Sunday, August 09, 2009

Small Victories!

by Tony Lenzer

The 2009 Legislative Session was a disastrous one for Hawaii’s elders, their families, disabled persons, and other vulnerable populations. The Legislature did not approve, or the Governor vetoed, legislation containing funding for many critical services. Nonetheless, four important bills were saved, either through Legislative overrides at the Special Session convened on July 15, or by the Governor allowing a bill to become law without her signature. However, the Governor has said she will not release any funds required by the bills.

House Bill 982: Establishes a new data collection system for family leave, and appropriates $10,000 from the disability benefits special fund for this purpose. Today, over one-fourth of Hawaii’s households have someone caring for a physically or mentally impaired older person. Over half of these caregivers are employed, and many indicate that their work is affected by caregiving responsibilities. Such data —from both the public and private sectors—is critical if Hawaii is to develop a 21st century family leave system.

House Bill 1504: Creates the Hawaii Health Authority to develop a plan to provide universal health care in Hawaii. Current estimates are that 10% of our population lack health insurance coverage. However, the percent of those under age 65 who lack coverage is much higher, possibly 25% or more. These include the growing number of part-time workers, as well as others not covered under Hawaii’s Prepaid Health Care Act. Uninsured people strain Hawaii’s health resources, and sick people represent a loss of productivity for Hawaii’s employers and the State. Given the serious Congressional disagreements about financing, as well as the structure of such reforms, Hawaii would be well advised to move ahead with its own planning and later adjusted to fit whatever national reform legislation is enacted.

House Bill 1379: Creates a process for a patient to direct his or her end-of-life treatment via a standardized physician orders form. The form is signed by the patient (or surrogate) and the patient’s physician, and all healthcare providers (including EMS Personnel and ER physicians) are required to comply with properly executed and signed forms. This instrument provides clear and immediate direction for healthcare providers, especially for patients who do not have an advance directive, or whose advanced directive is not available when end-of-life medical decisions must be made.

Senate Bill 415: Requires the Department of Health to license home care agencies. These agencies provide personal care and homemaker assistance to disabled persons and frail elders, and respite care for family members. Demand has increased due largely to the number of disabled and frail elders. At present, anyone can open a home care agency simply by getting a General Excise Tax license. There are no criminal history checks, training requirements, or ethical standards required. Home care agencies, like other health providers, should meet minimal standards and be licensed.