[PART XIV.] HOME AND COMMUNITY-BASED CASE MANAGEMENT
AGENCIES AND COMMUNITY CARE FOSTER FAMILY HOMES
Note
2004 amendment effective February 1, 2005. Part repealed June 30, 2006. L 2001, c 273, §§1, 6; L 2003, c 98, §3; L 2004, c 153, §§2, 5.
Report to 2006 legislature. L 2004, c 153, §3.
[§346-331] Definitions. As used in this part:
"Assisted living facility" means an assisted living facility as defined in section 321-15.1.
"Certificate of approval" means the certificate issued by the department or its designee that authorizes a person, agency, or organization to operate a community care foster family home.
"Client" means any person who receives home and community-based case management services to reside in a community care foster family home, expanded adult residential care home, or assisted living facility.
"Community care foster family home" or "home" means a home that, for the purposes of this part:
(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 are receiving the services of a licensed home and community-based case management agency; and
(3) Does not include expanded adult residential care homes or assisted living facilities, which shall continue to be licensed by the department of health.
"Designee" means a person, institution, organization, or agency authorized by the department to issue certificates of approval to community care foster family homes and to monitor these homes for certificate compliance and quality assurance. The department's designee shall perform these functions for the department and shall not at the same time function as a home and community-based case management agency or a community care foster family home as defined in this section.
"Expanded adult residential care home" means any facility providing twenty-four-hour living accommodations, for a fee, to adults unrelated to the family, who require at least minimal assistance in the activities of daily living, personal care services, protection, and health care services, and who may need the professional health services provided in an intermediate or skilled nursing facility.
"Home and community-based case management agency" means any person, agency, or organization licensed by the department to provide, coordinate, and monitor comprehensive services to meet the needs of clients whom the agency serves in a community care foster family home or any medicaid clients in an expanded adult residential care home, or an assisted living facility.
"License" means an approval issued by the department or its authorized agents for a person, agency, or organization to operate as a home and community-based case management agency. [L 2001, c 273, pt of §1, §6; am L 2003, c 95, §§17(1), 22 and c 98, §3; am L 2004, c 153, pt of §1]
[§346-332] Applicability. (a) Prior to June 30, 2006, this part shall apply to the demonstration project statewide.
(b) Community care foster family homes shall be required to reserve at least one bed for medicaid patients. [L 2001, c 273, pt of §1, §6; am L 2003, c 98, §§2, 3; am L 2004, c 153, pt of §1]
[§346-333] Home and community-based case management agency, authority over and evaluation of. (a) Any person, agency, or organization engaged in providing, coordinating, or monitoring comprehensive services to clients in community care foster family homes, or medicaid clients in expanded adult residential care homes, and assisted living facilities, shall meet the standards of conditions, management, and competence set by the department and hold a license in good standing issued for this purpose by the department.
(b) The department shall adopt rules pursuant to chapter 91 relating to:
(1) Standards for the organization and administration of home and community-based case management agencies;
(2) Standards of conditions, management, and competence of home and community-based case management agencies;
(3) Procedures for obtaining and renewing a license from the department; and
(4) Minimum grievance procedures for clients of case management services.
(c) As a condition for obtaining a license, a person, agency, or organization shall comply with rules adopted under subsection (b)(1), (2), and (3), and satisfy the background check requirements under section 346-335. The department may deny a license if:
(1) An operator, employee, or new employee of the home and community-based case management agency has been convicted of a crime other than a minor traffic violation involving a fine of $50 or less;
(2) The department finds that the criminal history record of an operator, employee, or new employee poses a risk to the health, safety, or well-being of adults receiving care in community care foster family homes, expanded adult residential care homes, or assisted living facilities;
(3) An operator, employee, or new employee of the home and community-based case management agency is a perpetrator of abuse as defined in section 346-222; or
(4) The holder of or an applicant for a home and community-based case management agency license, or one of its employees, has a certificate of approval to operate a community care foster family home, or a license from the department of health to operate an adult residential care home, expanded adult residential care home, or assisted living facility.
(d) Upon approval of any home and community-based case management agency, the department or its authorized agents shall issue a license, which shall continue in force for one year, or for two years if a home and community-based case management agency has been licensed for at least one year and is in good standing pursuant to standards adopted by the department, unless sooner revoked for cause. The department or its authorized agents shall renew the license only if, after an annual or biennial evaluation, the agency continues to meet the standards established by the department.
(e) The department shall evaluate the home and community-based case management agency to determine compliance with the requirements established under this section:
(1) Annually or biennially; or
(2) Upon receipt of a complaint that the home and community-based case management agency is in violation of the requirements established under this section.
(f) The department may suspend or revoke a license if the department deems that the agency is unwilling or unable to comply with the rules adopted under this section; provided that:
(1) Upon suspension or revocation of a license, the home and community-based case management agency shall no longer be licensed and shall immediately notify the agency's clients and community care foster family homes, expanded adult residential care homes, and assisted living facilities in which the agency is providing services to clients;
(2) A home and community-based case management agency whose license has been suspended or revoked may appeal the suspension or revocation to the department through its established process, but the appeal shall not stay the suspension or revocation;
(3) A suspended or revoked license may be reinstated if the department deems that the agency is willing and able to comply with the rules adopted under this section; and
(4) A revoked license shall be restored only after a new application is made and reviewed under this part.
(g) Any home and community-based case management agency shall be subject to investigation by the department at any time and in the manner, place, and form as provided in the department's rules.
(h) The department shall adopt standard forms of contract that the home and community-based case management agency shall use with each of its clients, community care foster family homes, expanded adult residential care homes, and assisted living facilities.
(i) The department shall establish a review board consisting of three operators of community care foster family homes and three operators of expanded adult residential care homes. The review board shall monitor referrals and placements of clients by each home and community-based case management agency on a monthly basis. Each home and community-based case management agency shall be required to provide monthly reports to the review board.
(j) The home and community-based case management agency shall have a fiduciary duty to each client it serves.
(k) A home and community-based case management agency shall not enter into an agreement that requires a community care foster family home to accept that agency's clients exclusively. [L 2001, c 273, pt of §1, §6; am L 2003, c 98, §3; am L 2004, c 153, pt of §1]
[§346-334] Community care foster family home, authority over and evaluation of. (a) Any person in any household who wants to take in, for a fee, any adult who is at the nursing facility level of care and who is unrelated to anyone in the household, for twenty-four-hour living accommodations, including personal care and homemaker services, may do so only after the household meets the required standards established for certification and obtains a certificate of approval from the department or its designee.
(b) The department shall adopt rules pursuant to chapter 91 relating to:
(1) Standards of conditions and competence for the operation of community care foster family homes;
(2) Procedures for obtaining and renewing a certificate of approval from the department; and
(3) Minimum grievance procedures for clients of community care foster family home services.
(c) As a condition for obtaining a certificate of approval, community care foster family homes shall comply with rules adopted under subsection (b) and satisfy the background check requirements under section 346-335. The department or its designee may deny a certificate of approval if:
(1) An operator or other adult residing in the community care foster family home, except for adults receiving care, has been convicted of a crime other than a minor traffic violation involving a fine of $50 or less;
(2) The department or its designee finds that the criminal history record of an operator or other adult residing in the home, except for adults receiving care, poses a risk to the health, safety, or well-being of adults in care; or
(3) An operator or other adult residing in the community care foster family home, except for adults receiving care, is a perpetrator of abuse as defined in section 346-222.
(d) Upon approval of a community care foster family home, the department or its designee shall issue a certificate of approval that shall continue in force for one year, or for two years if a community care foster family home has been certified for at least one year and is in good standing pursuant to standards adopted by the department, unless sooner suspended or revoked for cause. The department or its designee shall renew the certificate of approval only if, after an annual or biennial evaluation, the home continues to meet the standards required for certification.
(e) Any community care foster family home shall be subject to investigation by the department or its designee at any time and in the manner, place, and form as provided in procedures to be established by the department.
(f) The department or its designee may suspend or revoke a certificate of approval if the department or its designee deems that a community care foster family home is unwilling or unable to comply with the rules adopted under subsection (b); provided that:
(1) The suspension or revocation shall be immediate when conditions exist that constitute an imminent danger to life, health, or safety of adults receiving care;
(2) A community care foster family home whose certificate of approval has been suspended or revoked shall immediately notify its clients and their case managers;
(3) A community care foster family home whose certificate of approval has been suspended or revoked may appeal to the department through its established process, but the appeal shall not stay the suspension or revocation;
(4) A suspended or revoked certificate of approval may be reinstated if the department or its designee deems that the home is willing and able to comply with the rules adopted under subsection (b); and
(5) A revoked certificate of approval shall be restored only after a new application for a certificate of approval is submitted to the department or its designee and approved.
(g) Any community care foster family home shall be subject to monitoring and evaluation by the department or its designee for certification compliance and quality assurance on an annual or biennial basis. [L 2001, c 273, pt of §1, §6; am L 2003, c 98, §3; am L 2004, c 153, pt of §1]
[§346-335] Background checks. (a) The department shall develop standards to ensure the reputable and responsible character of operators and employees of the home and community-based case management agencies and operators and other adults, except for adults in care, residing in community care foster family homes as defined in this chapter.
(b) An applicant for a home and community-based case management agency license and operators, employees, and new employees of a home and community-based case management agency shall:
(1) Be subject to criminal history record checks in accordance with section 846-2.7;
(2) Be subject to adult abuse perpetrator checks, if the individual has direct contact with a client. For the purposes of this section, "adult abuse perpetrator check" means a search to determine whether an individual is known to the department as a perpetrator of abuse as defined in section 346-222, by means of a search of the individual's name and birth date in the department's adult protective service file; and
(3) Provide consent to the department to conduct an adult abuse perpetrator check and to obtain other criminal history record information for verification.
(c) New employees of the home and community-based case management agency shall be fingerprinted within five working days of employment, for the purpose of complying with the criminal history record check requirement.
(d) The department or its designee shall obtain criminal history record information through the Hawaii criminal justice data center on applicants for home and community-based case management agency licenses, and operators, employees, and new employees of home and community-based case management agencies. The Hawaii criminal justice data center may assess the applicants and operators, employees, and new employees a reasonable fee for each criminal history record check conducted. The information obtained shall be used exclusively for the stated purpose for which it was obtained and shall be subject to federal laws and regulations as may be now or hereafter adopted.
(e) The department shall make a name inquiry into the criminal history records and the adult protective service file for the first two years a home and community-based case management agency is licensed and annually or biennially thereafter depending on the licensure status of the home and community-based case management agency.
(f) An applicant for a certificate of approval as a community care foster family home and operators and other adults residing in a community care foster family home shall:
(1) Be subject to criminal history record checks in accordance with section 846-2.7;
(2) Be subject to adult abuse perpetrator checks, if the individual has direct contact with a client. For the purposes of this section, "adult abuse perpetrator check" means a search to determine whether an individual is known to the department as a perpetrator of abuse as defined in section 346-222, by means of a search of the individual's name and birth date in the department's adult protective service file; and
(3) Provide consent to the department to conduct an adult abuse perpetrator check and to obtain other criminal history record information for verification.
(g) The department or its designee shall obtain criminal history record information through the Hawaii criminal justice data center on applicants for certificates of approval as community care foster family homes and operators and other adults residing in community care foster family homes, except for adults receiving care. The Hawaii criminal justice data center may assess the applicants and operators and other adults a reasonable fee for each criminal history record check conducted. The information obtained shall be used exclusively for the stated purpose for which it was obtained and shall be subject to federal laws and regulations as may be now or hereafter adopted.
(h) The department or its designee shall make a name inquiry into the criminal history records and the adult protective service file for the first two years a community care foster family home is certified and annually or biennially thereafter depending on the certification status of the community care foster family home. [L 2001, c 273, pt of §1, §6; am L 2003, c 95, §§17(2), 22 and c 98, §3; am L 2004, c 153, pt of §1]
[§346-336] Penalty. Any person violating this part or any rule made pursuant to this part shall be fined not more than $500. [L 2001, c 273, pt of §1, §6; am L 2003, c 98, §3; am L 2004, c 153, pt of §1]