323D-2  Definitions.  As used in this chapter:

Terms Used In Hawaii Revised Statutes 323D-2

     “Applicant” means any person who applies for a certificate of need under part V.

     “Assisted living facility” means a combination of housing, health care services, and personalized support services designed to respond to individual needs, and to promote choice, responsibility, independence, privacy, dignity, and individuality.  In this context, “health care services” means the provision of services in an assisted living facility that assists the resident in achieving and maintaining the highest state of positive well-being (i.e., psychological, social, physical, and spiritual) and functional status.  This may include nursing assessment and monitoring, and the delegation of nursing tasks by registered nurses pursuant to chapter 457, care management, monitoring, records management, arranging for, and/or coordinating health and social services.

     “Capital expenditure” means any purchase or transfer of money or anything of value or enforceable promise or agreement to purchase or transfer money or anything of value incurred by or in behalf of any person for construction, expansion, alteration, conversion, development, initiation, or modification as defined in this section.  The term includes the:

     (1)  Cost of studies, surveys, designs, plans, working drawings, specifications, and other preliminaries necessary for construction, expansion, alteration, conversion, development, initiation, or modification;

     (2)  Fair market values of facilities and equipment obtained by donation or lease or comparable arrangements as though the items had been acquired by purchase; and

     (3)  Fair market values of facilities and equipment transferred for less than fair market value, if a transfer of the facilities or equipment at fair market value would be subject to review under section 323D-43.

     “Certificate of need” means an authorization, when required pursuant to section 323D-43, to construct, expand, alter, or convert a health care facility or to initiate, expand, develop, or modify a health care service.

     “Construct”, “expand”, “alter”, “convert”, “develop”, “initiate”, or “modify” includes the erection, building, reconstruction, modernization, improvement, purchase, acquisition, or establishment of a health care facility or health care service; the purchase or acquisition of equipment attendant to the delivery of health care service and the instruction or supervision therefor; the arrangement or commitment for financing the offering or development of a health care facility or health care service; any obligation for a capital expenditure by a health care facility; and studies, surveys, designs, plans, working drawings, specifications, procedures, and other actions necessary for any such undertaking, which will:

     (1)  Result in a total capital expenditure in excess of the expenditure minimum,

     (2)  Substantially modify, decrease, or increase the scope or type of health service rendered, or

     (3)  Increase, decrease, or change the class of usage of the bed complement of a health care facility.

     “Expenditure minimum” means $4,000,000 for capital expenditures, $1,000,000 for new or replacement medical equipment and $400,000 for used medical equipment.

     “Extended care adult residential care home” means an adult residential care home providing twenty-four-hour living accommodation for a fee, for adults unrelated to the licensee.  The primary caregiver shall be qualified to provide care to nursing facility level individuals who have been admitted to a medicaid waiver program, or persons who pay for care from private funds and have been certified for this type of facility.  There shall be two categories of extended care adult residential care homes, which shall be licensed in accordance with rules adopted by the department of health:

     (1)  Type I home shall consist of five or less unrelated persons with no more than two extended care adult residential care home residents; and

     (2)  Type II home shall consist of six or more unrelated persons and one or more persons may be extended care adult residential care home residents.

     “Health” includes physical and mental health.

     “Health care facility” and “health care service” include any program, institution, place, building, or agency, or portion thereof, private or public, other than federal facilities or services, whether organized for profit or not, used, operated, or designed to provide medical diagnosis, treatment, nursing, rehabilitative, or preventive care to any person or persons.  The terms include, but are not limited to, health care facilities and health care services commonly referred to as hospitals, facilities that provide inpatient medical care and other related services for surgery or acute medical conditions or injuries (usually for a short-term illness or condition), extended care and rehabilitation centers, nursing homes, skilled nursing facilities, intermediate care facilities, hospices for the terminally ill that require licensure or certification by the department of health, kidney disease treatment centers including freestanding hemodialysis units, outpatient clinics, organized ambulatory health care facilities, emergency care facilities and centers, home health agencies, health maintenance organizations, and others providing similarly organized services regardless of nomenclature.

     “Health care provider” means a health care facility, physician, dentist licensed under chapter 448, chiropractor licensed under chapter 442, optometrist licensed under chapter 459, podiatrist licensed under chapter 463E, psychologist licensed under chapter 465, occupational therapist subject to chapter 457G, and physical therapist licensed under chapter 461J.

     “Organized ambulatory health care facility” means a facility not part of a hospital, which is organized and operated to provide health services to outpatients.  The state agency may adopt rules to establish further criteria for differentiating between the private practice of medicine and organized ambulatory health care facilities.

     “Person” means an individual or a natural person, a trust or estate, a society, a firm, an assembly, a partnership, a corporation, a professional corporation, an association, the State, any political subdivision of the State, a county, a state agency or any instrumentality of the State, a county agency or any instrumentality of a county.

     “Physician” means a doctor of medicine or osteopathy who is legally authorized to practice medicine and surgery by the State.

     “Primary care clinic” means a clinic for outpatient services providing all preventive and routine health care services, management of chronic diseases, consultation with specialists when necessary, and coordination of care across health care settings or multiple providers or both.  Primary care clinic providers include:

     (1)  General or family practice physicians;

     (2)  General internal medicine physicians;

     (3)  Pediatricians;

     (4)  Obstetricians and gynecologists;

     (5)  Physician assistants; and

     (6)  Advanced practice registered nurses.

     “Review panel” means the panel established pursuant to section 323D-42.

     “State agency” means the state health planning and development agency established in section 323D-11.

     “State health services and facilities plan” means the comprehensive plan for the economical delivery of health services in the State prepared by the statewide council.

     “Statewide council” means the statewide health coordinating council established in section 323D-13.

     “Subarea” means one of the geographic subareas designated by the state agency pursuant to section 323D-21.

     “Subarea council” means a subarea health planning council established pursuant to section 323D-21.

     “Substantially modify, decrease, or increase the scope or type of health service” refers to the establishment of a new health care facility or health care service or the addition of a clinically related (i.e., diagnostic, curative, or rehabilitative) service not previously provided or the termination of such a service which had previously been provided.