HOUSE OF REPRESENTATIVES

H.B. NO.

2005

TWENTY-EIGHTH LEGISLATURE, 2016

H.D. 1

STATE OF HAWAII

 

 

 

 

 

 

A BILL FOR AN ACT

 

 

RELATING TO HEALTH.

 

 

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

 


PART I

     SECTION 1.  The legislature finds that there are currently more than 238,000 Hawaii residents aged sixty and over.  This population constitutes 18.7 per cent of Hawaii's total population.  By 2030, people aged sixty and older are projected to increase to more than 27.4 per cent.  Hawaii's total population is expected to grow by twenty-one per cent between 2000 and 2030.  However, the number of adults sixty years and older will increase by 93.8 per cent and those eighty-five years and older will increase by 174.7 per cent during the same period.  The legislature further finds that there is a "silver tsunami" coming, with even more individuals entering their senior years and retirement.

     The recession of 2007 removed the possibility of a comfortable retirement for many of the State's elderly, and once seniors are no longer able to work or are employable, there is no safety net to keep retired Hawaii residents out of homelessness.  In the next ten years, the "silver tsunami" will substantially affect the entire State and the healthcare system.  Because of the "silver tsunami," the legislature finds that essential policies must be enacted to best address the care and interests of Hawaii's elderly and disabled.

     The purpose of this Act is to create and establish policies to adequately address the issues concerning the elderly and disabled and the community healthcare industry while ensuring consumer protection for Hawaii's elderly and disabled.

PART II

     SECTION 2.  Section 321-15.6, Hawaii Revised Statutes, is amended by amending subsection (a) to read as follows:

     "(a)  All adult residential care homes shall be licensed to ensure the health, safety, and welfare of the individuals placed therein.  The department shall conduct unannounced visits[, other than the inspection for relicensing,] to every licensed adult residential care home and expanded adult residential care home and any other community care home or day care center licensed or certified and under the purview of the department on an annual basis and at such intervals as determined by the department to ensure the health, safety, and welfare of each resident.  Unannounced visits may be conducted during or outside regular business hours.  All inspections relating to follow-up visits, visits to confirm correction of deficiencies, or visits to investigate complaints or suspicion of abuse or neglect shall be conducted unannounced during or outside regular business hours.  Annual inspections for relicensing may be conducted during regular business hours or at intervals determined by the department.  [Annual inspections for relicensing shall be conducted with notice, unless otherwise determined by the department.]"

PART III

     SECTION 3.  Section 321-15.62, Hawaii Revised Statutes, is amended by amending subsection (a) to read as follows:

     "(a)  All expanded adult residential care homes and any community-based care home or day care center providing healthcare to the elderly or disabled who are unrelated to the caregiver family shall be licensed to ensure the health, safety, and welfare of the individuals placed therein."

     SECTION 4.  Section 321-15.7, Hawaii Revised Statutes, is amended to read as follows:

     "§321-15.7  Penalty.  Any person who intentionally operates an adult residential care home, community-based foster family home, adult foster home, adult day care center, or hospice home without a license shall be guilty of a misdemeanor."

PART IV

     SECTION 5.  Section 321-1.8, Hawaii Revised Statutes, is amended to read as follows:

     "[[]§321‑1.8[]]  Inspections; public notice.  (a)  Beginning with inspections occurring on January 1, 2015, the department of health shall post on its website electronic copies of reports for all inspections it performs of the following state-licensed care facilities:

     (1)  Adult day health centers;

     (2)  Adult day care centers;

     (3)  Community care foster family homes;

     (4)  Developmental disabilities domiciliary homes as defined in section 321‑15.9;

     (5)  Developmentally disabled adult foster homes;

     (6)  Long-term care facilities as defined in section 349‑21(f); and

     (7)  Special treatment facilities as defined in section 334‑1.

     (b)  Each inspection report shall be posted on the department of health's website within five working days of the conclusion of each inspection and shall include the following information:

     (1)  The date of the inspection;

     (2)  A description of violations of relevant state laws or rules, if applicable;

     (3)  Plans of correction and the status of corrective actions in response to any violations, if applicable;

     (4)  A list and description of all corrective actions taken by the facility, if applicable, to be submitted by the facility and added to the report at a later time, as determined by the department; and

     (5)  Other information regarding the quality and conditions of the facility the department of health deems appropriate.

     (c)  Each inspection report posted on the department of health's website that reports a violation committed by a state-licensed care facility as described in subsection (a) shall be removed from the website after three years from the date the report was posted."

     SECTION 6.  (a)  No later than       , the department of health may convene a working group to discuss and provide feedback on the implementation and maintenance of a forum on its website where state-licensed care facilities may post vacancy information to facilitate the placement and referrals of individuals in the facilities within state-licensed care facilities, as specified in section 321-1.8(d), Hawaii Revised Statutes.

     (b)  The department of health shall submit a report to the legislature no later than twenty days before the convening of the regular session of 2017 of its findings and recommendations relative to the implementation and maintenance of a forum on its website, as specified in subsection (a).  The report shall also include feedback on the posting of vacancy information on the website.

     SECTION 7.  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 2016-2017 for the implementation and maintenance of a forum on the department of health's website as required by this part.

     The sum appropriated shall be expended by the department of health for the purposes of this part.

PART V

     SECTION 8.  The legislature finds that there is an ever-increasing need for community care foster family homes to support the health and long-term care needs of an aging population and families.  Community care foster family homes provide an essential function in the State by providing twenty-four-hour living accommodations, which include housing, supervision, personal care, and assistance with daily living activities for their residents.  These homes provide individuals who are at a nursing facility level of care with living accommodations in a family-like setting, an alternative to living in an institutional setting.

     Community care foster family homes are licensed to provide accommodations and services to not more than two adults at any one time, at least one of whom shall be a medicaid recipient, and who are at the nursing facility level of care. The department of health working together with the department of human services may certify a community care foster family home for a third adult who is at the nursing level of care and a medicaid recipient, provided that certain requirements are met.

     The legislature further finds that not only do medicaid clients have limited options for long-term care, but so do individuals who do not rely on medicaid for long-term care.  Besides providing accommodations to medicaid recipients, community care foster family homes also provide accommodations to private-pay individuals.  There is also a recognized need to accommodate private-pay individuals who share a long-term relationship.  As the cost of medical care continues to rise, it is becoming apparent that even those who do not rely on medicaid for their long-term care cannot afford the cost of private care, leaving this population, also, with limited options.

     The purpose of this part is to recognize the varied needs of the State's aging population by giving the department of health the flexibility to permit two private-pay individuals to be cared for in the same community care foster family home, provided they meet certain qualifying conditions.

     SECTION 9.  Section 321-481, Hawaii Revised Statutes, is amended by amending the definition of "community care foster family home" or "home" to read as follows:

     ""Community care foster family home" or "home" means a home that:

     (1)  Is regulated by the department in accordance with rules that are equitable in relation to rules that govern expanded adult residential care homes;

     (2)  Is issued a certificate of approval by the department or its designee to provide, for a fee, twenty-four-hour living accommodations, including personal care and homemaker services, for not more than two adults at any one time, at least one of whom shall be a medicaid recipient, who are at the nursing facility level of care, who are unrelated to the foster family, and who are receiving the services of a licensed home and community-based case management agency; provided that [the]:

         (A)  The department of health, working together with the department of human services, may jointly in their discretion allow two private-pay individuals to be cared for in the same community care foster family home if all of the following are met:

              (i)  The community care foster family home is certified for three beds;

             (ii)  Operators of three-bed community care foster family homes immediately notify the department or its designee of any vacancy in writing; and

            (iii)  The two private-pay clients are in a relationship with each other as a married or civil union couple;

         (B)  The department, in its discretion, may certify a home for a third adult who is at the nursing level of care and a medicaid recipient; provided further that the:

        [(A)(i)  Home has been certified and in operation for not less than one year;

        [(B)] (ii)  Primary caregiver is a certified nurse aide, as defined in section 457A‑1.5, who has completed a state-approved training program and other training as required by the department; and

       [(C)] (iii)  Substitute caregiver is a nurse aide, as defined in section 457A-1.5, who has completed a state-approved training program and other training as required by the department; and

     (3)  Does not include expanded adult residential care homes or assisted living facilities."

     SECTION 10.  The department of health and the department of human services shall jointly submit a report of their findings and recommendations to the legislature, no later than twenty days prior to the convening of the regular session of 2017, on the authorization to allow two private-pay individuals to be cared for in the same community care foster family home as provided under this part, including its impact on the availability of space for medicaid clients.

     SECTION 11.  It is the intent of this part not to jeopardize the receipt of any federal aid.  If this part is found to be in conflict with federal requirements that are a prescribed condition for the allocation of federal funds to the State, this part shall be deemed void.

PART VI

     SECTION 12.  The department of health shall submit a report to the legislature with respect to community health care facilities no later than twenty days before the convening of the regular session of 2017 on:

     (1)  The actions taken to ensure timely payments to community health care facilities and case managers;

     (2)  Any operational problems or legal impediments that are anticipated to affect or have affected the department's ability to make timely payments to community health care facilities and case managers; and

     (3)  A cost analysis on the savings to the State in relation to providing health care services to the elderly and disabled persons.

PART VII

     SECTION 13.  Statutory material to be repealed is bracketed and stricken.  New statutory material is underscored.

     SECTION 14.  This Act shall take effect on July 1, 3000.



 

Report Title:

Caregivers Omnibus Bill

 

Description:

Amends provisions relating to the care of the elderly and disabled in state-licensed care facilities.  (HB2005 HD1)

 

 

 

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