HB185

SECTION 1. 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 visits and inspections pursuant to section 321-1.9.

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

(4) 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) The department shall not license any adult residential care home that is financed, managed, supervised, directed, or owned in whole or in part by an individual convicted of an offense under chapter 712, part III.

[~~(g)~~] (h) 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 2. Section 321-15.62, Hawaii Revised Statutes, is amended to read as follows:

"§321-15.62 Expanded adult residential care homes; licensing. (a) All expanded adult residential care homes shall be licensed to ensure the health, safety, and welfare of the individuals placed therein. The department shall conduct visits and inspections pursuant to section 321-1.9.

(b) The director of health shall adopt rules regarding expanded adult residential care homes in accordance with chapter 91 that shall implement a social model of health care designed to:

(1) Protect the health, safety, civil rights, and rights of choice of residents in a nursing facility or in home- or community-based care;

(2) Provide for the licensing of expanded adult residential care homes for persons who are certified by the department of human services, a physician, advanced practice registered nurse, or registered nurse case manager as requiring skilled nursing facility level or intermediate care facility level of care who have no financial relationship with the home care operator or facility staff; provided that the rules shall allow group living in the following two categories of expanded adult residential care homes as licensed by the department of health:

(A) A type I home shall consist of five or fewer residents with no more than two nursing facility level residents; provided that more nursing facility level residents may be allowed at the discretion of the department; and provided further that up to six residents may be allowed at the discretion of the department to live in a type I home; provided 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) A type II home shall consist of six or more residents, with no more than twenty per cent of the home's licensed capacity as nursing facility level residents; provided that more nursing facility level residents may be allowed at the discretion of the department;

provided further that the department shall exercise its discretion for a resident presently residing in a type I or type II home, to allow the resident to remain as an additional nursing facility level resident based upon the best interests of the resident. The best interests of the resident shall be determined by the department after consultation with the resident, the resident's family, primary physician, case manager, primary caregiver, and home operator;

(3) Comply with applicable federal laws and regulations of title XVI of the Social Security Act, as amended; and

(4) Provide penalties for the failure to comply with any rule.

(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 expanded 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 expanded adult residential care home facility. The department shall develop appropriate forms and patient summaries for this purpose.

(f) The department shall not license any expanded adult residential care home that is financed, managed, supervised, directed, or owned in whole or in part by an individual convicted of an offense under chapter 712, part III."

SECTION 3. Section 321-15.9, Hawaii Revised Statutes, is amended to read as follows:

"§321-15.9 Developmental disabilities residential services. (a) The department of health is authorized to license developmental disabilities domiciliary homes for individuals with developmental or intellectual disabilities who are unable to live independently and who require supervision or care, but do not require care by licensed nurses in a domiciliary setting; provided that nothing in this section shall exclude the department of human services from licensing, certifying, regulating, or entering into contracts for child foster homes or providers that serve persons with developmental or intellectual disabilities.

(b) For the purposes of this section:

"Developmental disabilities" shall be as defined under section 333E-2.

"Developmental disabilities apartment complex" means an apartment building composed of five or more separate apartment units in which every apartment unit, except for one apartment unit occupied by the operator or staff for the complex, is dedicated to providing residences for individuals with developmental or intellectual disabilities who do not require twenty-four hour supervision or care.

"Developmental disabilities domiciliary home" means a residence for not more than five persons with developmental or intellectual disabilities that require twenty-four hour supervision or care, but do not require care by licensed nurses in a domiciliary setting.

"Intellectual disability" shall be as defined under section 333F-1.

(c) The director shall adopt rules regarding developmental disabilities domiciliary homes in accordance with chapter 91 that shall be designed to:

(1) Establish criteria for licensure of homes, including inspections, registration, fees, qualifications of operators and staff, and other factors necessary to ensure safe and appropriate operation of each home;

(2) Protect the health, safety, and civil rights of persons residing in the homes;

(3) Provide for plans of care that include community integration and support of persons residing in the licensed homes;

(4) Provide for the licensure of homes of up to five persons with developmental or intellectual disabilities, and who are not related to the home operator or facility staff;

(5) Establish penalties for the failure to comply with any rule; and

(6) Establish criteria for training of operators and staff of any developmental disabilities domiciliary home licensed under this section.

(d) Rules adopted under this section shall be enforced by the director.

(e) No single apartment in a developmental disabilities apartment complex funded under this section shall be occupied by more than two residents with developmental or intellectual disabilities.

(f) The director shall establish criteria for contracts for developmental disabilities apartment complexes and where necessary to provide for additional funding for developmental disabilities domiciliary homes.

(g) The department shall maintain a registry of all developmental disabilities domiciliary homes licensed under this section and a current inventory of vacancies.

(h) The department of health may enter into contracts for additional payments for residential services to the providers of developmental disabilities domiciliary homes and payments to operators of developmental disabilities apartment complexes for residential services on terms determined by the department of health.

(i) The department shall not license any developmental disabilities domiciliary home that is financed, managed, supervised, directed, or owned in whole or in part by an individual convicted of an offense under chapter 712, part III."

SECTION 4. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 5. This Act shall take effect upon its approval.

INTRODUCED BY:	_____________________________

HOUSE OF REPRESENTATIVES	H.B. NO.	185
THIRTY-THIRD LEGISLATURE, 2025
STATE OF HAWAII