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State Health Department Aims To Shorten Senior Care Facility Licensing Process

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Hawaii lawmakers held an informational briefing Tuesday on the state's crackdown on unlicensed elderly care homes, but some in the industry say Hawaii Department of Health licensing procedures may have contributed to the problem. 

In 2018, Gov. David Ige signed a law that allowed the health department to investigate care facilities believed to be operating without a valid license and to impose fines for violations of up to $1,000 a day.

The legislation was aimed at ensuring that care homes for Hawaii's growing elderly population are licensed, covered by insurance, subject to health department oversight and checking employees for criminal histories.

Nicole Coglietta, the CEO of CareSift, a company that helps match seniors with care providers, said she would ask unlicensed care home owners if they could apply for their license so they could be used by clients.

“The feedback that I received, years ago, is licensing took an unreasonable amount of time, it took too long and they couldn’t wait, they couldn’t sustain their cost of living,” she said. But Coglietta added things have improved in the past year.

Keith Ridley from the Hawaii Department of Health’s Office of Health Care Assurance said licensing has become more streamlined. In the past, he said the majority of care homes took at least nine months to receive a license, and that some would have to wait longer than a year.

“We have significantly reduced that amount of time. About a third of licenses are now being processed and issued within three to six months,” he said.

Offiicals want to reduce that further, Ridley said. “We are working more with creating templates that new licensees can use to help them to create the polices that they need and that we look for.”

Despite these efforts, Maui Sen. Rosalyn Baker said she did not think the department was doing enough to make the licensing process easier to understand.

“It seems to me that not only are you the agency that needs to be the monitor or the policeman, but you also need to be the instructor and the assistant to make sure that these homes get off on the right foot,” she said.

The problem of illegal care homes had come to a head after lawmakers heard of licensed care home operators who had given up their licenses in order to operate more cheaply outside of state oversight, prompting licensed homes to ask what incentive they had to remain certified.

Demand for care facilities is rapidly expanding as the state's population ages. According to the state Executive Office of Aging, the number of older adults 85 years of age and older will increase by 31.7% by 2030. 

The public can check whether a care home is licensed on the state health department's website but many are marked as "pending."

Ashley Mizuo is the government reporter for Hawaiʻi Public Radio. Contact her at amizuo@hawaiipublicradio.org.
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