RELATING TO COMMUNITY CARE FOSTER FAMILY HOMES.

SB2340

THE SENATE

S.B. NO.

2340

THIRTY-THIRD LEGISLATURE, 2026

STATE OF HAWAII

A BILL FOR AN ACT

relating
to community care foster family homes
.

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

����
SECTION 1.
�
The legislature finds that community care
foster family homes provide a vital residential option for individuals who need
twenty-four-hour support in a home-like setting.
�
Although existing law and administrative
rules permit these homes to serve up to three residents, uncertainty remains
about whether individuals who qualify for the medicaid intellectual and
developmental disabilities home and community based services waiver, also known
as the HCBS I/DD waiver, may live in such homes without losing access to their
waiver services.

����
The legislature further finds that individuals
with intellectual and developmental disabilities who wish to reside in a
community care foster family home must disenroll from the HCBS I/DD waiver and
transition to the medicaid section 1115 waiver.
�
This requirement disrupts continuity of care
and may result in the loss of essential, individualized services.
�
Clarifying that waiver status shall not
disqualify individuals from living in a community care foster family home will
remove systemic barriers and uphold the right to choose where to live.

����
The purpose of this Act is to ensure
that individuals with intellectual and developmental disabilities who meet an
intermediate care facility or nursing facility level of care shall not be
denied residency in a licensed community care foster family home solely because
of their disability or enrollment in a specific medicaid waiver program.
�
This Act affirms the right of individuals to
live in the least restrictive setting, promotes housing equity, and preserves
continuity of essential services.

����
SECTION
2
.
�
Section
321-483, Hawaii Revised Statutes, is amended to read as follows:

����
"
�321-483
�
Community care foster
family home, authority over and evaluation of.
�
(a)
�

Any person in any household who wants to take in, for a fee, any adult
who is at the nursing facility level of care and who is unrelated to anyone in
the household, for twenty-four hour living accommodations, including personal
care and homemaker services, may do so only after the household meets the
required standards established for certification and obtains a certificate of
approval from the department or its designee.

����
(b)
�

The department shall adopt rules pursuant to chapter 91 relating to:

����
(1)
�
Standards of conditions
and competence for the operation of community care foster family homes;

����
(2)
�
Procedures for
obtaining and renewing a certificate of approval from the department;

����
(3)
�
Minimum grievance
procedures for clients of community care foster family home services; and

����
(4)
�
Requirements
for primary and substitute caregivers caring for three clients in community
care foster family homes including:

���������
(A)
�
Mandating that
primary and substitute caregivers be twenty-one years of age or older;

���������
(B)
�
Mandating that
primary and substitute caregivers complete a minimum of twelve hours of
continuing education every twelve months or at least twenty-four hours of
continuing education every twenty-four months;

���������
(C)
�
Allowing the
primary caregiver to be absent from the community care foster family home for
no more than twenty-eight hours in a calendar week, not to exceed five hours
per day; provided that the substitute caregiver is present in the community
care foster family home during the primary caregiver's absence;

���������
(D)
�
Where the primary
caregiver is absent from the community care foster family home in excess of the
hours as prescribed in subparagraph (C), mandating that the substitute
caregiver be a certified nurse aide; and

���������
(E)
�
Mandating that the
substitute caregiver have, at a minimum, one year prior work experience as a
caregiver in a community residential setting or in a medical facility.

����
(c)
�

As a condition for obtaining a certificate of approval, community care
foster family homes shall comply with rules adopted under subsection (b) and
satisfy the background check requirements under section 321-15.2.
�
The department or its designee may deny a
certificate of approval if:

����
(1)
�
An operator or
other adult residing in the community care foster family home, except for
adults receiving care, has been convicted of a crime other than a minor traffic
violation involving a fine of $50 or less;

����
(2)
�
The department or
its designee finds that the background check record of an operator or other
adult residing in the home, except for adults receiving care, poses a risk to
the health, safety, or well-being of adults in care; or

����
(3)
�
An operator or
other adult residing in the community care foster family home, except for
adults receiving care, is a perpetrator of abuse as defined in section 346-222.

����
(d)
�

Upon approval of a community care foster family home, the department or
its designee shall issue a certificate of approval that shall continue in force
for one year, or for two years if a community care foster family home has been
certified for at least one year and is in good standing pursuant to standards
adopted by the department, unless sooner suspended or revoked for cause.
�
The department or its designee

shall renew the certificate of
approval only if, after an annual
or biennial

evaluation, the home continues to meet the standards required for
certification.

����
(e)
�

Any community care foster family home shall be subject to investigation
by the department or its designee at any time and in the manner, place, and
form as provided in procedures to be established by the department.

����
(f)
�

The department or its designee may suspend or revoke a certificate of
approval if the department or its designee deems that a community care foster
family home is unwilling or unable to comply with the rules adopted under
subsection (b); provided that:

����
(1)
�
The suspension or
revocation shall be immediate when conditions exist that constitute an imminent
danger to the life, health, or safety of adults receiving care;

����
(2)
�
A community care
foster family home whose certificate of approval has been suspended or revoked
shall immediately notify its clients and their case managers;

����
(3)
�
A community care
foster family home whose certificate of approval has been suspended or revoked
may appeal to the department through its established process, but the appeal
shall not stay the suspension or revocation;

����
(4)
�
A suspended or
revoked certificate of approval may be reinstated if the department or its
designee deems that the home is willing and able to comply with the rules
adopted under subsection (b); and

����
(5)
�
A revoked
certificate of approval shall be restored only after a new application for a
certificate of approval is submitted to the department or its designee and
approved.

����
(g)
�

Any community care foster family home shall be subject to monitoring and
evaluation by the department or its designee for certification compliance and
quality assurance on an annual or biennial basis.

����
(h)
�
No person who meets an intermediate care
facility or nursing facility level of care and is eligible for services under
either the 1915(c) medicaid waiver or medicaid section 1115 demonstration
waiver shall be denied residency in a certified community care foster family
home solely based on the person's disability status or waiver enrollment.
�
A certified caregiver may serve as a provider
under the 1915(c) and 1115 medicaid waivers; provided that each resident of the
home is enrolled in only one waiver and receives services in accordance with
that waiver's rules and requirements.

����
(i)
�
The
department shall p
rovide technical assistance and training to support
the appropriate placement of individuals with intellectual and developmental
disabilities in community care foster family homes, in collaboration with case
management agencies, licensing entities, and medicaid programs; provided that
the department shall c
onsult with the
Med-QUEST division of the department of human services to align waiver
language, provider qualifications, and payment models to facilitate this
inclusive housing option; provided further that the department shall issue
guidance to case management agencies and foster home operators to ensure
compliance.
"

����
SECTION 3.
�
New statutory material is underscored.

����
SECTION 4.
�
This Act shall take effect upon its approval.

INTRODUCED BY:

_____________________________

Report Title:

Community
Care Foster Family Homes; Individuals with Intellectual and Developmental
Disabilities; Medicaid; Housing Access

Description:

Clarifies
that
individuals with intellectual and developmental disabilities who
meet an intermediate care facility or nursing facility level of care shall not
be denied residency in a licensed community care foster family home solely
because of their disability or enrollment in a specific medicaid waiver program.

The summary description
of legislation appearing on this page is for informational purposes only and is
not legislation or evidence of legislative intent.