts of the Senate’s version of the health care bill, known as the Better Care Reconciliation Act (BCRA), reveal drastic cuts to Medicaid funding over the next decade. The cuts to the federal program are expected to have serious implications for the home health care sector.

Conversely, the Kupuna Care Act provides more funding for home- and community-based services for the non-Medicaid population in Hawaii.

“As for how this fits into the existing infrastructure: It builds from the Aging and Disability Resource Center (ADRC) in Hawaii to use them as hubs for care workers and service delivery, rather than re-inventing the wheel about how to connect caregivers to families,” Simowitz told HHCN.

The legislation could show that while the national trend could reduce financing for home- and community-based services, individual states may be more willing to increase funding.

“We need to be strengthening and investing in our care infrastructure right now, not slashing it,” Simowitz said in a statement. “Helping family caregivers in the workforce while they take care of their aging family members is a great step forward.”

The biggest impact is likely to be on family caregivers, who will be able to pass on some of their responsibilities to professional home- and community-based service provider in Hawaii with the state financing. Female family members, in particular, often shoulder significant caregiving responsibilities that impact their own lives and careers.

There are 43.5 million family caregivers in the United States who provide an estimated $470 billion worth of unpaid care annually, according to Caring Across Generations. Up to 75% of these caregivers are women, and one-third of all women in the workplace are estimated to provide some care to an older relative or spouse over the course of their career. On average, a woman will lose $324,044 in wages and benefits over her lifetime as a result.

Hawaii is one state with a large senior population—by 2030, 23% of the state will be 65 and older.

Written by Amy Baxter

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