STAND. COM. REP. NO. 250

                                 Honolulu, Hawaii
                                                   , 1999

                                 RE: H.B. No. 646
                                     H.D. 1




Honorable Calvin K.Y. Say
Speaker, House of Representatives
Twentieth State Legislature
Regular Session of 1999
State of Hawaii

Sir:

     Your Committees on Human Services and Housing and Health, to
which were referred H.B. No. 646 entitled: 

     "A BILL FOR AN ACT RELATING TO ADULT RESIDENTIAL CARE
     HOMES,"

beg leave to report as follows:

     The purpose of this bill is to provide a mechanism whereby
operators of Type I adult residential care homes are guaranteed
an opportunity to defend themselves in cases of alleged
misconduct against residents, including abuse and neglect.

     Specifically, the bill requires the Department of Human
Services to convene an ad hoc complaint committee, as a first
step, to hear presentations from Type I adult residential care
home operators only, to determine whether the allegations are
sufficient to warrant a continuation of the review process under
part X, chapter 346, Hawaii Revised Statutes.  If sufficient, the
Department of Human Services is required to proceed with further
investigation or review.  The bill requires the Department of
Human Services to withdraw its client immediately if a charge of
abuse or neglect is involved, but prohibits the the withdrawal of
a client during the review process if the alleged misconduct does
not involve abuse or neglect.  The bill also gives all interested
parties involved the right to seek other remedies including
judicial action.

 
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     Your Committees received testimony from various interested
parties and wish to note two items of discussion:

     (1)  Setting of a two-week limit for appealing any decision
          regarding a finding of abuse or neglect; and

     (2)  The need to have this bill, as amended, to be
          considered by the Committee on Consumer Protection and
          Commerce to which this bill is referred.

     Upon further consideration, your Committees have amended
this bill by slightly amending section 1 of the bill reflecting
the changed purpose of the bill and by deleting its substance,
which is contained in section 2, providing for the creation of
the ad hoc complaint committee and its operation.  In its place,
your Committees have substituted a new section 2 containing the
following provisions:

     (1)  Creating a two-year adult protective services review
          panel for involuntary removal of residents from adult
          residential care homes demonstration project on Oahu,
          within the Department of Human Services;

     (2)  Requiring the Department of Human Services, upon
          receiving a report of alleged abuse or neglect of a
          resident, to notify and keep informed the Department of
          Health;

     (3)  Requiring the Department of Human Services to
          investigate whether abuse or neglect has occurred;

     (4)  If abuse or neglect is determined to have occurred, and
          removal of the resident is necessary, requiring the
          adult protective services worker to:

          (A)  Discuss the removal from the care home with the
               care home operator and the resident and obtain the
               resident's consent to place the resident in
               another appropriate facility;

          (B)  If the resident has the capacity to make his or
               her own decisions, the adult protective services
               worker shall abide by the wishes of the resident
               regarding where the resident wishes to live;


 
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          (C)  If the resident does not have the capacity to make
               his or her own decisions, the adult protective
               services worker shall contact the resident's
               guardian to obtain consent to place the resident
               in another appropriate facility;

          (D)  If the guardian cannot be contacted in a timely
               manner, the adult protective services worker shall
               place the resident in another appropriate facility
               and shall contact the guardian as soon as possible
               following the placement.  If the resident does not
               appear to have the capacity to make his or her own
               decisions, and does not have a guardian, the adult
               protective services worker shall consult with the
               Department of the Attorney General regarding the
               need for a court order for immediate protection;
               and

          (E)  If the resident has a case manager, the case
               manager shall be notified of the actions taken by
               the adult protective services worker and shall
               take part in decisions regarding the resident as
               appropriate;

     (5)  Allowing the operator to request a review of the
          removal of a resident if:

          (A)  A resident who has the capacity to make his or her
               own decisions is removed against the resident's
               wishes; or

          (B)  The resident's guardian does not concur with the
               removal;

     (6)  Prohibiting a review if the resident's removal was
          ordered by the Family Court;

     (7)  Providing for the making of a request for review by the
          accused operator;

     (8)  Creating the review panel and specifying its
          membership, including the Department of Health;

     (9)  Providing for the specific operation of the review
          panel, including:


 
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          (A)  Reviewing a written summary submitted by the the
               adult protective services worker regarding the
               circumstances of the alleged incident of abuse or
               neglect;

          (B)  Reviewing the oral or written summary of pertinent
               information presented by the care home operator
               requesting the review;

          (C)  Reviewing the report of the Protection and
               Advocacy Agency of Hawaii after an interview with
               the resident; and

          (D)  Deciding whether the action taken by the
               Department of Human Services was warranted;

    (10)  Requiring the review panel proceedings to be audiotaped
          and stored in the Department of Human Services and
          distributing copies of the review panel findings to
          the:

          (A)  Director of Human Services;

          (B)  Director of Health;

          (C)  Oahu Adult and Community Care Services Section
               Administrator of the Department of Human Services;

          (D)  Care home operator requesting the review;

          (E)  Members of the review panel; and

          (F)  Resident who is the subject of the alleged abuse
               or neglect or the resident's guardian;

    (11)  Making all information presented during the review
          panel proceedings confidential; and

    (12)  Requiring the Department of Human Services, assisted by
          the Department of Health, to evaluate the effectiveness
          of the project and report findings and recommendation
          to the legislature no later than twenty days prior to
          the regular session of 2001.

     Your committee has also amended section 3 of the bill to
repeal the Act on June 30, 2001.

 
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     As affirmed by the records of votes of the members of your
Committees on Human Services and Housing and Health that are
attached to this report, your Committees are in accord with the
intent and purpose of H.B. No. 646, as amended herein, and
recommend that it pass Second Reading in the form attached hereto
as H.B. No. 646, H.D. 1, and be referred to the Committee on
Consumer Protection and Commerce.

Respectfully submitted on         Respectfully submitted on
behalf of the members of the      behalf of the members of the
Committee on Health               Committee on Human Services
                                  and Housing



______________________________     ______________________________
ALEXANDER C. SANTIAGO, Chair       DENNIS A. ARAKAKI 

 
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