HomeMy WebLinkAbout2016, 3-2-2016 Committee on Aging Minutestr or
William P. Kenoi�r'" !r
Mayor
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 Are Keohokalole Highway, Kailua-Kona, Hawai'i 96740
Phone (808) 323-4390 • Fax (808) 323-4398
COMMITTEE ON AGING
Minutes
March 2, 2016
CALL TO ORDER: The meeting was called to order at 10:00 a.m.
INTRODUCTIONS:
C. Kimo Alameda, Ph.D.
Executive on Aging
OFFICERS PRESENT: Meizhu Lui, Chair (North Hilo); Judy Bell, Vice -Chair (North
Kona); Donna Payesko, Secretary (North Kona)
MEMBERS PRESENT: Dorothy Baxter (Lower Puna); Jim Cisler (PABEA); Chris Ridley
(Life Care Center, Hilo and Alzheimer's Association); Michael Sumja (North Kohala),
Rowena Tiqui (Kona Adult Day Center), Earl Tanaka (Hamakua); Robert Masuda
(AARP/South Kohala)
Ex -OFFICIO MEMBERS PRESENT: Susan Akiyama (Housing), J. Yoshimoto (Legal),
Tamila Singleton (Social Security),
OFFICE OF AGING AND GUESTS: C. Kimo Alameda, Executive; Luana Ancheta-
Kauwe, I&A Clerk; Debbie Shimizu, State Executive Office of Aging (EOA); Leolinda
Parlin, State Executive Office of Aging (EOA); Teana Kaho'ohanohano, Regency Hilo; and
Jesse Floyd, Developmental Disability
EXCUSED: Amos Meyers (Upper Puna); Lily Inouye (South Hilo); Steve Ono
(HARA/South Hilo); George Ito (Sounth Hilo); Tiffany Kai, Mass Transit Administrator;
Aaron Ueno, District Health Officer, Department of Health; and Tim Kitagawa (DOH - Adult
Protective Services)
The minutes of
December 2, 2015 meeting was approved. The motion to approve was made by Chris
Ridley and seconded Michael Sumja.. The motion passed unanimously.
Hawaii County is an Equal Opportunity Provider and Employer.
An Area Agency on Aging
COMMENTS FROM THE CHAIR:
Meizhu Lui mentioned that Teana Kaho'ohanohano, Regency Hilo was introduced and is
interested in becoming a member on the Committee on Aging.
M. Lui mentioned in memoriam, Phyllis LaForge, who was sworn in at the last meeting,
passed away suddenly in early January. Condolences to her loved ones.
M. Lui discussed the committee membership. Tim Kitagawa may be joining the Committee
on Aging. Tamila Singleton is precluded from joining due to regulations and will remain ex -
officio. The only difference between members and ex -officio members is voting.
STATEMENTS FROM THE PUBLIC (Agenda Items): There were no public comments.
EXECUTIVE REPORT
C. Kimo Alameda reiterated that Teana Kaho'ohanohano, Regency Hilo, be considered
for membership on the committee. Now that she is working at Regency Hilo, she has time
available to devote to the committee as well as the obvious interest in issues related to
aging.
K. Alameda mentioned parking issues at the Aging and Disability Resource Center
(ADRC). The size of the stalls is inconsistent. The issues with inconsistent signage and
reserved spaces (closer to the building) is being looked at and trying to attempt to strike a
balance between the needs of the office staff and consumers.
K. Alameda mentioned the committee wanted to take a look at how they are doing and
what is being accomplished. There are about 350 clients receiving meals, housekeeping,
bathing, etc. Trying to find a balance between the pay/benefits for the aides. Is it better to
use an agency (getting background check, important); generally better than private hire.
The committee feels it is important that we encourage the use of agencies to get these
benefits. The consensus is that we need more CNAs, and we need to support the
agencies (only about six agencies right now). Generally the process is that Services for
Seniors does the referral and that is a good check and balance. The agency is not doing
the evaluation to minimize risk that unnecessary services will be recommended due to the
inherent conflict of interest.
K. Alameda reported on the following:
►The Big Island caucus regarding legislative spending should remain status quo. That's
the word from the legislators.
No- Marketing — K. Alameda has been evaluating Jim's suggestions. The capacity to help is
there. Timeline for services - 24 hours for medical; one week all else; meals one month
(requires advance for site prep) the bored/lonely addressed @ meal site. Also, working
on a trifold brochure format.
►On the Area Plan just waiting for one more affirmation from the State which is needed
for formal adoption and getting good feedback from them.
No- K. Alameda reported that the data merge is on March 15th. This is the date that the
merge will take place between Hawaii County Office of Aging (HCOA) and the State
Executive on Aging (EOA). Kimo is hopeful it will work out.
OUTSTANDING OLDER AMERICANS LUNCHEON
Jim Cisler reported that the Older Americans event is meeting with EOA and gathering
donors and sponsors. These will be people, businesses that service the older citizens.
Kimo wants the event to be a sustaining and the focus of which is to recognize outstanding
older American. Jim's involvement at the state level is helpful. The date is May 6, 2016, at
the Hilton Waikoloa Village Resort. Looking at changing the process. Want to recognize
all who are nominated as outstanding. If a person gets nominated at the County event
they will be recognized. Then based in minimum criteria, names will be placed in a
drawing one or more times based on the nomination criteria. More criteria, more chances
in drawing. We will then pick one male and one female from the all the nominees to go to
Honolulu. Interesting that the purpose originally was to acknowledge those who had
served in military and not necessarily age -based. Want to shift focus away from getting
more credit solely based on age.
AGENCY AND DISTRICT REPORTS — None.
LEGISLATIVE PRIORITIES: PABEA (Jim Cisler) and AARP (Bob Masuda)
Jim Cisler reported on legislative update. The big priority is the long-term care support
services bill. The Senate version of the bill was deferred and the House version is alive
but is not looking good. Probably not happening this session, but it will survive until next
session.
► The public awareness campaign - legislative approval for $500K working on a solution
to find where the need is for funding.
► Kupuna care increased funding and reflects additional use from last year and the needs
of different counties.
► Jim encourages all to use the legislative process. It makes a difference in the process
and is effective.
Meizhu Lui asked what is the financing component of the bill? Is there a use of a small
percentage of GET to long-term care? Not sure.
Robert Masuda, AARP - Long term Care Act - the priority is about discharge planning and
the requirement that a family member be identified and trained prior to discharge.
Hospitals are concerned about the liability aspect and the impact on their processes they
have in place. AARP is hopeful that might find a place of agreement because the issue is
important. Our county has a different position. A suggestion is to invite AARP and
hospital reps to present after legislative session to discuss where the issue is going.
On March 10, 2016, AARP in Hilo is sponsoring the "I Love Caregivers' event at the Hilo
Hawaiian from 9:00 a.m. to 12:00 p.m.
With regard to the legislative process, it was noted that if our committee is going to submit
testimony it must go through the Mayor's office.
Meizhu Lui mentioned that the HHSC is privatizing Honoka'a Hospital. The concern in the
community is about the obvious issues with privatizing.
DEBBIE SHIMIZU — REPORT AND DISCUSSION ON "NO WRONG DOOR"
Power point presentation (see attached handout)
Debbie Shimizu and Leolinda Partin from the State office reported "No Wrong Door
(NWD)". There is a three-year grant for NWD. We are in the implementation phase.
NWD is meant to provide a streamlined referral process between different agencies. The
grant is $850,000 per year for implementation and infrastructure. The idea is that a
consumer need only tell their story once and have all the agencies communicate with each
other.
There is information available at: http://hinwd.blogspot.com, including meeting information,
notes from meetings, links to documents and comments.
The overall idea of NWD is to help all agencies and consumers navigate the system
together and to provide support for agencies to work together. The SOA wants to hear our
concerns.
Question from R. Masuda. How does this improve services to the consumer? There is a
higher level of service, more awareness, more tools for staff, better information gathering
by staff and helps to avoid misinformation.
Jim Cisler questioned that the NWD has money to do things that ADRC has already
figured out. We hope that ADRC is the dog (not the tail) and that NWD complements
ADRC as opposed to the state changing what an ADRC has already accomplished. The
disability advocate/lobby is strong and we're "out lobbying" the vets also strong lobby, up
to same level. The concern is that the "A" (aging) is not impacted and then the aging
community suffers especially at the county level.
Jim Cisler asked who are the advisory committee. The grant requirements set that out.
There are twenty-four (24) persons on the committee; meeting every other month.
Meizhu Lui asked is this yet another level of red tape? The goal is that the money will be
saved in other areas and money will be available for programs. Also, what will be the
criteria to evaluate the success/impact of the program? Debbie responded that there is
oversight evaluation from the University of Hawaii Disability Center. Evaluation should
include how many more people were served and how they were impacted. The hope is
that this is not just more bureaucracy, but actually improves life for consumers. Looking at
creating a community health worker to assess needs on the ground.
ANNOUNCEMENTS and NEXT MEETING:
Chris Ridley, Alzheimer's Association announced classes in April at the ADRC, and
Kona and Waimea in June. The schedule is on the website. Also, April 16th is National
AHCD day; get them done! Opportunities at the ADRC are on 4/16 and on 4/15 at Life
Care. Also, requested that people go to the website on Alzheimer's.org and register a
team for the walk on 9/17/2016. Registration alone helps — no need to walk.
Meizhu Lui mentioned that it was noted that Lily Inouye was not doing well and may need
to resign from the committee.
Meizhu Lui announced the next meeting: April 6, 2016
ADJOUNMENT: Michael Sumja moved to adjourn and Jim Cisler seconded. The meeting
was adjourned at 12:04 p.m.
Respectfully submitted,
(IV Ate l,Inc�hQn/G1�
Luana Ancheta-Kauwe
Recorder
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NO WRONG DOOR
A System of Access to Long Term Services and Supports
for All Populations and Payers
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RESENTATION
BACKGROUND
WHAT is the No Wrong Door?
WHO Is involved?
WHY do we need the NWD system?
HOW are we going to do this?
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• In 2014, the US Administration for Community Living (ACL), the Centers for Medicare &
Medicaid Services (CMS) and the Veterans Health Administration (VHA) provided grants to
states to plan a "No Wrong Door" (NWD) system that would help individuals stay at home as
long as possible.
• Purpose:
• Make it easier for people of all ages, disabilities and income levels to learn about and
have access to the services and supports they need to keep them in their homes
• Break down silos to better coordinate and integrate the multiple state administered
programs
• Offer people choices and develop a plan for what they want (person -centered)
0 Develop a 3 -year plan to include a detailed strategy and work plan
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• September 2014- Office of Health Care
Transformation (Office of the Governor) received
1 year planning grant
• July 2015, DOH received 3 year implementation
grant ($850,000/ yr for 3 years)
• September 2015, the Governor designated the
Executive Office on Aging (EOA) to lead the 3 year
implementation grant
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WHAT IS THE NO WRONG DOOR SYSTEM?
NWD is a single statewide system of access to long term services and supports (LTSS)* for all
populations and all payers
*LTSS= Long Term Services and Supports means:
• Assistance with activities of daily living (ADL) such as bathing, dressing, toileting, eating or
• Assistance with Instrumental activities of daily living (IADL) such as cooking, driving, shopping,
help with finances or
• Cannot perform ADLs or IADLs due to a physical, cognitive, or chronic health condition that is
expected to continue for an extended period of time, typically 90 days or more
7
WHAT DOES IT MEAN???
The NWD System includes:
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• Public Outreach and Coordination with Key Referral Sources
➢ A coordinated system
➢ Not just one entity. Built upon existing resources and places known to individuals
• Person -Centered Counseling
➢
Based on what YOU want
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• Streamlined Access to LTSS Programs
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Tell your story only once
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➢
Standard process with common protocols
➢
Easier for the consumer
• State Governance and Administration
➢
Advisory committee including partners and stakeholders
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WHO is involved and WHO is it for?
FOA Requirements
12 -month Planning process to generate a 3 -year implementation plan to transform the
state LTSS access function into a No wrong Door System for all populations and all payers.
* Funding
Opportunity
Announcement
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The Hawaii Plan- Our Vision
ARE WE GOING TO DO THIS?
The Aging and Disability Resource Center (ADRC) is the mechanism that we are using to build
the No Wrong Door system.
Develop the current Aging and Disability Resource Center (ADRC) into a fully coordinated,
integrated and person -centered system of long term services and supports (LTSS) for individuals
of all ages, all disabilities and all payers
• Currently ADRCs are at the County Area Agencies on Aging
• ADRCs are designed by the county and are different in each county
• Future- We want to build a network around ADRC
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Aging and Disability Resource
Centers (ADRC)
Information and Referral
• ADRCs provide information and referrals to community service providers, such as adult day
care, transportation, adult crisis intervention, home delivered meals
Intake
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• ADRC specialists listen to the individual's needs and conduct an assessment over the phone
or may meet them in person
• ADRC specialists provide individuals and their families with choices and options about long
term services and supports based on what the individual and their family want
Support Plan
• ADRC specialists assist the individual and their family develop a plan based on what is
important to them
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WHY DO WE NEED A NO WRONG DOOR SYSTEM?
• Meet Federal requirements in managed care rules and
Affordable Care Act guidance for person -centered counseling
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• Strengthen the "D" in ADRC (Aging and Disability Resource Center)
• Current ADRC is primarily focused on the Aging population
We need to strengthen the system for individuals with disabilities and veterans.
• Build a network (ADRCs and pool of providers) to provide counseling and supports
for all participants and populations
• Improve coordination and streamline referral protocols between Doors in the network
so we can provide services more efficiently
• Reduce duplication through data sharing
• Need for sustainable funding
• Diversify funding (Medicaid, Veterans, health plans)
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GOAL: Support all individuals with USS needs make informed choices about their
supports so they can lead meaningful lives
OBJECTIVES:
• Develop the current publicly funded LTSS access points (Doors) into an
integrated, coordinated network
• Expand the capacity of the network to support all populations (Include other
providers)
• Develop infrastructure for training on person -centered counseling
0 Establish diversified and sustainable funding
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NO WRONG DOOR BLOG
http://hinwd.bloaspot.com
• Meeting information
• Notes from stakeholder meetings
• Links to important documents
• Comments
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