In-Home Care in Hawaii

With it’s tropical climate, stunning natural beauty and warm, welcoming culture, Hawaii has long been a favorite retirement destination. Seniors aged 65 and older make up 19% of Hawaii’s total population, which was estimated to be just over 1.4 million as of July, 2019. Older Hawaiians who want to age in the comfort of their own homes can seek support from a number of government and non-profit agencies, including the State Department of Health, Executive Office on Aging which oversees a number of free and low-cost services for seniors. Elders who need in-home assistance may want to hire an in-home caregiver or homemaker. In Hawaii, the average monthly cost of in-home care is $5,100 per month, which is $810 more than the national average.

This guide includes information on the cost of in-home care in Hawaii, along with links to financial aid programs to help seniors cover in-home care costs. There’s also a list of free and low-cost resources for adults who want to age in place, and answers to frequently-asked questions about in-home support services for older adults.

The Cost of In-Home Care in Hawaii

In-Home Care Costs in Nearby States

Genworth’s 2019 Cost of Care Survey, shows that the average cost of 44 hours of weekly in-home care in Hawaii is $5,100 per month. In-home care in The Aloha State is high compared to the national average, which is $4,290 per month. Costs in mainland states along the Pacific coast and Alaska are slightly higher than costs in Hawaii, and range from $5,148 in Oregon up to $5,720 in Washington state.

Cost of Other Types of Care in Hawaii

In addition to in-home care, Hawaii seniors who need long-term support have a number of community and residential care options to choose from. The least-expensive option is adult day health care at $1,582, while 44 hours of care from a weekly home health aide costs $5,220 per month. Residential care services start at $4,375 per month for assisted living, while nursing home care is the costliest at $11,650 per month.

The Cost of In-Home Care in Hawaii’s Top Cities

While the statewide average cost of care is $5,100, actual costs vary slightly depending on the location within Hawaii. Costs are just above the state average in Honolulu at $5,148 per month, and just under the statewide average in Kahului at $5,053 per month. On the U.S. mainland, costs are higher in cities near the coast such as San Diego, CA, ($5,335); San Francisco, CA, ($6,292) and Seattle, WA, ($6,244).

Financial Assistance for In-Home Care in Hawaii

Med-QUEST

Unlike many states with Medicaid home and community-based waiver programs, Hawaii has a single managed care program called Med-QUEST. Med-QUEST provides coverage for medically-necessary in-home care services, such as assistance with housekeeping, grocery shopping and personal care, to help seniors remain independent in their own homes.

Who Is Eligible?
To be eligible for Med-QUEST, Hawaii seniors need to be aged 65 or older and meet the current income and asset limits. Once enrolled in Med-QUEST, services are assigned based on medical need as determined by a physician, registered nurse or allied health professional approved by Med-QUEST.

How to Apply
To apply for Med-QUEST, seniors can submit applications at their nearest Med-QUEST office, online or by calling 1-877-628-5076.

Kupuna Caregivers Program

Hawaii’s Kupuna Caregivers Program is a state-sponsored program designed to help cover the cost of in-home care for seniors aged 60 and older who don’t qualify for Med-QUEST in-home care services, and who are unable to afford the full cost of private care. The program provides daily financial benefits that can help cover the cost of adult day health care, meal delivery, transportation, housekeeping services, personal care and respite care.

Who Is Eligible?
To qualify for Kupuna Care, Hawaii residents must be aged 60 or older, reside in their own home, and require assistance with at least two activities of daily living such as managing medications, bathing, toileting or preparing meals.

How to Apply
The Kupuna Caregivers Program is managed through Hawaii’s statewide network of county Aging and Disability Resource Centers. Call 643-2372 to connect with the nearest ADRC, or locate the closest ADRC office online.

VA Aid and Attendance Benefits and Housebound Allowance

Veterans, dependents and survivors who need in-home assistance may qualify for monthly cash benefits that can be used towards their care costs through the VA Aid and Attendance Benefits and the Housebound Allowance. These two VA enhanced pension programs provide a higher monthly pension benefit than the regular VA pension does for those who meet the eligibility criteria.

Who Is Eligible?
To be eligible for Aid and Attendance, applicants must qualify for the regular VA pension. They must also need help from another person to perform one or more activities of daily living, be bedridden as a result of a chronic illness or disability, or be legally blind.

For the Housebound Allowance, applicants must qualify for the regular VA pension and have a disability rated as 100% by the VA that leaves them largely restricted to their home. Alternatively, applicants may also have one disability rated at 100%, and a second disability rated at 60% or greater.

How to Apply
To apply for either VA enhanced pension benefit, contact the Hawaii Office of Veterans’ Services at (808) 433-0420, apply online, or visit the nearest VA location.

More Ways to Pay for In-Home Care

While the above programs help many people finance in-home care, they won’t cover all costs for everyone. There are other ways to pay for in-home care, including out-of-pocket arrangements with siblings, annuities, reverse mortgages, private insurance and more. Read Caring.com’s Guide to In-Home Care Costs to learn more about these alternative payment options.

Free and Low-Cost In-Home Care Resources in Hawaii

Seniors in Hawaii have access to a number of free and low-cost resources that can help them remain safe, healthy and independent in their own homes.

	Contact	Services Provided
Aging and Disability Resource Center	643-2372	Hawaii’s Aging and Disability Resource Center helps older adults connect with long-term supports and services. ADRC services are funded by the state and individual counties, and staff provide referrals to regional, state and federal programs.
Hawaii Office of Veterans’ Services	(808) 433-0420	Hawaii’s Office of Veteran’s Services works to ensure eligible vets, survivors and dependents receive their maximum entitlements from federal, state and county programs. Vets can contact the office to arrange for internment in a veteran cemetery, get assistance with VA pension and health care benefits, and apply for state tax exemptions on real property and passenger vehicles.
Hawaii State Health Insurance Assistance Program	(808) 586-7299 or 1 (888) 875-9229	Hawaii SHIP is a free, unbiased Medicare counselling program. Certified volunteer SHIP counselors help seniors understand their Medicare and Medicare Advantage coverage options, provide information about Medigap, and assist with individual health insurance planning through one-on-one phone or in-person appointments.
University of Hawaii Elder Law Program	(808) 956-6544	The University of Hawaii Elder Law Program, or UHELP, provides free legal advice, information and referrals to low-income seniors aged 55 and older who are residents of O’ahu, as well as caregivers who are acting on behalf of an eligible elder. UHELP assists with non-criminal matters related to health insurance, housing and guardianship.
Catholic Charities Hawaii – Senior Programs	(808) 521-4357	Catholic Charities Hawaii operates a number of community-based free and low-cost programs on O’Ahu to support seniors age 60 and older. Programs include case management for seniors, friendly home visiting, transportation and housing assistance for older adults.

In-Home Care Laws and Regulations in Hawaii

Hawaii’s Department of Health, Office of Care Assurance is responsible for the licensing and regulation of home health agencies statewide. Since many home health agencies also provide home care, or homemaker, services, state guidelines for home health agencies often apply to in-home care services as well.

Scope of Care	In-home caregivers/homemakers can provide routine housecleaning and laundry service and shop for household supplies. Homemakers can also run errands and pick up medications, prepare meals, escort clients to medical, nutritional and social appointments, and offer medication reminders. In-home caregivers cannot administer medications or manage finances on behalf of a client.
Care Plan Requirements	Clients of a licensed home care agency must have a service plan in place developed in consultation with the client and a supervisor employed by the agency, and that plan must be reviewed at least once annually.
Medication Management Requirements	Homemakers can provide clients with medication reminders, pick up medication from the pharmacy and read prescription labels for clients.
Staff Screening Requirements	Direct care staff must have tuberculosis clearance before commencing work with clients. Staff must also complete a background check, and be free of charges such as theft, assault, fraud and neglect of a child or vulnerable adult.
Staff Training Requirements	Agency administrators must ensure caregivers work within their scope of duties and in compliance with state licensing requirements. Caregivers who provide personal care services must be trained as a personal care aide.
Medicaid Coverage	Hawaii’s Med-QUEST Medicaid managed care plan covers the cost of in-home care for eligible Med-QUEST members.
Reporting Abuse	Anyone who suspects an Hawaiian elder is being neglected, abused or exploited should file a report with the Department of Human Services, Adult Protective Services. There are five APS offices throughout the state. Situations involving an immediate threat to safety should be reported to local law enforcement.

Frequently Asked Questions