REPORT TITLE:
ARCHs; Underuse; Moratorium


DESCRIPTION:
Requires DOH to stop licensing new Type I adult residential care
homes (ARCH) on an island until the percentage of ARCH vacancies
falls below 10% on that island but allows licensing on a case-by-
case basis on neighbor islands that demonstrate a need for ARCHs.
Requires DHS, where appropriate, to encourage public-pay clients
to use underutilized ARCHs.  Upon approval.  (HB644, HD2)

 
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                                                        644
HOUSE OF REPRESENTATIVES                H.B. NO.           H.D. 2
TWENTIETH LEGISLATURE, 1999                                
STATE OF HAWAII                                            
                                                             
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                   A  BILL  FOR  AN  ACT

RELATING TO ADULT RESIDENTIAL CARE HOMES.



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

 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 are based in the community and offer an important long-term care
 
12 alternative.  This is particularly true with the advent of newly
 
13 authorized expanded adult residential care homes which provide
 
14 twenty-four-hour living accommodations to nursing facility level
 
15 individuals who have been admitted to a medicaid waiver program,
 
16 or private pay clients who have been certified for this type of
 
17 facility.
 
18      However, the legislature finds that many regular Type I
 
19 adult residential care homes are currently underutilized.  Some
 

 
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                                     H.B. NO.           H.D. 2
                                                        
                                                        


 1 have only one, two, or three residents.  This low utilization
 
 2 rate does not allow the operators of these Type I adult
 
 3 residential care homes to take full advantage of economies of
 
 4 scale in providing time- and labor-intensive twenty-four-hour
 
 5 care for their clients and thus creates great financial pressure
 
 6 for the operators to remain in business.  The purpose of this Act
 
 7 is to maximize the utilization of regular Type I adult
 
 8 residential care homes (not expanded adult residential care
 
 9 homes) by imposing a moratorium on the licensing of new regular
 
10 Type I adult residential care homes and by requiring the
 
11 department of human services, where appropriate, to encourage its
 
12 public-pay clients to enter these existing underutilized homes.
 
13 Because the underutilization problem exists primarily on the
 
14 island of Oahu, where most of the homes are located, provision is
 
15 made to avoid exporting the problem to the neighbor islands by
 
16 allowing the department of health to issue new licenses on the
 
17 neighbor islands on a case-by-case basis where there is a
 
18 demonstrable need for new homes.
 
19      SECTION 2.  (a)  The department of health shall determine
 
20 the number of existing Type I adult residential care homes in the
 
21 State that have any vacancy within their licensed capacity and
 
22 shall specifically identify each such facility.  The department
 
23 of health shall further determine, on each island, the Type I
 

 
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                                     H.B. NO.           H.D. 2
                                                        
                                                        


 1 adult residential care home:
 
 2      (1)  Total bed capacity;
 
 3      (2)  Total number of vacancies; and
 
 4      (3)  Percentage of vacancies.
 
 5 The department of health shall cease issuing licenses to operate
 
 6 new regular Type I adult residential care homes on each island
 
 7 until the percentage of vacancies on each island falls below ten
 
 8 per cent of the total bed capacity of regular Type I adult
 
 9 residential care homes on each island; provided that the
 
10 department may issue new licenses on a case-by-case basis on the
 
11 neighbor islands if there is a demonstrable demand for such
 
12 facilities.
 
13      (b)  The department of human services, where appropriate,
 
14 shall encourage its clients, for whom the department makes
 
15 reimbursement payments for residence in regular Type I adult
 
16 residential care homes but who have not yet been admitted, to
 
17 enter those homes identified as having a vacancy by the
 
18 department of health pursuant to this Act.
 
19      (c)  This Act shall not apply to expanded adult residential
 
20 care homes.
 
21      SECTION 3.  This Act shall take effect upon its approval.
 

 
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