Loading...
HomeMy WebLinkAboutSeptember 27, 2019Harry Kim Mayor 1. 04 County of Hawaii OFFICE OF AGING Aging and Disability Resource Center, 1055 Kino'ole Street, Suite 101, Hilo, Hawai'i 96720-3872 Phone (808) 961-8600 • Fax (808) 961-8603 West Hawai'i Community Center, 74-5044 Ane Keohokalole Highway, Kailua-Kona, Hawai'i 96740 Phone (808) 323-4390 • Fax (808) 323-4398 MINUTES COMMITTEE ON AGING MEETING Friday, September 27, 2019, 10:00 AM 1055 Kinoole Street, ADRC Training Room Hilo, HI 96720 Wil Okabe Manaqinq Director CALL TO ORDER: Meizhu Lui, Committee Chair called the meeting to order at 10:05 a.m. INTRODUCTIONS: PRESENT: Members present: Meizhu Lui, Chair; Lito Asuncion, Vice Chair; Judy Bell, Frankie Stapleton, George Ito, Steve Ono, Earl Tanaka, Rowena Tiqui, Ruth Raza, Leonor Corpuz, Charlintorn Burian Ex -Officio present: Duane Hosaka, County Housing Staff members present: Horace Farr, Jolean Yamada, Meredith Catalini, Cherine Pai, Luana Ancheta-Kauwe Guests: Shinichi Matsumoto, Seniors Helping Seniors; Michelle Yamasaki, Services for Seniors; Kara Osada D'Avella, Island CPR; Carol Copeland, Com munity Ties of America; Cionie Patricio, Nurse Aide Training School; Melinda Toa and Carrie Masulit, Mastercare; and Marcie Saquing, Hawaii Island Adult Care Excused Members and Ex-Officios: Jim Cisler; Teana Kaho'ohanohano; Hawaii County is an Equal Opportunity Provider and Employer. NZY An Area Agency on Aging Committee on Aging Meeting Minutes Friday, September 27, 2019 Page 2 Malia Hall, Corporation Counsel; Eric Honda, State DOH; Laron Kageyama, State DOH -APS 3. APPROVAL OF MINUTES OF THE MAY 31, 2019 MEETING Motion - Judy Bell, Seconded - Rowena Tiqui. Unanimously approved 4. WELCOME FROM MAYOR'S MANAGING DIRECTOR, WIL OKABE Wil was not able to attend the meeting, and asked Horace Farr to attend the meeting. Horace mentioned about what he does in the "back of the house," in keeping the necessary data in order, and flowing properly. He has been the office's data plumber! He also assured us that even though it is not yet clear when the Mayor will post the Executive Director position or appoint a different temporary Executive on Aging. The office will continue to run smoothly and deliver services to kupuna as always. He commended the staff for pulling together to make this happen. 5. IN-HOME WORKFORCE SHORTAGE: Discussion with guest experts: Shinichi Matsumoto, Seniors Helping Seniors Michelle Yamasaki, Services for Seniors Kara Osada D'Avella, Island CPR Carol Copeland, Community Ties of America Cionie Patricio, Nurse Aide Training school owner Jolean Yamada, Hawaii County Office of Aging Melinda Toa, Mastercare A. Meizhu Lui started the discussion with some facts about in-home care services. While the majority of caregivers are family members, today our discussion was focused on paid health and chore service personnel. • We have 7500 semi -dependent kupuna on Hawaii Island today which is 28% of the total population. The numbers will rise rapidly and the percentage will also rise. • In the needs assessment conducted last year, the Office of Aging found that people identified the shortage of home -care workers to be a top issue. • While needs continue to rise, the workforce is shrinking. While there are more than enough available jobs, people are not moving to home -care occupations. Committee on Aging Meeting Minutes Friday, September 27, 2019 Page 3 • Currently, many home -care workers, while employed, are either living under the poverty line or barely making it. B. Almost everyone in the room has been a caregiver or has had experience trying to get help for a semi -dependent family member. It's an issue that affects us all! C. What are some of the obstacles to developing this workforce? Why is there a shortage? How does it look from the workers' point of view? • Kara D'Avella, Island CPR said that they tried to start a CNA class in Honoka'a where these services are much needed; even with financial assis- tance only 2 people showed up. While financial aid helps, it is also im- portant that the students pay something; without "skin in the game" they don't take it seriously and may never work in the field. She noted that many don't want to work in an institution, but there are no good alternatives. • Certification renewal is also a problem. It costs $280 and requires 24 -hours of in-service; it's expensive and it is not easy to find places to do the in-service hours. • Cionie Patricio, Nurse Aide Training School said that CNA's are being snapped up by hospitals (especially in Honolulu) which pay $18.00 an hour and up, and home service providers unable to compete with those wages. Hospitals call them "clinical assistants" and they are in huge demand - but still, too few are finding these occupations attractive. • Some of the health aides are being hired privately at $25.00 an hour. For a kupuna who can afford this, that might be ok, but many cannot. • The work itself is stressful. The in-home worker has TWO bosses. One from the agency, and the other one is the kupuna they are caring for. • Steve Ono noted that because of the shortages, existing workers are over burdened. Rather than put someone on the waitlist, a case worker is given yet another person to care for. We do not want people to wait - often they really CAN'T wait - but how much can we put on the existing workforce? Overwork is another reason workers leave the field. • Many who are CNA's would like a career ladder; their goal is to eventually become RN's. 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 Committee on Aging Meeting Minutes Friday, September 27, 2019 Page 5 households now needing two income earners rather than just (typically) the husband, the number of family caregivers is also declining. E. What are some solutions? • From HCOA's point of view, outdated and unnecessary compliance require- ments add administrative burden that waste time and money. • Service providers also have too much paperwork. Build volunteer networks for Kupuna. HCOA's model of Kupuna Care services does this, moving people from Kupuna Care to personal community-based assistance. • Could high school students help fill the gap? Some are looking for a voca- tion rather than college; could start them while in high school be part of the solution? Kara D'Avella, Island CPR said that this is being tried on a small scale. We did not agree as to whether high school age people are "too young" to be able to handle this work. • Care workers need more respect and gratitude so they know they are valued. Calling them "community contributors" as Melinda Toa does in Mastercare rather than "caregivers" or "care workers" helps, making sure they hear the compliments from kupuna can also have a positive effects. Shinichi Matsumoto, Seniors Helping Seniors mentioned that "clustering" having the worker go to several people's homes in one neighborhood to lessen travel burdens - could help; Jolean said that they have been talking about doing just that. • Lito Asuncion remembers a co-op model that was effective. With members signed up from various parts of the island including rural areas, when a call from one of those more hard -to -reach places come in, there is someone available who lives nearby. The co-op no longer exists, but it is a model that needs to be re -visited. F. Concluding remarks 0 NETWORK NETWORK NETWORK! Horace said that the HCOA needs to re -prioritize building networks rather than just the delivery of services. The work we are talking about involves both COMPETENCE and COM- PASSION for the kupuna, for staff, for the agencies, and each other. Committee on Aging Meeting Minutes Friday, September 27, 2019 Page 6 • Meizhu mentioned that raising the minimum wage has been effective in other states to increase the workforce. Hawaii has a legislative proposal that failed last year. There are many others around the country grappling with this issue, and there are several big ideas being proposed: A Care Corps similar to Americorps which would pay stipends and give educational scholarships to high school and/or college graduates who spend time doing caregiving work. A new tax only on wages over $132,000 a year that would fund home care. Some states are proposing tax credits for family caregivers. A national organization, Caring Across Generations (see their website) is doing a good job bringing these issues to the national stage. We should also be working with AARP to start working with our elected representatives for policy changes. She thanked everyone for their lively input, and in hopes that this dialogue can be continued and expanded. There are other agencies, public and private, local and State that will be needed to design a solution. Stay tuned! 7. LEGISLATIVE REPORT: Chalintorn Burian, AARP Chalintorn reported that legislative sub -committee has agreed with the priorities set by AARP for the Hawaii state 2020 session: (1) Hawai'i Saves to help people in jobs that don't provide pension plans to save for retirement through payroll deductions at work; (2) Lowering drug costs; and (3) Improve support to family caregivers. 8. AGENCY AND DISTRICT NEWS AND UPDATES Judy Bell reported that there are two telephone scams going on right now that is mostly targeting seniors. Reminding us to let all our friends know not to give any important numbers and other information to callers you don't know. 9. ANNOUNCEMENTS: None. 11. NEXT MEETING: Wednesday, December 18, 2019 at 10:00 am 12. ADJOURNMENT Meizhu Lui called the meeting to Adjourn at 11:59 a.m. Judy Bell motion to adjourn, Lito Asuncion, seconded. The meeting is adjourned. Submitted by: Meizhu Lui, Committee Chair Recorded by: Luana Ancheta-Kauwe, HCOA