The majority of the licensed care home and foster home operators in Hawaii gladly applaud the state Attorney General’s closing of an aging-in-place (AIP) operator in the Kalihi area. They have been waiting for such an action for a long time. They strongly feel that such a move has long been overdue. Now they can breathe a sigh of relief. They hope the AG’s move serves as an eye-opener for those who plan to open an AIP care home.

The prevalence of unlicensed caregivers makes long-time caregivers feel betrayed and stress. They think there is an ambiguity of the licensing procedure. While others wait a long time to have their licenses issued, members of AIP do not have this problem. They operate their businesses freely.

A case in point is a Salt Lake caregiver who takes care of seven residents. ARCH (Adult Residential Care Home) members licensed by the state Department of Health are allowed only five residents — and only after a rigid and thorough inspection of their homes/facilities.

What kind of services do AIP members provide their residents? Are these done by registered nurses or certified nurse’s aides? Are they providing the care and needs our aging population badly needed? Does the home they are using meet all the requirements, same as those set by the DOH? The safety of the elderly residents is a must. All current caregivers must realize that they eventually will end up in a care home or nursing home. As the saying goes: Do unto others what you like others to do unto you.

Meantime, members of ARCH (those licensed by DOH) feel very strongly that there should be only one state agency to effectively control, oversee and monitor the activities of caregivers — and that agency is DOH. Although some members don’t like DOH’s policy of unannounced visits to their facilities because they feel uncomfortable, especially if one of their residents is being bathed, they realize that there is nothing to worry about as long as they do their job well.

While DOH has its own flaws and shortcomings, these could be rectified by hiring more workers or surveyors to expedite the licenses of qualified applicants. Further, for fairness sake and to avoid favoritism, DOH must ask/instruct the social workers of hospitals and nursing homes that if a discharged patient needs a place to go, DOH should do the placement.

The practice now is that placements are done by case management agencies, which charge monthly fees of $500-$600, and visit the home once a month. Further, this method of placement is unfair. Favoritism exists. Those licensed caregivers who have vacancies for a long time are being left out.

Hawaii residents have the longest life expectancy in the nation. There is a great demand for licensed caregivers. Existing nursing homes in the state cannot meet this demand. The state Legislature must allocate ample amounts to build state-run nursing homes. The DOH also must be given enough funding to hire more surveyors and inspectors to expedite the issuance of licenses to qualified applicants.

We would like to thank and commend leaders of other groups who also express their dissatisfaction of the mushrooming of unlicensed caregivers. Working together, we can make this caregiving industry a group of compassionate, caring and loving people.

Honolulu resident Constante A. Domingo is president of the Caregivers Association of Hawaii; his wife, a nurse, is a care home operator.