THE SENATE |
S.C.R. NO. |
81 |
TWENTY-FIFTH LEGISLATURE, 2010 |
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STATE OF HAWAII |
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SENATE CONCURRENT
RESOLUTION
requesting the Department of Human Services to examine and evaluate the financial viability and effectiveness of requiring the substitute caregiver in a community care foster family home to be a certified nurse aide when a third client is cared for in the home.
WHEREAS, by amendment to section 346‑331, Hawaii Revised Statutes, the Legislature amended the definition of "community care foster family home" (effective on July 1, 2007) to allow the Department of Human Services, in its discretion, to "certify a home for a third adult who is at the nursing level of care and a medicaid recipient"; and
WHEREAS, however, this discretionary power to certify a third client beyond the two clients that a community care foster family home may care for is conditioned on a requirement that "the primary and substitute caregivers are certified nurse aides who have completed a state-approved training program and other training as required by the department"; and
WHEREAS, under section 17‑1454‑2, Hawaii Administrative Rules (HAR) (Human Services), "nurse aide" is defined as an individual who has successfully completed an approved nurse aide course, or has passed an approved equivalency test, or an individual who has one year of full-time employment as a nurse aide under the supervision of a registered nurse in a hospital, skilled nursing facility, intermediate care facility, or home health agency"; and
WHEREAS, section 17‑1454‑2, HAR, also defines:
(1) A "primary caregiver" as "the individual who is directly responsible for the supervision and care of the client"; and
(2) A "substitute caregiver" as "an individual who is trained and identified in the service plan to provide daily personal care to clients in the absence of the primary caregiver"; and
WHEREAS, section 17‑1454‑41(d), HAR, which was amended and compiled on February 7, 2005, prior to the grant of discretion to the Department of Human Services to certify a community care foster family home for a third client, already requires "the substitute caregiver who provides three or more hours of services per day to a client shall, at minimum, be a NA [nurse aide]"; and
WHEREAS, before the grant of discretion, many community care foster family homes did not need the substitute caregiver to be a nurse aide because there has not always been a need for the substitute caregiver to provide three or more hours of care; and
WHEREAS, after the grant of discretion beginning on July 1, 2007, there have been reports that allowing a third client clearly requires the substitute caregiver to provide more than three hours of care per day, triggering the need for the substitute caregiver to obtain credentials as a nurse aide; and
WHEREAS, however, the cost of providing a second nurse aide, in the person of the substitute caregiver, nullifies the financial benefit of taking on a third client; now, therefore,
BE IT RESOLVED by the Senate of the Twenty-fifth Legislature of the State of Hawaii, Regular Session of 2010, the House of Representatives concurring, that the Department of Human Services is requested to examine and evaluate the financial viability and effectiveness of requiring the substitute caregiver in a community care foster family home to be a certified nurse aide when a third client is cared for in the home; and
BE IT FURTHER RESOLVED that the Department of Human Services is also requested to examine the effects of the requirement for a second certified nurse aide on:
(1) The effectiveness of caregiving in terms of the safety, health, and wellbeing of all three clients in the home;
(2) The financial viability of the community care foster family home operator; and
(3) The creation of any unintended effects; and
BE IT FURTHER RESOLVED that the Director of Human Services is requested to submit a report of findings and recommendations, including any necessary proposed legislation, to the Legislature no later than twenty days prior to the convening of the Regular Session of 2011; and
BE IT FURTHER RESOLVED that certified copies of this Concurrent Resolution be transmitted to the Director of Human Services.
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OFFERED BY: |
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Community Care Foster Family Home; Second Caregiver; Nurse Aide