Bills

SB 1438: Home Care Agencies; Prohibitions; Limitations

Session Year: 2025-2026
House: Senate
Latest Version Date: 2025-03-31

Current Status:

In Progress

(2025-05-15: Act 051, on 05/15/2025 (Gov. Msg. No. 1151).)

Introduced

In Committee

First Chamber

In Committee

Second Chamber

Final Decking

Enacted

Version:

Prohibits home care agencies from providing services outside the scope of their facility license. (HD1)

Version:

SB1438 HD1

THE SENATE	S.B. NO.	1438
THIRTY-THIRD LEGISLATURE, 2025		S.D. 1
STATE OF HAWAII		H.D. 1

A BILL FOR AN ACT

RELATING TO HOME CARE AGENCIES.

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

SECTION 1. Section 321-14.8, Hawaii Revised Statutes, is amended to read as follows:

"§321-14.8 Home care agencies; licensing. (a) Beginning July 1, 2010, each home care agency shall be licensed by the department of health to ensure the health, safety, and welfare of clients.

(b) The department of health shall adopt [interim rules, which shall be exempt from chapters 91 and 201M, to effectuate the licensure of home care agencies; provided that the interim rules shall remain in effect until the sooner of October 1, 2018, or the adoption of] rules pursuant to chapters 91 and 201M to:

(1) Protect the health, safety, and civil rights of clients of home care agencies; and

(2) Provide for the licensure of home care agencies.

(1) Under contract for services with the city and county of Honolulu, elderly affairs division[;] of the department of community services; or

(2) Exclusively to participants in the medicaid home and community based services waiver, pursuant to section 1915(c) of the Social Security Act, by an agency approved by the department of human services med-QUEST division.

(d) A home care agency shall only provide home care services or related tasks, functions, and activities in accordance with its license, and shall not provide services authorized by chapter 457 unless those services are provided by a registered nurse, a licensed practical nurse, or an advanced practice registered nurse.

(e) Violations of this section shall be subject to the penalties and remedies provided in this chapter and rules adopted by the department of health.

[~~(d)~~] (f) For the purposes of this section:

"Home care agency" means a public or proprietary agency, a private, nonprofit organization, or a subdivision of an agency or organization, engaged in providing home care services to clients in the client's residence. [~~The term "home care agency"~~] "Home care agency" does not apply to an individual, including an individual who is incorporated as a business, or is an unpaid or stipended volunteer.

"Home care services" may include [~~but are not limited to~~]:

(1) Personal care, including assistance with dressing, feeding, and personal hygiene to facilitate self-care;

(2) Homemaker assistance, including housekeeping, shopping, and meal planning and preparation; and

(3) Respite care and assistance and support provided to the family."

SECTION 2. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 3. This Act shall take effect upon its approval.

Report Title:

Home Care Agencies; Prohibitions; Limitations

Description:

Prohibits home care agencies from providing services outside the scope of their facility license. (HD1)

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

SB1438 SD1

THE SENATE	S.B. NO.	1438
THIRTY-THIRD LEGISLATURE, 2025		S.D. 1
STATE OF HAWAII

A BILL FOR AN ACT

RELATING TO HOME CARE AGENCIES.

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

SECTION 1. Section 321-14.8, Hawaii Revised Statutes, is amended to read as follows:

"§321-14.8 Home care agencies; licensing. (a) Beginning July 1, 2010, each home care agency shall be licensed by the department of health to ensure the health, safety, and welfare of clients.

(b) The department of health shall adopt interim rules, which shall be exempt from chapters 91 and 201M, to effectuate the licensure of home care agencies; provided that the interim rules shall remain in effect until the sooner of October 1, 2018, or the adoption of rules pursuant to chapters 91 and 201M to:

(1) Protect the health, safety, and civil rights of clients of home care agencies; and

(2) Provide for the licensure of home care agencies.

(1) Under contract for services with the city and county of Honolulu, elderly affairs division; or

(d) A home care agency shall only provide home care services or related tasks, functions, and activities in accordance with its license, and shall not provide services authorized by chapter 457 unless those services are provided by a registered nurse, licensed practical nurse, or advanced practice registered nurse.

(e) Violations of this section shall be subject to the penalties and remedies provided in this chapter and in rules adopted by the department of health.

[~~(d)~~] (f) For the purposes of this section:

"Home care agency" means a public or proprietary agency, a private, nonprofit organization, or a subdivision of an agency or organization, engaged in providing home care services to clients in the client's residence. The term "home care agency" does not apply to an individual, including an individual who is incorporated as a business, or is an unpaid or stipended volunteer.

"Home care services" may include [~~but are not limited to~~]:

(1) Personal care, including assistance with dressing, feeding, and personal hygiene to facilitate self-care;

(2) Homemaker assistance, including housekeeping, shopping, and meal planning and preparation; and

(3) Respite care and assistance and support provided to the family."

SECTION 2. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 3. This Act shall take effect on July 1, 2050.

Report Title:

Home Care Agencies; Prohibitions; Limitations

Description:

Prohibits home care agencies from providing services outside the scope of their facility license. Effective 7/1/2050. (SD1)

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

SB1438

THE SENATE	S.B. NO.	1438
THIRTY-THIRD LEGISLATURE, 2025
STATE OF HAWAII

A BILL FOR AN ACT

RELATING TO HOME CARE AGENCIES.

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

SECTION 1. Section 321-14.8, Hawaii Revised Statutes, is amended to read as follows:

"§321-14.8 Home care agencies; licensing. (a) Beginning July 1, 2010, each home care agency shall be licensed by the department of health to ensure the health, safety, and welfare of clients.

(1) Protect the health, safety, and civil rights of clients of home care agencies; and

(2) Provide for the licensure of home care agencies.

(1) Under contract for services with the city and county of Honolulu, elderly affairs division; or

(d) A home care agency shall only provide home care services or related tasks, functions, and activities in accordance with its license, and shall not provide services authorized by chapter 457 unless those services are provided by a registered nurse, licensed practical nurse, or advanced practice registered nurse.

(e) Violations of this section shall be subject to the penalties and remedies provided in this chapter and in rules adopted by the department of health.

[~~(d)~~] (f) For purposes of this section:

"Home care agency" means a public or proprietary agency, a private, nonprofit organization, or a subdivision of an agency or organization, engaged in providing home care services to clients in the client's residence. The term "home care agency" does not apply to an individual, including an individual who is incorporated as a business, or is an unpaid or stipended volunteer.

"Home care services" may include [~~but are not limited to~~]:

(1) Personal care, including assistance with dressing, feeding, and personal hygiene to facilitate self-care;

(2) Homemaker assistance, including housekeeping, shopping, and meal planning and preparation; and

(3) Respite care and assistance and support provided to the family."

SECTION 2. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 3. This Act shall take effect upon its approval.

INTRODUCED BY:

_____________________________

BY REQUEST

Report Title:

Home Care Agencies; Prohibitions; Limitations

Description:

Prohibits home care agencies from providing services outside the scope of their facility license.

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

Date	Status
May 15, 2025	Act 051, on 05/15/2025 (Gov. Msg. No. 1151).
May 15, 2025	Act 051, 05/15/2025 (Gov. Msg. No. 1151).
Apr 16, 2025	Enrolled to Governor.
Apr 16, 2025	Received notice of Final Reading (Sen. Com. No. 806).
Apr 16, 2025	Passed Final Reading. Ayes, 21; Aye(s) with reservations: none. Noes, 2 (Senator(s) Awa, DeCorte). Excused, 2 (Senator(s) Fevella, Ihara).
Apr 15, 2025	Received notice of reconsideration and Senate agreement (Sen. Com. No. 786).
Apr 15, 2025	One Day Notice 04-16-25
Apr 15, 2025	Senate agrees with House amendments. Placed on the calendar for Final Reading on 04-16-25.
Apr 15, 2025	Reconsideration of action taken on 04-04-25 in disagreeing to the House amendments.
Apr 4, 2025	Received notice of disagreement (Sen. Com. No. 590).
Apr 4, 2025	Senate disagrees with House amendments.
Apr 4, 2025	Received from House (Hse. Com. No. 491).
Apr 3, 2025	Passed Third Reading as amended in HD 1 with Representative(s) Reyes Oda voting aye with reservations; Representative(s) Alcos, Garcia, Matsumoto, Muraoka, Pierick voting no (5) and Representative(s) Cochran, Woodson excused (2). Transmitted to Senate.
Apr 1, 2025	Forty-eight (48) hours notice Thursday, 04-03-25.
Apr 1, 2025	Reported from CPC (Stand. Com. Rep. No. 1746) as amended in HD 1, recommending passage on Third Reading.
Mar 25, 2025	The committee on CPC recommend that the measure be PASSED, WITH AMENDMENTS. The votes were as follows: 8 Ayes: Representative(s) Matayoshi, Chun, Ilagan, Iwamoto, Kong, Lowen, Marten, Tam; Ayes with reservations: none; 1 Noes: Representative(s) Pierick; and 1 Excused: Representative(s) Ichiyama.
Mar 21, 2025	Bill scheduled to be heard by CPC on Tuesday, 03-25-25 2:00PM in House conference room 329 VIA VIDEOCONFERENCE.
Mar 21, 2025	Passed Second Reading and referred to the committee(s) on CPC with Representative(s) Matsumoto voting aye with reservations; Representative(s) Alcos, Garcia, Pierick voting no (3) and Representative(s) Cochran, Garrett, Kapela, Kitagawa, Ward excused (5).
Mar 21, 2025	Reported from HLT (Stand. Com. Rep. No. 1417), recommending passage on Second Reading and referral to CPC.
Mar 19, 2025	The committee on HLT recommend that the measure be PASSED, UNAMENDED. The votes were as follows: 7 Ayes: Representative(s) Takayama, Keohokapu-Lee Loy, Amato, Chun, Marten, Olds, Takenouchi; Ayes with reservations: none; 2 Noes: Representative(s) Alcos, Garcia; and Excused: none.
Mar 14, 2025	Bill scheduled to be heard by HLT on Wednesday, 03-19-25 9:05AM in House conference room 329 VIA VIDEOCONFERENCE.
Mar 6, 2025	Referred to HLT, CPC, referral sheet 19
Mar 6, 2025	Pass First Reading
Mar 4, 2025	Received from Senate (Sen. Com. No. 334) in amended form (SD 1).
Mar 4, 2025	Report Adopted; Passed Third Reading, as amended (SD 1). Ayes, 23; Aye(s) with reservations: none. Noes, 2 (Senator(s) Awa, DeCorte). Excused, 0 (none). Transmitted to House.
Feb 27, 2025	48 Hrs. Notice 03-04-25.
Feb 27, 2025	Reported from CPN (Stand. Com. Rep. No. 740) with recommendation of passage on Third Reading, as amended (SD 1).
Feb 19, 2025	The committee(s) on CPN recommend(s) that the measure be PASSED, WITH AMENDMENTS. The votes in CPN were as follows: 3 Aye(s): Senator(s) Keohokalole, Fukunaga, McKelvey; Aye(s) with reservations: none ; 1 No(es): Senator(s) Awa; and 1 Excused: Senator(s) Richards.
Feb 14, 2025	The committee(s) on CPN will hold a public decision making on 02-19-25 9:35AM; Conference Room 229 & Videoconference.
Feb 14, 2025	Report adopted; Passed Second Reading and referred to CPN.
Feb 14, 2025	Reported from HHS (Stand. Com. Rep. No. 501) with recommendation of passage on Second Reading and referral to CPN.
Feb 5, 2025	The committee(s) on HHS recommend(s) that the measure be PASSED, UNAMENDED. The votes in HHS were as follows: 4 Aye(s): Senator(s) San Buenaventura, Aquino, Hashimoto, Keohokalole; Aye(s) with reservations: none ; 0 No(es): none; and 1 Excused: Senator(s) Fevella.
Jan 31, 2025	The committee(s) on HHS has scheduled a public hearing on 02-05-25 1:00PM; Conference Room 225 & Videoconference.
Jan 27, 2025	Referred to HHS, CPN.
Jan 23, 2025	Introduced and passed First Reading.
Jan 21, 2025	Pending Introduction.

Date	Description	Location	Votes
Apr 16, 2025	Final Reading	Senate Floor	21 2 2 Passed
Apr 3, 2025	Third Reading	House Floor	43 5 2 Passed
Mar 25, 2025	The committee on CPC recommend that the measure be PASSED, WITH AMENDMENTS	House Standing Committee on Consumer Protection & Commerce	8 1 1 Passed
Mar 19, 2025	The committee on HLT recommend that the measure be PASSED, UNAMENDED	House Standing Committee on Health	7 2 0 Passed
Mar 4, 2025	Third Reading	Senate Floor	23 2 0 Passed
Feb 19, 2025	The committee(s) on CPN recommend(s) that the measure be PASSED, WITH AMENDMENTS	Senate Standing Committee on Commerce and Consumer Protection	3 1 1 Passed
Feb 5, 2025	The committee(s) on HHS recommend(s) that the measure be PASSED, UNAMENDED	Senate Standing Committee on Health and Human Services	4 0 1 Passed

Key

Pro

Against

Did Not Vote

This list shows positions taken on this bill by organizations on the date displayed, which is linked to the original source.

Positions by individuals are not included.

* Testimony in a hearing

** Position recorded in bill analysis

*** Position recorded in written testimony

Organization	Position	Date
Department of Health	** Support
Department of Health	*** Support	Mar 25, 2025
Department of Health and Hawaiʻi Association of Professional Nurses	** Support
Libertarian Party of Hawaii	** Against

* Testimony in a hearing

** Position recorded in bill analysis

*** Position recorded in written testimony

HSCR1746 Administrator HSCR.dotm clerk2 2 6 2025-03-28T22:55:00Z 2025-04-01T03:20:00Z 2025-04-01T03:20:00Z 2 366 1966 HSCR template, revision no. 00005 23272 80 25 2334 16.00 00005 Print 89 0 0 false false false EN-US X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman",serif;}

STAND. COM. REP. NO. 1746

Honolulu, Hawaii

, 2025

RE: S.B. No. 1438

S.D. 1

H.D. 1

Honorable Nadine K. Nakamura

Speaker, House of Representatives

Thirty-Third State Legislature

Regular Session of 2025

State of Hawaii

Madame:

Your Committee on Consumer Protection & Commerce, to which was referred S.B. No. 1438, S.D. 1, entitled:

"A BILL FOR AN ACT RELATING TO HOME CARE AGENCIES,"

begs leave to report as follows:

The purpose of this measure is to prohibit home health care agencies from providing services outside the scope of their facility license.

Your Committee received testimony in support of this measure from the Department of Health. Your Committee received testimony in opposition to this measure from the Libertarian Party of Hawaii and one individual.

Your Committee finds that home care agencies are entities that provide personal care services, homemaker services, and respite care to clients in their homes. These agencies provide essential services to individuals who require assistance with daily living activities, allowing individuals to remain in their homes while receiving necessary care. However, your Committee further finds that some home care agencies are providing nursing services, which require specialized training, that are rendered by individuals who are not licensed under state law to engage in the practice of nursing. To bolster the State's ability to protect patient safety, this measure clarifies the scope of the home care agency license and authorizes the Department of Health to take enforcement action against home care agencies that are providing services outside of the scope of their license.

Your Committee has amended this measure by:

(1) Changing the effective date to upon approval; and

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

As affirmed by the record of votes of the members of your Committee on Consumer Protection & Commerce that is attached to this report, your Committee is in accord with the intent and purpose of S.B. No. 1438, S.D. 1, as amended herein, and recommends that it pass Third Reading in the form attached hereto as S.B. No. 1438, S.D. 1, H.D. 1.

Respectfully submitted on behalf of the members of the Committee on Consumer Protection & Commerce,

____________________________

SCOT Z. MATAYOSHI, Chair

HSCR1417 Administrator HSCR.dotm clerk4 2 9 2004-10-13T00:57:00Z 2025-03-21T00:18:00Z 2025-03-21T00:18:00Z 2 260 1379 HSCR template, revision no. 00005 23072 65 21 1636 16.00 00005 Print 70 0 0 false false false EN-US KO X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman",serif;}

STAND. COM. REP. NO. 1417

Honolulu, Hawaii

, 2025

RE: S.B. No. 1438

S.D. 1

Honorable Nadine K. Nakamura

Speaker, House of Representatives

Thirty-Third State Legislature

Regular Session of 2025

State of Hawaii

Madame:

Your Committee on Health, to which was referred S.B. No. 1438, S.D. 1, entitled:

"A BILL FOR AN ACT RELATING TO HOME CARE AGENCIES,"

begs leave to report as follows:

The purpose of this measure is to prohibit home health care agencies from providing services outside the scope of their facility license.

Your Committee finds that some operators of home care agencies provide skilled nursing services to clients that are not rendered by a licensed nurse. Your Committee further finds that because the Board of Nursing may not have the authority to regulate unlicensed providers of nursing care employed by home care agencies, providing the Department of Health with enforcement authority will ensure appropriate services are provided and more effectively ensure patient safety.

As affirmed by the record of votes of the members of your Committee on Health that is attached to this report, your Committee is in accord with the intent and purpose of S.B. No. 1438, S.D. 1, and recommends that it pass Second Reading and be referred to your Committee on Consumer Protection & Commerce.

Respectfully submitted on behalf of the members of the Committee on Health,

____________________________

GREGG TAKAYAMA, Chair

SSCR740 Jane Lee SSCR Ainoa Naniole 2 25 2025-02-21T01:14:00Z 2025-02-25T23:24:00Z 2025-02-25T23:24:00Z 2 317 1718 House of Representatives 21581 73 23 2032 16.00 Print 0 0 false false false EN-US JA X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman",serif;}

STAND. COM. REP. NO. 740

Honolulu, Hawaii

RE: S.B. No. 1438

S.D. 1

Honorable Ronald D. Kouchi

President of the Senate

Thirty-Third State Legislature

Regular Session of 2025

State of Hawaii

Sir:

Your Committee on Commerce and Consumer Protection, to which was referred S.B. No. 1438 entitled:

"A BILL FOR AN ACT RELATING TO HOME CARE AGENCIES,"

begs leave to report as follows:

The purpose and intent of this measure is to prohibit home care agencies from providing services outside the scope of their facility license.

Your Committee received testimony in support of this measure from the Department of Health and two individuals.

Your Committee finds that services authorized to be provided under a home care agency license do not include services that would otherwise require a nursing license pursuant to chapter 457, Hawaii Revised Statutes. Despite this limitation, some operators of home care agencies are providing skilled nursing services that are not being rendered by licensed nurses, putting patients' safety at risk. This measure will enable the Department of Health to pursue enforcement actions against home care agencies that provide unauthorized services without the requisite licensure, thereby increasing public safety and ensuring home care agencies do not exceed the scope of their authorized services.

Your Committee has amended this measure by:

(1) Inserting an effective date of July 1, 2050, to encourage further discussion; and

(2) Making a technical, nonsubstantive amendment for the purposes of clarity and consistency.

As affirmed by the record of votes of the members of your Committee on Commerce and Consumer Protection that is attached to this report, your Committee is in accord with the intent and purpose of S.B. No. 1438, as amended herein, and recommends that it pass Third Reading in the form attached hereto as S.B. No. 1438, S.D. 1.

Respectfully submitted on behalf of the members of the Committee on Commerce and Consumer Protection,

________________________________

JARRETT KEOHOKALOLE, Chair

SSCR501 SMA SSCR Ainoa Naniole 2 9 2025-02-07T21:42:00Z 2025-02-13T20:54:00Z 2025-02-13T20:54:00Z 2 283 1505 House of Representatives 21316 64 19 1785 16.00 Print 0 0 false false false EN-US JA X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman",serif;}

STAND. COM. REP. NO. 501

Honolulu, Hawaii

RE: S.B. No. 1438

Honorable Ronald D. Kouchi

President of the Senate

Thirty-Third State Legislature

Regular Session of 2025

State of Hawaii

Sir:

Your Committee on Health and Human Services, to which was referred S.B. No. 1438 entitled:

"A BILL FOR AN ACT RELATING TO HOME CARE AGENCIES,"

begs leave to report as follows:

The purpose and intent of this measure is to prohibit home care agencies from providing services outside the scope of their facility license.

Your Committee received testimony in support of this measure from the Department of Health and Hawaiʻi Association of Professional Nurses.

Your Committee finds that some operators of home care agencies (HCAs) provide skilled nursing services to clients that are not rendered by a nurse licensed pursuant to chapter 457, Hawaii Revised Statutes. Your Committee further finds that because the State Board of Nursing may not have the authority to regulate unlicensed providers of nursing care employed by HCAs, providing the Department of Health with the authority to ensure appropriate services are provided will more effectively protect patient safety. This measure clarifies that the Department of Health may take enforcement action against HCAs that provide services outside of the scope of their license.

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. 1438 and recommends that it pass Second Reading and be referred to your Committee on Commerce and Consumer Protection.

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

________________________________

JOY A. SAN BUENAVENTURA, Chair

Date	Testimony PDF
Mar 25, 2025	SB1438_SD1_TESTIMONY_CPC_03-25-25_.PDF
Mar 19, 2025	SB1438_SD1_TESTIMONY_HLT_03-19-25_.PDF
Feb 19, 2025	SB1438_TESTIMONY_CPN_02-19-25_.PDF
Feb 5, 2025	SB1438_TESTIMONY_HHS_02-05-25_.PDF

Discussed in Hearing

1MIN

Authors shown for version:
SB1438_HD1 (3/31/2025)

SB 1438: Home Care Agencies; Prohibitions; Limitations

Current Status:

House Standing Committee on Consumer Protection & Commerce

House Standing Committee on Health

House Standing Committee on Human Services & Homelessness

Senate Floor