STAND. COM. REP. NO. 2421

Honolulu, Hawaii

RE: S.B. No. 2340

S.D. 1

Honorable Ronald D. Kouchi

President of the Senate

Thirty-Third State Legislature

Regular Session of 2026

State of Hawaii

Sir:

Your Committee on Health and Human Services, to which was referred S.B. No. 2340 entitled:

"A BILL FOR AN ACT RELATING TO COMMUNITY CARE FOSTER FAMILY HOMES,"

begs leave to report as follows:

The purpose and intent of this measure is to clarify 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.

Your Committee received testimony in support of this measure from the State Council on Developmental Disabilities, Hawaii Disability Rights Center, Hawaii Self-Advocacy Advisory Council, and three individuals.

Your Committee received comments on this measure from the Department of Human Services, Department of Health, and one individual.

Your Committee finds that there is uncertainty 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 community care foster family homes without losing access to their waiver services. Your Committee 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. This measure affirms the right of individuals to live in the least restrictive setting, promotes housing equity, and preserves continuity of essential services.

Your Committee has amended this measure by:

(1) Deleting language that would have required each resident of the certified community care foster family home to be enrolled in only one waiver and receive services in accordance with that waiver's rules and requirements, for the authorization of a certified caregiver to serve as a provider under the 1915(c) and 1115 Medicaid waivers;

(2) Inserting language to provide that this measure shall take effect upon the revision of community care foster family home standards by the Department of Health and the approval of 1915(c) Medicaid waiver updates by the Centers for Medicare and Medicaid Services;

(3) Inserting an effective date of January 30, 2050, to encourage further discussion; and

(4) Making technical, nonsubstantive amendments for the purposes of clarity and consistency.

As affirmed by the record of votes of the members of your Committee on Health and Human Services that is attached to this report, your Committee is in accord with the intent and purpose of S.B. No. 2340, as amended herein, and recommends that it pass Second Reading in the form attached hereto as S.B. No. 2340, S.D. 1, and be referred to your Committee on Judiciary.

Respectfully submitted on behalf of the members of the Committee on Health and Human Services,

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JOY A. SAN BUENAVENTURA, Chair