Hawaii lawmakers are moving forward with a bill to give state inspectors more power to investigate unlicensed care facilities that have proliferated in the absence of Health Department rules.

House Majority Leader Della Au Belatti on Wednesday sought assurances from state Office of Health Care Assurance Chief Keith Ridley about how he would use the new enforcement authority, which includes the ability to enter unlicensed homes that have received complaints.

“It’s almost the Airbnb of care homes,” she said. “The care models have changed and we haven’t kept up. … That’s why we’re hamstrung.”

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Draft administrative rules to govern whether home care agencies need to be licensed will finally go out to public hearings statewide starting May 14, Ridley said. The department has taken nearly 10 years to create them, exasperating lawmakers.

“I don’t understand why we’re here at this point,” Belatti said, rejecting the “lack of resources” argument. “I don’t know what the solution is. There are so many problems in this area.”

Ridley reaffirmed that his office needs House Bill 1911 to pass before the legislative session ends May 3 so his office can properly investigate reports of unlicensed facilities, often referred to as aging in place homes.

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“This is a regulatory function,” he said. “We are not seeking police powers for criminal investigations.”

His office oversees roughly 1,700 licensed facilities that care for about 13,000 elderly and disabled residents. For license or certification, the operators have to comply with annual inspections, unannounced visits, staffing requirements, criminal background checks, building and fire code requirements, caregiver and resident rights requirements and CPR certification.

But there has been a growing number of reports about unlicensed homes caring for up to 20 people with no state oversight. They are skirting the law by having the residents sign agreements as renters instead of clients receiving health care services, according to lawmakers and licensed care home operators.

“It’s important that everyone is under scrutiny and regulated,” said Kathy Wyatt, who runs an adult day care center in Aiea.

Inspectors have been denied entry into some of the unlicensed homes. Ridley said he has grown increasingly worried about the potential for harm to the residents, since the caregivers are not subject to the traditional regulations.

“It’s probably the most important consumer protection bill that we have before us this 2018 legislative session,” said Rep. John Mizuno, who chairs the Health and Human Services Committee and organized the two-hour briefing for lawmakers Wednesday at the Capitol. It was at least the second such briefing this session.

“Is it perfect right now? Maybe not. We’ll look at what we can do in conference,” Mizuno said, referring to the joint House-Senate committee negotiations that start next week.

It’s one of the last bills related to the elderly that is still alive this session, he said, adding that the overall state budget bill will serve as the vehicle to fund other kupuna programs.

“If this bill doesn’t pass it will send a strong message that it’s OK to be unlicensed,” said Agnes Reyes, who heads a case management group based in Waipahu.

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