Honolulu Senior AdvisorWhat qualifications does a Hawaii ARCH primary care giver need?
A Type I ARCH primary care giver must be a Hawaii resident at least 21 years old, at least a nurse aide, living in the home (or hired by a licensee who does not), trained through the department's ARCH teaching modules, and experienced with at least one year of full-time nurse aide work in a licensed facility, home health agency or hospital (HAR 11-100.1-8).
They must also have first aid, CPR, nutrition and behavior management skills appropriate to the residents, enough English to meet the rules, and complete six hours of documented training a year. The department may require a physical or mental health examination if it doubts the care giver's capability.
What about substitute care givers?
Every ARCH and expanded ARCH must have a primary care giver present at all times unless a qualified substitute care giver is covering (HAR 11-100.1-3); in foster family homes the substitute must be approved by the department, at least 18, and at least a nurse aide if giving three or more hours of care a day (HAR 11-800-41).
Substitutes are where small-home care is most variable. Ask how many hours a week the substitute covers, whether it is the same person each time, and whether the substitute has been trained on your parent's care plan, which the rules require for expanded ARCH residents (HAR 11-100.1-87).
What qualifications do foster family home caregivers need?
A foster family home primary caregiver must live in the home and be a nurse aide, LPN or RN with at least one year of experience in a home setting, at least 21, cleared for tuberculosis and background, trained in CPR, first aid and infection control, and able to provide or arrange transportation (HAR 11-800-41).
The primary caregiver attends 12 hours of in-service training a year and the substitute 8, and the department assesses both for competency in the specific skills each resident's service plan requires.
What should a family verify about the care giver?
Verify who the named primary care giver is, that they live in or staff the home as the license requires, their nurse aide status, how long they have run this home, and who covers when they are out.
- Ask to see training records; the rules require them to be documented and current.
- Ask how the care giver learns about a new resident's medications: from the physician, a pharmacist or the case manager.
- Ask what happens if the primary care giver gets sick for a week.
- Read the home's inspection reports for citations involving staffing or training.
At a glance
| The rules require | The rules do not require | |
|---|---|---|
| Primary care giver | Nurse aide minimum, 21+, a year of experience | A licensed nurse in the home |
| Presence | A primary or qualified substitute present at all times | A second awake staff member at night |
| Training | 6 hours a year (ARCH), 12 hours (CCFFH primary) | Dementia-specific certification |
| Nursing oversight | An RN case manager for E-ARCH and CCFFH residents | RN visits for regular ARCH residents |
Sources include Hawaii Administrative Rules chapters 11-100.1, 11-90 and 11-800, HRS 321-481 and 321-1.8, Office of Health Care Assurance rosters and pages, the 2026 HHS poverty guidelines, CMS, CareScout and VA rate tables as cited above; see our editorial standards.
