long-term care - Legislative Reference Bureau

INTRODUCTION
adult residential care facilities (ARCHs) are looked at. The Maluhia Waitlist Demonstration
Program which routes nursing home-level patients staying in acute care hospitals to certain
Hawaii ARCHs is introduced. The thorny issue revolving around the categorical vs. the
generic, or functional, approaches to long-term care access, and their respective advantages
and disadvantages, are examined. The disabled of all ages, including the developmentally
disabled (DO), can also be considered using either approach. How the perception of longterm
services may affect the ease of integration or coordination of the long-term care system
is examined. Next, living arrangements and various federal programs for the DO population
are described. Following this, services to the developmentally disabled are examined. Finally
family support services for DO individuals are examined.
Chapter 4 reviews the situation in other states and begins with a discussion of the
dearth of literature on single entry point systems for the three designated target populations.
Material from Colorado, Indiana, North Dakota, and Texas are presented. In addition,
material from a well-known six-state (Arkansas, Illinois, Maine, Maryland, Oregon, and
Wisconsin) study is discussed.
Chapter 5 examines the provision of publicly-funded long-term care services in Hawaii
to the three designated populations. Services provided by or through the Departments of
Human Services and Health and the Executive Office on Aging are presented. The opinions
of the three agencies on the pros and cons of an SEP in Hawaii are also reported.
Chapter 6 offers a brief summary of the concept of a single entry point and the
implications for a policy choice between a generic and a categorical approach. It summarizes
the advantages and disadvantages of an SEP process. This chapter also offers a number of
cautions that policymakers should be aware of regardless of whether an SEP is to be
implemented or not. In addition, if an SEP is decided upon, further cautions are raised. Next,
existing support for some sort of system coordination is reviewed. Finally, chapter 6 makes
recommendations for a two-phase pilot project.
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