Hawaii County Case Management (CM)

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which we see as a waste of money). Our model requires more intensive CM, but moving people off KC after 1 to 6 months allows us to serve more people and reduce the wait list (our KC model means people are less likely to die either in KC or on the wait list). IL What are the problems we see with how Kupuna Care Case Management is currently delivered? A. Services are not delivered equitably to all parts of the island. 47% of case management services are in South Hilo. Rural areas are not as well served. B. It takes too long from a client's initial call to getting services. In looking at the chart on the administrative process, we saw that there are numerous ways to cut the wait time. To start with, using volunteers to take the initial calls, fill out an information sheet, and then wait for Intake specialists to pick up the sheets wastes several days. If I&R staff who are like "walking Rolodexes" took the calls, they could immediately refer to other agencies (VA, transportation..) or to Case Management. C. Client satisfaction is our main concern - and this is NOT a problem. Both HCOA and Services for Seniors which provides Case Management services do evaluations, and Advi- sory Committee hear from residents. All agree that clients are satisfied. III. Compliance with the State 5 year plan The 5 year plan has come and gone. It was from 2011 to 2016, and while we are technically out of compliance, no sanctions were ever placed on us. The plan requested that we bring Case Management in-house. There were three parts to that request. * Intake and assessment: "Hawaii County... must establish the HCOA as the single point of en- try by bringing -house the intake and assessment functions currently performed by the Coordi- nated Services division of the County Department of Parks and Recreation ...." (p. 43) This was accomplished. * Case Management: "Each County will need to get county executive and legislative approvals to restructure case management into an in-house agency function." (p.22) We have not gotten that approval, and the Advisory Committee would not recommend such approval. * Case Management services are to be brought in-house, to conform to the new "common oper- ational model" for all Counties. We disagree that a common model is in the best interests of our Hawaii County kupuna, and would want a chance for our Mayor to negotiate a different model with the state. IV. Advisory Committee recommendations We offer a third option that would resolve some of the problems listed in Section I and also help with the compliance issue: A. We recommend against hiring 5 in-house CMs after the SFS contract runs out at the end of June, 2019. We feel that would be too drastic and rapid a change, disruptive in terms of services, and based on an untested assumption that in-house would work better. B. We recommend one in-house CM/Care Coordinator. This staff person would assign them- selves some cases, and oversee CM and case coordination overall. Preferably, they would