Report Title:

Expanded ARCH Resident; Case Manager; Rules

Description:

Requires DOH to adopt rules to allow a private pay resident in an expanded adult residential care home at the intermediate care facility level to have as the resident's case manager a family member who need not be a registered nurse.

HOUSE OF REPRESENTATIVES

H.B. NO.

117

TWENTY-THIRD LEGISLATURE, 2005

 

STATE OF HAWAII

 


 

A BILL FOR AN ACT

 

relating to adult residential care homes.

 

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

SECTION 1. The legislature finds that the cost of long-term care is already expensive and burdensome and continues to increase. The State has encouraged the use of home- and community-based residential long-term care options as a less restrictive and more cost-effective means of caring for our elderly. Living in expanded adult residential care homes, which is governed by section 321-15.62, Hawaii Revised Statutes, and administered by the department of health, is one such alternative to institutional nursing home care. Type I expanded adult residential care homes allow up to two nursing facility level residents. Type II expanded adult residential care homes allow up to twenty per cent of six or more residents to be at the nursing facility level. These residents achieve great savings over the cost of institutional nursing care.

Current department of health rules require that residents at the intermediate care level in expanded adult residential care homes have a case manager. Department of health rules only require that the case manager be unrelated to the licensee or staff of the care home. Although department of health rules do not require the case manager to be unrelated to the resident and to be registered nurse, current departmental practice is to prohibit family members of residents from acting as the resident's case manager and to require that the case manager be a registered nurse. These unwritten rules increase the financial burden of families who have a family member living in an expanded adult residential care home.

Part of the problem may lie in the department of health's attempt to act consistently when dealing with private pay residents versus medicaid and medicare patients, as department of human services rules involving medicaid patients require case managers who are registered nurses and who meet other department of human services qualifications. However, it is often the case that family members are the ones who are most knowledgeable about the resident's needs. Many family members visit up to twenty times per month versus a case manager's one or two visits a month. Section 11-101-2, Hawaii Administrative Rules (department of health), only defines a case manager as "an individual other than and not related to the licensee or staff of the extended care ARCH who plans, locates, coordinates, and monitors comprehensive services to meet the individual resident's needs."

The purpose of this Act is to require the department of health to adopt or amend its rules in accordance with chapter 91, Hawaii Revised Statutes, to allow a private pay resident in an expanded adult residential care home at the intermediate care facility level to have as the resident's case manager a family member who need not be a registered nurse.

SECTION 2. The department of health shall adopt rules in accordance with chapter 91, Hawaii Revised Statutes, to allow a private pay resident in an expanded adult residential care home at the intermediate care facility level to have as the resident's case manager a family member who need not be a registered nurse.

SECTION 3. This Act shall take effect upon its approval.

INTRODUCED BY:

_____________________________