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chapter-349•Hawaii Revised Statutes, Chapter 349 — PROGRAMS ON AGING REPEALED. L 1976, c 217, §2. CHAPTER 349 EXECUTIVE OFFICE ON AGING
chapter-349Haw. Rev. Stat. ch. 349CodeJan 1, 1976
Division 1. Government — Title 20. Social Services
Hawaii Revised Statutes as published by the Hawaii State Legislature (files updated 1/5/2026 7:14 PM).
(a) The legislature hereby declares that, in keeping with the traditional American concept of the inherent dignity of the individual in our democratic society, the older people of our State are entitled to, and it is the joint and several duty and responsibility of the State of Hawaii and its counties to enable our older people to secure equal opportunity to the full and free enjoyment of the following:
(1) An adequate income in retirement in accordance with the American standard of living;
(2) The best possible physical and mental health which science can make available, without regard to economic status;
(3) Suitable housing, independently selected, designed, and located with reference to special needs and available at costs which older citizens can afford;
(4) Full restorative services for those who require institutional care;
(5) Opportunity for employment with no discriminatory personnel practices because of age;
(6) Retirement in health, honor, and dignity;
(7) Pursuit of meaningful activity within the widest range of civic, cultural, and recreational opportunities;
(8) Efficient community services which provide social assistance in a coordinated manner and which are readily available when needed;
(9) Immediate benefit from proven research knowledge which can sustain and improve health and happiness;
(10) Freedom, independence, and the free exercise of individual initiative in planning and managing their own lives.
(b) In support of the declaration of purpose in subsection (a), it shall be the policy of the State and its counties to:
(1) Make available comprehensive programs which include a full range of health, education, and social services to our older residents who need them;
(2) Give full and special consideration to older residents with special needs in planning such programs; and, pending the availability of such programs for all older residents, give priority to elders with the greatest economic and social need;
(3) Provide comprehensive programs which will assure the coordinated delivery of a full range of essential services to our older residents, and where applicable, also furnish meaningful employment opportunities for individuals, including older persons from the community; and
(4) Insure that the planning and operation of such programs will be undertaken as a partnership of older residents, the at-large community, and the State and its counties with appropriate assistance from the federal government.
(c) It shall be the duty and responsibility of every state department and county agency providing programs and services to elders to actively work toward the goals articulated in subsections (a) and (b) and to employ the State's policy as included in the state master plan for elders in the planning and implementation of their individual programs.
[L 1976, c 217, pt of §2; am L 1990, c 67, §8]
(a) There is established within the department of health, for administrative purposes only, an executive office on aging.
(b) The head of this office shall be known as the director of the executive office on aging, hereinafter referred to as director. The director shall have professional training in the field of social work, education, public health, and other related fields; extensive direct experience in programs or services related to elders; and recent experience in a supervisory, consultative, or administrative position. The director shall be nominated and appointed by the governor without regard to chapters 76 and 89. Effective July 1, 2005, the director shall be paid a salary set by the appointing authority that shall not exceed sixty-nine per cent of the salary of the director of human resources development. The director shall be included in any benefit program generally applicable to the officers and employees of the State.
[L 1976, c 217, pt of §2; am L 1982, c 129, §12; am L 1986, c 128, §11; am L 1989, c 329, §9; am L 1990, c 67, §8; am L 2002, c 148, §39; am L 2003, c 204, §1; am L 2005, c 226, §9]
The director shall have the following principal functions, duties, and powers:
(1) Serve as the principal official in state government solely responsible for the performance, development, and control of programs, policies, and activities on behalf of elders;
(2) Oversee, supervise, and direct the performance by the director's subordinates of activities in such areas as planning, evaluation, and coordination of elder programs and development of a statewide service delivery network;
(3) Assess the policies and practices of other agencies impacting on elders and conduct advocacy efforts for elders;
(4) Advise the governor on new legislation, programs, and policy initiatives and conduct such liaison as would be required to implement them;
(5) Serve as a member of advisory boards and regulatory panels of state agencies in such areas as income maintenance, public employment, retirement systems, certification of health care facilities and programs, social service and medical assistance, and housing and employment, among others;
(6) Administer funds allocated for the executive office on aging; and apply for, receive, and disburse grants and donations from all sources for elder programs and services;
(7) Establish a clearinghouse for complaints of persons regarding services to elders, or operations of state and county agencies affecting elders, investigate the complaints, and refer the complaints and the director's findings to the appropriate agency for corrective action;
(8) Adopt, amend, and repeal rules pursuant to chapter 91 for the purposes of this chapter;
(9) Employ and retain such staff as may be necessary for the purposes of this chapter, in conformity with chapter 76; and
(10) Contract for or grant such services as may be necessary for the purposes of this chapter, including master contract with other state agencies receiving federal and state funds for programs and services for the aging, and purchase of service agreements with appropriate agencies.
[L 1976, c 217, pt of §2; gen ch 1985; am L 1990, c 67, §8; am L 2000, c 253, §150]
L 2017, c 102, §4.
There is established within the executive office on aging an Alzheimer's disease and related dementia services coordinator to coordinate the provision of public and private Alzheimer's disease and related dementia services. The coordinator shall be appointed by the director.
[L 2013, c 214, §1; am L 2019, c 127, §2]
(a) There shall be a policy advisory board for elder affairs, appointed by the governor under section 26-34. The board shall advise the director in but not limited to the following areas:
(1) The identification of issues and alternative approaches to solutions;
(2) The development of position statements and papers;
(3) Advocacy and legislative actions; and
(4) Program development and operations.
The board shall consist of not less than fifteen nor more than twenty-one members, a majority of whom are over sixty years of age and who shall be selected on the basis of their interests and knowledge in and their ability to make contributions to the solution of problems relating to aging, and shall include at least one member from the county of Hawaii, one member from the county of Maui, one member from the county of Kauai, and one member from the city and county of Honolulu. There may be up to ten members who shall serve as ex officio[,] nonvoting members and may consist of the heads of the following agencies that provide services or programs affecting elders: health, human services, education, labor and industrial relations, commerce and consumer affairs, University of Hawaii, transportation, the state retirement system, and, by invitation, the Hawaii representatives of the United States Department of Health and Human Services and the Social Security Administration. Ex officio members may delegate their board responsibilities to another member of their agency. Of the non ex officio members, one-third of the members shall be appointed for the term of four years, one-third for the term of three years, and one-third for the term of two years; and thereafter the terms of office of each member shall be four years. The members shall serve without compensation, but shall be paid their necessary expenses in attending meetings and carrying out the responsibilities of the board. The chairperson shall be elected annually from the nongovernmental members of the board. There shall be not less than twelve meetings of the board each year. Quorum shall be a majority of the currently serving members, but in no event fewer than eight members shall constitute a quorum.
(b) The policy advisory board for elder affairs may honor a non ex officio member by voting to award the member a lifetime honorary kupuna title at a meeting called for the purpose and attended by a quorum. The governor:
(1) Shall take into consideration a person's receipt of a lifetime honorary kupuna title when considering the person's reappointment to the board; and
(2) Notwithstanding section 26-34, may reappoint a person who holds the lifetime honorary kupuna title for continued terms over the person's lifetime.
[L 1976, c 217, pt of §2; am L 1979, c 136, §1(1); am L 1987, c 339, §4; am L 1990, c 67, §8; gen ch 1993; am L 2013, c 8, §1; am L 2018, c 134, §2; am L 2019, c 125, §2]
(a) The provision of administrative and program support for the executive office on aging shall be accomplished by the creation of two principal organizational divisions in the executive office on aging. One division shall be known as the planning and administrative services division and the other shall be known as the community assistance and program management division.
(b) The planning and administrative services division shall engage in the following activities, including but not limited to:
(1) Preparation and submission of programs and budgets;
(2) Preparation of an annual evaluation report on elder programs for the governor and legislature, which shall include a section detailing outcomes of the kupuna caregivers program, including but not limited to:
(A) Evaluation metrics;
(B) A cost breakdown and de-identified, aggregated analysis of individuals served, by county and type of service received;
(C) Identification of the number of service providers contracted by county and the types of services provided;
(D) Consolidated data of the existing waiting list broken down by county; and
(E) Recommendations to support the implementation and execution of the program to maximize the number of caregivers served by the program;
(3) Preparation of studies and analysis;
(4) Maintenance of personnel records;
(5) Management of contracts and agreements entered into by the executive office on aging with public and private vendors, consultants, and suppliers;
(6) Monitoring the purchase of service agreements with public and private agencies and rendering technical assistance to elder program service providers; and
(7) Establishment and maintenance of reimbursement systems for services provided by agreement with federal, state, and county agencies, as well as private groups.
(c) The community assistance and program management division shall engage in the following activities, including but not limited to:
(1) Legislative research and development as well as liaison on state and federal legislative matters;
(2) Conducting public affairs programs on elder affairs programs, projects, and needs;
(3) Development and implementation of educational, recreational, and cultural programs for elder persons;
(4) Provision of technical assistance and liaison with community groups, organizations, and independent programs of benefit to elders;
(5) Development and implementation of active programs of consumer protection and pre-retirement counseling;
(6) Establishment of a statewide information and referral system, and an annual inventory of elder programs and service agencies;
(7) Technical assistance and liaison for the purpose of establishing elder-controlled local service delivery systems providing comprehensive services and employment opportunities for elders throughout the State; and
(8) Development and management of federally funded programs and special projects under the federal Older Americans Act and other federal sources.
[L 1976, c 217, pt of §2; am L 1990, c 67, §8; am L 2019, c 126, §2]
(a) There is established in the state treasury the executive office on aging administrative claiming special fund into which shall be deposited:
(1) All revenues from medicaid administrative claiming designated for the department of health that are allowable for operating the aging and disability resource centers and programs within the executive office on aging;
(2) Appropriations made by the legislature to the fund; and
(3) Grants and gifts made to the fund.
(b) The executive office on aging administrative claiming special fund shall be administered and expended by the department of health to administer and implement services for kupuna and individuals with disabilities who need long-term services and supports.
[L 2019, c 89, §2; am L 2023, c 249, §2]
The executive office on aging shall be responsible for the continued development, implementation, and continuous updating of a comprehensive master plan for elders which shall include, but not be limited to, the following:
(1) Compilation of basic demographic data on elders in the State;
(2) Identification of the physical, sociological, psychological, and economic needs of elders in the State;
(3) Establishment of immediate and long-range goals pursuant to programs and services for elders in the State;
(4) Establishment of priorities for program implementation and of alternatives for program implementation; and
(5) Organization of administrative and program structure, including the use of facilities and personnel.
The state master plan for elders shall be developed in accordance with the requirements of the executive budget act.
[L 1976, c 217, pt of §2; am L 1990, c 67, §8]
(a) The executive office on aging shall prepare an update of the state plan on Alzheimer's disease and related dementias no less frequently than once per fiscal biennium. The executive office on aging shall include information on progress made toward the goals of the state plan in its annual report to the legislature.
(b) The update report shall include:
(1) An implementation work plan specifying the tasks, timelines, and milestones for each goal along with parties assigned to each task;
(2) Efforts taken by the State to achieve the goals and strategies identified in the most recent state plan on Alzheimer's disease and related dementias;
(3) Recommendations for state policy relating to Alzheimer's disease and dementias; and
(4) A review of services initiated and coordinated among public and private agencies to meet the needs of persons with Alzheimer's disease and related dementias and their families.
(c) In preparing the update report, the executive office on aging shall review the most recent state plan on Alzheimer's disease and related dementias for appropriateness and revise the plan as necessary. In determining the appropriateness of the current plan, the executive office on aging shall solicit input from task forces and working groups formed to address Alzheimer's disease and related dementias, families affected by Alzheimer's disease and related dementias, and members of the medical community.
[L 2018, c 146, §2]
The executive office on aging shall be the single state agency responsible for programs affecting senior citizens of this State; provided that those programs affecting senior citizens now operated by other departments or agencies shall not be transferred to the executive office on aging except by executive order of the governor.
[L 1976, c 217, pt of §2]
It shall be the duty and responsibility of every state department and county agency providing programs and services to the aging, in actively working toward the goals and objectives articulated in the state comprehensive master plan for elders, to coordinate with the executive office on aging the development of its program plans and clear its final plans with the office prior to implementation of such plans. The executive heads of all such departments and agencies shall cooperate with the executive office on aging in providing information as the office deems necessary for the effective discharge of its duties under sections 349-3, 349-5, 349-6, and 349-7. However, nothing contained in this chapter shall be deemed to delegate or detract in any way from the functions, powers, and duties prescribed by law for any other department or agency of this State, nor to interrupt or preclude the direct relationships of any such department or agency or units of county government in the performance of such functions, powers, and duties. Each department, agency, officer, and employee of the State and of the counties shall cooperate and assist the executive office on aging in the performance of the function, powers, and duties of the office.
[L 1976, c 217, pt of §2; am L 1990, c 67, §8]
Each county may establish a county office on aging and a county council on aging pursuant to the Older Americans Act of 1965, as amended.
[L 1976, c 217, pt of §2; am L 1979, c 136, §1(2)]
Each county may hold an annual senior citizen's fair in its respective county. The county shall be responsible for the planning, organizing, and coordinating of the fair in every respect. The state policy advisory board for elder affairs may assist the county in any aspect upon request. Proceeds earned from this fair are deemed to be proceeds earned from casual sales as defined in chapter 237. The county shall distribute such proceeds to the various senior citizen organizations and individuals who participate in the fair in accordance with appropriate methods of distribution as determined by the county.
[L 1976, c 217, pt of §2; am L 1979, c 136, §1(3); am L 1990, c 67, §8]
The executive office on aging shall be responsible for establishing state policy for senior centers. Such policy shall include, but not be limited to, the following:
(1) Establishment of comprehensive long range and immediate goals and objectives pursuant to chapter 349;
(2) Establishment of state standards for the operation and maintenance of senior centers;
(3) Establishment of priorities for program implementation and of alternatives for program implementation;
(4) Delineation of the separate and mutual roles, responsibilities, and authorities of the State and of the several counties relative to the development and administration of senior centers and senior center programs; and
(5) Establishment of a mechanism to provide for the effective monitoring of senior centers and senior center programs.
[L 1976, c 141, §§1, 2]
The executive office on aging shall submit to the legislature a progress report on the Hawaii state health insurance assistance program no later than twenty days prior to the convening of each regular session. The report shall include but not be limited to:
(1) The number of persons in the State's medicare population served by outreach programs;
(2) The number of previously uninsured persons who received assistance with enrollment in medical or prescription drug coverage; and
(3) The number of persons assisted by the Hawaii state health insurance assistance program with enrollment in low-income subsidy programs.
[L 2023, c 252, §3]
The executive office on aging shall coordinate a statewide system of caregiver support services by, among other things:
(1) Integrating family caregiver support with the aging and disability resource center demonstration project;
(2) Analyzing the long-term care needs of older adults and the capacity of family and informal caregivers to help them remain safely at home;
(3) Advocating, mobilizing, and coordinating employer and community resources to enable and augment family caregiver support;
(4) Establishing and maintaining protocols and standards for federal and state caregiver services administered by state, county, or other local agencies on aging;
(5) Establishing and supervising the alignment of long-term care advocacy assistance staff caregiver support objectives with the planning, resource development, grants management, data management, and evaluation functions of the executive office on aging; and
(6) Coordinating statewide support for grandparents and other aging relative caregivers of children eighteen and under.
[L 2006, c 262, §5]
Unless the context clearly requires a different meaning, when used in this part:
"Activities of daily living" means the following activities that individuals perform as a part of daily living: eating, dressing, bathing, toileting, transferring in and out of a bed or chair, and walking.
"Adult day care" means personal care for dependent elders in a supervised, protective, and congregate setting during some portion of a day. Services offered in conjunction with adult day care include social and recreational activities, training, and counseling.
"Aging and disability resource centers" means an entity established by the State as part of the state system of long-term care, serving as a highly visible and trusted source where people of all incomes and ages can obtain information on the full range of long-term support options, and as a single point of entry for access to public long-term support programs and benefits.
"Area agency on aging" means an agency designated by the executive office on aging to develop and administer the area plan for a comprehensive and coordinated system of aging services.
"Assisted transportation" means assistance and transportation, including escort, for a person who has cognitive or physical difficulties using regular vehicular transportation.
"Attendant care" means standby assistance, supervision, or cues, including verbal prompts for medication, bathing, eating, grooming, and dressing, and may also include other activities to help maintain the independence of an individual at home. "Attendant care" does not include physical contact in support, including weight-bearing assistance with transfers, washing, bathing, and dressing.
"Care coordination" means a person-centered, assessment-based, interdisciplinary approach to integrating health care and social support services that are tailored to an individual's needs and goals across all care services.
"Caregiver" means a spouse, adult child, other relative, partner, or friend who has a personal relationship with and provides a broad range of unpaid assistance for an older adult having a chronic or disabling condition.
"Caregiver support services" means services that offer education, skills, knowledge, or mental, emotional, or social support to caregivers or employed caregivers.
"Care recipient" means an individual who:
(1) Is a citizen of the United States or a qualified alien; provided that for the purposes of this paragraph, "qualified alien" means a lawfully admitted permanent resident under the Immigration and Nationality Act;
(2) Is sixty years of age or older;
(3) Is not covered by any comparable government or private home- and community-based care service, except or excluding kupuna care services;
(4) Does not reside in a long-term care facility, such as an intermediate care facility, assisted living facility, skilled nursing facility, hospital, adult foster home, community care foster family home, adult residential care home, expanded adult residential care home, or developmental disabilities domiciliary home; and
(5) Has impairments of at least:
(A) Two activities of daily living;
(B) Two instrumental activities of daily living;
(C) One activity of daily living and one instrumental activity of daily living; or
(D) Substantive cognitive impairment requiring substantial supervision because the individual behaves in a manner that poses a serious health or safety hazard to the individual or another person.
"Case management" means assistance either in the form of access or care coordination in circumstances where an individual is experiencing diminished functioning capacities, personal conditions, or other characteristics that require the provision of services by formal service providers, caregivers, or employed caregivers. Activities of case management may include assessing needs, developing care plans, authorizing and coordinating services among providers, and providing follow-up and reassessment, as required.
"Chore" means assistance such as heavy housework, yard work, or sidewalk maintenance for a person.
"Employed caregiver" means an individual who:
(1) Provides care for a care recipient; and
(2) Is employed at least twenty hours per week by one or more employers or is self-employed.
"Financial management service provider" means an agency under contract with the executive office on aging to act as the fiscal and employer agent on behalf of a care recipient to manage employer-related functions, process payment to employees and vendors, and monitor the care recipient's allocation of funds.
"Home-delivered meals" means a meal provided to a care recipient in the care recipient's place of residence; provided that the meal is served in a program administered by the executive office on aging or an area agency on aging and meets all of the requirements of the Older Americans Act of 1965, as amended, and all state and local laws.
"Homemaker" means a person who provides assistance with preparing meals, shopping for personal items, managing money, using the telephone, or performing light housework.
"Instrumental activities of daily living" means the following instrumental activities that individuals perform as a part of daily living: preparing meals, shopping for personal items, medication management, managing money, using the telephone, performing light housework, performing heavy housework, and making use of available transportation.
"Kupuna care services" means services for the care recipient, caregiver, or employed caregiver, including:
(1) Adult day care;
(2) Attendant care;
(3) Assisted transportation;
(4) Caregiver support services;
(5) Case management;
(6) Care coordination;
(7) Chore;
(8) Homemaker;
(9) Home-delivered meals;
(10) Personal care;
(11) Transportation; or
(12) Respite care.
"Personal care" means personal assistance, standby assistance, supervision, or cues.
"Person-centered planning" means a process intended to identify the strengths, capacities, preferences, needs, and desired outcomes of the care recipient, caregiver, or employed caregiver.
"Person-centered support plan" or "support plan" means a plan developed by a care recipient, caregiver, or employed caregiver that allows the care recipient, caregiver, or employed caregiver to establish the goals, skills, and knowledge necessary to work toward the desired outcomes and lays out practical steps toward the achievement of the goals; provided that family members and friends may provide assistance in developing a care recipient's plan if the care recipient chooses to include them.
"Respite care" means services that offer temporary, substitute supports, or living arrangements for care recipients to provide a brief period of rest to caregivers or employed caregivers. "Respite care" includes:
(1) In-home respite (personal care, homemaker, and other in-home respite);
(2) Respite provided by attendance of the care recipient at a nonresidential program;
(3) Institutional respite provided by placing the care recipient in an institutional setting such as a nursing home for a short period of time as a respite service to the caregiver or employed caregiver; and
(4) Any combination of services to assist the caregiver or employed caregiver as deemed appropriate by the area agency on aging.
"Service provider" means an entity that has all required licenses or certificates, and is registered as a business entity in the State.
"Transportation" means transportation from one location to another with a vehicle and does not include any other activity.
[L 2017, c 102, pt of §2; am L 2022, c 160, §2; am L 2023, c 18, §2]
(a) The executive office on aging may establish the kupuna care program. The program shall provide an array of long-term services and supports to address the needs of Hawaii's older adults to age in place and avoid institutionalization and to provide support services to caregivers or employed caregivers in their efforts to assist older adults to continue residing in their homes.
(b) The program shall be coordinated and administered by the executive office on aging and implemented through the area agencies on aging.
(c) To qualify for the kupuna care program, an individual shall be a care recipient, caregiver, or employed caregiver as defined in section 349-16.
(d) An area agency on aging, through the aging and disability resource center or any other entity designated by the executive office on aging, shall determine eligibility for the program, which may include the following:
(1) An intake process to preliminarily determine eligibility for publicly funded services and supports, including kupuna care services;
(2) A comprehensive in-home assessment of the care recipient or a caregiver assessment, if necessary; and
(3) A written, individualized, person-centered support plan that identifies all services and supports needed or currently used to meet the needs of the care recipient, caregiver, or employed caregiver, including those provided by other programs such as medicaid or privately paid programs.
(e) An area agency on aging shall use the assessment data and individual's support plan to confirm kupuna care program eligibility before authorizing and coordinating services and supports. An area agency on aging shall authorize and allot kupuna care services and shall not delegate the service authorization function to the agency's subcontractors.
(f) The kupuna care program shall be delivered through two distinct service options: traditional service delivery or participant-directed services and support, based on an individualized, person-centered support plan for each eligible care recipient, caregiver, or employed caregiver; provided that:
(1) Traditional service delivery shall be by a service provider that provides services to care recipients, caregivers, and employed caregivers under a formal contractual arrangement with the executive office on aging or applicable area agency on aging; and
(2) Participant-directed services and support shall address the care recipient's assessed needs through person-centered planning. The care recipient shall have decision-making authority over their own budget to purchase and manage their needed services and supports based upon their person-centered support plan.
(g) An individual shall be determined to be ineligible for kupuna care services when:
(1) The individual does not meet the eligibility requirements specified;
(2) The individual's need is not substantiated through an in-home assessment;
(3) The individual leaves the State or the individual's whereabouts are unknown; or
(4) The individual refuses services.
(h) An area agency on aging shall provide an individual with written notice of the disposition of ineligibility for kupuna care services.
(i) An individual who has been determined ineligible for kupuna care services shall have the opportunity to appeal the decision to the applicable area agency on aging.
(j) Prior to termination of kupuna care services, service providers shall notify the applicable area agency on aging of the date and reason for termination. Termination of kupuna care services may occur if the care recipient, caregiver, or employed caregiver:
(1) Moves and the provider is unable to locate the care recipient, caregiver, or employed caregiver;
(2) Is transferred to another area agency on aging;
(3) Dies;
(4) No longer needs or wants kupuna care services and supports, or no longer needs or wants a particular kupuna care service or support;
(5) Is uncooperative with the service provider;
(6) Is noncompliant with the basic requirements of the program;
(7) Engages in behavior that threatens or demonstrates violence toward the service provider;
(8) Is placed or resides in a long-term care facility, such as an intermediate care facility, assisted living facility, skilled nursing facility, hospital, community care foster family home, adult foster home, adult residential care home, expanded adult residential care home, or developmental disabilities domiciliary home;
(9) Uses comparable services from other programs; or
(10) Has a communicable disease that threatens the safety and welfare of the service provider.
(k) All area agencies on aging shall record all consumer data, assessments, and service delivery within a statewide consolidated database.
(l) The kupuna care program shall award an allocation of funds to cover costs for services, subject to availability of funding; provided that the allocated funds shall be issued directly to the service provider or financial management service provider upon request and receipt of an invoice for services rendered.
(m) The executive office on aging shall develop an outreach plan to inform individuals of the kupuna care program and services of the program.
(n) The executive office on aging shall submit an annual report to the legislature, no later than twenty days prior to the convening of each regular session, on the kupuna care program. The report shall include, at minimum:
(1) The number of individuals who participate in the kupuna care program, including the types of programs in which they participate; and
(2) The number of individuals on a program waitlist, including the types of programs for which they are on a waitlist.
(o) The director may adopt rules pursuant to chapter 91 necessary for the purposes of this section.
[L 2012, c 238, §2; §349-3.1; ren and am L 2017, c 102, §4; am L 2022, c 160, §3]
[Repealed]
[L 2022, c 160, §4]
(a) There is established the office of the long-term care ombudsman in the executive office on aging to protect the health, safety, welfare, and rights of residents of long-term care facilities in accordance with state and federal law. The office of the long-term care ombudsman shall be headed by the long-term care ombudsman.
(b) The long-term care ombudsman shall:
(1) Be hired pursuant to chapter 76;
(2) Be free of conflict of interest;
(3) Have expertise and experience in the fields of long-term care and advocacy;
(4) Serve on a full-time basis; and
(5) Prepare an annual report in accordance with the federal Older Americans Act, as amended.
(c) The long-term care ombudsman, personally or through a designee, shall:
(1) Represent the interests of residents of long-term care facilities, individually and as a class, to:
(A) Protect their health, safety, welfare, and rights; and
(B) Promote improvement in the quality of care they receive and their quality of life;
(2) Identify, investigate, and resolve complaints, including complaints against providers of long-term care services and their representatives, made by or on behalf of residents of long-term care facilities relating to actions, inactions or decisions that may adversely affect the health, safety, welfare, or rights of residents of long-term care facilities, including the appointment and activities of guardians and representative payees;
(3) Monitor and comment on the development and implementation of federal, state, and local laws, regulations, policies, and actions that pertain to the health, safety, welfare, or rights of residents of long-term care facilities, including the adequacy of long-term care facilities and services in the State, and recommend changes as necessary;
(4) Provide information as appropriate to public agencies regarding the problems of residents of long-term care facilities;
(5) Train volunteers and employees;
(6) Promote the development of citizen organizations to participate in the advocacy program;
(7) Establish procedures for appropriate access by the long-term care ombudsman to long-term care facilities and to residents of long-term care facilities;
(8) Establish procedures for appropriate access by the long-term care ombudsman to all resident records or portions thereof necessary for the long-term care ombudsman to evaluate the merits of a specific complaint or complaints; provided that resident records shall be divulged only with the written consent of the resident or the resident's legal representative;
(9) Establish procedures for appropriate access to files maintained by the long-term care ombudsman, except that the identity of any complainant or resident of a long-term care facility shall not be disclosed unless:
(A) The complainant or resident, or the complainant's or resident's legal representative, consents in writing to the disclosure;
(B) The complainant or resident consents orally and the consent is documented contemporaneously in writing by the long-term care ombudsman or designee; or
(C) The disclosure is required by court order;
(10) Provide technical support for the development of resident and family councils to help protect the health, safety, welfare, and rights of residents of long-term care facilities;
(11) Provide residents of long-term care facilities with:
(A) Information regarding how to obtain necessary services;
(B) Regular access to the office of the long-term care ombudsman at times deemed reasonable and necessary by the long-term care ombudsman; and
(C) Regular and timely responses to their complaints;
(12) Seek administrative, legal, or other remedies to carry out this part; and
(13) Carry out all other responsibilities as provided by state or federal law.
(d) The long-term care ombudsman shall establish procedures to ensure that all designees, employees, and volunteers are free of conflict of interest.
(e) The long-term care ombudsman shall adopt rules pursuant to chapter 91 for the purposes of administering and implementing this part.
(f) For the purposes of this part:
"Conflict of interest" includes:
(1) Any direct involvement in the licensing or certification of a long-term care facility or of a provider of a long-term care service;
(2) An ownership or investment interest in a long-term care facility or a long-term care service;
(3) Employment by, or participation in the management of, a long-term care facility; and
(4) Receipt of, or the right to receive, directly or indirectly, remuneration under a compensation arrangement with an owner or operator of a long-term care facility.
"Long-term care facility" means any:
(1) Skilled nursing facility as defined in section 1819(a) of the Social Security Act, as amended;
(2) Nursing facility, as defined in section 1919(a) of the Social Security Act, as amended;
(3) Adult residential care home, including any expanded adult residential care home;
(4) Assisted living facility;
(5) Intermediate care facility as defined in section 1905(c) of the Social Security Act, as amended; and
(6) Other similar facility licensed by the State serving elders.
[L 1979, c 206, §2(1); gen ch 1985; am L 1990, c 67, §8; am L 2007, c 93, §5]
(a) A long-term care facility shall permit immediate access to the long-term facility and to the residents of the long-term care facility to the long-term care ombudsman or designee at any time deemed necessary and reasonable by the long-term care ombudsman for the performance of the duties and functions under this part.
(b) Access to the residents of the long-term care facility shall include the provision of privacy.
(c) A long-term care facility shall permit access by the long-term care ombudsman or designee to all resident records or portions thereof necessary for the long-term care ombudsman to evaluate the merits of any complaint; provided that resident records shall be divulged only with the written consent of the resident or the resident's legal representative.
(d) The long-term care ombudsman shall report violations of this section to the department of health.
(e) The department of health shall adopt rules, including the establishment of administrative fines or other penalties, pursuant to chapter 91 for the violation of this section.
[L 1979, c 206, §2(2); am L 2007, c 93, §6]
(a) No resident of a long-term care facility seeking advocacy assistance as provided for in section [349-21] or making a complaint concerning a long-term care facility or any of its employees shall be subject to any retaliatory act by the long-term care facility or any of its employees for seeking advocacy assistance or making a complaint.
(b) No person seeking advocacy assistance as provided for in section [349-21] or making a complaint concerning a long-term care facility or any of its employees on behalf of a resident of a long-term care facility shall be subject to any retaliatory act by the long-term care facility or any of its employees for seeking advocacy assistance or making a complaint.
(c) For the purposes of this section, the term "retaliatory act" includes actual or threatened physical injury, psychological abuse or neglect, sexual abuse, negligent treatment, maltreatment, or any form of discrimination as reprisal for seeking advocacy assistance or making a complaint.
(d) A violation of this section shall be reported by the long-term care ombudsman to the appropriate police department or prosecuting attorney.
(e) Any long-term care facility or long-term care facility employee who violates this section shall be guilty of a misdemeanor. Each separate retaliatory act and each day during which any retaliatory act continues shall constitute a separate offense.
[L 1979, c 206, §2(3); am L 1982, c 104, §1; am L 2007, c 93, §7]
Any individual, including any long-term care facility or long-term care facility employee, who wilfully interferes with or impedes the long-term care ombudsman or designee in the performance of the long-term care ombudsman's or designee's duties pursuant to this part shall be guilty of a misdemeanor. Each separate act of wilful interference and each day during which any wilful interference continues shall constitute a separate offense.
[L 2007, c 93, pt of §2]
(a) The long-term care ombudsman shall provide each long-term care facility with brochures and a poster with information regarding the office of the long-term care ombudsman, including the name, address, and telephone number of the office of the long-term care ombudsman, and a brief description of the services provided by the office of the long-term care ombudsman.
(b) A long-term care facility shall provide each resident of the long-term [care] facility with a copy of the brochure and shall post the poster in a conspicuous location that is accessible to all residents of the long-term care facility.
[L 2007, c 93, pt of §2]
[PART IV.] AGING AND DISABILITY RESOURCE CENTERS PROGRAM
[ §349-31] Definitions. As used in this part, unless the context otherwise requires:
"Aging and disability resource centers" means an entity established by the State as part of the state system of long-term care serving as a highly visible and trusted source where people of all incomes and ages can obtain information on the full range of long-term support options and a single point of entry for access to public long-term support programs and benefits.
"Area agency on aging" means the agency in each county designated by the executive office on aging, under section 305(a)(2)(A) of the Older Americans Act, P.L. 89-73, as amended, to facilitate the area-wide development and implementation of a comprehensive, coordinated system for providing long-term care in home and community-based settings, in a manner responsive to the needs and preferences of older individuals and their family caregivers.
"Dementia" means a group of symptoms affecting intellectual and social abilities severely enough to interfere with daily functioning.
"Developmental disability" means a severe, chronic disability of an individual that:
(1) Is attributable to a mental or physical impairment or combination of mental and physical impairments;
(2) Is manifested before the individual attains age twenty-two;
(3) Is likely to continue indefinitely;
(4) Results in substantial functional limitations in three or more of the following areas of major life activity:
(A) Self-care;
(B) Receptive and expressive language;
(C) Learning;
(D) Mobility;
(E) Self-direction;
(F) Capacity for independent living; or
(G) Economic self-sufficiency; and
(5) Reflects the individual's need for a combination and sequence of special, interdisciplinary, or generic services, individualized supports, or other forms of assistance that are of lifelong or extended duration and are individually planned and coordinated.
An individual from birth to age nine, inclusive, who has a substantial developmental delay or specific congenital or acquired condition, may be considered to have a developmental disability without meeting three or more of the criteria described in paragraphs (1) through (5) of this definition if the individual, without services and supports, has a high probability of meeting three or more of those criteria later in life.
"Family caregiver" means a spouse, adult child, other relative, partner, or friend who has a personal relationship with, and provides a broad range of unpaid assistance for an older adult with a chronic or disabling condition.
"Informal caregiver" means a person who provides care for an older person or person with a disability who needs long-term supports and services, but does not receive compensation.
"Intellectual disability" means a person's attributes or characteristics that demonstrate a limitation in intellectual functioning and adaptive behavior as expressed in conceptual, social, and practical skills, which are apparent prior to the age of eighteen. This definition shall be based on the following assumptions:
(1) Limitations in present functioning shall be considered within the context of community environments typical of the individual's age peers and culture;
(2) Validate assessment considers cultural and linguistic diversity as well as differences in communication, sensory, motor, and behavioral factors;
(3) Within the individual, limitations often coexist with strengths;
(4) An important purpose of describing limitations is to develop a profile of needed supports; and
(5) With appropriate personalized supports over a sustained period, the life functioning of the person with intellectual disability generally will improve.
"Long-term supports and services" means the broad range of assistance and care needed by older persons or persons with physical or mental disabilities who have lost or never acquired the ability to function independently.
"Options counseling" means an interactive decision-support process whereby consumers, family members, and significant others are supported in their deliberations to determine appropriate long-term care choices in the context of a consumer's needs, preferences, values, and individual circumstances.
"Physical disability" means the broad range of disabilities including orthopedic, neuromuscular, cardiovascular, and pulmonary disorders, which may be congenital or a result of aging or injury.
"Severe mental illness" means one of several diseases that affects the brain and significantly and functionally impairs an individual for an indefinite period of time.
[L 2012, c 237, pt of §2]
[ §349-32] Aging and disability resource centers; established. (a) A statewide aging and disability resource center may be established with sites in each county to streamline access to long-term supports and services by integrating the full range of long-term supports and services into a single, coordinated system.
(b) The aging and disability resource center may be the single point of entry in every county where persons of all ages, incomes, and disabilities may access information in a person-centered manner on the full range of long-term supports and services options, including but not limited to:
(1) Federal, state, and county revenue-funded programs and services including those funded by medicaid, medicare, the Older Americans Act, the Department of Veterans Affairs, and kupuna care;
(2) A centralized application process for publicly funded long-term services and supports;
(3) Privately administered programs and services;
(4) Supports and services for persons with Alzheimer's disease and other related dementia;
(5) Transportation services;
(6) Housing options;
(7) Elder rights protection;
(8) Hospital and nursing home discharge planning and care transition;
(9) Health, prevention, and wellness programs;
(10) Support for grandparents raising grandchildren and other relatives age fifty-five years or older caring for children;
(11) Informal and family caregiver support services; and
(12) Community resources and services for individuals with disabilities.
(c) The aging and disability resource centers shall target delivery of services to:
(1) Persons sixty years of age and older;
(2) Persons of any age with physical disabilities, severe mental illness, dementia, and developmental or intellectual disabilities;
(3) Informal and family caregivers providing assistance to persons needing long-term supports and services;
(4) Professionals seeking long-term supports and services on behalf of their clients; and
(5) Persons planning for their future long-term supports and services needs.
(d) The executive office on aging shall coordinate the implementation of the statewide aging and disability resource center.
(e) The aging and disability resource center may be a function of each area agency on aging within the respective geographic service area.
[L 2012, c 237, pt of §2]
For the purposes of this part:
"Annual wellness visit" means a preventive service visit covered by medicare part B between a medicare beneficiary and a primary care provider that occurs once every twelve months and includes developing or updating a personalized prevention plan and performing a health risk assessment but does not include a physical exam.
"Health care provider" means a physician or surgeon licensed under chapter 453, or an advanced practice registered nurse licensed under chapter 457.
"Medicare" means the program established under title XVIII of the Social Security Act of 1935, as amended (42 U.S.C. 1395 et seq.).
"Medicare part B" means the voluntary supplementary medical insurance benefits program provided under title XVIII of the Social Security Act of 1935, as amended (42 U.S.C. 1395j to 1395w-6).
"Medicare part C" means the medicare advantage program provided under title XVIII of the Social Security Act of 1935, as amended (42 U.S.C. 1395w-21 to 1395w-28).
"Qualified patient" means an individual medicare beneficiary, including but not limited to an individual with developmental disabilities who is predisposed to early cognitive decline, and who has coverage under medicare part B or medicare part C.
[L 2025, c 286, pt of §2]
(a) The cognitive assessment provided to qualified patients at an annual wellness visit shall be conducted using standardized, validated assessment tools.
(b) A qualified patient may decline the use of a standardized, validated cognitive assessment tool after being informed of its purpose, benefits, and any risks.
[L 2025, c 286, pt of §2]
. This part shall not apply to:
(1) Health care providers who do not accept medicare insurance;
(2) Qualified patients who have already received a diagnosis of dementia or mild cognitive impairment; and
(3) Qualified patients who are unable to undergo a cognitive assessment due to a physical or mental impairment or disability.
[L 2025, c 286, pt of §2]
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