Definitions
HRS §321-481
in effect321-481. Definitions
As used in this part:
"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:
(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 who are receiving the services of a licensed home and
community-based case management agency; provided that:
(A) The department, in its discretion, may
certify a home for a third adult who is at the nursing facility level of care
and is a medicaid recipient; provided further that:
(i) The home has been certified and in
operation for not less than one year;
(ii) The primary caregiver is a certified nurse
aide, as defined in section 457A-1.5, who has completed a state-approved
training program and other training as required by the department; and
(iii) The substitute caregiver is a nurse aide,
as defined in section 457A-1.5, who has completed a state-approved training
program and other training as required by the department;
(B) The department, in consultation with the department
of human services, and in its discretion, and considering the past admission
history and current client mix of the community care foster family home, may
allow two private-pay individuals to be cared for in the same community care
foster family home after considering the following relevant factors:
(i) The community care foster family home is
certified for three beds;
(ii) The operator of the three-bed community
care foster family home has had a vacant medicaid bed for at least six months;
provided that the operator shall not transfer out a medicaid or private-pay
client from the community care foster family home in order to accept a
private-pay individual;
(iii) The two private-pay individuals are in a
relationship with each other as a married couple or in a civil union and one of
the private-pay individuals is currently residing in the community care foster
family home for at least six months;
(iv) The department, in its discretion,
determines that no other adult residential care home, expanded adult
residential care home, or health care facility within the area has an available
opening and is capable of providing care to both private-pay individuals; and
(v) There are no medicaid recipients seeking
placement in the community care foster family home that the married or civil
union private-pay individuals are seeking to occupy;
(C) If the legal relationship of the marriage
or civil union of the individuals ceases to exist, including but not limited to
as a result of death or divorce, one of the two private-pay beds shall
immediately, upon the death or the effective date of divorce, become a medicaid
bed; and
(D) The department and its officers,
employees, and agents, in exercising discretion and in considering any other
factors that the department deems relevant to its decision, shall be immune
from suit and liability in the exercise of its discretion under this section;
and
(3) Does not include expanded adult residential care
homes or assisted living facilities.
"Department" means 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.
"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 2012, c 93,
pt of §2; am L 2017, c 30, §2]
Source: Hawaii State Legislature (capitol.hawaii.gov), via Internet Archive capturesURL: http://www.capitol.hawaii.gov/hrscurrent/Vol06_Ch0321-0344/HRS0321/HRS_0321-0481.htmFetched: 11/10/2026