Bill would change care rules

A bill that would make an exception for married couples who do not receive Medicaid to live together in the same Community Care Foster Family Home is advancing through the state House of Representatives.

The House Committee on Finance on Wednesday passed an amended version of House Bill 600. Currently, CCFFH operators are allowed to house a maximum of three clients, two of whom must be Medicaid beneficiaries.

The bill’s first draft authorized CCFFH operators to accept two private-pay individuals who are in a relationship, including siblings, best friends, reciprocal beneficiaries, spouses and parent-child pairs. The latest version of the bill limits the exception to married pairs.

Established by the state Department of Human Services, CCFFHs aim to save the state money by allowing Medicaid recipients to receive nursing facility-level health care in comfortable, home settings at lower costs. CCFFHs have been overseen by the state Department of Health’s Office of Health Care Assurance since July.

The Health Department, which opposed the bill’s first draft, submitted written testimony supporting the amended bill’s focus on keeping spouses together, and proposed additional legislative tweaking. Among the suggestions: expand "married couples" references to also include civil union couples and allow married and civil union couples to live together regardless of their sources of payment.

"We certainly support the intent to allow a married couple to live together in their latter years in the same CCFFH," Keith Ridley of the Health Department’s Office of Health Care Assurance told the Hono­lulu Star-Advertiser.

Last month the Department of Health opposed the bill’s first draft, in part because it would have changed the definition of a CCFFH to a residence servicing two private-pay residents and just one covered under Medicaid. Through such a switch, foster family homes would resemble adult residential care homes, which require different licensure to provide nursing home-level care for residents, the majority of whom are private-pay clients.

The Department of Human Services expressed concern that HB 600 could displace or reduce the availability of CCFFH beds for Medicaid recipients.

In a written statement, the agency said, "While DHS recognizes the need for the CCFFH operator to be able to have sufficient income and the desire to keep individuals such as spouses together," the state "must ensure the availability of CCFFHs for all Medicaid recipients who do not have the means to privately pay for housing."

The bill will now need to pass a third reading and cross over to the Senate.