long-term care - Legislative Reference Bureau

SINGLE ENTRY POINT FOR LONG-TERM CARE SERVICES
The Executive Office on Aging makes a similar observation in its 1988 report entitled
Long Term Care Plan For Hawaii's Older Adults: 3
More than eighty Federal, State, and local' government programs offer direct or
indirect assistance to persons with long-term care needs. Help may be in the form
of cash, in-kind assistance, or goods and services. Five programs (Medicaid,
Medicare, Social Services Block Grant, the Older Americans Act, and Supplemental
Security [Income] offer major Federal financial support for both community based
and institutional long-term care.
According to the Executive Office on Aging, at the level of program administration,
multiple funding sources cause fragmentation of services in Hawaii which, in turn, gives rise
to various negative consequences: 4
Unfortunately, the existence of multiple funding sources has resulted in the
proliferation of different, often confusing and frustrating sets of eligibility
requirements and program designs. In specific terms, some of the service and
system difficulties [among others] can be described as follows:
• Service providers have developed and apply different service definitions and
standards.
• There is irregular or little coordination of services among the majority of
providers.
• Standardized service records and complete client information are not
available on a Statewide basis.
• Access to services is often limited . due to geographical constraints,
particularly on the Neighbor Islands and in the rural Oahu communities, and
to the fact that many services are not widely advertised or located in such
resources as the phone book.
• Eligibility requirements vary by program and are inconsistent across the
board.
• There is a lack of full public awareness and understanding of services and
programs.
• Services are often fragmented and do not provide adequate follow-up.
SEP as One Component of an Integrated Long-Term Care System: Discussion of
fragmentation normally refers to the entire long-term care system. An SEP is only one
component of that system. The concept of an SEP implies some degree of integration of the
overall system. However, the existence or the establishment of an SEP neither implies nor
guarantees an integrated long-term care system in its entirety. The commonly cited
characteristics of a long-term care system are: 5
(1) Planning and policy development;
(2) System access, client assessment, and local service delivery;
(3) Cost containment and private sector involvement; and
(4) Quality assurance and consumer protection.
An SEP involves the second component (system access, client assessment, and local
service delivery) in which equal and easier access is sought for the greatest number. The
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