Strengthening long term care

In a recent tragic incident on the Big Island, an elderly foster home care client who was suddenly separated from his wife in Hilo and moved to another foster home in Honokaa died within a week of his transfer. Honokaa is about 45 minutes away from Hilo.

The man allegedly did not want to leave his wife, asked care providers to move him back, and called his spouse daily. Although the man received a waiver from the Department of Human Services (DHS) to remain with his wife in a community care foster home in 2007, that waiver was recently rescinded. The case is currently under investigation and cannot be discussed, but it seems that the man's status as a private client and not a Medicaid client was the reason he had to be separated from his wife. Community care foster homes only allow one private patient and two Medicaid patients.

Representative John Mizuno, chairman of the House Human Services committee, today held an informational briefing to discuss ways to prevent another tragic incident like this from occurring.

Lawmakers passed a bill this year which the governor signed into law that would allow two private-pay individuals to live in the same community care foster home under specified conditions. One of those conditions is that one member of the private-pay couple must have lived in the same care home for 5 consecutive years.

Caregivers, community care foster family homes, case managers, the Community Ties of America (CTA) and DHS met with lawmakers to share their concerns about transfer trauma and the need for stronger regulations and oversight of Hawaii's foster care program and its case managers to ensure the best quality care for the aging.

Donna Schmidt, the President of Case Management, Inc., testified in support of drafting a bill the next legislative session to create stronger regulations for case managers.

In her testimony she says, "the case management agency's role in providing oversight and supervision to the foster home is weakened when primary caregivers are unequivocally given the right to transfer clients to new agencies without cause and in particular when they are being openly recruited by case managers who interfere with established relationships between caregivers, clients and their case management agency."

Schmidt adds, the "role of oversight and supervision has been undermined as a result of case management agencies openly soliciting foster homes and encouraging them to transfer clients from one agency to their own. This trend while clearly unethical has become an accepted practice in the industry lowering the standards for all."

Lawmakers, stakeholders and government agencies will work together during the interim to develop solutions through higher case management standards in order to strengthen long term care in Hawaii.