Kupuna bills address housing, aid in dying

A package of five bills aimed at assisting Hawaii’s seniors in daily living — and dying — was unveiled Friday by the Kupuna Caucus, the only legislative caucus comprising members of the public, 126 organizations and agencies, and lawmakers.

Caucus leaders Sen. Sharon Moriwaki (D, Kakaako- Waikiki-Moiliili) and Rep. Troy Hashimoto (D, Waihee-Waiehu-Wailuku) held a news conference Friday via Zoom to discuss the companion bills.

Senate Bill 2620/House Bill 1823 would expand the 2018 law known as the Our Care, Our Choice Act, which authorized medical aid in dying for terminally ill patients. Advocates say provisions in the law and a shortage of physicians make it difficult for patients to complete the process.

“We get calls frequently,” said Samantha Trad, spokeswoman for Compassion &Choices in Hawaii and California.

The proposed measure would allow advanced practice registered nurses, in addition to physicians, to prescribe the lethal medications. It also authorizes psychiatric mental health nurse practitioners and clinical nurse specialists, in addition to psychiatrists, psychologists and clinical social workers, to provide counseling to qualified patients.

Additionally, the mandatory minimum waiting period between the two oral requests for aid in dying required of terminally ill adults would be reduced to 15 days from 20.

The bill also would waive the waiting period if the attending provider deems the patient is not expected to survive 15 days after the first request. In that case the patient may make a second request at any time.

“Hawaii has the longest wait period of all the states that have authorized medical aid in dying,” Trad said. “Data from Kaiser and Hawaii Pacific Health shows about 30% of people have actually died during this waiting period … because most people wait until they actually need the medication. Most people don’t realize what a cumbersome process it is to access the law.”

On the housing front, SB 2677/HB 1826 would establish a three-year pilot program to provide rent and counseling for those age 63 and older who are homeless or at imminent risk of homelessness. The program would be administered by the Hawaii Public Housing Authority.

“With the economy now, the cost of housing is increasing, and the kupuna are on fixed incomes,” Moriwaki said. “We have neglected to look at the vulnerable seniors who have no income to pay for the increasing rent.”

She said the bill would prevent homelessness among seniors and help those who are homeless get into housing.

The bill provides for staff to provide counseling as well as to pay for rent “to assist seniors so they don’t have to pay more than half their income on housing.”

SB 2676/HB 1824 would appropriate $500,000 in funds for five specialist positions in the state Executive Office on Aging’s Long-Term Care Ombudsman Program to serve as advocates for residents of long-term care facilities to ensure they enjoy quality care and quality of life.

The specialists would respond to complaints and provide information, assistance and referrals to long-term care residents and their families. The positions would be split among the counties: one each for Honolulu, Maui and Kauai counties and two for Hawaii County.

Long-term care ombudsman John McDermott said the program has been reduced to a staff of one: himself. Meanwhile, in 2021 there were 1,779 facilities statewide housing a total of 12,895 residents and not enough staff to visit each facility quarterly.

“Yes, we have wonderful volunteers, but they are no substitute” for full-time staff, he said.

“My kupuna are the most vulnerable,” McDermott said, adding many are alone and afraid to complain for fear of repercussions or are no longer able to speak for themselves.

SB 2679/HB 1922 would allow drivers in their 70s to renew their license every four years instead of every two years, with certification from a medical doctor attesting to their physical and mental competence.

“Having these licensees renew their licenses every two years has been burdensome,” said Sen. Bennette Misalucha (D, Pearl Harbor- Pearl City-Aiea). “For them it feels like an endless cycle of applying and going to appointments, especially during this pandemic.”

Regarding health care, SB 2678/HB 1825 requests funding to expand the State Health Insurance Assistance Program (SHIP) by contracting with third-party service providers, staffing consultants and recruiting more volunteers.

“SHIP provides free, local, unbiased one-on-one assistance and counseling to educate Medicare-eligible individuals, their families and caregivers, and soon-to-be retirees about cost-effective, informed health insurance decisions,” said Caroline Cadirao, director of the Executive Office on Aging.

The program is volunteer based but needs to expand as more baby boomers become eligible at age 65, she said.