HB2565

SECTION 1. The legislature finds that there is a nationwide health care trend towards providing care outside of the large institutional setting. More often, we are seeing health care move into the community, whether it be in the form of group homes, nursing homes without walls, or in-home provision of care.

The legislature also finds that this movement of health care into the community has unintended consequences, especially in the areas of land use and zoning. While many can point to the advantages to a more community-based system of care, our zoning laws and planning represent a delicate balance between residential and development, urban and agricultural. Great shifts, such as that represented by the move towards a community-based care system, need to be balanced accordingly.

Accordingly, the purpose of this Act is to clarify that county building codes, specifically, the 1,000 foot zone between group living facilities, apply to type I and type II facilities licensed under part I of chapter 321. The legislature further finds that such clarification does not represent a prohibition against group living, but represents a balance between the various uses within residential, commercial, agricultural, and urban zoned property in the State.

SECTION 2. Section 321-15.6, Hawaii Revised Statutes, is amended to read as follows:

"§321-15.6 Adult residential care homes; licensing. (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 unannounced visits, other than the inspection for relicensing, to every licensed adult residential care home and expanded adult residential care home on an annual basis and at such intervals as determined by the department to ensure the health, safety, and welfare of each resident. Unannounced visits may be conducted during or outside regular business hours. All inspections relating to follow-up visits, visits to confirm correction of deficiencies, or visits to investigate complaints or suspicion of abuse or neglect shall be conducted unannounced during or outside regular business hours. Annual inspections for relicensing may be conducted during regular business hours or at intervals determined by the department. Annual inspections for relicensing shall be conducted with notice, unless otherwise determined by the department.

(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 categories of adult residential care homes as licensed by the department of health:

(A) Type I allowing five or fewer residents; provided that up to six residents may be allowed at the discretion of the department to live in a type I home; provided further that the primary caregiver or home operator is a certified nurse aide who has completed a state-approved training program and other training as required by the department; and

(B) Type II allowing six or more residents, including but not limited to the mentally ill, elders, persons with disabilities, the developmentally disabled, or totally disabled persons who are not related to the home operator or facility staff;

(3) Provide that licenses shall not be granted to type I and type II adult residential care homes that are located within 1000 feet of a type I or type II adult residential care home or a group living facility, as defined by county ordinance;

[~~(3)~~] (4) Comply with applicable federal laws and regulations of Title XVI of the Social Security Act, as amended; and

[~~(4)~~] (5) Provide penalties for the failure to comply with any rule.

For the purposes of this subsection:

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

"Elder" has the same meaning as defined under section 356D-1.

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

"Persons with disabilities" means persons having a disability under section 515-2.

"Totally disabled person" has the same meaning as a person totally disabled as defined under section 235-1.

(c) The department may provide for the training of and consultations with operators and staff of any facility licensed under this section, in conjunction with any licensing thereof, and shall adopt rules to ensure that adult residential care home operators shall have the needed skills to provide proper care and supervision in a home environment as required under department rules.

(d) The department shall establish a standard admission policy and procedure which shall require the provision of information that includes the appropriate medical and personal history of the patient as well as the level of care needed by the patient prior to the patient's referral and admission to any adult residential care home facility. The department shall develop appropriate forms and patient summaries for this purpose.

(e) The department shall maintain an inventory of all facilities licensed under this section and shall maintain a current inventory of vacancies therein to facilitate the placement of individuals in such facilities.

(f) The department shall develop and adopt a social model of health care to ensure the health, safety, and welfare of individuals placed in adult residential care homes. The social model of care shall provide for aging in place and be designed to protect the health, safety, civil rights, and rights of choice of the persons to reside in a nursing facility or in home- or community-based care.

(g) Any fines collected by the department of health for violations of this section shall be deposited into the office of health care assurance special fund."

SECTION 3. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 4. This Act does not affect rights and duties that matured, penalties that were incurred, and proceedings that were begun, before its effective date.

SECTION 5. This Act shall take effect on January 1, 2009.

INTRODUCED BY:	_____________________________

HOUSE OF REPRESENTATIVES	H.B. NO.	2565
TWENTY-FOURTH LEGISLATURE, 2008
STATE OF HAWAII