Hawaii

HAWAII 2020 STATE POLICY PRIORITIES

Increase Public Awareness, Early Detection And Diagnosis

Encourage Utilization of the CMS Care Planning Code

Since January 1, 2017, the Centers for Medicare and Medicaid Services (CMS)—through CPT® billing code 99483 — allows clinicians to be reimbursed for providing a comprehensive set of care planning services to cognitively impaired individuals and their caregivers. Participating in planning in the early stages of the disease allows individuals with Alzheimer’s to create advance directives regarding their care and finances as well as address driving and safety issues so that their wishes can be carried out when they are no longer cognitively able to make such decisions. Individuals receiving dementia-specific care planning have fewer hospitalizations, fewer emergency room visits, and better medication management. The low rate of usage of the Medicare care planning benefit in the first year shows that patients and providers are generally not aware of the existence of the benefit. In order to address this, we support establishing an outreach program in Hawaii's Department of Health to inform physicians and appropriate non-physician practitioners participating in Medicare that comprehensive care planning services for those with Alzheimer's and other dementias is a covered benefit under Medicare.

Build a Dementia-Capable Workforce

Establish Dementia-Specific Training Standards

Quality care for those with dementia, now and in the future, depends upon the quality of the workforce providing that care, as well as other factors. Competency-based dementia training of all direct service, administrative, supervisory and other staff who are involved in the delivery of care to those with Alzheimer’s disease employed by licensed providers is needed in Hawaii.

Increase Access to Home and Community-Based Services

Improving the Kupuna Caregivers Program

Families and friends undertake the majority of caregiving for individuals with Alzheimer’s. Respite services, including in-home personal care and adult day care, can provide family caregivers with much needed relief and support. The Kupuna Caregivers program is a prevention program, assisting families before crisis strikes. Studies have shown that people who age at home with family are more likely to have better health outcomes, reducing hospitalization, ER visits, and institutionalization. The Kupuna Caregivers program aims to prevent burnout and reduce long-term costs. Currently, this program is underfunded. We support an incease in funding for Hawaii's Kupuna Caregivers program increasing support to $2,000,000 annually, ensuring more families living with dementia have access to much needed caregiver supports.



Hawaii State Plan Overview

In 2011 the Hawaii Executive Office on Aging, in partnership with the Alzheimer's Association, Aloha Chapter, formed a special Task Force to develop a State Plan on Alzheimer's Disease and Related Dementias (ADRD). The task force included representatives from state agencies, care provider organizations, community organizations, faith communities, and research centers as well as advocates, long-term care providers, consumers, and elder law attorneys. In December 2013, the Office on Aging published Hawaii 2025: State Plan for Alzheimer's Disease and Related Dementias.


This year, we are supporting these bills:


• Funding the Alzheimer's Disease and Related Dementia Services Coordinator HB581 & SB366
Hawaii Revised Statute §349-3.2 established the position within the Executive Office on Aging but it has not been funded.  While the Hawaii 2025: State Plan Alzheimer’s Disease and Related Dementias identifies strategies in addressing the multifaceted issues in dealing with the disease, the services and activities needed requires coordination at a systemic level through an Alzheimer’s Disease and Related Dementia Services Coordinator.


• Recognizing Dementia is a Chronic Disease HB579 & SB676
Presently, there is no Dementia-Specific position within the Chronic Disease Prevention and Health Promotion Division (CDPHPD).  We support legislation to expand CDPHPD by establishing a position to promote wellness through effective prevention, detection, and management of dementia.


• Establishing a Screening Pilot Program HB474 & SB1032
Hawaii does not perform a sufficient number of screenings for dementia.  Additionally, there are disparities in care received by certain communities including for people of Native Hawaiian ancestry.  We support establishing a pilot program within the Department of Health to: promote dementia screenings and education; and partner with providers to screen eligible participants.


ADVOCACY EVENTS

Hawaii State Advocacy Day

March 02, 2020

Join advocates at the Hawaii State Capitol and help create change make a difference for those with Alzheimer’s Disease and their families. We will start the day with an advocacy training followed by meetings with key legislators. For more information and to RSVP please visit: https://act.alz.org/aloha


Sign Up to Learn More About Advocacy Opportunities in Hawaii


Sign me up to participate in the upcoming State Advocacy Day!

State Affairs Contact Ian Ross | 808-652-3380 | [email protected]



Elected Officials

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Alzheimer's Facts and Figures in Hawaii

Number of People Aged 65 and Older With Alzheimer's by Age

Year 65-74 75-84 85+ TOTAL
* Totals may not add due to rounding
2020 4,000 12,000 13,000 29,000
2025 5,000 16,000 14,000 35,000

Percentage change from 2020

Medicaid

$240

MILLION

Medicaid costs of caring for people with Alzheimer's (2020)

18.7%

change in costs from 2020 to 2025


Medicare

$20,009

per capita Medicare spending on people with dementia (in 2019 dollars)


HOSPICE (2017)

943

#

of people in hospice have a primary diagnosis of dementia


16%

of people in hospice with a primary diagnosis of dementia

Geriatricians

61

Number of geriatricians in 2019


5%

increase needed to meet Alzheimer's population needs in 2050

Hospitals (2017)

1,225

#

of emergency department visits per 1,000 people with dementia


17.4%

dementia patient hospital readmission rate


24.0%

increase in emergency deparment visits since 2007

Caregiving

65 Thousand

Number of Caregivers



74 Million

Total Hours of Unpaid Care



$975 Million

Total Value of Unpaid Care


Number of Deaths from Alzheimer's Disease (2018)

480 total deaths in Hawaii
6th leading cause of death in Hawaii
307% increase in Alzheimer's deaths since 2000

For more information, view the 2020 Alzheimer's Disease Facts and Figures report at alz.org/facts.

U.S. Statistics

Over 5 million Americans are living with Alzheimer's, and as many as 13.8 million will have the disease in 2050. The cost of caring for those with Alzheimer's and other dementias is estimated to total $305 billion in 2020, increasing to $1.1 trillion (in today's dollars) by mid-century. Nearly 1 in 3 seniors who dies each year has Alzheimer's or another dementia.



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