H.C.R. NO.














requesting the attorney general to review the guardianship process with respect to patients in hospitals who are waitlisted for post-acute care.




     WHEREAS, the current lengthy guardianship process requires certain patients to be waitlisted in hospitals for extended periods after they have been treated and are well enough to be transferred to post-acute care; and


     WHEREAS, these waitlisted patients receive care at an inappropriate level, and, as a result, they unnecessarily incur the high costs of acute care when they could be receiving appropriate care at a much lower cost; and


     WHEREAS, the current process of requesting guardianship begins in the hospital, where legal teams within the hospital work to prepare paperwork to request a guardian, and a hearing is scheduled and conducted through the Office of the Public Guardian; and


     WHEREAS, for non-urgent cases, that process can take up to sixty days, and is followed by a post-hearing assignment of a public guardian that may take up to three weeks; and


     WHEREAS, an existing process used by the Judiciary for emergency guardianship determinations is limited to medical emergencies, so discharge planning arrangements do not qualify for the expedited process; and


     WHEREAS, in the interim, hospitals are left to locate family or friends who are willing to serve as decision-makers on behalf of patients as they await the scheduling process to ensue for a guardianship hearing; and


     WHEREAS, the time required to complete the usual guardianship determination process contributes to delays in transferring waitlisted patients from an acute to post-acute care setting, which in a number of cases, has resulted in lost placement opportunities; now, therefore,


     BE IT RESOLVED by the House of Representatives of the Twenty-fifth Legislature of the State of Hawaii, Regular Session of 2010, the Senate concurring, that the Attorney General is requested to review the current guardianship process and to develop an expedited process for patients in hospitals who are waitlisted for post-acute care and ready for discharge once a guardian has been identified; and


     BE IT FURTHER RESOLVED that the Attorney General is requested to make efforts to initiate changes that can be made without statutory amendment; and


     BE IT FURTHER RESOLVED that the Attorney General is requested to report to the Legislature on any findings and recommendations, including proposed legislation, no later than twenty days prior to the convening of the Regular Session of 2011; and


     BE IT FURTHER RESOLVED that certified copies of this Concurrent Resolution be transmitted to the Governor, the Chief Justice of the Supreme Court, the Attorney General, the Director of Health, the Director of Human Services, and the Chief Executive Officer of the Healthcare Association of Hawaii.









Report Title: 

Guardianship; Hospital Patients Waitlisted for Post-Acute Care