HB 1853: Executive Office on Aging; Hanai Memory Network Program; Dementia Care; Appropriation

A BILL FOR AN ACT

RELATING TO DEMENTIA.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

     SECTION 1.  The legislature finds that dementia and cognitive impairment are growing public health concerns in Hawaii, particularly among the State's aging population.  The impacts of dementia extend beyond individuals to families, caregivers, and communities, placing emotional and financial strain on households and the health care system.

     The legislature further finds that access to early diagnosis, care planning, and long-term support for individuals with dementia and cognitive impairment is limited, especially in rural areas and on neighbor islands.  Many residents face barriers to receiving timely and coordinated care due to geographic isolation, workforce shortages, and fragmented service delivery.

     The need for systemic reform for dementia and cognitive impairment treatment cannot be overstated.  Alzheimer's disease is estimated to affect one in nine Hawaii residents over age sixty-five.  With the older adult population in the State expected to double in the next twenty-five years, the number of individuals living with Alzheimer's disease will exceed sixty‑two thousand by 2050.  This surge will have devastating financial consequences.  Medicaid spending for Alzheimer's care in Hawaii rose from $240,000,000 in 2020 to $309,000,000 in 2025.  Without intervention, those costs are projected to approach $1,000,000,000 annually by 2050, placing an unsustainable strain on the state budget.

     The legislature further recognizes that Hawaii's long-term care infrastructure is already at or above capacity, with memory care beds in short supply.  Families face crushing financial burdens, paying more than $15,000 per month, or $180,000 per year, for memory care in long-term care facilities.  Neighbor islands and rural communities experience even greater challenges, with limited access to diagnosis and treatment leading to delayed care and higher costs.  Caregivers lack guidance and support, compounding emotional and financial stress.

     The legislature notes that the Alzheimer's Association is launching the Hanai Memory Network to address these challenges head-on by ensuring earlier diagnosis, equitable access to care across all counties, and coordination that reduces emergency room visits and hospitalizations.  By shifting from crisis‑driven care to proactive planning, Hawaii can improve outcomes for kupuna and caregivers while reducing medicaid costs and alleviating pressure on the State's long-term care system.

     The legislature additionally finds that a coordinated statewide approach is necessary to ensure equitable access to dementia care services.

     The purpose of this Act is to establish a Hanai memory network program to integrate community-based specialists, clinical partnerships, and public education to improve early detection, care coordination, and long-term support for individuals with dementia and their caregivers.

     SECTION 2.  Chapter 349, Hawaii Revised Statutes, is amended by adding a new part to be appropriately designated and to read as follows:

"Part    .  Hanai memory network program

     §349-     Definitions.  As used in this part:

     "Dementia care specialist" means a trained social worker, nurse, or allied health professional who provides community-based dementia screening, care planning, and coordination services.

     "Memory clinic" means a clinical partnership between the State and a health care provider or health system that provides diagnostic and treatment services for individuals with cognitive impairment.

     §349-     Hanai memory network program; established.  (a)  There is established within the executive office on aging the Hanai memory network program.

     (b)  The Hanai memory network program may:

     (1)  Establish dementia care specialists;

     (2)  Establish one or more memory clinics;

     (3)  Ensure coordination between dementia care specialists, memory clinics, and programmatic services;

     (4)  Develop and maintain a statewide referral network and care options directory for dementia care;

     (5)  Provide training and technical assistance to participating providers in the program;

     (6)  Operate a public-facing website to serve as a central hub for education, referrals, and provider listings for dementia care; and

     (7)  Collect and securely maintain data relevant to the program.

     (c)  The executive office on aging may enter into contracts or memoranda of agreement with health care providers, health systems, and community-based organizations for the purpose of implementing the Hanai memory network program.

     (d)  The executive office on aging shall:

     (1)  Administer and oversee the Hanai memory network program;

     (2)  Collaborate with area agencies on aging, health care providers, and community health centers; and

     (3)  Submit an annual report to the legislature no later than twenty days prior to the convening of each regular session, which shall include:

          (A)  The number of individuals screened and diagnosed;

          (B)  The number of care plans created;

          (C)  Provider and caregiver satisfaction data; and

          (D)  Any proposed legislation."

     SECTION 3.  There is appropriated out of the general revenues of the State of Hawaii the sum of $3,000,000 or so much thereof as may be necessary for fiscal year 2026-2027 to establish and implement the Hanai memory network program.

     The sum appropriated shall be expended by the executive office on aging for the purposes of this Act.

     SECTION 4.  This Act shall take effect on July 1, 2026.

Report Title:

Executive Office on Aging; Hanai Memory Network Program; Dementia Care; Appropriation

Description:

Establishes the Hanai Memory Network Program within the Executive Office on Aging to create a network of dementia care specialists and support systems to assist individuals with dementia and their caregivers.  Appropriates funds.  (CD1)

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.

A BILL FOR AN ACT

RELATING TO DEMENTIA.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

     SECTION 1.  The legislature finds that dementia and cognitive impairment are growing public health concerns in Hawaii, particularly among the State's aging population.  The impacts of dementia extend beyond individuals to families, caregivers, and communities, placing emotional and financial strain on households and the health care system.

     The legislature further finds that access to early diagnosis, care planning, and long-term support for individuals with dementia and cognitive impairment is limited, especially in rural areas and on neighbor islands.  Many residents face barriers to receiving timely and coordinated care due to geographic isolation, workforce shortages, and fragmented service delivery.

     The need for systemic reform for dementia and cognitive impairment treatment cannot be overstated.  Alzheimer's disease is estimated to affect one in nine Hawaii residents over age sixty-five.  With the older adult population in the State expected to double in the next twenty-five years, the number of individuals living with Alzheimer's disease will exceed sixty‑two thousand by 2050.  This surge will have devastating financial consequences.  Medicaid spending for Alzheimer's care in Hawaii rose from $240,000,000 in 2020 to $309,000,000 in 2025.  Without intervention, those costs are projected to approach $1,000,000,000 annually by 2050, placing an unsustainable strain on the state budget.

     The legislature further recognizes that Hawaii's long-term care infrastructure is already at or above capacity, with memory care beds in short supply.  Families face crushing financial burdens, paying more than $15,000 per month, or $180,000 per year, for memory care in long-term care facilities.  Neighbor islands and rural communities experience even greater challenges, with limited access to diagnosis and treatment leading to delayed care and higher costs.  Caregivers lack guidance and support, compounding emotional and financial stress.

     The legislature notes that the Alzheimer's Association is launching the Hanai Memory Network to address these challenges head-on by ensuring earlier diagnosis, equitable access to care across all counties, and coordination that reduces emergency room visits and hospitalizations.  By shifting from crisis‑driven care to proactive planning, Hawaii can improve outcomes for kupuna and caregivers while reducing medicaid costs and alleviating pressure on the State's long-term care system.

     The legislature additionally finds that a coordinated statewide approach is necessary to ensure equitable access to dementia care services.

     The purpose of this Act is to establish a Hanai memory network program to integrate community-based specialists, clinical partnerships, and public education to improve early detection, care coordination, and long-term support for individuals with dementia and their caregivers.

     SECTION 2.  Chapter 349, Hawaii Revised Statutes, is amended by adding a new part to be appropriately designated and to read as follows:

"Part    .  Hanai memory network program

     §349-     Definitions.  As used in this part:

     "Dementia care specialist" means a trained social worker or allied health professional who provides community-based dementia screening, care planning, and coordination services.

     "Memory clinic" means a clinical partnership between the State and a health care provider or health system that provides diagnostic and treatment services for individuals with cognitive impairment, staffed by primary care providers and geriatricians.

     §349-     Hanai memory network program; established.  (a)  There is established within the executive office on aging the Hanai memory network program.

     (b)  The Hanai memory network program shall:

     (1)  Establish dementia care specialists;

     (2)  Establish one or more memory clinics;

     (3)  Ensure coordination between dementia care specialists, memory clinics, and programmatic services;

     (4)  Develop and maintain a statewide referral network and care options directory for dementia care;

     (5)  Provide training and technical assistance to participating providers in the program;

     (6)  Operate a public-facing website to serve as a central hub for education, referrals, and provider listings for dementia care; and

     (7)  Collect and securely maintain data relevant to the program.

     (c)  The executive office on aging may enter into contracts or memoranda of agreement with health care providers, health systems, and community-based organizations for the purpose of implementing the Hanai memory network program, including but not limited to the operation of memory clinics, training of dementia care specialists, and provision of community-based services.

     (d)  The executive office on aging shall:

     (1)  Administer and oversee the Hanai memory network program;

     (2)  Collaborate with area agencies on aging, health care providers, and community health centers; and

     (3)  Submit an annual report to the legislature no later than twenty days prior to the convening of each regular session, which shall include:

          (A)  The number of individuals screened and diagnosed;

          (B)  The number of care plans created;

          (C)  Provider and caregiver satisfaction data; and

          (D)  Any proposed legislation."

     SECTION 3.  There is appropriated out of the general revenues of the State of Hawaii the sum of $           or so much thereof as may be necessary for fiscal year 2026-2027 to establish and implement the Hanai memory network program, to be allocated as follows:

     (1)  $           for salaries and fringe benefits for the establishment of the following positions:

          (A)  One full-time equivalent (1.00 FTE) memory network program manager; and

          (B)  One full-time equivalent (1.00 FTE) dementia care specialist; and

     (2)  $           for equipment, supplies, operational costs, and memory clinic partnerships, including but not limited to:

          (A)  Clinical infrastructure and support services;

          (B)  Technology and data systems;

          (C)  Public education and outreach materials; and

          (D)  Contracts and memoranda of agreements with health care providers and health systems to establish memory clinics.

     The sum appropriated shall be expended by the executive office on aging for the purposes of this Act.

     SECTION 4.  This Act shall take effect on January 30, 2050.

Report Title:

Executive office on Aging; Hanai Memory Network Program; Dementia Care; Appropriation

Description:

Establishes the Hanai Memory Network Program within the Executive Office on Aging to create a network of dementia care specialists and support systems to assist individuals with dementia and their caregivers.  Appropriates funds.  Effective 1/30/2050.  (SD1)

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.

A BILL FOR AN ACT

RELATING TO DEMENTIA.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

     SECTION 1.  The legislature finds that dementia and cognitive impairment are growing public health concerns in Hawaii, particularly among the State's aging population.  The impacts of dementia extend beyond individuals to families, caregivers, and communities, placing emotional and financial strain on households and the healthcare system.

     The legislature further finds that access to early diagnosis, care planning, and long-term support for individuals with dementia and cognitive impairment is limited, especially in rural areas and on neighbor islands.  Many residents face barriers to receiving timely and coordinated care due to geographic isolation, workforce shortages, and fragmented service delivery.

     The need for systemic reform for dementia and cognitive impairment treatment cannot be overstated.  Alzheimer's disease is estimated to affect one in nine Hawaii residents over age sixty-five.  With the older adult population in the State expected to double in the next twenty-five years, the number of individuals living with Alzheimer's disease will exceed sixty-two thousand by 2050.  This surge will have devastating financial consequences.  Medicaid spending for Alzheimer's care in Hawaii rose from $240,000,000 in 2020 to $309,000,000 in 2025.  Without intervention, those costs are projected to approach $1,000,000,0000 annually by 2050, placing an unsustainable strain on the state budget.

     The legislature further recognizes that Hawaii's long-term care infrastructure is already at or above capacity, with memory care beds in short supply.  Families face crushing financial burdens, paying more than $15,000 per month, or $180,000 per year, for memory care in long-term care facilities.  Neighbor islands and rural communities experience even greater challenges, with limited access to diagnosis and treatment leading to delayed care and higher costs.  Caregivers lack guidance and support, compounding emotional and financial stress.

     The legislature notes that the Alzheimer's Association launched the Hanai Memory Network to address these challenges head-on by ensuring earlier diagnosis, equitable access to care across all counties, and coordination that reduces emergency room visits and hospitalizations.  By shifting from crisis-driven care to proactive planning, Hawaii can improve outcomes for kupuna and caregivers while reducing medicaid costs and alleviating pressure on the State's long-term care system.

     The legislature additionally finds that a coordinated statewide approach is necessary to ensure equitable access to dementia care services.

     The purpose of this Act is to establish a Hanai memory network program to integrate community-based specialists, clinical partnerships, and public education to improve early detection, care coordination, and long-term support for individuals with dementia and their caregivers.

     SECTION 2.  Chapter 349, Hawaii Revised Statutes, is amended by adding a new part to be appropriately designated and to read as follows:

"Part    .  Hanai memory network program

     §349-     Definitions.  As used in this part:

     "Dementia care specialist" means a trained social worker or allied health professional who provides community-based dementia screening, care planning, and coordination services.

     "Memory clinic" means a clinical partnership between the State and a health care provider or health system that provides diagnostic and treatment services for individuals with cognitive impairment, staffed by primary care providers and geriatricians.

     §349-     Hanai memory network program; established.  (a)  There is established within the executive office on aging the Hanai memory network program.

     (b)  The Hanai memory network program shall:

     (1)  Establish dementia care specialists;

     (2)  Establish one or more memory clinics;

     (3)  Ensure coordination between dementia care specialists, memory clinics, and programmatic services;

     (4)  Develop and maintain a statewide referral network and care options directory for dementia care;

     (5)  Provide training and technical assistance to participating providers in the program;

     (6)  Operate a public-facing website to serve as a central hub for education, referrals, and provider listings for dementia care; and

     (7)  Collect and securely maintain data relevant to the program.

     (c)  The executive office on aging may enter into contracts or memoranda of agreement with health care providers, health systems, and community-based organizations for the purpose of implementing the Hanai memory network program, including but not limited to the operation of memory clinics, training of dementia care specialists, and provision of community-based services.

     (d)  The executive office on aging shall:

     (1)  Administer and oversee the Hanai memory network program;

     (2)  Collaborate with area agencies on aging, health care providers, and community health centers; and

     (3)  Submit an annual report to the legislature no later than twenty days prior to the convening of each regular session, which shall include:

          (A)  The number of individuals screened and diagnosed;

          (B)  The number of care plans created;

          (C)  Provider and caregiver satisfaction data; and

          (D)  Any proposed legislation."

     SECTION 3.  There is appropriated out of the general revenues of the State of Hawaii the sum of $           or so much thereof as may be necessary for fiscal year 2026-2027 to establish and implement the Hanai memory network program, to be allocated as follows:

     (1)  $           for salaries and fringe benefits for the following positions:

          (A)  One full-time equivalent (1.00 FTE) memory network program manager; and

          (B)  One full-time equivalent (1.00 FTE) dementia care specialist; and

     (2)  $           for equipment, supplies, operational costs, and memory clinic partnerships, including but not limited to:

          (A)  Clinical infrastructure and support services;

          (B)  Technology and data systems;

          (C)  Public education and outreach materials; and

          (D)  Contracts and memoranda of agreements with health care providers and health systems to establish memory clinics.

     The sum appropriated shall be expended by the executive office on aging for the purposes of this Act.

     SECTION 4.  This Act shall take effect on July 1, 3000.

Report Title:

Executive office on Aging; Hanai Memory Network Program; Dementia Care; Appropriation

Description:

Establishes the Hanai Memory Network Program within the Executive Office on Aging to create a network of dementia care specialists and support systems to assist individuals with dementia and their caregivers.  Appropriates funds.  Effective 7/1/3000.  (HD1)

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.

A BILL FOR AN ACT

relating to dementia.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

     SECTION 1.  The legislature finds that dementia and cognitive impairment are growing public health concerns in Hawaii, particularly among the State's aging population.  The impacts of dementia extend beyond individuals to families, caregivers, and communities, placing emotional and financial strain on households and the healthcare system.

     The legislature further finds that access to early diagnosis, care planning, and long-term support for individuals with dementia and cognitive impairment is limited, especially in rural areas and on neighbor islands.  Many residents face barriers to receiving timely and coordinated care due to geographic isolation, workforce shortages, and fragmented service delivery.

     The need for systemic reform for dementia and cognitive impairment treatment cannot be overstated.  Alzheimer's disease is estimated to affect one in nine Hawaii residents over age sixty-five.  With the older adult population in the State expected to double in the next twenty-five years, the number of individuals living with Alzheimer's disease will exceed sixty-two thousand by 2050.  This surge will have devastating financial consequences.  Medicaid spending for Alzheimer's care in Hawaii rose from $240,000,000 in 2020 to $309,000,000 in 2025.  Without intervention, those costs are projected to approach $1,000,000,0000 annually by 2050, placing an unsustainable strain on the state budget.

     The legislature further recognizes that Hawaii's long-term care infrastructure is already at or above capacity, with memory care beds in short supply.  Families face crushing financial burdens, paying more than $15,000 per month, or $180,000 per year, for memory care in long-term care facilities.  Neighbor islands and rural communities experience even greater challenges, with limited access to diagnosis and treatment leading to delayed care and higher costs.  Caregivers lack guidance and support, compounding emotional and financial stress.

     The legislature notes that the Alzheimer's Association launched the Hanai Memory Network to address these challenges head-on by ensuring earlier diagnosis, equitable access to care across all counties, and coordination that reduces emergency room visits and hospitalizations.  By shifting from crisis-driven care to proactive planning, Hawaii can improve outcomes for kupuna and caregivers while reducing medicaid costs and alleviating pressure on the State's long-term care system.

     The legislature additionally finds that a coordinated statewide approach is necessary to ensure equitable access to dementia care services.

     The purpose of this Act is to establish a Hanai memory network program to integrate community-based specialists, clinical partnerships, and public education to improve early detection, care coordination, and long-term support for individuals with dementia and their caregivers.

     SECTION 2.  Chapter 349, Hawaii Revised Statutes, is amended by adding a new part to be appropriately designated and to read as follows:

"Part    .  Hanai memory network program

     §349-     Definitions.  As used in this part:

     "Dementia care specialist" means a trained social worker or allied health professional who provides community-based dementia screening, care planning, and coordination services.

     "Memory clinic" means a clinical partnership between the State and a health care provider or health system that provides diagnostic and treatment services for individuals with cognitive impairment, staffed by primary care providers and geriatricians.

     §349-     Hanai memory network program; established.  (a)  There is established within the executive office on aging the Hanai memory network program.

     (b)  The Hanai memory network program shall:

     (1)  Establish dementia care specialists;

     (2)  Establish one or more memory clinics;

     (3)  Ensure coordination between dementia care specialists, memory clinics, and programmatic services;

     (4)  Develop and maintain a statewide referral network and care options directory for dementia care;

     (5)  Provide training and technical assistance to participating providers in the program;

     (6)  Operate a public-facing website to serve as a central hub for education, referrals, and provider listings for dementia care; and

     (7)  Collect and securely maintain data relevant to the program.

     (c)  The executive office on aging may enter into contracts or memoranda of agreement with health care providers, health systems, and community-based organizations for the purpose of implementing the Hanai memory network program, including but not limited to the operation of memory clinics, training of dementia care specialists, and provision of community-based services.

     (d)  The executive office on aging shall:

     (1)  Administer and oversee the Hanai memory network program;

     (2)  Collaborate with area agencies on aging, health care providers, and community health centers;

     (3)  Submit an annual report to the legislature no later than twenty days prior to the convening of each regular session, which shall include:

          (A)  The number of individuals screened and diagnosed;

          (B)  The number of care plans created;

          (C)  Provider and caregiver satisfaction data; and

          (D)  Any proposed legislation."

     SECTION 3.  There is appropriated out of the general revenues of the State of Hawaii the sum of $           or so much thereof as may be necessary for fiscal year 2026-2027 to establish and implement the Hanai memory network program, to be allocated as follows:

     (1)  $           for salaries and fringe benefits for the following positions:

          (A)  One full-time equivalent (1.00 FTE) memory network program manager; and

          (B)  One full-time equivalent (1.00 FTE) dementia care specialist; and

     (2)  $           for equipment, supplies, operational costs, and memory clinic partnerships, including but not limited to:

          (A)  Clinical infrastructure and support services;

          (B)  Technology and data systems;

          (C)  Public education and outreach materials; and

          (D)  Contracts and memoranda of agreements with health care providers and health systems to establish memory clinics.

     The sum appropriated shall be expended by the executive office on aging for the purposes of this Act.

     SECTION 4.  This Act shall take effect on July 1, 2026.

Report Title:

Executive office on Aging; Hanai Memory Network Program; Dementia Care; Appropriation

Description:

Establishes the Hanai Memory Network Program within the Executive Office on Aging to create a network of dementia care specialists and support systems to assist individuals with dementia and their caregivers.  Appropriates funds.

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.

STAND. COM. REP. NO.  849-26

Honolulu, Hawaii

                , 2026

RE:   H.B. No. 1853

      H.D. 1

Honorable Nadine K. Nakamura

Speaker, House of Representatives

Thirty-Third State Legislature

Regular Session of 2026

State of Hawaii

Madame:

     Your Committee on Finance, to which was referred H.B. No. 1853, H.D. 1, entitled:

"A BILL FOR AN ACT RELATING TO DEMENTIA,"

begs leave to report as follows:

     The purpose of this measure is to establish and appropriate funds for the Hanai Memory Network Program within the Executive Office on Aging to create a network, including dementia care specialists, memory clinics, and community-based services, to assist individuals with dementia and their caregivers.  

     Your Committee received testimony in support of this measure from the State Health Planning and Development Agency; Disability and Communication Access Board; AARP Hawaiʻi; Alzheimer's Association - Hawaii; Hawaii Alliance for Retired Americans; Hawaii Disability Rights Center; Hawaii Primary Care Association; and numerous individuals.  Your Committee received comments on this measure from the Executive Office on Aging.

     As affirmed by the record of votes of the members of your Committee on Finance that is attached to this report, your Committee is in accord with the intent and purpose of H.B. No. 1853, H.D. 1, and recommends that it pass Third Reading.

Respectfully submitted on behalf of the members of the Committee on Finance,

STAND. COM. REP. NO.  342-26

Honolulu, Hawaii

                , 2026

RE:   H.B. No. 1853

      H.D. 1

Honorable Nadine K. Nakamura

Speaker, House of Representatives

Thirty-Third State Legislature

Regular Session of 2026

State of Hawaii

Madame:

     Your Committees on Health and Human Services & Homelessness, to which was referred H.B. No. 1853 entitled:

"A BILL FOR AN ACT RELATING TO DEMENTIA,"

beg leave to report as follows:

     The purpose of this measure is to establish the Hanai Memory Network Program within the Executive Office on Aging to create a network of dementia care specialists and support systems to assist individuals with dementia and their caregivers.

     Your Committees received testimony in support of this measure from the Hawaii Disability Rights Center; AARP Hawaiʻi; Alzheimer's Association–Hawaii; Hawaii Alliance for Retired Americans; and numerous individuals.  Your Committees received comments on this measure from the Executive Office on Aging.

     Your Committees find that dementia and cognitive impairment are increasing public health challenges in Hawaii and place growing emotional, financial, and care‑related burdens on families, caregivers, and the health care system.  This measure will help establish a coordinated statewide approach to improve early detection, care coordination, and long‑term support for individuals living with dementia and their caregivers.

     Your Committees have amended this measure by:

     (1)  Changing the effective date to July 1, 3000, to encourage further discussion; and

     (2)  Making a technical, nonsubstantive amendment for the purposes of clarity, consistency, and style.

     Your Committees note the testimony of the Alzheimer's Association that estimates that the initial annual budget requirements for this program would be $3,000,000, which would include amounts for establishing three clinics, hiring staff, procuring community-based services, and developing appropriate programs.  Accordingly, your Committees respectfully request your Committee on Finance, should it deliberate on this measure, to consider an appropriation amount of $3,000,000.

     As affirmed by the records of votes of the members of your Committees on Health and Human Services & Homelessness that are attached to this report, your Committees are in accord with the intent and purpose of H.B. No. 1853, as amended herein, and recommend that it pass Second Reading in the form attached hereto as H.B. No. 1853, H.D. 1, and be referred to your Committee on Finance.

Respectfully submitted on behalf of the members of the Committees on Health and Human Services & Homelessness,