Enacted in 2017, Hawaii’s Kapuna Caregivers Act may be a model for other states that want to help unpaid family caregivers. The Hawaiian word kapuna has multiple meanings but is commonly used to describe an elder or grandparent. In some contexts, the word also means “ancestor” or “source” and implies that members of earlier generations have acquired spiritual wisdom and act as a source of knowledge, guidance, and inspiration to younger generations.
The Kapuna Caregivers Act was the first of its kind in the nation. The law provides vouchers worth up to $70 a day for family members who hold down jobs and act as caregivers. While the Act does not pay family members directly, family caregivers can use the vouchers to pay for services they would otherwise perform themselves, such as transportation, adult day care, and respite care.
Nationally, the median hourly rate for paid caregiver services is $24 per hour. The Kapuna Caregivers Act might cover caregiving services for two or three hours a day, making it possible for family caregivers to pick up overtime at work, take care of their children, and run errands while assuring that aging parents or grandparents receive care when they’re not around.
While the Kapuna Caregivers Act prioritizes older adults who have the greatest economic need and those who are at risk for institutional placement, the only eligibility requirements are: (1) a family member is acting as a caregiver for a disabled individual who is age 60 or older, (2) the caregiver is a resident of Hawaii, (3) the disabled individual does not live in a long-term care institution and does not receive comparable services through another program, and (4) the caregiver must work outside the home for at least 30 hours per week.
Families Who Need the Help Most Can’t Afford It
This funding is also important because many times families who need the most help cannot afford it. “In Hawaii, we’ve heard time and again that it’s not wealthy people that are hiring domestic workers — it’s people who need some support here and there,” Ai-jen Poo, director of the National Domestic Workers’ Alliance, explained to Slate. “It’s working families who are … working part-time or temporary [jobs], or they’re self-employed and they’re trying to piece together work.”
Act Doesn’t Interfere with Cultural Norms
This Act is not only a potential lifeline for families who need it, it also reinforces culture. Kevin Simowitz, Caring Across Generations political director, told Slate that as they looked for ways to help Hawaii’s aging population, they saw an unexpected pushback from locals. “I was surprised at how often, early in the conversation, people would say some version of, ‘I don’t think this is somebody else’s responsibility. I think care is my responsibility. My parents are getting older — I should take care of them’.”
In Hawaii, the job of a caregiver is revered with respect and dignity. The elderly are lovingly referred to as Kupuna, and the responsibility of a child to care for their parents is one that is not second-guessed. So, when local leaders and advocacy groups started poking around and learning more about Hawaii’s elderly and those who care for them, they were surprised to find that family caregivers shied away and generally refused outside help, even if it was needed.
It’s the balance between family eldercare and specialized help that has aided in this bill’s support. The legislation doesn’t replace the tradition of eldercare in the Hawaiian community, but rather reinforces it by providing vital resources to families in need.
Other State Approaches
The bill is also timely. The U.S. census projected that by 2030, more than one-fifth of the population will be 65 or older. On the island state of Hawaii, that number is expected to reach 30 percent by the same year.
Hawaii’s Kapuna Caregiver’s Act is a response to the growth of America’s population of older adults as Baby Boomers continue to age. The Census Bureau projects that by 2030, about 20% of Americans will be 65 or older. Hawaii had nearly reached that percentage by 2020. By 2030, almost 25% of the state’s population will be 65 or older.
While Hawaii leads the way in providing financial support to working family caregivers, some other states have made varying efforts to address the financial burden that caregiving places upon working families. Thirteen states require large employers to offer short-term paid leaves to employees who need time off from work to care for a disabled relative. Washington recently enacted a law that offers publicly funded long-term care insurance plans to state residents.
Most states offer some form of compensation to family members who care for disabled Medicaid or Medi-Cal recipients. Compensation for family caregivers is a benefit of some Medicare Advantage programs. Veterans might also be eligible for caretaker compensation through the VA’s Program of Comprehensive Assistance for Family Caregivers.
(This article was updated January 2025 since it was originally published July 2017.)
