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Committee on Aging Meeting Minutes Friday, September 27, 2019 Page 4 • Workers do not like to travel distances for only a 2 -hour shift. With travel time, it is not worth it. The agencies do pay mileage and travel time, but that also eats up their budget, and may cause them to be unable to give workers raises. D. How does it look from the service provider's point of view including that of the Office of Aging? • Melinda Toa, Mastercare noted that with limited staff, the agencies have to decide whether to add more people to a worker's caseload than they are sup- posed to handle. They also have to prioritize what help is provided - is it personal care? Housekeeping? While the kupuna may need and be eligible for all the above, due to the lack of staff, not every need can be met for the person. Horace said that HCOA has the same issue. They have to prioritize who and how to serve those who need help. • Shinichi Matsumoto, Seniors Helping Seniors said that most able seniors that come to his agency do not want to perform chore services and personal care. Also, he is unwilling to pay exploitative wages; therefore, he's closing up Seniors Helping Seniors (and that will add to our County's shortage)! • Meizhu Lui wondered whether HCOA sets rates too low in order to stretch dollars and serve more people; for example, the rate for case management was very low. This could backfire and cause more to leave these occupa- tions. • Jolean Yamada, HCOA pointed out that what we do in terms of case man- agement and home care is a tiny fraction of all those services performed. Medicaid is the biggest provider and those programs are overseen by the State Department of Human Services (DHS) and the State Department of Health (DOH). Agencies higher than HCOA set the parameters, and we have to figure out how to do the best we can within those parameters. • Michelle Yamasaki, Services for Seniors noted that we are undergoing a generational culture shift: kids and grandkids no longer come around to talk story and help their aging grandparents; that sense of responsibility and com- passion for our elders is ebbing, unfortunately. And due to the burdens of