Hawaii Senate Bill SB2340

Hawaii 2026 Regular Session

• Introduced: 1/21/26
• Refer: 1/26/26
• Report Pass: 2/19/26
• Refer: 2/19/26
• Report Pass: 3/6/26
• Engrossed: 3/10/26
• Refer: 3/12/26
• Report Pass: 3/30/26
• Refer: 3/30/26
• Report Pass: 4/10/26
• Report Pass: 5/1/26
• Enrolled: 5/6/26

Caption

RELATING TO COMMUNITY CARE FOSTER FAMILY HOMES.

Summary

SB2340 clarifies and expands access to community care foster family homes for adults with intellectual and developmental disabilities who meet an intermediate care facility or nursing facility level of care. The bill states that a person may not be denied residency in a certified community care foster family home solely because of disability status or enrollment in a Medicaid waiver program, specifically the 1915(c) home and community-based services waiver or the Medicaid section 1115 demonstration waiver. It also recognizes that these homes can serve as a home-like, 24-hour support setting and seeks to preserve continuity of care for people who otherwise might have to change waiver programs to live in this setting. The bill amends Hawaii Revised Statutes section 321-483 to add explicit nondiscrimination language and to authorize certified caregivers to serve under both the 1915(c) and 1115 Medicaid waivers. It also directs the Department of Health to provide technical assistance and training to support appropriate placements, and to work with Med-QUEST and other agencies on aligning waiver language, provider qualifications, and payment models. The effective date for the substantive changes is tied to both Department of Health rule revisions and federal approval of waiver updates by the Centers for Medicare and Medicaid Services. The bill’s impact on state law is to remove ambiguity in the community care foster family home statute and make clear that waiver enrollment cannot be used as a basis to exclude eligible individuals from these homes. It also reinforces the department’s regulatory role over certification, monitoring, background checks, caregiver qualifications, and enforcement, while adding a new affirmative duty to support placement of individuals with intellectual and developmental disabilities. In practical terms, it could broaden housing options for Medicaid beneficiaries and reduce disruptions in services when moving into a foster family home. Overall sentiment around the bill appears strongly supportive. The measure passed its committee and conference votes unanimously or near-unanimously, with no recorded dissent in the provided voting history. The bill’s findings and purpose section frame it as a housing equity and continuity-of-care measure, and the lack of opposition in the available record suggests broad agreement on the need to clarify access for this population. The main point of contention addressed by the bill is not a partisan dispute but a policy and administrative barrier: whether individuals enrolled in the HCBS I/DD waiver must disenroll and switch to another waiver to live in a community care foster family home. The bill resolves that issue in favor of access, while still leaving implementation details to the Department of Health and CMS approval. Any practical concerns are likely to center on waiver alignment, provider qualifications, payment structures, and regulatory compliance rather than on the underlying goal of expanding access.

Impact

SB2340 amends Hawaii law governing community care foster family homes, particularly section 321-483 of the Hawaii Revised Statutes, to prohibit denial of residency based solely on disability status or enrollment in the 1915(c) Medicaid waiver or the section 1115 demonstration waiver. It also authorizes certified caregivers to serve under both waiver programs and requires the Department of Health to provide technical assistance, training, and interagency coordination to support these placements. The bill’s operative changes depend on state rule revisions and federal CMS approval of waiver updates, so it affects both state administrative practice and Medicaid program implementation.

Sentiment

The available legislative history shows broad support and little to no opposition. The bill passed Senate Health and Human Services, Senate Judiciary, House Conference, and Senate Conference with unanimous or near-unanimous votes and was enrolled to the Governor. The framing of the bill as a housing-access and continuity-of-care measure suggests a generally favorable sentiment among lawmakers and stakeholders.

Contention

The central issue the bill addresses is whether people with intellectual and developmental disabilities who qualify for Medicaid home- and community-based services can live in a community care foster family home without losing services or changing waiver programs. Supporters view the current situation as a barrier to least-restrictive housing and continuity of care. Any remaining concerns are administrative: how the Department of Health, Med-QUEST, and CMS will align waiver language, provider qualifications, and payment models, and how certification and oversight will work in practice.