ARCHs; Utilization Review

Requires the DOH and DHS to determine the highest and best use of
existing Type I adult residential care homes, establish need by
geographic regions, develop rating scales with incentive points,
develop consumer brochures; and report back to the legislature.

a                                                        99-1698
HOUSE OF REPRESENTATIVES                H.B. NO.           644
TWENTIETH LEGISLATURE, 1999                                H.D. 1
STATE OF HAWAII                                            

                   A  BILL  FOR  AN  ACT



 1      SECTION 1.  The legislature finds that adult residential
 2 care homes play a crucial role in addressing the long-term care
 3 needs of Hawaii's aging population.  Adult residential care homes
 4 provide twenty-four-hour living accommodations for unrelated
 5 adults who require at least minimal assistance in the activities
 6 of daily living, personal care services, protection, and health
 7 care services, but who do not need the professional health
 8 services provided in an intermediate, skilled nursing, or acute
 9 care facility.  Type I adult residential care homes are allowed
10 to accommodate a maximum of five unrelated adults.  Type II homes
11 allow accommodations for six or more such persons.  These homes
12 are based in the community and offer an important long-term care
13 alternative.  This is particularly true with the advent of newly
14 authorized expanded adult residential care homes which provide
15 twenty-four-hour living accommodations to nursing facility level
16 individuals who have been admitted to a medicaid waiver program,
17 or private pay clients who have been certified for this type of
18 facility.
19      However, the legislature finds that many regular Type I

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Page 2                                                     644
                                     H.B. NO.           H.D. 1

 1 adult residential care homes are currently underutilized.  Some
 2 have only one, two, or three residents.  This low utilization
 3 rate does not allow the operators of these Type I adult
 4 residential care homes to take full advantage of economies of
 5 scale in providing time- and labor-intensive twenty-four-hour
 6 care for their clients and thus creates great financial pressure
 7 for the operators to remain in business.
 8      The purpose of this Act is therefore to maximize the
 9 utilization of regular Type I adult residential care homes (not
10 expanded adult residential care homes) by requiring the
11 department of human services and the department of health to
12 examine the utilization of existing licensed Type I adult
13 residential care homes to determine their highest and best use,
14 establish need for services by county, develop rating scales with
15 incentive points for homes with special features, develop
16 consumer brochures on selecting appropriate homes; and report
17 back to the legislature.
18      SECTION 2.  Type I adult residential care homes; utilization
19 review.  The department of human services and the department of
20 health shall:
21      (1)  Determine the highest and best use of existing licensed
22           Type I adult residential care homes;

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Page 3                                                     644
                                     H.B. NO.           H.D. 1

 1      (2)  Determine and establish the need for services provided
 2           by Type I adult residential care homes by geographic
 3           regions in the State by county;
 4      (3)  Develop rating scales with incentive points for Type I
 5           adult residential care homes with special features,
 6           including space and location, for example, convenience
 7           to shopping and recreation and amenities in the home;
 8      (4)  Develop consumer brochures or pamphlets on selecting an
 9           appropriate Type I adult residential care home for
10           prospective residents and families; and
11      (5)  Report findings and recommendations, including any
12           proposed implementing legislation, to the legislature
13           no later than twenty days before the convening of the
14           regular session of 2001.
15      SECTION 3.  This Act shall take effect on July 1, 1999.

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