REPORT TITLE:
Long-Term Residential Care


DESCRIPTION:
Establishes uniform assessment tool and information and referral
process; makes appropriation to the Executive Office on Aging to
implement statewide initial information and referral screening;
requires DOH to report on study for adult residential care
facilities.   (SD1)

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
                                                        2490
THE SENATE                              S.B. NO.           S.D. 1
TWENTIETH LEGISLATURE, 2000                                
STATE OF HAWAII                                            
                                                             
________________________________________________________________
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                   A  BILL  FOR  AN  ACT

RELATING TO LONG-TERM RESIDENTIAL CARE.



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

 1      SECTION 1.  The legislature finds that Hawaii's citizens are
 
 2 faced with an overwhelming financial burden of caring for their
 
 3 elderly and disabled residents whose needs will continue to grow
 
 4 as the population ages.  The cost of nursing home care is
 
 5 currently the highest of all types of long-term care and is
 
 6 continuing to escalate.  Consequently, long-term residential care
 
 7 has become a realistic and cost-effective alternative.
 
 8      The legislature further finds that there is no one, simple,
 
 9 uniform way for a person who needs long-term care to easily and
 
10 quickly access the appropriate care.  An information and referral
 
11 system would provide a simple and uniform, yet sophisticated and
 
12 comprehensive way to allow people easy access into the long-term
 
13 residential care system.
 
14      Act 339, Session Laws of Hawaii 1997, created a two-year
 
15 joint legislative committee on long-term care financing.
 
16 Subsequently, House Concurrent Resolution No. 225, H.D. 1,
 
17 S.D. 1, 1998, required the joint committee to create a
 
18 subcommittee to study long-term residential care facilities.
 
19      The recommendations of the subcommittee included:
 

 
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 1      (1)  Improving the regulatory environment to reduce
 
 2           fragmentation in the adult long-term residential care
 
 3           industry by consolidating and simplifying
 
 4           organizational categories of facilities, increasing
 
 5           uniformity of regulation across facility types, and
 
 6           promoting parity of provider reimbursement for similar
 
 7           services provided regardless of facility type;
 
 8      (2)  The use of a uniform assessment tool across facility
 
 9           types; and
 
10      (3)  The implementation of an information and referral
 
11           process for all adult long-term residential care
 
12           facilities in the State, which is being addressed by
 
13           the department of health by administrative rule.
 
14      Pursuant to Act 339, S.B. No. 856, 1999 Regular Session, was
 
15 introduced and was pending in conference committee.  Your
 
16 Committee believes that the provisions in S.B. No. 856, relating
 
17 to organizing the various residential care homes and facilities
 
18 into two categories of adult residential care facilities, has
 
19 merit and should be pursued by the department of health.
 
20      The purpose of this measure is to provide for an efficient,
 
21 streamlined, and accessible long-term care system.
 
22      SECTION 2.  Chapter 321, Hawaii Revised Statutes, is amended
 
23 by adding two new sections to be appropriately designated and to
 

 
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 1 read as follows:
 
 2      "§321-    Uniform assessment tool.  (a)  To implement the
 
 3 standard admission procedures, the department of health shall
 
 4 employ, as a uniform assessment tool, a scaled-down version of
 
 5 the Medicaid waiver program's social and health assessment forms
 
 6 for all licensed care homes regulated by the department.
 
 7      (b)  The department shall also employ the one-page form
 
 8 currently being used by the department termed "Level of Care
 
 9 Evaluation", as updated from time to time, for all residential
 
10 care facilities regulated by the department to assure the correct
 
11 placement of only non-nursing facility level residents.
 
12      (c)  The data elements in the uniform assessment tool in
 
13 subsection (a) and the one-page tool in subsection (b) shall be
 
14 standardized to reduce the need to obtain identical data
 
15 subsequently, and to allow different providers to access and
 
16 share standard information, as necessary.  The data elements
 
17 shall be consistent with the two-page information and referral
 
18 screening form, administered at the time of entry, termed the
 
19 "Coordinated Screening Form", that is recommended for use in the
 
20 long-term care information and referral process under section
 
21 321-  .
 
22      (d)  The:
 
23      (1)  Uniform assessment tool in subsection (a);
 

 
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 1      (2)  One-page tool in subsection (b); and
 
 2      (3)  Two-page information and referral screening form in
 
 3           subsection (c) and the long-term information and
 
 4           referral process;
 
 5 are meant to be flexible tools to be modified as required from
 
 6 time to time without the need for further legislative amendment
 
 7 to this part.  Nothing in this section shall prevent any agency
 
 8 or care provider regulated under this part from obtaining any
 
 9 additional data, as necessary, to appropriately assess a resident
 
10 or potential resident or to plan for their care.
 
11      (e)  The purpose of the uniform assessment tool is to help
 
12 reduce system fragmentation, increase system efficiency and
 
13 effectiveness, enhance quality of care, and make the system more
 
14 consumer-friendly.
 
15      §321-    Long-term care information and referral.  Subject
 
16 to legislative appropriations, the department of health shall
 
17 establish an information and referral process that shall serve
 
18 all potential clients of licensed care homes, namely, the
 
19 elderly, the non-elderly under age sixty, and disabled persons of
 
20 all ages.  The information and referral process shall include a
 
21 uniform initial information and referral screening using a tool
 
22 to be developed by the executive office on aging."
 

 
 
 
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 1      SECTION 3.  The department of health shall conduct a study
 
 2 on reorganizing all adult residential care homes and facilities
 
 3 into a new "adult residential care facilities", for regulatory
 
 4 purposes, as contained in S.B. No. 856, H.D. 2, 1999 Regular
 
 5 Session.  The study shall either recommend enactment of a new
 
 6 adult residential care facilities model with two facility
 
 7 categories and seven designated entities, or recommend an
 
 8 alternative model with proposed legislation to reduce the
 
 9 fragmentation, increase cost-effectiveness, and improve
 
10 operational effectiveness of residential care services.
 
11      For purposes of the study, the department of health is
 
12 encouraged to solicit the input of organizations concerned with
 
13 long-term care and providers of long-term care, including
 
14 facilities, homes, and hospitals.
 
15      The department of health shall report on findings and
 
16 recommendations to the legislature no later than twenty days
 
17 prior to the convening of the Regular Session of 2001.
 
18      SECTION 4.  There is appropriated out of the general
 
19 revenues of the State of Hawaii the sum of $          , or so
 
20 much thereof as may be necessary for fiscal year 2000-2001, to be
 
21 expended as follows:
 
22      (1)  An augmentation of the executive office on aging's
 
23           Aging Network to perform initial information and
 

 
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 1           referral screening for all persons aged sixty and
 
 2           older;
 
 3      (2)  The executive office on aging to expand its screening
 
 4           and referral program to coordinate the establishment
 
 5           and operation of similar services to be provided by
 
 6           ASK-2000, or other information and referral providers
 
 7           as appropriate, for clients under age sixty.  The
 
 8           development of this expansion shall begin in July,
 
 9           2001, and full operation shall begin in July, 2002;
 
10      (3)  A subcontract by the executive office on aging with
 
11           ASK-2000, or other information and referral providers
 
12           to provide similar supplementary initial information
 
13           and referral screening for all potential clients under
 
14           age sixty.  The development of this supplementary
 
15           service shall begin in July, 2001, and full operation
 
16           shall begin in July, 2002; and
 
17      (4)  One-time startup costs and annual operating costs.
 
18      SECTION 5.  The sum appropriated shall be expended by the
 
19 department of health.
 
20      SECTION 6.  New statutory material is underscored.
 
21      SECTION 7.  This Act shall take effect upon its approval;
 
22 provided that sections 4 and 5 shall take effect on July 1, 2000.