State lawmakers are clashing with the Executive Office on Aging over whether Kupuna Care services should be provided to poor seniors — a disagreement that flared up in a committee hearing on aging program funding Monday.
"This issue has been brewing throughout the session, and I think we need to clarify the legislative intent that Kupuna Care services should be available to all of our frail and vulnerable population," Rep. Della Au Belatti, chairwoman of the House Health Committee, said during the committee’s hearing.
The office last year began implementing a protocol that restricts Medicaid recipients from receiving Kupuna Care services, such as home-delivered meals, to prevent duplication of services under future expansion of the federally funded program.
Director Wesley Lum explained to lawmakers that, according to Kupuna Care policy, funds should go toward elderly residents who are at risk of needing Medicaid services, not those already receiving Medicaid.
But the office’s move has riled lawmakers and senior advocates who contend the policy shift created a coverage gap.
"If we’re not able to provide through our programs and Medicaid is not going to provide because of their tough criteria, they’re going to fall through the cracks," Lyn Moku, director of Lanakila Meals on Wheels, said after the hearing.
Belatti told Lum she is "baffled by why we have, in fact, created a gap group through interpretation," and asked him what prompted the policy change. Lum responded by saying he is baffled by the disagreement because there has been no such policy change.
"It’s been the state’s policy to target the near-Medicaid," Lum told the committee. He noted that while the federal Older Americans Act, which matches state Kupuna Care funds, doesn’t preclude states from putting those funds towards services for Medicaid recipients, "that’s been our position since we’ve been receiving these funds."
Belatti, on the other hand, told the Honolulu Star-Advertiser she is "concerned that an administrative, executive interpretation of laws that have in the past allowed for the serving of all kupuna is now undermining those services."
Lum characterized the concern over coverage loss as a fear of breaking with the status quo. He said the office is working to integrate Medicaid and Kupuna Care to be able to serve everybody in need; it just requires time to determine through which funding source people can best be served.
"We recognize that there is a gap, so we’re addressing it," he told lawmakers. "But it’s not something that we can fix overnight."
Gov. Neil Abercrombie, who made a brief appearance at a state Capitol rally to support Meals on Wheels and other Kupuna Care programs, said he is confident the situation will be resolved.
