HONOLULU (HawaiiNewsNow) - People who care for the elderly say our kupuna may be at risk as more care homes operate without licenses or state oversight.
The Health Department wants more enforcement power to help them identify operators who are breaking the law.
But supporters of the unlicensed homes argue they are legal.
Lawmakers called in stakeholders on Wednesday to discuss how to take on what they call a fast-growing problem.
Hundreds of care homes are now operating without inspections, insurance, or other regulations.
Those who are regulated say if nothing is done, many more will choose to go off the state radar.
"I had at least 100 ARCA (Alliance of Residential Care Administrators) members there that can attest to not wanting to be regulated if it's gonna continue at this pace, with the unlicensed care homes not having to follow the rules and regulations of the state of Hawaii," said Wannette Gaylord, owner of Gaylord's Adult Residential Care Home.
There are approximately 1,700 legal licensed care facilities serving 12,300 residents in Hawaii. But case managers estimate there are more than 300 other unlicensed care homes in Honolulu alone, which the Department of Health has no oversight over.
"We're not policeman, we're not law enforcement. We're regulatory inspectors. If someone says, 'This is private property. Please get off my property.' That's what we do," said Keith Ridley, the Department of Health's Office of Health Care Assurance Chief.
House Bill 1911 would authorize the Department of Health to investigate care facilities reported to be operating without a license and allow penalties for violations.
The current law states if health care is provided in a home to someone who is not a family member, a license is required. However, a growing number of homeowners claim to rent to elders while health care is provided by a contracted agency, so they say they don't need a license.
Leading lawmakers say that can be dangerous.
"These unlicensed care homes do not have any training or experience for caregivers, there's no criminal background checks, they can be a murder or rapist and care for people," said Rep. John Mizuno, Chair of the Health & Human Services Committee.
Case managers told lawmakers if HB1911 does not pass, it will send a strong message to the public that it is OK to be unlicensed.
"A lot of our foster homes are saying, once this bill doesn't pass, I'm gonna close my home and open unlicensed. Because why not? They don't have to carry insurance," case manager Elsa Talavera said.
There are competing ideas about how to handle this issue which will now be debated between house and senate negotiators.