Report Title:

Adult Residential Care Homes

Description:

Creates a new Type IA Adult Residential Care Home (ARCH) category. Allows various announced and unannounced inspections and visits to ARCHs during or outside normal business hours. Creates an ARCH liability insurance assigned risk pool to make liability insurance affordable for ARCHs. Authorizes the Department of Health to waive annual inspections at their discretion (SB1061 HD1).

THE SENATE

S.B. NO.

1061

TWENTY-SECOND LEGISLATURE, 2003

S.D. 1

STATE OF HAWAII

H.D. 1


 

A BILL FOR AN ACT

 

relating to adult residential care homes.

 

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

PART I

SECTION 1. The legislature finds that certain residents in adult residential care homes who have physical and mental impairments may live many years at the same level of care with the same caregivers. The legislature believes that if the level of care of a resident changes, the department of health should allow the resident to remain at the same care home to age in place, as long as the operator of the adult residential care home, the resident, and other interested persons agree.

Current law allows such residents, whose level of care needs have escalated to the nursing facility-level, to remain and age in place in Type I expanded adult residential care homes. A Type I expanded adult residential care home cares for five or fewer residents and is allowed to care for no more than two residents who require nursing facility-level care. However, the department has the discretion to allow more such residents to be cared for in the home.

Nonetheless, not all adult residential care homes who have residents requiring higher levels of care are classified as Type I.

Accordingly, the purpose of this Act is to allow residents who require nursing facility-level care to continue living in adult residential care homes that are not Type I or Type II expanded adult residential care homes, in order to age in place.

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

"(b) The director shall adopt rules regarding adult residential care homes in accordance with chapter 91 that shall be designed to:

(1) Protect the health, safety, and civil rights of persons residing in facilities regulated;

(2) Provide for the licensing of adult residential care homes; provided that the rules shall allow group living in [two] three categories of adult residential care homes as licensed by the department of health:

(A) Type I allowing group living by five or fewer unrelated persons; [and]

(B) Type IA allowing group living by five or fewer unrelated persons of whom no more than two require nursing facility-level care; provided that more nursing facility-level residents may be allowed at the discretion of the department; and

[(B)] (C) Type II allowing six or more persons including the mentally ill, elders, the handicapped, the developmentally disabled, or totally disabled persons who are not related to the home operator or facility staff[.];

provided that a license for a Type IA home shall identify to the department the resident or residents requiring nursing facility-level care and the conditions for additional training, staffing, or both, to meet the health and safety needs of the nursing facility-level resident or residents who reside in the Type IA facility. The department shall conduct annual unannounced inspections of the Type IA facilities. The Type IA license shall terminate immediately upon discharge or transfer of the nursing facility-level resident or residents in whose name the Type IA license was issued.

For the purposes of this section:

"Mentally ill person" means a mentally ill person as defined under section 334-1.

"Elder" means an elder as defined under sections 201G-1 and 201G-151.

"Handicapped person" means an individual with a physical handicap as defined under section 515-2.

"Developmentally disabled person" means a person with developmental disabilities as defined under section 333F-1.

"Totally disabled person" means a person totally disabled as defined under section 235-1;

(3) Comply with applicable federal laws and regulations of Title XVI of the Social Security Act, as amended; and

(4) Provide penalties for the failure to comply with any rule."

PART II

SECTION 3. 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 investigative inspections or evaluative visits, as appropriate, of licensed Type I, Type II, or expanded adult residential care homes as follows:

(1) Unannounced investigative inspections, to be conducted either during or outside regular business hours, upon receipt of a complaint;

(2) Unannounced annual evaluative visits, to be conducted during regular business hours only, for the sole purpose of evaluating the health status of residents and not to determine compliance with licensing regulations under sections 321-15.3, 321-15.6, 321-15.61, 321-15.62, 321-15.7, or any rules adopted by the department;

(3) Announced annual licensing inspections, to be conducted during regular business hours only, for the purpose of determining compliance with licensing regulations under sections 321-15.3, 321-15.6, 321-15.61, 321-15.62, 321-15.7, or any rules adopted by the department; and

(4) Unannounced annual investigative inspections, to be conducted either during or outside regular business hours, for no more than three consecutive twelve-month periods, to determine compliance with licensing requirements only if:

(A) The Type I adult residential care home has had a complaint or charge sustained against it for a violation of rules or sections 321-15.3 or 321-15.6, or has been found guilty under section 321-15.7;

(B) The Type II adult residential care home has had a complaint or charge sustained against it for a violation of rules or sections 321-15.3 or 321-15.6, or has been found guilty under section 321-15.7; or

(C) The expanded adult residential care home has had a complaint or charge sustained against it for a violation of rules or sections 321-15.3, 321-15.6, 321-15.61, or 321-15.62, or has been found guilty under section 321-15.7;

within the three years prior to the initial unannounced inspection.

The department may waive annual inspections at its discretion."

PART III

SECTION 4. The purpose of this part is to assist adult residential care home operators, including expanded adult residential care home and community care foster family home operators, with the high costs of insurance related to caring for clients.

SECTION 5. Pursuant to section 431:14-116, Hawaii Revised Statutes, the insurance commissioner shall establish an adult residential care home liability insurance assigned risk pool wherein agreements may be made among insurers with respect to the equitable apportionment among them of insurance that may be afforded adult residential care home applicants for liability insurance who are in good faith entitled to, but who are unable to procure at reasonable rates, such insurance through ordinary methods. Within the adult residential care home liability insurance assigned risk pool, the insurers may agree among themselves on the use of reasonable rate modifications for such insurance; provided that the agreements and rate modifications shall be subject to the approval of the insurance commissioner.

SECTION 6. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 7. This Act shall take effect upon its approval.