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Hawaii becomes first state to invest in elder care infrastructure

The newly launched Kupuna Caregivers Program will help working caregivers pay for vital support services for their elderly charges.

Will Caron

Working caregivers who pay for services to support kūpuna may now be eligible for up to $70 per day of financial help to cover the cost of adult day care, chore services, home-delivered meals, homemaker services, personal care, respite and transportation.

The Hawaiʻi Executive Office on Aging (EOA) has officially launched the state’s Kupuna Caregivers Program which was mandated through a law signed earlier this year by Gov. David Ige. The law, Act 102, was championed by the Hawaiʻi branch of a national initiative called Caring Across Generations (CAG) through a campaign called “Care For Our Kūpuna.”

“The landmark initiative is a first step in recognizing the significant contributions and sacrifices of Hawaiʻi’s working caregivers as they celebrate and honor their kūpuna,” said Gov. David Ige in a press release. “Support for our caregivers is critically needed as Hawaiʻi’s population is aging more rapidly than the national average and our seniors live longer than seniors in any other state.”

“We are hopeful that this program will provide working caregivers with the opportunity to continue working and with peace of mind knowing that their loved ones are safe and are receiving services and supports that maximize their independence and quality of life,” said Terri Byers, director of the EOA. “[We are] looking forward to analyzing the data we collect during this first six-month pilot period to evaluate demand for services, provider capacity and how effective the program is in helping caregivers retain employment and ease financial burden.”

Hawaiʻi was the second state in the nation to pass a domestic workers bill of rights, signed into law by former Governor Abercrombie in 2013. As part of her work on that initiative, Director of the National Domestic Workers Alliance Ai-jen Poo realized that the importance of the domestic workforce would become increasingly vital as the United States population continues to age. “More and more of us have family members who are growing old and living longer, and we want them to be able to stay at home and be a part of their families and their communities,” she said in an interview conducted for The Independent’s sister publication, Summit. “The need for care is just exploding.”

So she returned to Hawaiʻi, and visited a few other states, to help create CAG. “We have a major problem in this country where we really underpay and undervalue our caregivers—whether they are family caregivers or professional caregivers. Hawaiʻi is poised to become the first states in the country to reverse that trend,” said Poo.

Every day, 10,000 people turn 65 in America. That’s one person every 8 seconds; 4 million per year. Because of advances in healthcare and medicine, people are living longer, healthier lives. By the year 2020, about 300,000 people will be over the age of 65 in Hawaiʻi alone.

“It’s potentially a great opportunity: the ability to live longer also means the ability to connect with your family longer, to work longer, to contribute, to love—all these opportunities, if we have the right support in place to actually take care of people, and to make sure that have what they need to live healthy lives. And that’s what this campaign is all about,” Poo said.

Under Act 102, qualified caregivers who apply for the program may receive up to $70 per day in services (subject to the availability of funds and paid directly to contracted service providers, not the caregiver). To be eligible, caregivers must be employed at least 30 hours a week by one or more employers and provide direct care to a care recipient who is a citizen of the U.S. or a qualified alien, 60 years of age or older, and not covered by any comparable government or private home and community-based care service, except kūpuna care services. The care recipient cannot reside in a long-term care facility and must have impairments of at least two activities of daily living or two instrumental activities of daily living or one activity of daily living and one instrumental activity of daily living or substantive cognitive impairment requiring substantial supervision.

There are about 4 million home care workers and caregivers providing elder care in the United States, and about 52 million family caregivers: people who are providing up to 20 hours a week of care for their family members on top of full-time jobs, class and other commitments. Managing the pressures of working while supporting family members is one of the primary pain points that working families experience today.

“When we think of infrastructure ... we think of roads and bridges and pipes and fiber optic cables. In the 21st century, when 75 percent of children are growing up in households where all of the adults are working outside the home, we actually need a whole new infrastructure to support people while they care for their families,” said Poo. “And Hawaiʻi, through the Kupuna Caregiver bill, has become the first state to invest in that infrastructure, to invest in the ability of working families to keep their loved ones at home instead of putting them in institutions; to insure that the workforce that supports that infrastructure is fairly compensated. It invests in both workers and families. It’s about the value of care giving.”

Interested caregivers should contact the Aging and Disability Resource Center (ADRC) as soon as possible to apply for the program. Program funding is limited to a total of $600,000 available until June 30, 2018 unless a subsequent appropriation is made by the Hawaii State Legislature. Applying for the program includes employment verification, assessment of the care recipient, and a caregiver burden assessment. For further information or to apply, call the ADRC statewide phone number (808) 643-2372, ADRC TTY line (808) 643-0899, or go to

To read the complete interview with Ai-jen Poo, visit