State of Hawaii

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STATE OF HAWAII STATE COUNCIL ON DEVELOPMENTAL DISABILITIES 919 ALA MOANA BOULEVARD, ROOM 113 HONOLULU, HAWAII 96814 TELEPHONE: (808) 586-8100 FAX: (808) 586-7543 February 17, 2016

The Honorable Della Au Belatti, Chair House Committee on Health Twenty-Eighth Legislature State Capitol State of Hawaii Honolulu, Hawaii 96813

Dear Representative Belatti and Members of the Committee:

SUBJECT: HB 2005 HD1 – Relating to Health

The State Council on Developmental Disabilities (DD) SUPPORTS THE INTENT of HB 2005 HD1 to create and establish various policies to adequately address the various issues concerning the elderly and individuals with disabilities and the community healthcare industry while ensuring consumer protection for Hawaii's elderly and disabled.

However, we are concerned specifically with regards to Adult Foster Homes for individuals with DD referenced as a State-licensed care facility.

The Adult Foster Homes (AFH) for individuals with DD are certified and monitored under the Hawaii Administrative Rules, Title 11 Department of Health, Chapter 148 Certification of Adult Foster Homes. This chapter is based substantially upon Chapter 890, “Certification of Foster Family Boarding Home for Children,” Public Welfare Division, Department of Social Services and Housing. [Eff. 9/16/54; am 3/20/87]. Basically, the AFHs were intended to be exactly as a Child’s Foster Home which the individual lives with a family, in the family’s home, in a family environment. AFHs are not facilities, and they were not intended to be a business. They should not be categorized with such businesses because they ARE NOT a State-licensed care facility. Therefore, AFHs should not be included in the list.

Should the Legislature decide to include AFHs for individuals with DD to be subjected to licensure and inspection reports posted on the Department of Health’s website, we propose the following amendments for your consideration:

1. Page 3, line 6: Add “or recertification” after relicensing to read, “Annual inspections for relicensing or recertification may be conducted…”

The Honorable Della Au Belatti Page 2 February 17, 2016

2. Page 3, line 17: Add “or certified” after licensed to read, “caregiver family shall be licensed or certified to ensure the health, safety…”

3. Page 4, line 4: Add “or certification” after license to read, “without a license or certification shall be guilty of a misdemeanor.”

4. Page 4, line 12: Add “or state-certified adult foster homes” after “state- licensed care facilities” to read, “state-licensed care facilities or state-certified adult foster homes.”

Thank you for the opportunity to submit testimony supporting the intent of HB 2005 HD1, and for your consideration of the above proposed amendments.

Sincerely,

Waynette K.Y.“ Cabral, MSW &,,mc.w@@/Josephine C. Woll Executive Administrator Chair

V__‘__V,__n'_\?U»>>__v__mMW”°'9“_n 91”“,hm‘ET@' ___"_'_Mnl_1In“_~’,“'IIW:“My”_~<ﬁ__;[Mg___C_ ___ﬂ_“_A&_9_;Mn?= ‘IaI__HvfEN:4_ ‘_ "Q__ _v‘v\w:H_“’JM____'_I _}g‘I _>5IatIT _\_\\=§___‘ _‘_ I 'U."-@%%\\\‘_‘_q__ DAVID Y. IGE VIRGINIA PRESSLER, M.D. GOVERNOR OF HAWAII DIRECTOR OF HEALTH '___@_

STATE OF HAWAII DEPARTMENT OF HEALTH P. O. Box 3378 Honolulu, HI 96801-3378 [email protected]

Testimony in OPPOSITION to HB2005, HD1 RELATING TO HEALTH

REPRESENTATIVE DELLA AU BELATTI, CHAIR HOUSE COMMITTEE ON HEALTH Hearing Date: Wednesday, February 17, 2016 Room Number: 329

1 Fiscal Implications: Cannot be determined at this time.

2 Department Testimony: Thank you for the opportunity to testify in OPPOSITION to this bill.

3 This HD 1 omnibus bill removed items opposed by the department but continues to

4 contain provisions which the department opposes. However, the department does support or is

5 providing comments on other provisions.

6 Specifically, the department opposes the authority to implement and maintainan online

7 forum to be used by healthcare facilities to post vacancies. An online forum would be an easy

8 way for computer viruses to enter the state system, whether intentional or unintentional and

9 especially without required resources to prevent or monitor postings for viruses. IT hardware

10 and software would be required to implement a forum and IT staffing and management resources

11 would be necessary to monitor and take down inappropriate postings. Finally, the accuracy of

12 vacancy postings could not be easily verified by the state and, as a result, the vacancy listing

13 would become questionable at best. As a result, the department prefers to not have to submit a

14 written report to the 2017 legislature relative to the implementation and maintenance of the

15 forum..

HB2005, HD1 Page 2 of 2

1 Concerning the authority of DOH and DHS to re-designate a nursing bed in a community

2 care foster family home (CCFFH) to private-pay from Medicaid, the department opposes this

3 authority since the CCFFH program was designed to ensure availability of nursing beds in

4 CCFFHs specifically for the Medicaid population. CCFFHs are residential care facilities with

5 two (2) beds, one of which must be Medicaid and the other may be for private-pay clients.

6 CCFFHs may also be allowed to have three (3) beds, but two (2) beds must be for Medicaid

7 patients and only one (1) bed can be for private-pay. The issue surrounding the proposed

8 language in this bill is the ability for married couples to occupy the same CCFFH when both are

9 private pay. However, alternative residential care settings such as ARCHs and E-ARCHs exist

10 in the community that can accommodate married couples or related individuals who are private

11 pay, and, therefore maintains the CCFFH beds for persons on Medicaid. E-ARCHs also

12 accommodate nursing level of care patients as well as patients who are relatively independent.

13 The departments prefer to avoid political pressures that are anticipated for DHS and DOH to

14 exercise the authority to re-designate nursing beds.

15 Concerning issuing a report to the 2017 legislature on late payments, the department is

16 supportive of the intent.

17 Offered Amendments: Technical amendments to identify licensure for ARCHs and E-ARCHs

18 and other types of providers, amendments to identify certification (not licensure) for CCFFHs,

19 and change “developmental disabilities adult foster homes” to “adult foster homes” (their proper

20 name). DAVID Y. IGE RACHAEL WONG, DrPH 4 f;,_.9.f...ﬂ{4 GOVERNOR 41.; DIRECTOR - )3’? I“ . I //,/'.»~'//' 1‘?..'.-ﬂi‘ 1 L-“ PANKAJ BHANOT - $1.2‘ I5 . arr"- "'11 DEPUTY DIRECTOR ...;'..“:'_-Q:_ Q-v* 1: 1' "~.,___ ‘$3....,4)Ax ' ,. 4 ..-'5.. 7'-£2.?@w__-....-¢~t’:/1’. 1 AH 34?“.

STATE OF HAWAII DEPARTMENT OF HUMAN SERVICES P. O. Box 339 Honolulu, Hawaii 96809-0339

Date February 16, 2016

TO: The Honorable Della Au Bellati, Chair The House Committee on Health

FROM: Rachael Wong, DrPH, Director

SUBJECT: HB 2005 RELATING TO HEALTH

Hearing: Wednesday, February 17, 2016, 8:45 a.m. Conference Room 329, State Capitol

DEPARTMENT’S POSITION: The Department of Human Services (DHS) appreciates the circumstances which this bill is trying to remedy, but DHS opposes the bill as it has the potential to reduce access to community services for Medicaid beneficiaries. PURPOSE: The purpose of this Act is to create and establish various policies to adequately address the various issues concerning the elderly, disabled, and the community healthcare industry while ensuring consumer protection for Hawaii’s elderly and disabled. While the Department of Human Services (DHS) appreciates the intent to ensure access to services for the elderly and disabled, we have concerns about potentially reducing access to community services for Medicaid beneficiaries. Community Care Foster Family Homes (CCFFH) were created specifically for the Medicaid program for low-income recipients. The community foster family home was, and still is, an integral part of the long term care continuum of care for the Medicaid program and provides a less restrictive community-based home for Medicaid recipients who are at a nursing facility level of care. The CCFFH allows recipients to remain in the community rather than go into a nursing facility, which is a major national goal and the personal preference for many individuals and families. Currently, CCFFHs are licensed for two residents and may request for a third bed. In

AN EQUAL OPPORTUNITY AGENCY

order to obtain the third bed, it must be for a Medicaid recipient. This bill would permit the Department of Health to allow two private pay residents and only one Medicaid recipient if the two private pay individuals are married or in a civil union. With this change, there is the potential of reduced CCFFH beds for Medicaid recipients, which could result in individuals having to remain for longer periods of time in an acute hospital bed until a community-based bed becomes available, or going into a more costly nursing facility. If this change were enacted, coupled with other changes in the overall long-term care continuum such as the reduction of beds available at skilled nursing facilities, low-income elderly or people with disabilities may have fewer options available to them. Also, there are other alternative residential care setting options, such as Adult Residential Care Homes (ARCHs) and Expanded Adult Residential Care Homes (E-ARCHs) for married couples who are private pay. The latter can accommodate individuals with nursing level of care. Thus, we respectfully oppose the proposed changes so that CCFFHs can be maintained for Medicaid recipients as it is done currently. DHS defers to the Department of Health regarding the proposed licensing changes. Thank you for the opportunity to provide testimony on this bill.

AN EQUAL OPPORTUNITY AGENCY _ *>1%.’=’~'P i ‘ ADULT FOSTER HOME OF THE PACIFIC saw“~ it/..?%/atIn»ii:-¢~ /r_/Q‘ P.O. Box 971450 Waipahu, HI 96797 _ \\\@,%1./

Re: HB2005 — Testimony, Omnibus Caregivers Bill NOTICE OF HEARING DATE: Wednesday, February 17, 2016 TIME: 9:45:00 a.m. PLACE: Conference Room 329 State Capitol 415 South Beretania Street

Aloha, my name is Elma V. Tierra. I am a Community Care Foster Family Home operator, president of the Adult Foster of the Pacific. I am in support of the HB2005 but with comments on the various sections of the bill. 1. Unannounced visit doesn’t ensure the health, safety, and welfare of our elderly 8:, disabled elderly population. But I totally welcome the people who will conduct the inspection for relicensing or recertification. 2. I strongly support that all operator of any community-care home providing healthcare to the elderly or disabled who are un-related to the caregiver family shall be licensed to ensure the health, safety, and welfare of the individuals placed therein. 3. Starting January 2015 the department of Health post deficiencies of all the annual inspections on its Website. Aside from posting, the bill also requires the department to maintain a forum on the website allowing the care facilities operators to post vacancy, and to inform the public for a prospective home for their loved ones. In support. 4. The Office of Health Care Assurance has been persistent for the last 4-5 years, pushing this issue of collecting licensing and re-licensing fees from the care facilities. There are caregivers who take care of Medicaid beneficiaries, they are not compensated enough by the State. It is unreasonable, however, to levy fees on them. I believe $25-50 is a reasonable fee across the board. 5. I strongly support Part VI relating two private pay individuals as long as they are couples living together, married, or in a civil union. They shouldn’t be restricted in living under the same roof.

~ ~’ Elma V. £31->rra, President President, Adult Foster Home of the Pacific Date: February 17, 2016 Time: 8:45 A.M. Place: Conference Room 329 State Capitol 415 S. Beretania Street

RE: HB 2005, HD1- Relating to caregivers Omnibus Bill

Good Morning Chair, Vice Chair, and Members, My name is Lilia Fajotina, Vice President of ARCA(ALLIANCE OF RESIDENTIAL CARE ADMINISTRATORS) I strongly support of HB 2005 but in strong opposition of Part II Section 2 of in the bill. HRS 321 -15.6 has been in existence, I am respectfully asking the Committee to put back the language of the statute”ANNUAL INSPECTIONS FOR RELICENSING SHALL BE CONDUCTED WITH NOTICE, UNLESS OTHERWISE DETERMINED BY THE DEPARTMENT.” Community –based care facilities are governed by different regulations regarding unannounced visits and annual inspection for relicensing. The Department of Health has the jurisdiction of the adult Residential Care Homes under the guidance of HRS 321-15.6. On the other hand, the Department of Human Services has the jurisdiction of the foster family homes using the guidelines under Hawaii Administrative Rules Title 17, Chapter 1454. The current practice of the Department of Health through the Office of Health Care Assurance is to send notice to the care home operator regarding an upcoming annual relicensing inspection. The notice says ”a certain day of the month but it does not announce the exact date.” The reason OHCA has promulgated this system to allow the care home operator to be present during the inspection. There are many reasons that the care home operator to be present during the inspection. There are many reasons that the care home operator is out the house like bringing the residents to their medical appointments, outings with residents, or the care home operator have also personal appointments and errands. OHCA requires that the primary caregiver must be present during the annual relicensing inspection The statute already has the provision for unannounced visits. Anybody from the OHCA can conduct unannounced visits at any intervals at its discretion to confirm correction of deficiencies and to investigate complaints for suspicion of neglect and abuse. The issue of unannounced visit resurfaced last year because a resident passed away in a community- based care facility due to a decubitus ulcer. I do understand the public sentiment regarding the death. There was an emotional debate regarding the issue of “unannounced visit”. But such death could be prevented if caregivers are accountable and responsible for what they do. It only takes some administrative actions and measures to prevent such horrible death. In the care giving industry, nobody wants such death to happen. Unannounced visit could be deterrent but not a solution if caregivers involved in the care of the resident are not doing their responsibilities. What about oversight? Enacting bills for unannounced visit for relicensing survey is not the answer. We need to enforce, ACCOUNTABILITY, RESPONSIBILITY and strong OVERSIGHT. In general, caregivers in all the community-based care facilities are providing excellent care to our aging and frail Kupuna, as indicated by only 2 incidents for the last 25 years.

Thank you for allowing me to testify.

Lilia Fajotina Vice President, ARCA HLTtestimony

From: [email protected] Sent: Tuesday, February 16, 2016 10:55 PM To: HLTtestimony Cc: [email protected] Subject: Submitted testimony for HB2005 on Feb 17, 2016 08:45AM Attachments: AFHA HB2005 2.17.16.pdf

Categories: Blue Category

HB2005 Submitted on: 2/16/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Submitted By Organization Testifier Position Present at Hearing Adult Foster Home Norma Tan Support Yes Association of Hawaii

Comments:

Please note that testimony submitted less than 24 hours prior to the hearing, improperly identified, or directed to the incorrect office, may not be posted online or distributed to the committee prior to the convening of the public hearing.

Do not reply to this email. This inbox is not monitored. For assistance please email [email protected]

1 February l7, 2016

RE: HB2005 HD1 — Testimony in Strong Support of Section V and Requesting Amendments to Section II - HLT 2/17/16 — Rm. 329 8:45 a.m.

Dear Chair Belatti and Vice Chair Creagan, and Members of the Committees:

My name is . I am a member of the Adult Foster Home Association of Hawaii (AFHA) and a proud operator of a Community Care Foster Family Home (CCFFH). I support strongly support HB2005 HD1, especially Section V.

I have dedicated my life to care for my elderly and disabled clients who cannot care for themselves. My family also helps me, because it takes a family to care for these individuals. I make less than $2.00 per hour on Medicaid clients, and I am responsible 24/7.

Please note there are a lot of vacancies for Medicaid clients, and there is no shortage of beds for Medicaid clients. I know homes that have had vacancies for months. I know that the CCFFH program is primarily for Medicaid clients, but we should be sensitive where there is a special relationship between our clients, whether or not they are on Medicaid. Right now, CCFFHs are limited to a maximum of one Medicaid client. It breaks my heart that married couples are sometimes forced to live apart because of this rule. Please, for the sake of these elderly and disabled individuals, allow some ﬂexibility in the rules and have compassion. The health and well-being of these couples deteriorate when they are forced to live apart.

We welcome unannounced visits at anytime, but relicensing visits require us to prepare extra paperwork. We need some notice otherwise there may be delays because paperwork is not complete. This would waste everyone’s time and even the unnecessary revocation of our license, which jeopardizes patient care.

Please pass HB2005 HD1 allowing married couples to live together in CCFFHs regardless of the source of their payment.

Thank you,

Address:

Phone #: February 16, 2016

To: Representative Della Au Belatti Chair, Committee on Health

To: Representative Richard P. Creagan Vice-Chair, Committee on Health

Place: Conference Room 329 State Capitol 415 South Beretania Street Honolulu, HI 96814

Time: 8:45 AM

Hearing Date: Wednesday, February 17, 2016

Regarding: HB Z005, HD1(HSCR263-16)

My name is Sarah Suzuki. lam a Registered Nurse and a Managing Partner for a company called Blue Water Resources (BWR), LLC. BWR has been providing Case Management services to the aged, blind, and disabled population since 2002. We provide Case Management services under various settings: Community Care Foster Family Home (CCFFH), Expanded Adult Residential Care Home (E-ARCH) , and Assisted Living Facility (ALF).

Before admission, patients or their designated representatives are provided with options and information about the Home and Community Based Services (HCBS) and the alternatives. All clients or designated representatives are encouraged to explore the options before they come to a decision of placement. Many factors are considered before choosing a setting. Some of the factors include, but are not limited to, costs, location, if the facility will accept Medicaid clients once the private monies have been spent down, and the caregiver/s. The HCBS is a program of choice. Ultimately, the clients or their designated representatives choose the setting they would like to reside in and their caregiver/s.

I support HB2005, HDI (HSCR263-16), specifically part V. This portion would give the Department of Health (DOH) the flexibility, perhaps via a Waiver, to permit two private—pay individuals to be cared for in the same CCFFH, provided that they meet certain criteria set forth by the DOH. To: Representative Della Au Belatti, Chair, Committee on Health Representive Richard Creagan, Vice-Chair, Committee on Health Members of Health Committee

Date: February 17, 2016, 8:45 AM, House Conference, Rm 329 Re: H.B. 2005, HD1– Relating to Caregivers Omnibus Bill

Aloha Chair Belatti, Vice-Chair Creagan and Committee Members,

My name is Wannette Gaylord, the president of ARCA (Alliance of Residential Care Administrators) and a hands on care home operator. My written and in person testimony is in SUPPORT of HB2005 HD1, with strong OPPOSITION to Part II.

I am humbly requesting that your Committee put back the language of the existing HRS 321-15.6 “Annual inspections for relicensing shall be conducted with notice, unless otherwise determined by the department.”

The current statute requires the Department of Health to send operators notice specifying a specific month and day of the week for their annual relicensing inspection. This ensures that the care home operator is present during the inspection not taking residents to their medical appointments, picking up medications or shopping for food for both the residents and their own families.

That statute also requires the Department of Health to do an unannounced visit annually or more often if applicable.

So please put back the current language of the existing statute, so I won’t feel that I am a prisoner to what I thought was my calling in life.

Mahalo,

Wannette Gaylord

Care Home Operator From: [email protected] Sent: Friday, February 12, 2016 6:22 PM To: HLTtestimony Cc: [email protected] Subject: Submitted testimony for HB2005 on Feb 17, 2016 08:45AM

HB2005 Submitted on: 2/12/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Hawaii Disability Rights Louis Erteschik Comments Only Yes Center

Comments: While the bill addresses many issues related to various care homes, we are testifying in support of Part Five which would allow a private pay married couple to be able to live together in the same Community Care Foster Home.It is important to recognize that there are sometimes unintended consequences to the laws which pass and to correct them when that occurs. It is true that these homes were originally conceived as a way to ensure that the Medicaid population could be cared for in the community.We support that,especially since many of our clients are Medicaid recipients. We know first hand that they need all the services they can receive. Yet, we were touched last year when we read about and saw the plight of the Kawamoto family who were in their 90s and wanted to live out their remaining years together in a care home. We were dismayed when we saw that HB 600 from the past session did not pass. For that reason we made the decision to become more active in the discussion this session and undertake advocacy on behalf of the Kawamotos. We doubt that there is any member of the legislature who feels that their living apart is an acceptable result. We do not know why HB 600 did not pass last year-but we are committed to seeing that this year the Kawamotos are given an opportunity to again share their lives together. The provision in the bill that would provide for this was actually the law in Hawaii for a few years. It contained a sunset clause and as a result it did sunset. It is time to reinstate that as a very limited exception to the overall regulatory scheme for Community Care Foster Homes.It will not alter the overall intent of the homes and it will not detract from its major purpose. There will never be more than an isolated instance where that exception will be applicable.We cannot imagine than anyone thinks it makes any sense to keep the Kawamotos apart. It is heartbreaking and this measure represents an opportunity for the legislature to rectify a very unfortunate situation. Ideally, we would like to see HB 600 convened in the Conference Committee and acted upon so that it can receive the Governor's signature. In the absence of that, we urge the legislature to pass this part of this measure so that the Kawamotos can reside together before it may be too late.

Do not reply to this email. This inbox is not monitored. For assistance please email [email protected] From: [email protected] Sent: Tuesday, February 16, 2016 8:28 AM To: HLTtestimony Cc: [email protected] Subject: *Submitted testimony for HB2005 on Feb 17, 2016 08:45AM*

HB2005 Submitted on: 2/16/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing RACHEL CASTRO Individual Support No

Comments:

Do not reply to this email. This inbox is not monitored. For assistance please email [email protected] From: [email protected] Sent: Tuesday, February 16, 2016 8:27 AM To: HLTtestimony Cc: [email protected] Subject: *Submitted testimony for HB2005 on Feb 17, 2016 08:45AM*

HB2005 Submitted on: 2/16/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Grace Jadulang Individual Support No

Comments:

Do not reply to this email. This inbox is not monitored. For assistance please email [email protected] From: [email protected] Sent: Tuesday, February 16, 2016 8:26 AM To: HLTtestimony Cc: [email protected] Subject: *Submitted testimony for HB2005 on Feb 17, 2016 08:45AM*

HB2005 Submitted on: 2/16/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Franklin Mirasol Individual Support No

Comments:

Do not reply to this email. This inbox is not monitored. For assistance please email [email protected] From: [email protected] Sent: Tuesday, February 16, 2016 8:25 AM To: HLTtestimony Cc: [email protected] Subject: *Submitted testimony for HB2005 on Feb 17, 2016 08:45AM*

HB2005 Submitted on: 2/16/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Linda Mirasol Individual Support No

Comments:

Do not reply to this email. This inbox is not monitored. For assistance please email [email protected] From: [email protected] Sent: Tuesday, February 16, 2016 8:23 AM To: HLTtestimony Cc: [email protected] Subject: *Submitted testimony for HB2005 on Feb 17, 2016 08:45AM*

HB2005 Submitted on: 2/16/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Lorilyn Lagundi Individual Support No

Comments:

Do not reply to this email. This inbox is not monitored. For assistance please email [email protected] From: [email protected] Sent: Tuesday, February 16, 2016 8:22 AM To: HLTtestimony Cc: [email protected] Subject: *Submitted testimony for HB2005 on Feb 17, 2016 08:45AM*

HB2005 Submitted on: 2/16/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Rueda Ramos Individual Support No

Comments:

Do not reply to this email. This inbox is not monitored. For assistance please email [email protected] From: [email protected] Sent: Tuesday, February 16, 2016 8:19 AM To: HLTtestimony Cc: [email protected] Subject: *Submitted testimony for HB2005 on Feb 17, 2016 08:45AM*

HB2005 Submitted on: 2/16/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Royal Solmerin Individual Support No

Comments:

Do not reply to this email. This inbox is not monitored. For assistance please email [email protected] From: [email protected] Sent: Tuesday, February 16, 2016 8:18 AM To: HLTtestimony Cc: [email protected] Subject: *Submitted testimony for HB2005 on Feb 17, 2016 08:45AM*

HB2005 Submitted on: 2/16/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Joel Solmerin Individual Support No

Comments:

Do not reply to this email. This inbox is not monitored. For assistance please email [email protected] From: [email protected] Sent: Tuesday, February 16, 2016 8:17 AM To: HLTtestimony Cc: [email protected] Subject: Submitted testimony for HB2005 on Feb 17, 2016 08:45AM

HB2005 Submitted on: 2/16/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Benita Riingen Individual Support No

Comments: Thank you for allowing me to send my testimony.

Do not reply to this email. This inbox is not monitored. For assistance please email [email protected] From: [email protected] Sent: Tuesday, February 16, 2016 1:46 AM To: HLTtestimony Subject: Fwd: Submitted testimony for HB2005 on Feb 17, 2016 08:45AM

Supporting HB2005

Sent from my iPhone

Begin forwarded message:

From: [email protected] Date: February 15, 2016 at 9:51:53 PM HST To: [email protected] Cc: [email protected] Subject: Submitted testimony for HB2005 on Feb 17, 2016 08:45AM

HB2005 Submitted on: 2/15/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Maria Corazon E. Individual Support No Cariaga

Comments: I am in support for the HB2005 with the recommendation not to mandate the CCFFH , ARCH -E-ARCH & Case Management Agencies to pay an annual fee for certification , recertification, license and relicense because we already helping the state save millions of dollars by providing shelters and services to the sick, aged , disabled population of the community .Instead , we deserve pay raise for working 24/7, 365 or366 days a year.Two private pay individuals should be allow to reside in the same CCFFH . We need to be paid on time with clean claim. ARCH & E-ARCH needs to increase their clients . Thank you for allowing me to testify.

Do not reply to this email. This inbox is not monitored. For assistance please email [email protected] From: [email protected] Sent: Monday, February 15, 2016 11:28 PM To: HLTtestimony Cc: [email protected] Subject: *Submitted testimony for HB2005 on Feb 17, 2016 08:45AM*

HB2005 Submitted on: 2/15/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Ryan Tenorio Individual Support No

Comments:

Do not reply to this email. This inbox is not monitored. For assistance please email [email protected] From: [email protected] Sent: Monday, February 15, 2016 11:27 PM To: HLTtestimony Cc: [email protected] Subject: *Submitted testimony for HB2005 on Feb 17, 2016 08:45AM*

HB2005 Submitted on: 2/15/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Clemente Navalta Individual Support No

Comments:

Do not reply to this email. This inbox is not monitored. For assistance please email [email protected] From: [email protected] Sent: Monday, February 15, 2016 11:26 PM To: HLTtestimony Cc: [email protected] Subject: *Submitted testimony for HB2005 on Feb 17, 2016 08:45AM*

HB2005 Submitted on: 2/15/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Ailyn Navalta Individual Support No

Comments:

Do not reply to this email. This inbox is not monitored. For assistance please email [email protected] From: [email protected] Sent: Monday, February 15, 2016 11:25 PM To: HLTtestimony Cc: [email protected] Subject: *Submitted testimony for HB2005 on Feb 17, 2016 08:45AM*

HB2005 Submitted on: 2/15/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Melania Bermudez Individual Support No

Comments:

Do not reply to this email. This inbox is not monitored. For assistance please email [email protected] From: [email protected] Sent: Monday, February 15, 2016 11:24 PM To: HLTtestimony Cc: [email protected] Subject: *Submitted testimony for HB2005 on Feb 17, 2016 08:45AM*

HB2005 Submitted on: 2/15/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Emma de La Rosa Individual Support No

Comments:

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HB2005 Submitted on: 2/15/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Randy galzote Individual Support No

Comments:

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HB2005 Submitted on: 2/15/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Marisol Galzote Individual Support No

Comments:

Do not reply to this email. This inbox is not monitored. For assistance please email [email protected] To: Representative Della Au Belatti, Chair, Committee on Health Representative Richard Creagan, Vice-Chair

Date: February 17, 2016, 8:45 AM, House Conference, R Re: H.B. 2005, HD1– Relating to Caregivers Omnibus Bill

Aloha Chair Belatti, Vice-Chair Creagan and Committee Members:

My name is Ramon Sumibcay. I am a Care Home Operator and Vice President of the organization ARCA, Alliance of Residential Care Administrators. My written and in person testimony is in SUPPORT of HB 2005 but in strong OPPOSITION of Part II Section 2 of the bill.

HRS 321-15.6 has been in existence, I am respectfully asking the Committee to put back the language of the statute “Annual inspections for relicensing shall be conducted with notice, unless otherwise determined by the department.”

Community-based care facilities are governed by different regulations regarding unannounced visits and annual inspection for relicensing. The Department of Health has the jurisdiction of the Adult Residential Care Homes under the guidance of HRS 321-15.6. On the other hand, the Department of Human Services has the jurisdiction of the foster family homes using the guidelines under Hawaii Administrative Rules Title 17, Chapter 1454.

The current practice of the Department of Health through the Office of Health Care Assurance is to send notice to the care home operator regarding an upcoming annual relicensing inspection. The notice says “a certain day of the month but it does not announce the exact date.” The reason OHCA has promulgated this system to allow the care home operator to be present during the inspection. There are many reasons that the care home operator is out the house like bringing residents to their medical appointments, picking up medications, buying provisions and supplies for the residents, outings for residents, and once in a while a trip to the emergency room. In addition, care home operators have also personal appointments and errands. OHCA requires that the primary caregiver, the care home operator, and the residents must be present during the annual relicensing inspection.

The statute already has the provision for unannounced visits. Anybody from the OHCA can conduct unannounced visits at any intervals at its discretion to confirm correction of deficiencies and to investigate complaints for suspicion of neglect and abuse.

The issue of unannounced visit resurfaced last year because a resident passed away in a community-based care facility due to a decubitus ulcer. I do understand the public sentiment regarding the death. In the 90s, there was another death due to the same cause. There was an emotional debate regarding the issue of “unannounced visit”. But such death could be prevented if people are accountable and responsible for what they do. It only takes some administrative actions and measures to prevent such horrible death. In the care giving industry, nobody wants such death to happen. Unannounced visit could be a deterrent but not a solution if people involved in the care of the resident are not doing their responsibilities. What about oversight? Could we have done a better oversight after the case in the 90s? In other words, enacting bills for unannounced visit for relicensing survey is not the answer. We need to enforce, ACCOUNTABILITY, RESPONSIBILITY and strong OVERSIGHT,

In general, caregivers in all the community-based care facilities are providing excellent care to our aging and frail Kupuna, as indicated by only 2 incidents for the last 25 years. In 2012, Center for Medicare and Medicaid Services (CMS) reported 109 surgical deaths in Hawaii due to preventable complications. There are also many vehicular deaths occurring in our highways. Is there any law passed for conduct unannounced visits to surgical sites or to the DMV’s?

Mahalo for your attention.

Ramon Sumibcay, MHA, BSN, RN MAJ (ret), US Army From: [email protected] Sent: Monday, February 15, 2016 11:18 PM To: HLTtestimony Cc: [email protected] Subject: *Submitted testimony for HB2005 on Feb 17, 2016 08:45AM*

HB2005 Submitted on: 2/15/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Camille A. CARIAGA Individual Support No

Comments:

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HB2005 Submitted on: 2/15/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Lorilyn Lagundi Individual Support No

Comments:

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HB2005 Submitted on: 2/15/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Eden Sales Individual Support No

Comments:

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HB2005 Submitted on: 2/15/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Christina Martinez Individual Support No

Comments:

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HB2005 Submitted on: 2/15/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Francisca Parayno Individual Support No

Comments:

Do not reply to this email. This inbox is not monitored. For assistance please email [email protected] From: [email protected] Sent: Monday, February 15, 2016 11:12 PM To: HLTtestimony Cc: [email protected] Subject: Submitted testimony for HB2005 on Feb 17, 2016 08:45AM

HB2005 Submitted on: 2/15/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Joane E. Cariaga Individual Support No

Comments: Thank you for allowing me to send my testimony. Caregivers should not be charge with an annual fee of certification , recertification, licensing , and relicensing. With the high cost of living it's really hard to make both ends in running this small businesses . Instead we need a pay raise and be paid on time as a reward in helping the state save millions of dollars by giving shelter and a tender loving care for the sick , aged, disabled population of our community.

Do not reply to this email. This inbox is not monitored. For assistance please email [email protected] From: [email protected] Sent: Monday, February 15, 2016 11:02 PM To: HLTtestimony Cc: [email protected] Subject: *Submitted testimony for HB2005 on Feb 17, 2016 08:45AM*

HB2005 Submitted on: 2/15/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Grace Andres Individual Support No

Comments:

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HB2005 Submitted on: 2/15/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Edgar Bartolome Individual Support No

Comments:

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HB2005 Submitted on: 2/15/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Mercidita Tiangsing Individual Support No

Comments:

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HB2005 Submitted on: 2/15/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Dino Cacpal Individual Support No

Comments:

HB2005 Submitted on: 2/15/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Teresita Cacpal Individual Support No

Comments:

Do not reply to this email. This inbox is not monitored. For assistance please email [email protected] From: [email protected] Sent: Monday, February 15, 2016 10:58 PM To: HLTtestimony Cc: [email protected] Subject: Submitted testimony for HB2005 on Feb 17, 2016 08:45AM

HB2005 Submitted on: 2/15/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Frances Marie E. Individual Support No Cariaga

Comments: Thank you for giving the opportunity to send my testimony. Please don't mandate the caregivers to pay their annual fee. Actually they are underpaid . They need pay raise instead and to be paid on time to have their homes open to the aged , sick, disabled population whom they provide shelter and servicing with their daily activities 24/7, 365or 366 days in a year.

Do not reply to this email. This inbox is not monitored. For assistance please email [email protected] From: [email protected] Sent: Monday, February 15, 2016 10:07 PM To: HLTtestimony Cc: [email protected] Subject: Submitted testimony for HB2005 on Feb 17, 2016 08:45AM

HB2005 Submitted on: 2/15/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Maile Jane E. Cariaga Individual Support No

Comments: I am supporting this HB 2005 but please don't mandate the caregivers of CCFFH , ARCH , E-ARCH & Case management agencies their annual fee for certification , recertification, licensing and relicensing . I watched my mother worked hard in rendering help with tender loving care to these individuals who shared a place in her own house.Caregivers in the HCBS needs a pay raise and be paid in a timely manner in order to have their homes open to the needy individuals. Thank you for giving me the opportunity to testify.

Do not reply to this email. This inbox is not monitored. For assistance please email [email protected] From: [email protected] Sent: Monday, February 15, 2016 9:52 PM To: HLTtestimony Cc: [email protected] Subject: Submitted testimony for HB2005 on Feb 17, 2016 08:45AM

HB2005 Submitted on: 2/15/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Maria Corazon E. Individual Support No Cariaga

Do not reply to this email. This inbox is not monitored. For assistance please email [email protected] From: [email protected] Sent: Monday, February 15, 2016 4:23 PM To: HLTtestimony Cc: [email protected] Subject: *Submitted testimony for HB2005 on Feb 17, 2016 08:45AM*

HB2005 Submitted on: 2/15/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Maree Pederson Individual Support No

Comments:

Do not reply to this email. This inbox is not monitored. For assistance please email [email protected] From: [email protected] Sent: Monday, February 15, 2016 4:19 PM To: HLTtestimony Cc: [email protected] Subject: *Submitted testimony for HB2005 on Feb 17, 2016 08:45AM*

HB2005 Submitted on: 2/15/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Jim Baker Individual Support No

Comments:

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HB2005 Submitted on: 2/15/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Rafaela de Jesusr Individual Support No

Comments:

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HB2005 Submitted on: 2/15/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Lena Salom Individual Support No

Comments:

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HB2005 Submitted on: 2/15/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Genevie tuliao Individual Support No

Comments:

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HB2005 Submitted on: 2/15/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Victoria Llasus Baker Individual Support No

Comments:

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HB2005 Submitted on: 2/14/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Noboru Kawamoto Individual Support No

Comments:

Do not reply to this email. This inbox is not monitored. For assistance please email [email protected] From: [email protected] Sent: Friday, February 12, 2016 8:17 PM To: HLTtestimony Cc: [email protected] Subject: Submitted testimony for HB2005 on Feb 17, 2016 08:45AM

HB2005 Submitted on: 2/12/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Jonathan Hanks Individual Support Yes

Comments: Aloha, Chair Morikawa and Committee Members, My name is Jonathan P. Hanks. While the bill HB2005 addresses many issues related to various care homes, I am testifying in support of Part Six which would allow a private pay married couple to be able to live together in the same Community Care Foster Family Home. On April 22, 2009 then Governor Linda Lingle signed SB190 HD1 SD2 into law and said “This is a Great Day, because it ends an Injustice for one family and it brings hope for families who may find themselves in a similar situation”. In November of 2014, the Kawamoto family found themselves in a similar situation and the exact same Injustice as the Kaide family from Hilo had to endure in 2009. it was happening all over again, because of a sunset clause. They identified the problem but they didn’t affix a permanent solution, so history repeated itself. Almost a year ago to this day the Kawamoto family and I were here in this room 329, testifying on HB600. In the last year, I have witnessed the needless suffering, emotionally and spiritually of Noboru and Elaine Kawamoto, who were married under the laws of the State of Hawaii more than 68 years ago. Community Care foster family homes were originally created to serve Medicaid clients who, due to a lack of financial resources, have limited options for long-term care, but this law also punished the Kaide family and more recently the Kawamotos who can afford to pay for their own care. Due to the expiration of the sunset clause of SB190, state regulation was once again causing the separation of another married couple. It is important to recognize that there are sometimes unintended consequences to the laws which pass and to correct them when that occurs. HB600 HD1 SD2 would have rectified this issue but it was dragged out in conference committee and not given a release from Ways and Means/ and or Finance Committee. Yes, we want to preserve adequate space in long- term care facilities for those with limited options such as welfare or Medicaid Recipients. But, NO state regulation should separate a married couple; this is a fundamental right. It is heart wrenching to see Noboru and Elaine Split up. Noboru, a 95-year-old veteran who served the United States in the 100 th battalion, 442 regimental combat team. He fought in World War II for the freedoms we enjoy today. He has been married for 68 years now, this last year has been the first time he has been separated from his wife for any long period of time. Noboru only gets to see his wife for a short visit 2 times a month. Everyday valuable time is lost that could have been shared together. Every day I see the pain in his eyes, and the worry for his wife’s safety. Both Noboru and Elaine wish to be together and cared for at a Community Care Foster Family Home that is the best fit for his and his wife’s personal needs. I don’t think any member of the Hawaii legislature would deny their own family member their right to choose what is best medically or financially. There is an increasing need for community care foster family homes in Hawaii. There is also a recognized need to accommodate private-pay individuals who share a long-term relationship. As the cost of medical care continues to rise, it is becoming abundantly apparent that even those who do not rely on Medicaid for their long-term care cannot afford the cost of private care, leaving this population, also, with limited options. We are asking this committee to strike an appropriate and compassionate balance between meeting the needs of Medicaid clients and meeting the needs of private pay individuals by passing this part of this measure. We would like to see HB600 convened in the Conference Committee and acted upon so that it can receive the Governor's signature. In the absence of that, we urge the legislature to pass this part of this measure so that the Kawamotos can reside together and live out what time they have together. I humbly thank this committee for this opportunity to provide testimony. Jonathan P. Hanks

Do not reply to this email. This inbox is not monitored. For assistance please email [email protected] Feb 16 ‘I6 O2I40a casino 8083297597 p/I

1 a2/1s/zms 15:49 3211491 EVELYN “GE B

Febmuy I5, 2016

To: I-lonnrableRnp.Dc11:AuBelnﬂi—CommittucChlironHcalth RIp.llicha|dP.Cn:I.gm,MD—CoChn1r Rnp.FukamMoC]lIng-COChllt Rzp.Joloulan~CoChair Rap.BerlKobayu.shi——CoCl1air Rcp.Dayn|m:e(Deo)Mozikn\va-OoClni! R=p.Marcua0shIm-CoCinir R:p.A:IIlNO.T||poll—COChair

( lam 6§{~elHv\ CQQH/‘D lumb!ya|p|:x'lingt1\eHB2005withoonnn=|nsiIx Rpldlwcarfiflmfiomxwflfificafinmfiwblilflflflmlincnlili °fCCFH,ARC1:1>E'ARCH'"d ¢|g¢mmagaa.Canpwfidemsh0ddnmben\mdlIdmpaymanmn1fecfmhcanu¢fnd nHwnnwc¢rflficA1tm:wfldfimfimbwmwwemfl:mdyh¢lPi"8‘h”‘mf““m'ui“m”f

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Z00 ll:l:l V8'IV W903 ‘H'I€S3C808T ﬁ".:l SW91 QTOZ/SI/Z0 February 15, 2016

To: Honorable Daynette (Dee) Morikawa, 586-6281 Committee Chair of Human Services

Co. Chairs: Rep. Della Au Belati, 586-9431 Rep. Richard P. Creagan, Md., 586-9608 Rep. Fukumuto Chang, 586-8464 Rep. Bert Kobayashi, 586-6311 Rep. Marcus Oshiro, 586-6702 Rep. Andrea Tupola, 586-8469

Re: House Bill 2005

CCFFH, ARCH, E-ARCH and Case Managers Certification/Recertification/Licensing and Relicensing Fees Care providers should not be mandated to pay above-mentioned fees because the State has been saving millions of dollars from us. Instead of charging us these fees, I strongly believe that we deserve pay raise for providing shelter and services 24/7, 365 days a year for the sick/ aged/ disabled/population of the community.

Two (2) Private Pay in a CCFFH I firmly agree that a 2-private pay individuals who are married or in a civil union should be able to reside in the same CCFFH to preserve their marriage vows.

ARCH Operators Type-1 They should get at least 6 residents plus increase of pay.

E-ARCH Operators Type-2 At least 6 or more residents shall be allowed per discretion of the department.

In general, I strongly support HB 2005.

Hoping that you will consider my testimony.

Respectfully yours,

LIBERTY Q. ALBANO, CNA/PCG CCFFH Operator Member, Big Island Adult Foster Home Operators

6231532915 6?: 32 32T-"148? EVELYN PAGE B1

February 15, 2016

To: Honorable Rep. Della Au Belatti — Committee Chair on Health Rep. Richard P. Creagan, MD — Co Chair Rep. Fukamoto Chang — Co Chair Rep. Jo Jordan — Co Chair Rep. Bert Kobayashi — Co Chair Rep. Daynette (Dee) Morikawa — Co Chair Rep. Marcus Oshiro — Co Chair Rep. Andrea Tupola — Co Chair

I am H humbly supporting the HB 2005 with comments in regards to certification, recertification, licensing and relicensing of CCFH, ARCH, E-ARCH and ease managers. Care providers should not be mandated to pay an annual fee for license and relicense or certificate or reeertifieation because we are already helping the state save millions of dollars by providing shelter and services for the sick, aged and disabled population of the community. Instead, care providers deserve pay raises for working 24/7, 365 days a year.

Two private pay individuals who are married or in a civil union, should be able to reside in the same CCFFI-I to preserve their marriage vows and their rights as a couple.

Care providers deserve to be payed on time with clean claims. Payments in timely manner is rewarding for the care providers.

F2I_tb.e.AB.Q1i Tyre-1 They should be allowed at least 6 residents plus increase ofpay

.F&Lthe_E¢ARC;H§

TY!"-2 At least 6 or more residents should be allowed per discretion ofthe department.

Thank you for giving me the opporttmity to send my testimony.

Sincerely, 02/16/2016 09224 FAX 1808325-3144 EDGAR ALBA FFH 001

I ______‘ ‘______‘_,__ H___,‘ _,\_ Mi."-vi?----.. .v

February 9, 2016

To: Honorable Daynetre (Doc) Morikawa, Commimco Chair of Human Services

Co. Chair Rep. Della Au Bellati, Rep. Richard P. Creagan, M11, Beth Fukummo Chang, Mark Jun ll--lashem, Jo Jordan, Marcus Oshito

r?'_ | I am i\Li1)_(,-\_‘__ humbly supporting the HE 2005 with comments in regards to certification, recertificntion, licensing and reliocnsing of CCFI-L ARCH, E-ARCH and case managers. Care providers should not be mandated to pay an annual fee for license and relicense or certificate or rocerfification because we are already helping the state save millions of dollars by providing shelter and services‘ for the sick, aged and disabled population ofthe community. Instoad, care: providers deserve pay raises for working 24/7, 365 days n year.

Two private pay individuals who am married or in a civil union, should be able to reside in the same CC.F1*I-I lo preserve their mnrriage_ vows. Care providers deserve to be payed on time with clean claims.

For the ARC_i;l

Type-1 They should be allowed at least 6 residents plus increase of pay

For the Q-ARCI-IS

TYIMAt least 6 or more resldents. should be allowed per d.lSC‘l'¢Ii0l'lA of the department.

Thank you liar giving me the opportunity to send my testimony.

Sincerely, -z‘j(Q‘-):y(,.»€(-/l.Q/iﬂze OGM CO. PW-~fbi\ 'Tlf’1¢_; \ ;L-51, \F"lP\’il‘J\l r\uAw\\\ \O(¢- '\4'.|{>¢\L.LJk\{\ \¢-QR) f\ He-l. Clifld-[0 §§l)Ql>“ 1)?»-M5 '7-pl Lia} |,'d detrzosiotqw From: [email protected] Sent: Tuesday, February 16, 2016 9:37 AM To: HLTtestimony Cc: [email protected] Subject: Submitted testimony for HB2005 on Feb 17, 2016 08:45AM

HB2005 Submitted on: 2/16/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Helen Sumoba Sapla Individual Support No

Comments: February 16, 2016 Honorable Chair---Della Au Belatti Honorable Vice Chair---Richard P. Creagan Members: Mark J. Hashem Marcus R. Oshiro Jo Jordan Beth Fukumoto Chang Bertrand Kobayashi Andria P.L. Tupola Dee Morikawa I am Helen Sapla humbly supporting the HB 2005 with some recommendations: State saves millions of dollars by placing the frail elderly, the the mentally and physically challenge individual in our care homes instead in an institution. Due to the coming big waves of elderly generation the state should be more thoughtful without compromising the safety and health of the elderly population. We already have enough rules and regulations in place. All we have to do is to revisit them and see what works and doesn’t work. To improve the industry is to look at the big picture. There should be more open intelligent , practical and common sense approach to different sector of the industry which includes the legislators, health departments, health plans, caregivers, and consumers. Certification/re-certification, licensing and re-licensing of CCFH, ARCH, E-ARCH and Case Managers . We never have pay raise for long time and cost of living is always raising so fast so is in operating our business. Being a small business Care Home operator licensed for three clients these are the basic expenses: Mortgage/rent, homeowner and flood insurance, professional and liability insurance, car payment,car insurance,gas,foods,utilities: water , electricity, telephone,home maintainance/repair, respite caregivers fee $10.00 /hr,GE taxstate taxes for all the commodities we buy for the business 4%.With all the aforementioned expenses there is nothing left for the caregivers. In addition we still have to buy our own private health insurance because we want to maintain our good health to provide good services. Therefore no additional licensing/relicensing fee from caregivers for operating our business. With the love and compassion and good services we provide for our elderly 24/7 we deserve more respect and monetary compensation so we can maintain, improve and continue the quality of care that we are providing now to those needy individuals who depend on us. $46.06 per day per patient for services is just a sacrifice of love. We deserve to have a fair share of the American dream equality and justice for all. I strongly disagree with any licensing/relicensing fee. Private pay patient---CCFCH needs two private pay client either couple or two private individuals not related and a Medicaid patient in order to better operate our business for the benefit of client and caregivers. Thank you very much for this opportunity to testify. Helen Sapla CCFCH operator

Do not reply to this email. This inbox is not monitored. For assistance please email [email protected] From: [email protected] Sent: Tuesday, February 16, 2016 9:39 AM To: HLTtestimony Cc: [email protected] Subject: *Submitted testimony for HB2005 on Feb 17, 2016 08:45AM*

HB2005 Submitted on: 2/16/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Jayvie Sumoba Individual Support No

Comments:

Do not reply to this email. This inbox is not monitored. For assistance please email [email protected] From: [email protected] Sent: Tuesday, February 16, 2016 9:45 AM To: HLTtestimony Cc: [email protected] Subject: Submitted testimony for HB2005 on Feb 17, 2016 08:45AM

HB2005 Submitted on: 2/16/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Jonnel Saloma Individual Support No

Comments: 1. Support pay raise 2. No licensing/relicensing fee 3. Support 2 private pay individual or either 2 private pay not related to each other.

Do not reply to this email. This inbox is not monitored. For assistance please email [email protected] From: [email protected] Sent: Tuesday, February 16, 2016 9:44 AM To: HLTtestimony Cc: [email protected] Subject: Submitted testimony for HB2005 on Feb 17, 2016 08:45AM

HB2005 Submitted on: 2/16/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Genevie tuliao Individual Support No

Comments: 1. Support pay raise 2. No licensing/relicensing fee 3. Support 2 private pay individual or either 2 private pay not related to each other.

Do not reply to this email. This inbox is not monitored. For assistance please email [email protected] From: [email protected] Sent: Tuesday, February 16, 2016 9:42 AM To: HLTtestimony Cc: [email protected] Subject: Submitted testimony for HB2005 on Feb 17, 2016 08:45AM

HB2005 Submitted on: 2/16/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Edna Salom Individual Support No

Comments: 1. Support pay raise 2. No licensing/relicensing fee 3. Support 2 private pay individual or either 2 private pay not realted to each other.

Do not reply to this email. This inbox is not monitored. For assistance please email [email protected] From: [email protected] Sent: Tuesday, February 16, 2016 9:48 AM To: HLTtestimony Cc: [email protected] Subject: Submitted testimony for HB2005 on Feb 17, 2016 08:45AM

HB2005 Submitted on: 2/16/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Alejandro Salom Individual Support No

Comments: 1. Support pay raise 2. No licensing/relicensing fee 3. Support 2 private pay individual or either 2 private pay not related to each other.

Do not reply to this email. This inbox is not monitored. For assistance please email [email protected] From: [email protected] Sent: Tuesday, February 16, 2016 9:47 AM To: HLTtestimony Cc: [email protected] Subject: Submitted testimony for HB2005 on Feb 17, 2016 08:45AM

HB2005 Submitted on: 2/16/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Jopher Salom Individual Support No

Comments: 1. Support pay raise 2. No licensing/relicensing fee 3. Support 2 private pay individual or either 2 private pay not related to each other.

Do not reply to this email. This inbox is not monitored. For assistance please email [email protected] From: [email protected] Sent: Tuesday, February 16, 2016 9:46 AM To: HLTtestimony Cc: [email protected] Subject: Submitted testimony for HB2005 on Feb 17, 2016 08:45AM

HB2005 Submitted on: 2/16/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Romeo Salom JR Individual Support No

Comments: 1. Support pay raise 2. No licensing/relicensing fee 3. Support 2 private pay individual or either 2 private pay not related to each other.

Do not reply to this email. This inbox is not monitored. For assistance please email [email protected] From: [email protected] Sent: Tuesday, February 16, 2016 10:02 AM To: HLTtestimony Cc: [email protected] Subject: Submitted testimony for HB2005 on Feb 17, 2016 08:45AM

HB2005 Submitted on: 2/16/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Francesca Dalere Individual Support No

Comments: 1. Support pay raise 2. No licensing/relicensing fee 3. Support 2 private pay individual or either 2 private pay not related to each other.

Do not reply to this email. This inbox is not monitored. For assistance please email [email protected] From: [email protected] Sent: Tuesday, February 16, 2016 10:01 AM To: HLTtestimony Cc: [email protected] Subject: Submitted testimony for HB2005 on Feb 17, 2016 08:45AM

HB2005 Submitted on: 2/16/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Estela Ellazar Individual Support No

Comments: 1. Support pay raise 2. No licensing/relicensing fee 3. Support 2 private pay individual or either 2 private pay not related to each other.

Do not reply to this email. This inbox is not monitored. For assistance please email [email protected] From: [email protected] Sent: Tuesday, February 16, 2016 10:00 AM To: HLTtestimony Cc: [email protected] Subject: Submitted testimony for HB2005 on Feb 17, 2016 08:45AM

HB2005 Submitted on: 2/16/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Norma Subia Individual Support No

Comments: 1. Support pay raise 2. No licensing/relicensing fee 3. Support 2 private pay individual or either 2 private pay not related to each other.

Do not reply to this email. This inbox is not monitored. For assistance please email [email protected] From: [email protected] Sent: Tuesday, February 16, 2016 9:59 AM To: HLTtestimony Cc: [email protected] Subject: Submitted testimony for HB2005 on Feb 17, 2016 08:45AM

HB2005 Submitted on: 2/16/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Divina Eder Individual Support No

Comments: 1. Support pay raise 2. No licensing/relicensing fee 3. Support 2 private pay individual or either 2 private pay not related to each other.

Do not reply to this email. This inbox is not monitored. For assistance please email [email protected] From: [email protected] Sent: Tuesday, February 16, 2016 9:58 AM To: HLTtestimony Cc: [email protected] Subject: Submitted testimony for HB2005 on Feb 17, 2016 08:45AM

HB2005 Submitted on: 2/16/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Pancho Sumoba Individual Support No

Comments: 1. Support pay raise 2. No licensing/relicensing fee 3. Support 2 private pay individual or either 2 private pay not related to each other.

Do not reply to this email. This inbox is not monitored. For assistance please email [email protected] From: [email protected] Sent: Tuesday, February 16, 2016 9:56 AM To: HLTtestimony Cc: [email protected] Subject: Submitted testimony for HB2005 on Feb 17, 2016 08:45AM

HB2005 Submitted on: 2/16/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Rueda Ramos Individual Support No

Comments: 1. Support pay raise 2. No licensing/relicensing fee 3. Support 2 private pay individual or either 2 private pay not related to each other.

Do not reply to this email. This inbox is not monitored. For assistance please email [email protected] From: [email protected] Sent: Tuesday, February 16, 2016 9:55 AM To: HLTtestimony Cc: [email protected] Subject: Submitted testimony for HB2005 on Feb 17, 2016 08:45AM

HB2005 Submitted on: 2/16/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Nora Rimando Individual Support No

Comments: 1. Support pay raise 2. No licensing/relicensing fee 3. Support 2 private pay individual or either 2 private pay not related to each other.

Do not reply to this email. This inbox is not monitored. For assistance please email [email protected] From: [email protected] Sent: Tuesday, February 16, 2016 9:53 AM To: HLTtestimony Cc: [email protected] Subject: Submitted testimony for HB2005 on Feb 17, 2016 08:45AM

HB2005 Submitted on: 2/16/2016 Testimony for HLT on Feb 17, 2016 08:45AM in Conference Room 329

Present at Submitted By Organization Testifier Position Hearing Robert de la Cruz Individual Support No

Comments: 1. Support pay raise 2. No licensing/relicensing fee 3. Support 2 private pay individual or either 2 private pay not related to each other.

Do not reply to this email. This inbox is not monitored. For assistance please email [email protected] To: Representative Dee Morikawa, Human Services Committee Chair Date: February 11, 2016, 9:30 AM, House Conference, Rmi 329 Re: H.B. 2005 — Relating to Caregivers Omnibus Bill

Aloha Chair Morikawa, Vice-Chair Kobayashi and Committee Members: My name is/'~w»‘~1~1~> M“~"t"l'Jam a Care Home Operator in , My testimony is in SUPPORT of HB 2005 but with comments on the various sections of the bill. Unannounced visit by itself does not ensure the health, safety and welfare of the seniors placed in any of the community-based care facilities. There are already existing statute and administrative rules that govern, control and monitor caregivers under Department of Health (DOH) and the Department of Human Services (DHS), respectively. We just need to enforce responsibility and accountability to all the main players of the caregiving industry. HE! 2005 is a stark reminder or warning that it is a criminal act to operate a care facility not licensed or certified by either DOH or DHS. There have been rumors that people are engaged in that kind of activity. Who is responsible to police such illegal activity? Last year, a law was enacted mandating DOH to post deficiencies of all annual inspections on its website. In addition, HB 2005 requires the department to complete posting within 5-working days upon conclusion of all inspections. Under the current system, I am not sure how the 5 working days be achieved. The department may just have to be more efﬁcient in carrying out these tasks. For the last 4-5 years, OHCA has been pushing this issue of collecting licensing and relioensing fees from the care facilities. There are caregivers who take care of Medicaid beneficiaries, and they are not compensated enough by the State. It is unconscionable to levy fees on them. l believe $25-50 is reasonable fee across the board. HB 2005 brings back the argument whether community-based foster family homes should be allowed to care for 2|-private pay residents. At last years legislative session, we heard the appeal for an elderly couple, one is a private pay and the other is a Medicaid beneficiary, and they wanted to be in the same family foster home. DHS strongly defended the existing regulation that family foster home program was established to accommodate the placement for the Medicaid clients. The family foster home program is partly federally-funded. Undeniabiy, many community-based family foster homes are saving the state millions of dollars by taking care of clients who could be in a nursing home. We are all aware how much it costs to stay in nursing home. Are these caregivers paid enough? Do they deserve fair compensation? Are the Case Management agencies paid enough to handle the case load of foster home residents? The state has the responsibility responding to these questions. if only caregivers are paid in a timely manner, maybe we don’t have to discuss about late payment interest. The burden is on the Ettate to provide fair and timely cornpensation. As described at the beginning, Hawaii's elderly population is growing fast and living longer. It is just logical to increase the capacity of Type I home to 3 skilled~nursing level of care residents [musMahalo for youri\tr»J@~attention. Care Home Administrator B2/15/2915 16:59 3271487’ EVELYN P395 91

Fcbruary 15.2016

T0: Honomblc Rap. Della All Belattl — Commmfle Chair on Healfll Rcp.R1charclP. Cmagfln.MD—COChair Rep. Fukamoto Chang — Co Chaim Rep. Jo Jordan -~ Co Chair Rep. Bert Kobayahi — Co Chair Rap. Daynem: (Doc) M01‘i]t&WIl— C0 Chair Rep. Marcus Oshim — Co Chair Rcp.And1-ea Thpola — Co Chair

1 Rm ZHMIQQ L ~ /iQ§[Q 11umblY WPPMW' thcHB2005withcon'|mentsin mgarcls to cerlification, rcceftificafion, licensing and relicensing ofCCFH, ARCH, E-ARCH and eaae managers. Care providers should nut be manclmadm pay an annual fen: for lloanae and rclicenae or oercificam or rcccrtifiO¢fiOfl bemm wc am already helping the Sf-MC save million: of dollars by lmrviding nhelter and services fin flan aiqk, aged and disabled popumion ofthe community. Instead, eare pmviden deserve pay raises fbr working 24/7, 365 days a year.

'I‘woprivampay individuals whoucmmﬂedorinacivil union, shouldbe ablew reside inthc same CCFFI-I to pi-em-ve thoir mm-riage vows and their rights as a eouple.

Cm providers deserve to bu payed on time with clean claims. Payments in timely manner is rewarding for the aura provldars.

Enx.:ImABQI:1 ‘Um-1 Th¢yBh0lﬂdbcal10WUdatl0a5t6t05id\!niBplusincroaseofpay

EQI.1|I§.F=AB.QHS Type-2 A1 least 6 or more rcrsidenix should be allowed per discretion ofthe department.

Thank you for giving me the opportunity to send my tcatimony.

Sincerely, Q'e[M‘%M" _ ;’flr|/um L. »‘i"uwO /\"Lfl&""\flF

TUU XVH (“T570 ETUZ/Q2/EU Febmary 15, 2016

To: Honorable Rep. Della Au Belatti - Committee Chair on Health Rep. Richard P. Creagan, MD - Co Chair Rep. Fukamoto Chang - Co Chair Rep. Jo Jordan ~- Co Chair Rep. Bert Kobayashi - Co Chair Rep. Daynette (Dee) Morikawa — Co Chair Rep. Marcus Oshiro — Co Chair Rep. Andrea Tupola — Co Chair

lam S0l\iV\'\cT]f)____ humbly supporting the HB 2005 with comments in regards to certification, recertification, licensing and reliocnsing of CCFH, ARCI-I, E~ARCH and case managers. Care providers should not be rnanclated to pay an annual fee for license and relieense or certificate or 1-eeertlficatlonbecausc we are already helping the state save millions of dollars by providing shelter and services for the sick, aged and disabled population of the community. Instead, care providers deserve pay raises for working 24/7, 365 days a year.

Two private pay individuals who are married or in a civil. tmion, should be able to reside in the same CCIFFI-I to preserve their marriage vows and their rights as a couple.

Care providers deserve to be payed on time with clean claims. Payrncnts in timely mmuier is rewarding for the care providers.

For the ARCH.

Typed They should be allowed at least 6 residents plus inerease of pay

For the E-ARCI-_1§

Type-2 At least 6 or more residents should be allowed per discretion of the department.

Thank you for giving me the opportunity to send my testimony,

Sincerely, B2/15/2816 17:12 32?148? EVELYN PAGE Bl.

February 15, 2016

T0: Honorable Rep. DellaAu Belatti — Committee Chair on Health Rep. Richard P.Creagan,MD-C0Cl1air Rep. Fukamoto Chang - Co Chair Rep Jo Jordan — Co Chair . Rep. Bert Kobayeshi - Co Chair Rep. Daynette (Dee) Morikawa — Co Chair RFD. Marcus Oshiro — Co Chair Rep. Andrea Tupola — C0 Chair

Iam Ey)“-\€' D'DlY\§Y\LoQ humbly aupporti.ngtheH;B2005 with commentsin regards In certification, reccrlification, licensing and relicensing of CCFH, ARCH, E-ARCH and case managers. Care providers should not be mandated to pay an annual fee for license and relioense or eertificam or reoerfificalion because we are ah-eady helping the state save millions of dollars by providing shelter and services for the sick, aged and disabled population ofthe community. Instead, care providers deserve pay raises for working 24/7, 365 days a year.

Two private pay individuals who are married or in a civil union, should be able to reside in the same CCFFH to preserve their marriage vows and their rights as a couple.

Care providers deserve to be payed on time with clean claims. Payments in timely manner is rewarding ﬁor the care providers.

hub.e.AB.CH

TYW1 They should be allowed at least 6 residents plus increase efpaty

EQLIhG_E:ARCHS

Type-2 At least 6 or more residents should be allowed per discretion ofthe department.

‘Thank you for giving me the oppoi-u,u;ﬁty to send my testimony,

Sincerely,

Hf-Lie D"@"“’QW lo: Mepleeerfiue Dee Morikawa, Human Services Committee Chair Date: February 11, 2016, 9:30 AM, House Conference, Rm 329 Re: H.B. 2005 ~ Relating to Caregivers Omnibus Bill Aloha Chair Morlkawa, Vice-Chair Kobayashi and Committee Members: My name is />#//?/16% mi»/ti/,1_r,oi a Care Home Operator in"\i(/fir . My testimony is in SUPPORT of HB 2005 but with comments on the various sections bill. Unannounced visit by itself does not ensure the health, safety and welfare of the seniors placed in any of the community-based care facilities. There are already existing statute and administrative rules that govern. control and monitor caregivers under Department of Health (DOH) and the Department of Human Senrioes (DHS), respectively. We just need to enforce responsibility and accountability to all the main players of the caregiving industry. HB 2005 is a stark reminder or wamlng that it is a criminal act to operate a care facility not licensed or certified by either DOH or DHS. There have been rumors that people are engaged in thr kind of activity. Who is responsible to police sum illegal activity? Last year, a law was enacted mandating DOH to post deficiencies of llannual inspections on its website. In addition, HB 2005 requires the department to complete posting within 5-working days upon conclusion of all inspections. Under the current system, I am not sure how the 5 working days be achieved. The department may just have to be more efficient in carrying out these tasks. For the last 4~5 years, Oi-ICA has been pushing this issue of collecting licensing and re- lloensing fees frorn the care facilities. There are caregivers who take care of Medicaid beneficiaries, and they are not compensated enough by the State. lt is unconscionable to levy fees on them. I believe $25-50 is reasonable fee across the board. HB 2005 brings back the argument whether community-based foster family homes should be allowed to care for 2t-private pay residents. At last years legislative session, we heard the appeal for en elderly couple, one is a private pay and the other is a Medicaid beneficiary, and they wanted to be in the same family foster home. DHS strongly defended the existing regulation that family foster home program was established to accommodate the placement for tho Medicaid clients. The family foster home program is partly federally-funded. Undeniably, many community»based family foster homes are saving the state millions of dollars by taking care of clients who could be in a nursing home. We are all aware how much it costs in stay in nursing home. Are those caregivers paid enough? Do they deserve fair compensation? Are the Case Management agencies paid enough to handle the case load of - fomr home residents‘? The slate has the responsibilityresponding to these questions. If only caregivers are paid in a timely manner, maybe we don't have to discuss about late payment interest. The burden is on the Slate to provide fair and timely compensation. As described at the beginning, Hawaii's elderly population is growing fast and living longer. it is just logical to increase the capacity of Type l home to 3 skilled-nursing level of care residents. Mahalo for your attention. - v

C re Home"Mi9%.min‘ r VIA sax 808-58649608

February l7, 2016

RE: HB2005 HDl ~ Testimony in Strong Support of Section V and Requesting Amendments l.‘u Section II — HLT 2/17/16 —- Rm. 329 8:45 a.m.

Dear Chair Belatti and Vice Chair Creagan, and Members of the Committees!

MY name is' E EH _....,,....___??'Q-JD ii gi4 Egjggmher ofthe Adult Foster Home Association of Hawaii (AFI-lA) and a proud operator of a Community Care Foster Falnily Home (CCFFH). I support strongly support HB2005 H.Dl, especially Section V.

l have dedicated my life to care for my elderly and disabled clients who cannot care for themselves. My family also helps me, because it "takes a family to care for these individuals. I make less than $2.00 per hour on Medicaid clients, andl am responsible 24/7.

Please note there are a lot of vacancies for Medicaid clients, and there is no shortage of beds for Medicaid clients. l know homes that have had vacancies for months. I know that the CCFFI-1 program is primarily for Medicaid clients, but we should be sensitive where there is a special relationship between our clients, whether or not they are on Medicaid. R.igl1t11\0W, CCFFH.s are limited to a maximum ofone Medicaid client. It breaks my heal‘! that mﬂ1'1‘iBd couples are sometimes forced to live apart because of this rule. Please, for the sake of these elderly and disabled individuals, allow some flexibility in the rules and have 0011'1P1iESl0l1- The health and well~being ofthese couples deteriorate when they are forced to live apart.

We welcome unannounced visits at anytime, but relicensing visits require us to prepare extra paperwork. We need some notice otherwise there may be delays because PHPBIWOIK is ROI complete. This would waste everyone’s time and even the unnecessary revocation of our license, which jeopardizes patient care.

Please pass HB2005 l-lDl allowing married couples to live together in CCFFHS regardless of the source of their payment.

'l‘h£uik you,

Address: (D'2H)El Phone #1

TElr'lIEl E|ElVd NEi—NSE{ UJ.NE|IWEiVS'El ELLEELLB V3113 ‘3l|ZiZ,"'i?T»"ZlZl Feb.l6.2016 12:59 PM PAGE 1

"/‘7iX: @§,§g2

To: Representative Dee Morikawa, Human Services Committee Chair Date: February 11, 2016, 9:30 AM, House Conference. Rm 329 Re: H.B. 2005 — Relating to Caregivers Omnibus Bill

Aloha Chair Morikawa, Vice-Chair Kobayashi and Committee Members: _ ll‘ei"l

Fl ii I al n r er vi 3 (klare omeAdministrator emaue/lq I R (Fa H no l hgwmr)

gd . . O2/16/160'l!54Pi"l HPFAX80867‘|O901 Pagei

F7iX."T0 580» ¢?¢,,9g

To: Representative Dee Morikawa, Human Services Committee Chair Date: February 11, 2016, 9:30 AM, House Conference, Rm 329 Re: H.El. 2005 — Relating to Caregivers Omnibus Bill Aloha Chair Morikawa, Vice-Chair Kobayashi and Committee Members: My name is 4:-re-W no/some Care Home Operator in rl;,;4,»-as/;~,. My testimony is in SUPPORT of HB 2005 but with comments on the various sections ofthe bill. Unannounced visit by itself does not ensure the health, safety and welfare of the seniors placed in any of the community-based care facilities. There are already existing statute and administrative rules that govern, control and monitor caregivers under Department of Health (DOH) and the Department of Human Services (DHS), respectively. We just need to enforce responsibility and accountability to all the main players of the caregiving industry. HB 2005 is a stark reminder or warning that it is a criminal act to operate a care facility not licensed or certified by either DOH or DHS. There have been rumors that people are engaged in that kind of activity. Who is responsible to police such illegal activity? V Last year, a law was enacted mandating OOH to post deficiencies of all annual inspections on its website. ln addition, HB 2005 requires the department to complete posting within 5-working days upon conclusion of all inspections. Under the current system, l am not sure how the 5 working days be achieved. The department may iust have to be more effioierrt in carrying out these tasks. For the last 4-5 years, OHCA has been pushing this issue of collecting licensing and re- licensihg fees from the care facilities. There are caregivers who take care of Medicaid beneficiaries, and they are not compensated enough by the State. it is unconscionable to levy fees on them. l believe $25-50 is reasonable fee across the board. HB 2005 brings back the argument whether community-based foster family homes should be allowed to care for 2-private pay residents. At last year's legislative session, we heard the appeal for an elderly couple, one is a private pay and the other is a Medicaid beneficiary, and they wanted to be in the same family foster home. DHS strongly defended the existing regulation that family foster home program was established to accommodate the placement for the Medicaid clients. The family foster home program is partly federally-funded. Undeniably, many community-based family foster homes are saving the state millions of dollars by taking care of clients who could be in a nursing home. We are all aware how muoh it costs to stay in nursing home. Are these caregivers paid enough? Do they deserve fair compensation? Are the Case Management agencies paid enough to handle the case load of foster home residents? The state has the responsibility responding to these questions. if only caregivers are paid in a timely manner, maybe we don't have to discuss about late payment interest The burden is on the State to provide fair and timely compensation. ‘ As described at the beginning, Hawaii's elderly population is growing fast and living longer. lt is just logical to increase the capacity of Type I home to 3 skilled-nursing level of care residents. Mahalo for your attention.

tgare fioméfiillfinistrator

ed 7795." c'T@@~ qéﬁﬁp

To: Representative Dee Morikawa, Human Services Committee Chair Date: February 11, 2016, 9:30 AM, House Conference, Rm 329 Re: H.B. 2005 — Relating to Caregivers Omnibus Bill

Aloha Chair Morikaw_a, Vice—Chair Kobayashi and Committee Members: '\/eS'$5y_ ' My name is QM/I Mtbo . I am a Care Home Operator in flndfifij . My testimony is in SUPPORT of HB 2005 but with comments on the various sections of the bill. Unannounced visit by itself does not ensure the health, safety and welfare of the seniors placed in any of the community-based care facilities. There are already existing statute and administrative rules that govern, control and monitor caregivers under Department of Health (DOH) and the Department of Human Services (DHS), respectively. We just need to enforce responsibility and accountability to all the main players of the caregiving industry. HB 2005 is a stark reminder or warning that it is a criminal act to operate a care facility not licensed or certified by either DOH or DHS. There have been rumors that people are engaged in that kind of activity. Who is responsible to police such illegal activity? _ Last year, a law was enacted mandating DOH to post deficiencies of all annual inspections on its website. in addition, HB 2005 requires the department to complete posting within 5-working days upon conclusion of all inspections. Under the current system, I am not sure how the 5 working days be achieved. The department may lust have to be more efficient in carrying out these tasks. For the last 4-5 years, OHCA has been pushing this issue of collecting licensing and relicensing fees from the care facilities. There are caregivers who take care of Medicaid beneficiaries, and they are not compensated enough by the State. it is unconscionable to levy fees on them. l believe $25-50 is reasonable fee across the board. HB 2005 brings back the argument whether community-based foster family homes should be allowed to care for 2-private pay residents. At last year's legislative session, we heard the appeal for an elderly couple, one is a private pay and the other is a Medicaid beneficiary, and they wanted to be in the same family foster home. DHS strongly defended the existing regulation that family foster home program was established to accommodate the placement for the Medicaid clients. The family foster home program is partly federally-funded. Undeniabiy, many community-based family foster homes are saving the state millions of dollars by taking care of clients who could be in a nursing home. We are all aware how much it costs to stay in nursing home. Are these caregivers paid enough? Do they deserve fair compensation? Are the Case Management agencies paid enough to handle the case load of foster home residents? The state has the responsibility responding to these questions. If only caregivers are paid in a timely manner, maybe we don't have to discuss about late payment interest. The burden is on the State to provide fair and timely compensation. As described at the beginning, Hawaii's elderly population is growing fast and living longer. lt is just logical to increase the capacity of Type l home to 3 sKilled—nursing level of care residents.

alo for your a .- Z4 /' . / 1/Ls, V a Hom A inistrator

|,'d Feb 16 16 01I24p Simpliciano Carehome 8086710396 p.1

51X.- 5% ~ "la as

To; Representative Dee Mcrikawa, Human Services Committee Chair Date: February 11, 2016, 9:30 AM, House Conference, Rm 329 Re: HB. 2005 - Relating to Caregivers Omnibus Bill

Aioha Chair Morikawa, Vice-Chair Kobayashi and Committee Members: , _ Q11?!-lA 5I|»iiPi_lc/A Hi: IAECCH/5'51?/4 My name is 5 iiiirm, Atlgl am a Care Home Operator in lmlll’/3 it/1.,/i . My testimony is in SUPPORT of HB 2005 but with comments on the various sections of the bill. Unannounced visit by itself does not ensure the health, safety and welfare of the seniors ptaced in any of the community-based care facilities. There are already existing statute and administrative ruies that govern, control and monitor caregivers under Department of Health (DOH) and the Department of Human Sewices (DHS), respectively. We just need to enforce responsibility and accountability to all the main players of the caregiving industry. HB 2005 is a stark reminder or warning that it is a criminal act to operate a care facility not licensed or certified by either DOH or DHS. There have been rumors that people are engaged in that kind of activity. Who is responsible to police such illegal activity? Last year, a law was enacted mandating DOH lo post deficiencies of all annual inspections on its website. In addition, HB 2005 requires the department to complete posting within 5-working days upon conclusion of all inspections. Under the current system, l am not sure how the 5 working days be achieved. The department may just have to be more efficient in carrying out these tasks. For the last 4-5 years, OHCA has been pushing this issue of collecting licensing and relicensing fees from the care facilities. There are caregivers who take care of Medicaid beneficiaries, and they are not compensated enough by the State. It is unconscionable to levy fees on them. I believe $25-50 as reasonable fee across the board. HB 2005 brings back the argument whether community—based foster family homes should be allowed to care for 2-private pay residents. At last years legislative session, we heard the appeal for an elderly couple, one is a private pay and the other is a Medicaid beneficiary, and they wanted to be in the same family foster home. DHS strongly defended the existing regulation that family foster home program was established to accommodate the placement for the Medicaid clients. The family foster, home program is partly fed erally-funded. Undeniabty, many community-based family foster homes are saving the state millions of dollars by taking care of clients who could be in a nursing home. We are all aware how much it costs to stay in nursing home. Are these caregivers paid enough? Do they deserve fair compensation? Are the Case Management agencies paid enough to handle the case load of foster home residents? The state has the responsibility responding to these questions. lf only caregivers are paid in a timely manner, maybe we dlJn‘t have to discuss about late payment interest. The burden is on the State lo provide fair and timely compensation. As described at the beginning, Hawaii's elderly population is growing fast and living longer. it is just logical to increase the capacity of Type I home to 3 skilled-nursing level of care residents. Mahala for yopr attention. %1aZ~ e re Home Administrator

Hi Feb 16 16 11:32a AIDA CARE HOME 808-234-6517 P4

p.3 F4?‘-‘ 59% W592

To: Representative Dee Morikawa, Human Services Committee Chair Date: February 11, 2016. 9:30 AM, House Conference, Rm 329 Re: H.B. 2005 — Relating to Caregivers Omnibus Bill Aloha Chair Morikawa, \/ice-Chair Kobayashi and Committee Members:

My name is . I am a Care Home Operator in . My testimony is in SUPPORT of HB 2005 but with comments on the various sections of the bill. Unannounced visit by itself does not ensure the health, safety and welfare of the seniors placed in any of the com munity-based care facilities. There are already existing statute and administrative rules that govern, control and monitor caregivers under Department of Health (DOH) and the Department of Human Services (DHS), respectively. We just neect to enforce responsibility and accountability to all the main players ot the caregiving industry. HB 2005 is a stark reminder or warning that it is a criminal act to operate a care facility not licensed or certified by either DOH or DHS. There have been rumors that people are engaged in that kind of activity. Who is responsible to police such illegal activity? _ Last year, a law was enacted mandating DOH to post deficiencies of all annual inspections on its website. In addition, HB 2005 requires the department to complete posting within 5-working days upon conclusion of all inspections. Under the current system, I am not sure how the 5 working days be achieved. The department may just have to be more eflicient in carrying out these tasks. For the last 4-5 years, OHCA has been pushing this issue cf collecting licensing and relicensing fees from the care facilities. There are caregivers who take care of Medicaid beneficiaries, and they are not compensated enough by the State. It is unconscionable to levy fees on them. i believe $25-50 is reasonable fee across the board. HB 2005 brings back the argument whether ccmmu nity-based foster family homes should be allowed to care for 2-private pay residents. At last years legislative session, we heard the appeal for an elderiy couple, one is a private pay and the other is a Medicaid beneficiary, and they wanted to be in the same famity foster home. DHS strongly defended the existing regulation that family foster home program was established to accommodate the placement for the Medicaid clients. The family foster home program is partly federally-furded. Undeniably. many community-based family foster homes are saving the state millions of dollars by taking care of clients who could be in a nursing home. We are ail aware how much it costs to stay in nursing home. Are these caregivers paid enough? Do they deserve fair compensation? Are the Case Management agencies paid enough to handle the case load of foster home residents? The state has the responsibility responding to these questions. lf only caregivers are paid in a timely manner, maybe we don't have to discuss about late payment interest. The burden is on the State to provide fair and timely compensation. As described at the beginning, Hawaii's elderly population is growing fast and living longer. lt is just logical to increase the capacity of Type l home to 3 skilled-nursing level of care residents.

Mahalo for your attention. ,. oer, 44 /7 T re Home Ad Lnistrator ' Aug “I3 O9 O7:36p |-eD no |DU'iIOl-ip p/I p.'i

VIA FAX ans-ssa-9603 February 17, 2016

RE: HBZUUS 1-ID! ~ Testimony in Slrung Support of Section V am! Rlzqhesli hi Section lI— HLT2/17/I6 — Rm. 329 8:45 am. ng Anlenﬂments Dear Chair Belani and Vice Chair Crn.-ag-an, and Members ofthe Co miuees:

.MyIv;1rn:is {C a membT]o£"the Association ofHawaii AF!-IA) arid a proud open-arm cifa C0mmuni£Cam F Adult Foster Home (CCFFH), I support strongly support HBZDOS I-{D1, especially See: n V. aster Family Home I have rlcdicatnd my life zo care for my clderiy and disabled liems w than-isieives. My family also helps me, because it takesafimilyio e fi:|r‘Il'| make less firm $2.00 per hour on Medicaid cl icnts. and l Mn mpcnfiile 2=1J"?.hu cannflt care fiJr est: individuals. I Please note there are a lo: ofvacancies for Medicaid clients, Ind 1h beds for Medicaid clients. Iknow homes that have had vacancits fie: mentbs. is no shortage of CCI-ET-‘H program is prirnariiy for Medicaid cliems, but we should be < ensili special mlfltionship between our clients, whether or no: tiny are on nditrai . I know that the VB where then: is a CCFFI-lsare limited to a maximum of en: Medicaid client. It breaks hea coupiesare: sometimes forced to live apart because nfthis rule. Pleas , for d Righi now, elderly and disabled individuals, ailaw same flexibiiity in the ruiesan have rt tha§me1rir:=d tlha: sake Ofthesc health and well-being afihese eeuplcs deterioiralc when they are forc to I compas.-sinn. The ive apart. We welcome urmrmounced visits at anytime, but relicensing ‘sits r extra paperwork. We need some nntiec otherwise there may be delay; becacquire us to pfflparc complete. This would waste everyitmck time and even the umec U rev whichjeopardizes patient care. ’ Use paperwork is nor ocatien ofour license, Please pass i-[B2005 HDI ailowing marfled muplea :0 Hm: wfledm regardless ofthe source oftheir payment. ‘ n CC.FPHs ")i»~\@.;/i/~<+Thanlcyuu, wr/.4) _ ’“-d""""‘*"‘ qzig L/lb!/U1/101 L0 U]? l/t)¢?\,|[A/LE4;/L Pficnefl: 6i ‘2> r»‘l>r_--rm"!—I!' so ~ W; er S,

To: Representative Dee Morikawa, Human Services Committee Chair Date: February 11, 2018 9:30 AM, House Conference. Rm 329 Re: I-i.B. 2005 »- Relating to Caregivers Omnibus Bill

Aloha Chair Morikawa, Vice~Chalr Kolaayashl and Committee l\/ital-rtltsem. /7rl/€o:.~/ wk y _ My name is ,¢1>44/=?,1,v . I am ta Care Home Opel-aim ifi uJ;t/,0,-(,1,u4. My lBS’(il'fl0i'ty I5 in SUPPORT of HB 2005 but with comments on the various sections of the bill. Unar-nounced visit by Itself does riot ensure the health, safety and lN8'l8i8 oi inc '-3i!l'll1'Ji’S placed in any of the cotnmunityl-based care facilities, There are already e:<.:=iir>g,' statute and administrative rules that govern. oonlrol and monitor caregivers under Deporment of Health (OOH) and the Department of Hurnalt Sam.-ices (OHS), respetrtlvdiy We just nnecl tn enforce responsibility and accountability to all the main players of the caregning trdoswy. HB 2005 is a stark reminder or warning that it is at criminal act to operate: a core laollity not licensed or certified by either DOH or DHSt There have been run1ors;lit';:orsibi<»iy responding to these questions. it only caregivers are paid in a timely manner, maybe we don‘! have lo discuss about tale payment interest‘ Th burden ls on the State to provide ‘Fair and tirnely i.3"l"ilfZl€-3|'\5E!‘llCVl. As described at the laeglnrting, Hawails elderly population is growing fast and living longder. it is just logical to increase the capacity of Type l hot-no to ft nkilledmursing level of care rest en s.

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VIA FAX 308-586-9608

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R52 . HD1 - Tulimony in Strong Support of Seclinn V and R=a-flu tnfiecfinull-HI.T2lJ7!l6-Rm.329 8:45 mm. ' Annulment

Dear Clair Boliﬂi md Vim: Chair Cmagnn, and Mcmbqs oﬂha Cm-um iimezs:

Myllflmflis I Iamamgm nffln Aduit Feats: Home Association of!-Iawzii IAFHA) and a proud npumm of: Commnn Can: Foster Family Homa (CCFFH). lsuppul strongiysupporl HBJ005 HDI, espwidly Sui V. {hams dedicated my iii‘: tn care Bar my elderly and nfnahlcd tlnmselves Myfilnlyn alsohflflime, because |ttaknsufin|ilyinn um' is who mmnot cam Mr mnka!es:ni*n|$?..0DperhourunMedicniddi:uis,nndlmn Iwiwkforthese individuals. 1 24H. Plmenou: thunaze a Jo: mfvacancies for Medicaid clients, budsfi:n'Mcdicaidcliems. 13mowhumesthuhuvelndvar:a.nci=.s months.than‘nsnusbm-mgeofIknowihatlhe CC.FFHprugan1 isp|'i|na:iIyfiJrMadicaid4:U¢n|:,E|nv|a:slmuIdbe ipa:ialII:kIinnlhi;: bt1W¢¢n0|lrGIifl'lB,,\\liln!h::'|I'not‘IllQ}'Ireon ‘tivcwhanelhueisu GCFFHs are limimd to a maximum ofum Merlin-aid cIi:nL It ‘ myedkaid. Right nun, couples are sometimes fnrmd m live I.pa.rt Because ofthis rule. forihesakedflhusc ddtrly and disabled individuals, allow some flcxibility in the rules llnvcoomplssinn. Th: hmlth and well-being ufthuc aouyle: rletcrim-at: when they arc fa d mlivcaparr; ~ We vl-dcnmz mlanmumed visillal anycima, but rclioensing ism mquim as to prepare mdrapupcmnrk. Wemedsnmcuuticcoflmwisaflmm may bedzlql wmplm. This would Wm: everyone’: rim: and wen the un|I\mi¢because pl-pe:|'wu|'k is not rcvnulfiun ofour limos:

Pica: pass I-[B2085 I-IDI allowing Hlflrriedéouplci to live mindless tflhn uoume offlleir jslymmt. flfllfthfl in CCFP'Hs flank % '1 ‘ l.rf-/5 Add!'$$$Z _

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To: Represent iive Della Au Belatti. Chair. Committee on Health Representgtive Richard Creagan, Vice-Chat"

Date: February l7, 2016, 8:45 AM, House Conference, R Re: HB. 2005. HD1— Relating to Caregivers Omnibus Bill

Aloha Chair Belatti, Vice-Chair Creagan and Committee Membersi

My name is ggiviei am a Care Home Operator in Riﬂe Ci . My written testimony is iﬂ SUPPORT Of HB 2005 DUT il"l SIFOHQ OPPOS|T|0N Of Part ii Section 2 of the bill

HRS 321-15.6 h been in existence, I am respectfully asking the Committee to put back the languag of the statute “Annual inspections for relicensing shall he conducted wit?notice, unless otherwise determined by the department."

Community-base? care facilities are governed by different regulations regarding unannounced visi S and annual inspection for relicensing. The Department of Health has the jurisdiction of the Adult Residential Care Homes under the guidance of HRS 321-15.6. On the 0ther hand, the Department of Human Services has thejurisdiction of the foster family homes using the guidelines under Hawaii Administrative Rules Title 17, Chapter 1454. ThE current practice of the Department of Health through the Office of Health Care Assu iince is to send notice to the care home operator regarding an upcoming annual rGlicensing inspection. The notice says “a certain day of the month but it does not announCe the exact date." The reason OHCA has promalgated this system to allow the care me operator to be present during the inspection. There are many reasons that the are home operator is out the house like bringing residents to their medical appointm nts, picking up medications, buying provisions and supplies for the residents, outings for residents, and once in a while a trip to the emergency room, in addition, care ho e operators have also personal appointments and errands. OHCA requires that the rimary caregiver, the care home operator, and the residents must be present during thgannual relicensing inspection.

The statute alrea Y has the provision for unannounced visits. Anyoody from the OHCA can conduct Uf18I%\OLl|'\CBd visits at any intervals at its discretion to confirm correction of deficiencies and l investi gate complaints for suspicion of neglect and abuse.

The issue of unan ounced visit resurfaced last year because a resident passed away in a community-baséid care facility due to a decubitus ulcer. l do understand the public sentiment regardi g the death. In the 90$, there was another death due to the same cause. There was an emotional debate regarding the issue of ‘unannounced visit“. But such death could e prevented if people are accountable and responsible for what they do it only takes s me administrative actions and measures to prevent such horrible death. In the care£iving industry. nobody wants such death to happen. Unannounced visit couid be a de‘lerrent but not a solution if people involved in the care of the resident are not doing their responsibilities. What about oversight? Could we have done a better FEB—16—EEl1E- 14=24 FRUM:LILI H NUNQLES 88848 1 1 186 T81 8885869688 E‘eb.17.20lE 01:13 AM ouvzts czum HOME 2004231002 PAGE in-1/

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To: Representative Dee Morikawa, Human Services Committee Chair Date: February 11, 2016, 9:30 AM. House Conference, Rm 329 Re: H.B. 2005 — Relating to Caregivers Omnibus Bill Alone Chair Morittewa. Vice—Chair Kobayeehi and Committee Members: _ My name lsLi//Q. i\L°i/IQIES l ma Care Home Oporallot‘ lnfis/0“ teotimony is In SUPPORT of HB 2005 but with comment: on the various sections of tho bill. unannounced visit by itself does not ensure the health, safety and welfare of the seniors pieced in any of the community-based care facilities. There are already existing statute and adininistmtive rules that govern. control and monitor regivereunder Department of Health (OOH) and the Department of Human Services (Di-IS). respectively. We luai need to entoroe responsibility and accountability to all the main pioyrs of the oaraglving industry. HB 2005 is a stark reminder or wen-ling that it is a orrninai act to operate e care floiilty not liunsed or certified by either DOH or OHS. There have been rumora that people are engaged in that hind of activity. who is reaponelble to pollea ouch ilegai activity? Last year, a law was enacted mandating DOH to post deficiencies of all annual inspections on its website. in addition, HB 2005 requires the department to complete posting within 5-working days upon conclusion of all inspections. Underthe current syetom. l am not sure how the 5 working days be achieved. The department may lust have to be more oiiicient in carrying out these tasks. For the last 4~5 years, OHGA has been pushing-.thla iasue of collecting licensing and re- licensin lees from the care facilities. There are caregivers who take care or Medicaid bBI’lOflO|lfiBfi, and they are not oompenoallad enough by the Slate. it is unoonaoionabie to levy feee on them. i believe $25~50 is renewable fee across the board. l-iB 2005 brings hack the argument whether oommunlty-baaed foster family homes should be allowed to care for 2-private pay residents. At last years legislative session. we heard the appeal for an elderly couple, one is e private pay and the other la a Medicaid beneficiary, and they wanted to be in the some family foster home. DHS strongly defended the existing regulation that family foster home program was ealgbiiehed to accommodate the pldcumerrl for the Medicaid clients. The family footer home program is partly federally-funded. Undoniebiy, many community-based family footer homes are oevingthe etate millions of dollar: by taking care of clients who eouid be in e nursing homo. We are ell aware how much it coats to stay in nursing homo. Are these caregivers paid enough? Do they duenre lair oompenaailon? Are the Case Management agencies paid enough to handle the case load oi footer homo residents? The state has the responsibility responding to these questione. ifoniy oareglvom are paid in atirnely manner, maybe we don't have to discuss about iota payment. interest. The burden ie on the State to provide fair and timely mmpenaalion. As described attha beginning, I-iawali’a elderly population is growing first and living longer. it is lust logiml to increase the opacity of Type l home to 3 skilled-nuraing level oi care residents. Mehaio for your attention.

ea»are HometideAdministrator

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1 1 I 1 M. Huvl dadznqmd my hf: to em; for my nidcrlg-and dhlnlm whrmunmt um M lhmunlm. My fanuly also helps mu. bnniuu 1: ‘lflulslfnmily mm‘F... mm individuals. ! nuke lm ilnn $2.00 per haw on mama dflems, and lam mpumi la 24:1’. Hem mm ‘mere an n Mofvuauncna hr Madam! chum, lbcrcilnolhonngwaf beds hr Mzdlaaid elianls. uzmw Iwummlm hm lml vuwmiu in onflu. Iknuwlhmlfln cam: Pfligzlnr is whhflily rm Medicaid mm, but weshuuld ho itlvowhmmnlm spnunlmlumnlhip lmvmmnurcllcmu svllnlhuarmnmey mm mid. Rlihlnow, QGWHI flu limimd to n maximum otono Medicaid diam. It brat: heamhugmurlud WWIININ mmlmn fbmd to live npm because orthis rule. Pl fDI’ fllcaaluadfllreae vmrlw mndmmm individuals, afluwmmfluiuflinym In Mu havecomplaion. rm hnhhmo well-being ofthm couple: madman wiunlhey an ii; in llvn mun". We wclnomc nmmnumad vmiu nlqynmg hm ralmamma 1M: require as ta1:-upam mmpapcmorlc. We mndsorm notluurmherwhe more mnybnde ho mmplna, This would wast» l:'vary0M“a um andman mu unuwxi mil pnpuruvork in nu whiohjwflrdim patient am. mum-bu om: ldnlm. P1011: pus HD2015 HID! nlluwnng rnnmod uuupdw M hw rqamleaa oflhe scum nfflaoir payment. in OCHPHS T1unk,'|!N1. =‘~w W-»<»M,' mm, mm “W”; wzoz/4&5 [email protected].;/ ‘§C»<}<-W

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To: Representative Dee Moriltawa. Human Services Committee cl-lair Date: February 1 1. 201 6, 9:30 AM, House Conference, Rm 329 Re: H.B. 2005 - Relating to Caregivers Omnibus Blli . Aloha Chair Moriltawa, Vice-Chair Kcbayachl and Committee Members: /'fl_a/id My name is G!-D1-;1¢\ 172% am a Care Horne Operator in #:na/w/rm . My testimony in in SUPPORT of HB 2005 but with comments on the various sections of the bill. Unanncunoed visit by itself does not ensure the health, safety and welfare oflthe seniors placed in any cf the community-based care facilities. There are already existing statute and administrative rules that gcvem. control and monitor caregivers under Department of Health (DOH) and the Department of I-lumen Services (DHS), respectively. We lust need to enforce responsibility and accountability to all the main players of the caregiving industry. y HB 2005 is e stark reminder or warning that it is a criminal act to operate e care facility not licensed or certified by either DOH or DHS. There have been rumors that people are engaged in that kind of activity. Who la responsible to police such illegal activity? Last year, a law was enacted mandating DOH to post deficiencies of all annual inspections on its website. In addition. HB 2005 requires the department to complete posting within 5-working days upon conclusion of all inspections. Under the current aystem, ii am not sure how the 5 working days be achieved. The department may just have to be more efficient in carrying out these tasks. For the last 4-5 years. OHCA has been puahingiihisisaue cfcollecting licensing and re- iiconslrlg fees from the care facilities. There are caregivers who take care of Medicaid beneficiaries. and they are not compensated enough by the State. it is unconscionable to levy face on them. l believe $25-50 is reasonable fee across the board. HB 2005 brings back the argument whether community-based foster family homes should be allowed to care for 2-private pay residents. At iaat year's legislative session, we heard the appeal for an elderly couple, one is a private pay and the other is a Medicaid beneficiary, and they wanted to be in the same family foster home. DHS strongly defended the cxiatlnd regulation that family foster home program was established to accommodate the placement for the Medicaid cilenta. The family foster home program is partly federally-funded. Undeniably. many community-based family foster home: are saving the eiatei millions of doth-are by laldng care or clients who could be in a nursing home. We are all aware how much it coels to stay in nursing home. Are theac caregivers paid enough? Do they deserve fair ccrnpensation? Ara the Case Management agencies paid enough to handle the case load of foster home residents? The state has the responsibility responding to these questions. lf only caregivers are paid in a timely manner, maybe we don't have to discuss about late payment interest. The burden ie on the State to provide fair and timely compensation- Ac described at the beginning, Hawaii's elderly population is growing fast andi living longer. it is just logil to increase the capacity‘ oi Type l home to 3 skilled-nursing level of care residents. Mahaio for your attention. ,4/W‘-i /P/:55? Care Home Administrator

— i

T000/T000 V9ttcztsos xva we Ircr srnz/at/an Feb 171608I13a ‘ p/I 4% s~%- raw ‘N?

February 15, 2016

To: Honorable Rep. Della Au Belatti — Committee Chair on Health 4/Rep. Richard P. Creagan, MD — Co Chair Rep. Fukamoto Chang — Co Chair Rep. Jo Jordan — Co Chair Rep. Bert Kobayashi — Co Chair Rep. Daynette (Dee) Morikawa e Co Chair Rep. Marcus Oshiro — Co Chair Rep. Andrea Tupola — Co Chair lam Avelina Robianes humbly supporting the HB 2005 with comments in regards to certification, recertiﬁcation licensing and relicensing of CCFH, ARCH, E-ARCH and case managers. Care providers should not be mandated to pay an annual fee for license and relicense or certificate or recertification because we are helping the state saving millions of dollars by providing shelter and services for the sick, aged and disabled population of the community. Instead, care providers deserve pay raises for working 24/7, 365 days a year. Two private pay individuals who are married or in a civil union, should be able to reside in the same CCFFH to preserve their marriage vows and their rights as a couple. Care providers deserve to be payed on time with clean claims. Payments in timely manner is rewarding for the care providers.

For the ARCH Type-1 They should be allowed at least 6 residents plus increase of pay For the E—ARCHS Type~2 At least 6 or more residents should be allowed per discretion 0 the department. f

Thank you for giving me the opportunity to send my testimony.

Sincerely, , A

Aloha Chair Morikawa, \/ice-Chair Kobayashi and Committee Members:

My name is EMHPINQ /Zﬁam a Care Home Operator in l’l)V/Ff’/'l1/‘<~ l\/ly testimony is in SUPPORT of HB 2005 but with comments on the various sections ofthe bill. Unannounced visit by itself does not ensure the health, safety and welfare of the seniors placed in any of the community-based care facilities. There are already existing statute and administrative rules that govern, control and monitor caregivers under Department of Health (DOH) and the Department of Human Services (DHS), respectively. We just need to enforce responsibility and accountability to all the main players of the caregiving industry. HB 2005 is a stark reminder or warning that it is a criminal act to operate a care facility not licensed or certified by either DOH or DHS. There have been rumors that people are engaged in that kind of activity. Who is responsible to police such illegal activity? Last year, a law was enacted mandating DOH to post deficiencies of all annual inspections on its website. In addition, HB 2005 requires the department to complete posting within 5-working days upon conclusion of all inspections. Underthe current system, l am not sure how the 5 working days be achieved. The department may just have to be more efficient in carrying out these tasks. For the last 4-5 years, OHCA has been pushing this issue of collecting licensing and relicensing fees from the care facilities. There are caregivers who take care of Medicaid beneﬁciaries, and they are not compensated enough by the State. lt is unconscionableto levy fees on them. I believe $25-50 is reasonable fee across the board. HB 2005 brings back the argument whether community-based fosterfamily homes should be allowed to care for 2-private pay residents. At last year's legislative session, we heard the appeal for an elderly couple, one is a private pay and the other is a Medicaid beneficiary, and they wanted to be in the same family foster home. DHS strongly defended the existing regulation that family foster home program was established to accommodate the placement for the Medicaid clients. The family foster home program is partly federally-funded. Undeniably, many community-based family foster homes are saving the state millions of dollars by taking care of clients who could be in a nursing home. We are all aware how much it costs to stay in nursing home. Are these caregivers paid enough? Do they deserve fair compensation? Are the Case Management agencies paid enough to handle the case load of foster home residents’? The state has the responsibility responding to these questions. If only caregivers are paid in a timely manner, maybe we don’t have to discuss about late payment interest. The burden is on the State to provide fair and timely compensation. As described at the beginning, Hawaii's elderly population is growing fast and living longer. It is just logical to increase the capacity of Type l home to 3 skilled-nursing level of care residents.

Mahalo for your attention. °Qt/.a¢»w¢z/w /<6~ M71T) Care Home Administrator

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Dan: Chair Bntutl and Vim Chair Cmaglm, and Memhﬂs nfthi: Cothmitmcs:

Myrumczis & A nffl'nAdi|kI-hstcrflome Association offiawaii [AFI-IA) and 1: proud operator a Cmnmum Care Faster Family Home (CCFFI-D. Imlflmttshmgly support HBIODS I-ID}, especially ' V.

Ihmrzdomcatudwy liictocm tin-rny ekterlyanddisatalcd 1 W11! Emmet care fnr flrunaclvtst My tiluily also helps me, bonus; it tdces ufinily to fin-these individuals. I mz|lcelesstl'|an$2.00pu‘h0ttt0nMcdielidcIiflfl15.Incllalnle&pot%a24fl.

Pia note then": are a tot ofvncancies forflcdicaid clients, dtl-iuuisnoslioflngtof beds finr Medicaid climb. I know homes that have hail vauaucia fin! ontlu. Ilmowtlmlthe CCFFHprqgra:nisp:inm:ilyfinrMedicaidc1ia:I:,hatwushmfldbc itivewbenflllereisa Spflfliill fl!IIiwtS1Ii]7kl\h$fliIlrGli:IIhj,flf&I.hBr0fnutlfEyBI€€I1l\- ‘mid. llightnnw, CCFFHs are liinitzd to a maximum atone Medicaid client‘. It breaks been that mallind couplesaresomctimos f0rcedtoliwa;rattbecaus:ufti'iisn1l:. Pl forihesalneofthcse elderly and disabled individuala, allow some flexibility in the rules have compassion. The heath and wcfl-being ofthase dimples rkterimalle when they am: fa m live apart. We wide: nmmuumad visits; my:-it-ma, but mlicanslng ‘ fair: require usto pmpare extra flflpflwork. We need Slime: nulicr ntitarwisn them may be dc because paperwufl: isnut oomplcle This would wast: everyone’: time and even it-in unnnri mi-owtion o.t‘u|.r license, paticnl cart. Please pass !-{B2005 l-ID] allowing married maples to livewhether in CCFPH: regardless ti the scum: uffliet: pqlnmr.

Tiunlcynu,

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VIA FAX 308-586-9608 February 11', 2016 ‘

RE: HBZODS H1)! — Testimony' ' in Sirong Support of Secbon' V and Requasking Ammdments tnSec1"ion I! -HLT2/J7ll6— Rm. 329 8:45 am.

Dear Chair Belatti and Vice Chair Creagan, and Members nfthe Canmittecs:

Myname is l’[;l;},1/kl l 7Q§_{ _ lam arnern ufi:heA:lulr.FosterHome Association of Hawaii (AF!-IA) and u proud operator of a Commun Care Foster Family Home (CCFFH). Isupport strongly support I-LBZUDS HDI, especially S ‘on V. L have dedicated my lit‘: to care for my elderly and disabled lients who cannot care for themselves. My family also helps me, because it lakes a family to cEe for these individuals, I make less than $2.60 per hour on Medicaid clients, and lam r “hie 24/7.

Please note there are a lot ofvacancies for Medicaid clients, and 1lI:re is no shortage of beds for Medicaid clients. 1 know homes that have had vacancies fa" months. I know that the CCFFI-"l program is primarily for Medicaid clients, but we should Lofcmitivc whore there is a special relationship between our clients, Whether or not they arc on edicaid. Right now, CCFFI-is are limited to a maximum otnne Medicaid client. It bro , , mY tteanrhar married couples are sometimes forced to live apart becatse ofthi s rule. Plwj e, for the sake of these elderly and disabled individuals, allow someﬂexibility in the rules id have compassion. The health and wcll~beir-lg ofthese couples deteriorate when they are for H it to live apart

We welcome unannounced visits at anytime. but relicensing l istts rcqulr: Us 10 prepare extra paperwork. We need some notice oclrenwrlse there may be delibecause paperwork is not complete. This would waste everyone?» time and even the unueces revocation of DLI’ license, which jeopardizes patient care.

Please pass FIBQODS E-ED! allowing married couples to live!cgpther in CCFFH5 regardless of the source ofttieir payment.

T ‘

Address: I k4 It‘ \ M ‘ ‘

Phone #. /J-ow ‘ I7 ttblécl/ltreaazr Feb 16 16 O7 25p Microsoft 1 8087448729 Feb 16 1607 04p 11 P1

1 11

VIA FAX 808-58691608

February 17, 2016

RE: HB2005 tn): - Ti=s limony in St-tong Support of Section V and Reqne Ii 1 Amendments to Section II - HLT 2/1| 7/16 — Rm_ 329 8:45 a.i-n.

Dear Chair Bclatti and V cc Cllﬂlf' Creagart,_and Members ofthe Committees

My name is 1‘?/-ﬂlllft [ﬂag . I aim a membcrofllts 1. 1 i Foster Home Association of Hawaii (A FHA) and a pmud operator ofa Community Care. F 15 1 Family Horn: (CCFFH). I support strongly support HBZOOS HDI, especially Section V. ~=_Q~4

I have dcdicateirzl my life to care for my elderly and disabled clients w 10 imnot care for themselves My Family al so helps me, because it takes afamily to care for th s I ividuals. I make less than $2.00 pdr hour on Medicaid clients. and I am responsible 24/7 ‘i 1

Please note theie are a lot ofvacancies for Medicaid clients, and then beds for Medicaid clie 1 isl i shortage of l knew homes that have had vacancies far months. -0 w that the CCFFI-l program is pri 3lily for Medicaid clients, but we should be sensitive e there is a special relationship be can our clients, whether or not they are on Medicaid. ‘ 1 now, CCFFHs are limitzd to maximum ofone Medicaid client. lt breaks my hear l 1 married C0up|BS are sometimes lbreed to live apart because of this rule. Please, for lhl s 1 ofthese elderly and disablcd lflql \= lduals, allow some ﬂexibility in the rules and have r ) 1 ‘on_ The health and well-being 01:‘these couples deteriorate when they are Forced to live 1 .

We welcome u amounccd visits at anytime, but rcliccnsing visits req Ha to prepare extra papenvork. We n ed some notice otherwise thcrc may he delays bccaus : ilgrwork is not complete. ﬁris would sh: everyone‘s time and even the unnecessary rcvoci li 1 four license, whichjeopardizes patie L care. ]

?leasc pass HB2005 l-ID] allowing married couples to live together ir Cil "F1-I5 regardless of the source 0fthcir payment 1

Thank you, J‘ A W2 rim, W 1 Ph0J1e#: Mqiir/9;y([1/1,, i 4'4, ‘7q;7 (13950 71%/£72--47 B2.i’1Eu"2B1Ei 68:42PM 8888828842 APUVA PAGE 81r’lZ12 From 8443358703 1.844.335.8703 Tue Feb 16 17:58:13 Z016 MST Page 1 of 2

To: Representative Della Au Belatti, Chair, Committee on Health Representative Richard Creagan, Vice-Chair

Date: February 17, 2016, 8:45 AM, House Conference, R Re: H.B. 2005. HD1- Relating to Caregivers Omnibus Bill

Aloha Chair Belatti, Vice-Chair Creagan and Committee Members:

My name is l'lflV7H¢/Ilnm A P"lYRl am a Care Home Operator in /(@490/bi‘ . My written testimony is in SUPPORT of HB 2005 but in strong OPPOSITION of Part ll Section 2 of the bill, HRS 321-15.6 has been in existence, I am respectfully asking the Committee to put back the language of the statute “An nual inspections for rellcensing shall be conducted with notice, unless otherwise determined by the department." Community-based care facilities are governed by different regulations regarding unannounced visits and annual inspection for relicansing, The Department of Health has the jurisdiction of the Adult Residential Care Homes under the guidance of HRS 321-15.6. On the other hand, the Department of Human Services has thejurisdiction of the foster family homes using the guidelines under Hawaii Administrative Rules Title 17, Chapter 1454. The current practice of the Department of Health through the Office of Health Care Assurance is to send notice to the care home operator regarding an upcoming annual relicensing inspection. The notice says “a certain day of the month but it does not announce the exact date." The reason OHCA has promulgated this system to allow the care home operator to he present during the inspection. There are many reasons that the care home operator is out the house like bringing residents to their medical appointments, picking up medications, buying provisions and supplies for the residents, outings for residents, and once in a while a trip to the emergency room. In addition, care home operators have also personal appointments and errands. OHCA requires that the primary caregiver, the care home operator, and the residents must be present during the annual relicensing inspection. The statute already has the provision for unannounced visits. Ahyoociy from the OHCA can conduct unannounced visits at any intervals at its discretion to confirm correction of deficiencies and to investigate complaints for suspicion of neglect and abuse,

The issue of unannounced visit resurfaced last year because a resident passed away in a community-based care facility due to a decubitus ulcer. I do understand the public sentiment regarding the death. In the 90s, there was another death due to the same cause. There was an emotional debate regarding the issue of “unannounced visit". But such death could be prevented if people are accountable and responsible for what they do. it only takes some administrative actions and measures to prevent such horrible death. In the care giving industry, ggb_o_qy_wanis such death to happen. Unannounced visit could be a deterrent but not a solution if people involved in the care of ihe resident are not doing their responsibilities. What about oversight? Could we have done a better Dulig 8082367390 p/I Feb161608:31p P-l

VIA FAX 808-5 86-9608

February 17, 2016

RE: HB2005 HD1 — Testimony in Strong Support of Section V and Requesting Amendments to Section II — HIT 2/I 7/16 — Rm. 329 8:45 a.m.

Dear Chair Belatti and Vice Chair Creagan, and Members ofthe Committees: .1 My name isll/4/\l 5774 ”’Db¢LJ/C’; . 1 am a member ofthe Adult Foster Home Association ofHawaii (AFHAJ and a proud operator of a Community Care Foster Family Home (CCFFH). I support strongly support HBZOOS }EDl , especially Section V.

Please note there are a lot of vacancies for Medicaid clients, and there is no shortage of beds for Medicaid clienw. I know homes that have had vacancies for months. I know that the CCFFH program is primarily for Medic aid clients, but we should be sensitive where there is a special relationship between our clients, whether or not they are on Medicaid. Right now, CCE‘FHs are limited to a maximum of one Medicaid client. It breaks my heart that married couples are sometimes forced to live apart because of this rule. Please, for the sake of these elderly and disabled individuals, allow some ﬂexibility in the rulm and have compassion. The health and well-being ofthese couples deteriorate when they are forced to live apart.

Please pass HB2005 HDI allowing married couples to live together in CCFFI-Is regardless ofthe source of their payment.

Thank you,

Phoneﬂ.. <%,%?_3Gm,;3?0st?/\ /OM’; '45 A Zw‘K Aug 13 O9 07123;: p.1 Feb 16 1601:5432 pl

VIA FAX 808-$86-9608

February 17, 2016

REI HBZOOS HDI - Testimon," in Strung Support of Secdon V and RH!» toseciion 11- HLT2/)7/I6 — Rm. 329 8:45 L111. esting Amcndm ants

Dear Chair Belani and Vice Chair Creagn, and Members afthe Comm itrees: M'narucis5 . lam a memff 0F me Association ofi-Iawaii (AFHA) and a proud oocralur of a ClI|!I!TT1I!7\i' rum.the$9533;Adult_:_._-32,3;Foster Ho53;‘-E {CL}? rx). 1 sup-pun strongly supporl HBZOOS l-{D1, especially smlan V. I have dedicated my lit‘: to car: fur my elderly and rlisablcd iienls who cannot care for themselves. My family also helps me, buause ittakes a family toSE1: make less llzai-i $2.00 per hour on Medicaid clicms_ and I am respo ‘blefor Ihcse individuals. I 2417. Please 21.922 ".!:=:= an a la: sfvacaimifis Iui iviiiiiiiéliti éliihifi, beds for Medicaid clients. 1 know homes that have had vacancies md fhere as no slaorrage of onths. l know that the CCFFH pmgram is primarily for Medicaid clients, but we should bc c special relationship beiween our aliens, whether or not they are on i:nsitive where there is a CCFFI-is are limited to a maximum ofone Medicaid client. It break mdicard.‘ R1ght' now, couples are sometimes forced to live apar: because ufthi s rule. Plea e, y hcarnhm rnanicd elderly and disabled individuals, alluw some flexibility in the rulcs d for the salt: ofthcec have compassion. The health and well-being oftheie couples deteriorate when they are £034 to live apart. Wewelcome unannounced visits at anytime. but rcliccrlsing isits require us to prcpan: extra papcnwrk. We need some noLice otherwise there may be dela_js complete. This would wash: everyone": cirne and av an the iumcc _ because papcrworkis not revocation of our liccns=, which jeopardizes paticnl care

Please pass I-{B2005 HDI allowing manied couples to Ev: tog regardless ofthe source ofmeir payment. cﬁner in CC]-‘F E-ls

Thank you,

Address: qyqm, pm :4~ wupuw /ti " ‘W47 Phoneﬁ: @950 545 i

i |,cl 17660819909 SOLUEH ESHSBF (‘Z9-9U 9L 91- ‘3I‘5:i E|2f1E,/’2E|1E» 18: 58 8682383546 JOANNE BAVSA PQGE @1351 Feb161608241p p.‘l

vm FAX 808-5 86-9603 February 17, 2016

RE: I-IB2005 HD1 - Testimony in Strong Support: of Section V and Requesting Amendments to Section II — HIT 2/17/16 — Rm. 329 8:45 a_m_

Dear Chair Belatti and Vice Chair Creagan, and Me mbers ofthe Committees:

Mynameis -—-lom(m‘/ . I am a member ofthe Adult Foster Home Association ofHawaii (AFI-IA) and a proud operator ofaCom.1nu.nity Came Foster Family Home (CCPFH). I support strongly support H]?-2005 I-lDl , especially Section V.

I have dedicated my life to care ‘for my elrqf and disabled clients who cannot cafe for themselves. My family also helps me, because it cs a family to care for these individuals. [ make less than $2.00 per hour on Medicaid clients, cll am respmzsible 24/'7.

Please note there are a lot of vacancies for Medicaid clients, and there is no shortage of B0415 f0r Medicaid fllififltfl. I know 11011165 that have d vacancies for months. I know that the CCPPH program is primarily liar Medicaid clients, ut we should be sensitive where there is a special relationship between our clients, whether or ot they are on Medicaid. Right now, CCFFI-Is are limited to a maximum of one Medical client. It breaks my been that married couples are sometimes forced to live apart because ofthis rule, Please, for the sake of these ty . . I elderly and disabled individuals, allow some flexibi li 1n the rules and have compassion The health and well-being ofthese couples deteriorate when they are forced to live apart. We welcome unannounced visits at anytimg, but relicensing visits require us to prepare cxtm paperwork. We need some notice otherwise ere may be delays because paperwork is not complete. This would waste everyone’s time and even the unnecessary revocation ofour license, whichjeopardizes patient care,

Please pass I-[B2005 HD1 allowing married couples to live together in CCFF]-ls regardless ofthe source oftheir payment.

Thank you,

Address: "lid.-3} M adp/4»~,14~; tow?

Phone#: O2-l6-l6;O9I5OPM;Fr0miKONA HOSFWTAL TOIl8085869608 ;8083220l95 # 1/ lO ut-I 1.-u SHAH nu-wv us-|1.~vu| |-n-\-in —----M ---

Febmﬂry 15, 2016

To: i-iunomble Rep. Della Au Belani - Committee Chair on Health Rep. Richard P. Crengwa, MD — Co Chair Rep. Fulcamoto Chang — Co Chair Rep. Jo Jordan - C0 Chair Rep. Ben Kobayashi -— C0 Chair Rep. Daynette (Dee) Morikawa - Co Chair Rep.~ Marcus Oshiro - Co Chair Rep. Andrea Tupola - Co Chair

l am * humbly supporting the HB 2005 wiih comments in regards to certification, reeertifieatiou, licensing and relieensing ofCCFI-I, ARCH, E-ARCH and case managers. Care providers should not be mandated 10 pay an Btmflfll fee 1'01‘ ll¢lm8¢ find Ielieensc or certificate or xecertifioation because We are already helping the state save millions Of dollars by providing shelter and serviucs for the sick, aged and disabled population ofthe community. Instead, care providers desenre pay raises for working 24/7, 365 days n year-

'lWo private pay individuals who are married or in a civil ll-'0i0l1l, should be able to reside in the same CCFFH to preserve their marriage vows and their rights as a couple.

Caxe providers deserve to be payed on time with elem claims. Payments in timely manner is rewaxding for the care pmviders.

1’.Qt_1h¢.AB.QH

Type-1 They should be allowed ax least 6 residents plus increase ofpay

BzU=h§_E:AE.QHS

TYP°'2 At least 6 or more residents should be allowed per discretion ofthe depamnem.

Thank you for giving me the opportunity to send my testimony.

Sincerely, 82/15! 2515 BE: 18PM 8682684389 MIVAT PAGE 61/Bl Aug 13 as nazmp _ ‘ P "I Feb‘l81801:54p p.1

VIA FAX HD8686-9608

February" I7, 2016

REI1'lB?m$HDl—TeiileQnyin5fi‘—g$IIpprtolSocfim?a|flRnpIlhghmndmmm toSe:finnl1-I~I.LT2l17!l6—Bm. 329 8:45 a..m.

Dear G|lirBe1n:iu1d'Vi:eChirC::ngan,andM‘::nh:Ia urfmeCouInitw:a: icynmeiqlul MM /lam/lg 1-D’. lam eman ol‘fl:AduItFmiu' Home Association arl-Jzwaii (AF!-IA) and a proud operatorofa Comm Cm: Faster Family Home (OCFPH). Imppm siroagly sqapn-1 1181105 EDI, qmi-lly ' V. lhIved:ni:|ndn:yHi:D:ar:fi|'mye1d!dyUfldisubled1‘i¢d:WlnGlnulRI’ flumaelvce. Mylilrrilyulwbdlnmnbewuieitulmsnfimflyb forrhaeindivishak. l‘ mnl:elc1s1lnn$2.€l)pcthn'|.n' onfidiwiddieulamdlnm reaponsi 2417.

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|,'d QQVZOOZQOQ 99173003908 d8l73LO 9L 9L qezl 01/28/2007 12241 FAX 8084230599 LUCY I 001/U02 Aug 13 O9 07:40]) . I _!p.1 . ~ r-- // V t, / / .

VIA FAX 803-586-96U3

.F8lMl.lIl'y I7, 2016 ‘

RE: HB2005 HDI —~ Testimony in Strong Supponutfleefim Vn+ Requesting Amuuluenu bn$l!t:fionII-HLT2/17116-Rm_ 329 B24511“. _

Dear Chair Belatti and Vice Chair Creagan, and Members ofthe Committees!

M" """"" “' ._ ‘Q Q-‘3\\'q_\ :1...... ‘ -4.‘.-= numtt roam: Home Association ofHawaii (AFHA) and n proud apemm of: COmm\Il$‘Cfl|'B Fmmr Fpmfly I-|'()|1'|g (CCFFH). I support strongly support HD2005 I-lDl, especially Sect V. .1.--H I-Al=lI|\iIIlll'll my me to elite tor my elderly and disabled lienta who cannot can mi- themselves. My family also helps me, beclule it takes n fiunily to c for these inclividuals. I make less than $2.00 par hour on Medicaid clients. and lam respcae to 240. Please note then: are a lot nfvucamies for Medicaid clientgind there is no Sl'lUYtEg¢ of beds for Medicaid clients. I know homes that have had vacancies months. l know that the CCFFH );_)l'0g|'Im in nrimaril-u flnr MflH;Hdlfl z-ll-.1-mq 1...‘ -... -|.... l.I 1 nu :1 T __ Ln.“ m“_ H - arpwlw rctanonsmp between our elierlta. Mmhcror not they are on h edicaid. Right now, CCFFH5 ll! limited In 5. maximum ofone Medicaid client. It breaks y hem that married couples-are sometimes forced tn live npartlaecmse ofthi: rule. Plea . ft» rt» we- -rm--.‘ ' ‘ 7, .. ..' .1.;.;.2..~.. ;...... ;..¢-=, ll-IUW some 1t:x|m|l!y In the r|.|Je5 amhave compassion. The health and well-being oflhese couples deteriorate when they am: flan: to live apart.

W! we-In-nmn III\Ill\I\I'\wuwun»-I _-!-:1- -- - -:_ U! ~__;__v;_w.ﬂ""a MW “Hum ‘aw wgpam mm plperworlc. We need some notice otherwise there may be delay bceluse paperwork is not Obmplele. This vlmuld waste |:w.|'yune': time and even the un revocation ofowlieettse, which jenpnlﬂizei patient care.

Please piss HBZGUS I-[DI allowittg married cutmlm to live together in CCFPI~Is regardless of‘the source ofthoir payment. _

Trunk you, \‘\ok\' J\>==- - Address: Q °\ -. "\c> ¥~\\§ "'\"\'l..*.‘~\I5":.> ~\

\ 2,78 aiaw ?’sc/<¢5;¢,,, Ira 94»? *~. \l Q

February 15, 2016

T03 Honorable Rep. Della Au Belatli — Committee Chair on Health Rep. Richard P. Creagan, MD — Co Chair Rep. Fukamoto Chang — Co Chair Rep. Jo Jordan — Co Chair Rep. Bert Kobayashi — Co Chair Rep. Daynette (Dee) Morikawa — Co Chair Rep. Marcus Oshiro — Co Chair Rep. Andrea Tupola — Co Chair I am /»-aflh/rugtg (‘fig8/ humbly supporting the HB 2005 with comments in regards to certification, recertification licensing and relicensing of CCFH, ARCH, E—ARCH and case managers. Care providers should not be mandated to pay an annual fee for license and relicense or certificate or recertification because we are helping the state saving millions of dollars by providing shelter and services for the sick, aged and disabled population of the community. Instead, care providers deserve pay raises for working 24/7, 365 days a year. Two private pay individuals who are married or in a civil union, should be able to reside in the same CCFFH to preserve their marriage vows and their rights as a couple. Care providers deserve to be payed on time with clean claims. Payments in timely manner is rewarding for the care providers.

For the ARCH Type—l They should be allowed at least 6 residents plus increase of pay For the E-ARCHS Type-2 At least 6 or more residents should be allowed per discretion 0 the department. f

Thank you for giving me the opportunity to send my testimony.

Sincerely,

Waéii/“i/11¢‘ 84/r aw 1e-FEE:-eoie 1?=a3 F|"omiEl@Ei4B543TE P "E :1’1

VIA FAX 808-586-9608

February 17, 2016

RE: HB2005 HDl - Testimony in Strong Support of Section V and Requesting Amendments to Section II — HLT 2/l7/16 — Rm. 329 8:45 a.m.

Dear Chair Belatti and Vice Chair Creagan, and Members of the Committees:

My name is W7-5'11V7 ' . I am a member of the Adult Foster Home Association of Hawaii (AFHA) and a proud operator of a Community Care Foster Family Home (CCFFH). I support strongly support HB2005 HD1, especially Section V.

I have dedicated my life to care for my elderly and disabled clients who cannot care for themselves. My family also helps me, because it takes a family to care for these individuals. I rnake less than $2.00 per hour on Medicaid clients, and I am responsible 24/7.

Please note there are a lot of vacancies for Medicaid clients, and there is no shortage of beds for Medicaid clients. I know hornes that have had vacancies for months. I know that the CCFFH program is primarily for Medicaid clients, but we should be sensitive where there is a special relationship between our clients, whether or not they are on Medicaid. Right now, CCFFHs are limited to a maximum of one Medicaid client. It breaks my heart that married couples are sometimes forced to live apart because of this rule. Please, for the sake of these elderly and disabled individuals, allow some ﬂexibility in the rules and have compassion. The health and well-being of these couples deteriorate when they are forced to live apart.

Please pass l-[B2005 I-IDI allowing married couples to live together in CCFFHs regardless of the source of their payment.

Thankyou, _ ¢r1=61W-' l\’lP<’\1-\fJ7l5'l-’l?7- 'l_A4\S Address: \. \ A-’l"l‘7A’l-i4/ll H/I Q0494 Phone #: (W5) "v&>L/~v4eL/ @2¢"lEn"2E|1E\ BE: 51PM E\?E|4913 MCALQPINI PIQGE B1.-"'91 Feb161606:52p , P4

WA FAX 808-586-9608

February I7, 20l6

RE: HE-2005 HD1 — Testimony in Strong Support of Section V and Requesting Amenflmellifl to Secfion H 1 HLT 2fl7ll6 ~— Rm. 329 3:45 a.m. .

Dear Chair Belarti and Vice Chair Creagan, and Members ofrhe Commlneus. . - / I . My name Is MAR! TE“; CA/I/Ala H . lam a member ofthe Adult Foster Home Association ofHawaii (AFHA) and a proud operator of a Community Care Foster Family Home (CCFFH). l support strongly support I-[B2005 HDI, especially Section V.

- I have dedicated my life to care for my elderly and disabled clients who cannot care for themselves, My ﬁemily also helps me, because it takes a family to care for these individuals. l make less than $2.00 per hour on Medicaid clients, and I am responsible 24/7.

Please note there are a lot of vacancies for Medicaid cliems, and there is no shortage of beds for Medicaid clients. 1 know homes that hive had vacancies for months. I know that the CCFFH program is primarily for Medicaid clients, but we should be sensitive where there is a special relaoonship beiween Our clients, whether or not they are on Medicaid. Right now, CC1-"F!-is are limited to a maximum ofone Medicaid client It breaks my heart that married couples are sometimes forced to live apart beoeuse of thiS rule. Please. for the Sake ofthese elderly and disabled individuals, allow some ﬂexibility in the rules and have compassion. The health and well-being ofthese couples deteriorate when they are forced to live apart.

We welcome unannounced visits at anytime, but relicensing visits require us to prepare BXIIB paperwork. We need some notice othBrwi$B there may he delays beeﬂmie paperwork is not eqmpleta. This would waste everyone’; time and even the unnecessary revocation of our license, which jeopardizes patient care.

Please pass l-B32005 l-{D1 allowing married couples to live together in CCFFI-ls regardless ofthe source oftheir payment. .

Thank you,

Address: 6?£{-/Di’ /‘l"/ILA KT VOA"/PA/"L1" [+1

Phoneii: (97[y— IMI3, |\/laekoh 18088888819 p.1 Feb 18 16C-7tO8p F’-1

VIA FAX 808-586-9608

February I7, 2015

RE: I-{B2005 I-[DI —- Testimony in Strong Support of Section V and Requesting Amendments to Section II — HLT2/l7ll6 — Rm. 329 8345 am.

Dear Chair Belatti and Vice Chair Creagan, and Members of the Committeest

l My name is ’ I am H II'l€fl"| isEl‘ O fth B Adult‘ Foster Home Association of Hawaii (AFHA) and a proud operator of a Community Care Foster Family Home (CCFFH). I support strongly support l-IB2005 HDI , especially Section V. l

l have dedicated my life to care for my elderly and disabled clients who cannot care for Il'lCTl1S¢l vcs. My family also helps me, because it takes a family to care for these individuals. l make less than $2.00 per hour on Medicaid clients. and 1 am responsible 24/7‘ l

Please note there are a lot of vacancies for Medicaid clients, and there IS no shortage of beds for Medicaid clients l know homes that have had vacancies for months. l know that the CCFFH program is primarily for Medicaid clients, but we should be sensitive nlhere there is a special relationship between our clients, whether or not they are on Medicaid. Right now, CCFF!-is are limited to a maximum of one Medicaid client. It breaks my heart that married couples are sometimes forced to live apart because of this rule. Please, for the nake of these elderly and disabled individuals, allow §om.e ﬂexibility in the rules and have cornpassion. The health and well-being of these couples deteriorate when they are forced to live aparL

We welcome unannounced visits at anytimc, but reliccnsing visits require us to prepare extra paperwork. We need some notice otherwise there may be delays because paperwork is not complete. This would waste everyone’s time and even the unnecessary revocation ofour license, which jeopardizes patient carc_ l l Please pass l-[B2005 HD1 allowing married couples to live together in ¢CFFHs regardless of the source of their payment. l

Thank you,

. , ‘ " O J v’ Address: 55%-Q L-l \‘-"\-"\4- ‘L ' Aria“ ' -Q/M ‘ J0 .;() PG } Ph0nc#;l'\/~‘K0§ E’ LQWIQ @2.*’1E|»"2E|1E\ @El:4T"F'M 8982564398 MIYAT pF_'IAGE B1? B3 AUQ 13 U9 U5I'I4|J 9.1 FQh‘l61B01254p

vm FAX 808-586-9608 February 17, 2016

RE: HBQMSHDX —TuIi$onyin Bh'l§5|lppnrldfBwll|;I| Vgflflpggfluggmgflggng in Seefionll-H1-TIl17Il6-— Rm. 329 3:45 Lrn.

Dar Chair Belmi and Via: Clair Crengan, and Mamba; aim; (Jug-mimgg; rm B -uffln Ad\dtFost:r Home Asuwiution of!-Iawafi (AF Jand a pr upcnnx of! Cemm Care Foam Family Home (BCFFH). I mppm-tsirongly support 14112005 HUI, upminliy '\ V. lhlwdodiensdntyliflztocnrcfizrmy ckkrlylrzlclisabled %fG'|1IW|l‘llIIIIIlIGllIlf0l’ themseivas. My family also hulps me, beam: itlnlmsa fin-lily to forthwe individunh, I mfl::!c:sd|u|S2mpathnwmtM¢diI:dfldr¢rB.andIam. ' ncspomi 2U7.

Plane-not: thus In. a lat GfVi|:i.rl;|¢s lb; Medicmd ehmm, thnluisnosbmmgcuf bcd:fixMnd|cudcl|mu.1Imowhom|:iflathuveh:duumm:abr I115. llmwflwlme CG='PHprqg1rl:spnmIiIyf0rMndzcadcl1e|n:,hxw1esluuldbe wcwhutfliflcisa spnculmlnmnllnp betwuonuurchuIq,wke\!|gu-ormul\¢y|:=nn aid. Riflimw, CGF&mmiMhamu1mndom lrbraaks heutflaagmn-rind cuuplulmsometimcsfnmedmliveagnrt Eamu. r1 for fllsabeflflhese aidezly Ind disablad individuals, allow aomaflcuibifity in the rules have cmnpuwion. The lweflliaandwtlbbcilggaflhesecnuplcs d¢1|=|'icl'al:whm\l1cylIBfiI ‘ I0 liveapnm

We welculnl umluwunad visih at Inytime, but mlinensing “.5Il‘8' luquileusloprcpuc extra papcrvmk. We mad some notice nuhsrwiuflum may Ix: (khy banusepflpmmrkiamt complain. This would wash: |:vcryunc‘s and E\rc:n flm revocation ofour license, wbidljaopardiacs peticm 0-arc. . . I Plus: pin! HBZDOS HDI llkvwmg named eowlcs to live In in CC!-'FHs rqpldletsofthn: soulceuflheirprymait. Thlnkyou, H~ $-~‘~‘/~\

Adams 132% }k<\\(;.‘0c~. Ki. R-<>v1-\H- Ci-Qgllg

Pbﬂnlllt l-Eb lb"l6UfI'|;$p

VIA FAX 808-586-9608

February l7,20l6

RE: HB2005 HD1 - Testimony in Strong Support of Section V and Requesting Amendments to Section ll- HLT 2/17/l6 -— Rm. 329 8:45 am.

Dear Chair Belatti and Vice Chair Creagan, and Members of the Committees:

My name isgge “Q. I am a member ofthc Adult Foster Home Association of-Hawaii (AFHA) a pr ud operator of a Community Care Foster Family Home (CCPFH). I support strongly support HBZOOS HDI, espetliﬂlly Section V.

I have dedicated my life to care for my elderly and disabled clients who cannot care for themselves. My ﬁimily also helps me, because it takes a family to care for these individuals. I make less than $2.00 per hour on Medicaid clients, and I am responsible 24/7.

Please note there are a lot ofvacancies for Medicaid clients, and there is no shortage of beds for Medicaid clients. J know homes that have had vacancies for months. 1 know that the CCFFH program is primarily for Medicaid clients, but we should be sensitive where there is a special relationship between our clients, whether or not they are on Medicaid. Right now, CCFFI-ls are limited to a maximum ofone Medicaid client. lt breaks my heart that married couples are sometimes forced to live apart because of this rulc. Please, for the sake Of t.l'1t’:$e elderly and disabled individuals, allow some ﬂexibility in the rules and have compassion. The health and well-being ofthese couples deteriorate when they are forced to live apart.

We welcome unannounced visits at anytime, but rcliccnsing visits require us to prepare extra paperwork. We need some notice otherwise there may be delays because paperwork is not complete. This would waste everyone’s time and even the unnecessary revocation of our license, which jeopardizes patient care.

Please pass HB2005 HDI allowing married couples to live together in CCFFI-Is regardless ofthe source oftheir payment.

Thank you,

Address: Cﬁi-' [(1]/if H-Ooywﬂkoa gt-, I _H»{,

Phone it: lo}; Feb 16 1607I38p p.1 Feb is ieoroop H P-l

VIA FAX 808-586-9608

February 17, 2016

RE: I-{B2005 l-{D1 — Testimony in Strong Support of Section V and Requesling Amendments to-Section lI- HLT2/17/16 - Rm 3298145 a.m.

Dear Chair Belatti and Vice Chair Creagan, and Members of the Committees:

My name is 90' G-0*)?-nc,e» . I am amember of the Adu1rFostcr Home Association ofl-lawaii (AFHA) and a proud operator ofa Community Care Poster Family Home [CCFFI-l). l support strongly support I-[B2005 I-{D1, especially Section V.

I have dedicated my life to care for my elderly and disaaled clients who cannot care for themselves. My family also helps me, because ittakes a family to care for these individuals. I make less than $2.00 per hour on Medicaid clients. and I am responsible 24/‘7.

Please note there are a lot of vacancies for Medicaid clients, and there IS no shortage of beds for Medicaid clients. l know homes that have had vacancies for months. I know ihat the CCFFH program is primarily for Medicaid clients, but we should be sensitive where there is a special relationship between our clienls, whether or not they are on Medicaid Righr now, CCFFl-Es are limited to a maximum of one Medicaid client. It breaks my heart that married couples are sometimes forced to live apart because of this rule. Please, for the sake of these elderly and disabled individuals, allow some ﬂexibility in the rules and have compassion. The health and well-being of ihese couples deteriorate when they are forced to live apart

We welcome unannounced visits at anytime, but relioensing visits require us to prepare extra paperwork. We need some notice otherwise there may be delays because paperwork is not complete. This would waste everyone’s time and even the unnecessary revocation ofour license, \»\’i'l‘i cl‘. jeopardizes patient care.

Please pass I-[B2005 l-ID! allowing married couples to live together in CC!-‘Fl-ls regardless of the source oftheir payment. Thank you. ?4w4& Address: iias @ ?a~/Z Q0??? Phone #:(¢?DK) Q51’ —3@ - ¢,,.]q—, §'?@b Feb 16 16 O5I16p Grace Jadulang 3089592236 D-1

February 15, 2016

To: Honorable Rep. Della Au Belatti —— Committee Chair on Health Rep. Richard P. Creagan, MD — Co Chair Rep. Fukamoto Chang — Co Chair Rep. Jo Jordan— Co Chair Rep. Bert Kobayashi - Co Chair Rep. Daynette (Dee) Morikawa — Co Chair Rep. Marcus Oshiro — Co Chair Rep. Andrea Tupola — Co Chair '

1 am _ {E-0 ‘if/* L so L M glu-N. humbly supporting the HB 2005 with comments in regards to certification, recertification, licensing and relicensing ofCCFH, ARCH, E- ARCH and ease managers. Care providers should not be mandated to pay an annual fee for license and reliccnse or certificate or recertification because ‘we are already helping the state save millions of dollars by providing shelter and services for the sick, aged and disabled population ofthe community. Instead, care providers deserve pay raises for working 24/7, 365 days a year.

Two private pay individuals who are married or in a civil union, should be able to reside in the same CCFFH to preserve their marriage vows and their rights as a couple.

Care providers deserve to be payed on time with clean claims. Payments in timely manner A is rewarding for the care providers.

For the ARCH

Type-1 . They should be allowed at least 6 residents plus increase ofpay

For the E-ARCHS

Type-2 At least 6 or more residents should be allowed per discretion ofthe department.

Thank you for giving me the opportunity to send my testimony.

Sincerely, ~¢l4D¢/“)5 /-l11»€=,c~i/1»;-f UU/in Fvjé ,g@;/Wt Fogfr;/L CA-eel’ rwwé 1 /+7l1;U/‘-'H Feb 16 1eo7;oep P-1

VIA FAX 808-586-9608

February 17, 2016

RE: HBZOUS HDl — Testimony in Strong Support of Section V and Requesting Amendments to Section II — HLT 2/I 7/16 — Rm. 329 8:45 am.

Dear Chair Beiatti and Vice Chair Creagan, and Members of the Committees;

My name is -' V ’ ' 1' ' ' lam a member ofthe Adult Foster Home Association of Hawaii (AFHA) and a proud operator ofa Community Care Foster Family Home (CCFFH). I support strongly support HBZOOS HDI, especially Section V.

I have dedicated my life to care for my elderly and disabled clients who cannot care for themselves. My family also helps me, because it takes a family to care for these individuals. l make less than $2.00 per hour on Medicaid clients, and l am responsible 24/7.

Please note there are a lot 01°vacancies for Medicaid clients, and there is no shortage of beds for Medicaid clients. l know homes that have had vacancies for months. I know that the CCFFH program is primarily for Medicaid clients, but we should be sensitive where there is a special relationship between our clients, whether or not they are on Medicaid. Right now. CCFFHs are limited to a maximum ofone Medicaid client. It breaks my heart that married couples are sometimes forced to live apart because ofthis rule. Please, for the sake of these elderly and disabled individuals, allow some ﬂexibility in the rules and have com passion. The . health and well-being ofthese couples deteriorate when they are forced to live apart.

Please pass HBZOOS l-{D1 allowing married couples to live together in CCFFI-ls regardless ofthe source of their payment.

Thank you, ‘ -

Address: -

Phone #1 TESSIE FACTORA 200-5917 M WXHD ~52-‘I21 ~ qfépga

To: Representative Dee Morikawa, Human Services Committee Chair Date: February 11, 2616, 9:30 AM, House Conference, Rm 329 Re: H.B. 2005 - Relating to Caregivers Omnibus Bill Aloha Chair Moriltawa, Vice-Chair Kobayashl and Committee Members: My name is 7E§;/1? fytcgtlgma Care Home Operator in fgflf 6/}? . My testimony is in SUPPORT of HB 2005 but with comments on the various sections of th bill. Unannounced visit by itself does not ensure the health, safety and welfare of the seniors placed in any of the community-based care facilities. There are already existing statute and administrative rutes that govern. control and monitor caregivers under Department of Health (DOH) and the Department of Human Services (DHS), respectively. We just need to enforce responsibility and accountability to all the main players of the oaregiving industry. HB 2005 is a stark reminder or warning that it is a criminal act to operate a care facility not licensed or certified by either DOH or DHS. There have been rumors that people are engaged in that kind of activity. Who is responsible to police such illegal activity? , Last year, a law was enacted mandating DOH to post deficiencies of all annual inspections on its website. in addition, HB 2005 requires the department to complete posting within 5-working days upon conclusion of all inspections. Under the current system, l am not sure how the 5 working clays be achieved. The department may just have to be more eificient in carrying out these tasks. For the last 4—5 years, OHCA has been pushing this issue of collecting licensing and relicensing fees from the care facilities. There are caregivers who take care of Medicaid beneficiaries, and they are not compensated enough by the State. It is unconscionable to levy fees on them. l believe $25-50 is reasonable fee across the board. HB 2005 brings back the argument whether community-based foster family homes should be allowed to care for 2-private pay residents. At last year's legislative session, we heard the appeal for an elderly couple, one is a private pay and the other is a Medicaid beneficiary, and they wanted to be in the same family foster home. DHS strongly defended the existing regulation that family foster home program was established to accommodate the placement for the Medicaid clients. The family foster home program is partly federally-funded. Undeniably, many comm unity-based family foster homes are saving the state millions of dollars by taking care of clients who could be in a nursing home. We are all aware how much it costs to stay in nursing home. Are these caregivers paid enough? Do they deserve fair compensation? Are the Case Management agencies paid enough to handle the case load of foster home residents? The state has the responsibility responding to these questions. if only caregivers are paid in a timely manner, maybe we don't have to discuss about late payment interest. The burden is on the State to provide fair and timely compensation. As described at the beginning, Hawaii’s elderly population is growing fast and living longer. it is just logical to increase the capacity of Type I home to 3 skilled-nursing level of care residents. Mahalo for your attention.

Ca strator

t-<1 VIA FAX 808-536-9608

February l7, 2016

RE: HB2005 HD1 — Testimony in Strong Support of Section V and Requesting Amendments to Section II - HLT 2/17/16 — Rm. 329 8:45 a.m.

Dear Chair Belatﬁ and Vice Chair Creagan, and Members of the Committees:

My name is I h€/M101 3 cl [lg 0F'!L'6L/ . I am a member ofthe Adult Foster Home Association of Hawaii (AFHA) and a p ud operator of a Community Care Foster Family Home (CCFFH). I support strongly support HB2005 EDI, especially Section V.

I have dedicated my life to care for my elderly and disabled clients who cannot care for thernselves. My family also helps me, because it takes a family to care for these individuals. I make less than $2.00 per hour on Medicaid clients, and I am responsible 24/7.

Please note there are a lot ofvacancies for Medicaid clients, and there is no shortage of beds for Medicaid clients. I know homes that have had vacancies for months. I know that the CCFFH program is primarily for Medicaid clients, but we should be sensitive where there is a special relationship between our clients, whether or not they are on Medicaid. Right now, CCFFHs are limited to a maximum ofone Medicaid client. It breaks my heartthat married couples are sometimes forced to live apart because ofthis rule. Please, for the sake ofthese elderly and disabled individuals, allow some ﬂexibility in the rules and have compassion. The health and well-being ofthese couples deteriorate when they are forced to live apart

Please pass HB2005 HD1 allowing married couples to live together in CCFFHs regardless ofthe source oftheir payment.

Thankyou, __

Address, 94-/07¢/1 Kamkem $7/. 40%»/bah». /7’/ 7!; 7??

Phone#: @/@§’} [07/— 17L-5450

|,'d dL17 8O9L9Lq9:| Feb.16.2016 08:23 PM FAX FOR YOU 808 676 95 2 2 PAGE l"BD IO IOUIIBQP ,.. .

vm FAX 808-586-9608 February 17, 2016

RE: HBZOO5 1'lDl - Testimony in Sn-on; Sugnrt of Suction V and Regulating Amrmrlnnnu tn Section It -l-l'LT2Jl7Jl6— Rm. 329 8:45 Mn. Door Chair Belatri and Vice Chair Creagan, and Mernbers Dflhg Cummings,

My name is lM -am emu-n ofthe Adult ‘Foster Home Association -of Hawaii (AF!-Mland a proud peraw-r of o Common Cane Foster Family Home (CCFFl"l'). l support strongly support HB2005 HDI, especially V. I have dedicatedt my life. lo car: for my elderly and disabled. ‘ l J.ems who cannot care for themselves. My family also helps me, because it mks; it funny to it-it-these individual; 1' make less fl1an$2.00 per hour on Medicaid clients. and taro ble 244’? Please note then: are a lo: ofvseancies for Medicaid clients cl there is no shortage of beds for Medicaid clients I know homes that have had vaemoles mDnths I know thatttie CFFH rc am is unari for Medicaid clients but weshouldbe C P H pr‘ vb - I . itiveF where there isI a special relationship between our clients, whether or not they are on edieud' ' . Rifiit now, CCFFl-lsare llfflttetl to a maxumarn of one Medicaid client, Ii b my hum that married couples an: sometimes forced to live apart because ofihis rule. Plea , for the sake ofthese elderly and dlflblfitl individuals, allow some flexibility in the rules o have compassion. The 111981111 and well-being ofiliese couples deteriorate when they are for: cl to live open. We welcome unannmmcod visits at anytime, but lelicmsing‘ lsils require us to prepare extra pnpenvork. We need some notice otherwise then; may be d¢1.%,be¢:au;e paperwork is ndl complete. This would waste everyonek time and even the imneu.-.s revocation ofour license, Whichjcopardlzes patient care.

Please pass HBZOGS I-{DI allowing married couples to live lﬂpﬂhtr in CCFFI-Is regardless ofthe source oftheir payment. 1

Thank you, ..ll¢l9_ 'lln'r\0\ 9*‘ Address: {LA/l/vv\\\_h-.‘ Phonetl,

l Feb 16 16 O5255p Yolanda Razon Collo EARCH 808 422 7881 P4

Frix: ~5—§3&=— ¢_f5,pg

To: Representative Dee Morikawa, Human Services Committee Chair Date: February 11, 2016, 9:30 AM, House Conference, Rm 329 Re: i-l.B. 2005 - Relating to Caregivers Omnibus Bill Aloha Chair Morikawa, \fiChair Kobayashi and Committee Memberszi ' I \ _ t My name is X4?” €°ll'.7’l am a Care Home Operator in H6“ i. My testimony is in SUPPORT of HB 2005 but with comments on the various sections of the bill. Unannounced visit by itself does not ensure the health, safety and welfare of the seniors placed in any of the community-based care facilities. There are already existing statute and administrative rules that govern control and monitor caregivers uncler Department oi Health (DOH) and the Department of Human Services (DHS), respectively. We just need to enforce responsibility and accountability to all the main players of the careglving industry HB 2005 is a stark reminder or warning that it is a criminal act to operate a care facility not licensed or certified by either DOH or DHS. There have been rumors that people are engaged in that kind of activity. Who is responsible to police such illegal activity? Last year, a law was enacted mandating DOH to post deficiencies of all annual inspections on its website. In addition, HB 2005 requires the department to complete posting within 5-working days upon conclusion of all inspections. Under the current system, I am not sure how the 5 working days be achieved. The department may just have to be more efficient in carrying out these tasks. For the last 4-5 years, OHCA has been pushing this issue of collecting licensing and relicensing fees from the care facilities. There are caregivers who take care of Medicaid beneficiaries, and they are not compensated enough by the State. it is unconscionable to levy fees on them. I believe $25-50 is reasonable fee across the board. HB 2005 brings back the argument whether community-based foster family homes should be allowed to care for 2~private pay residents. At last year's legislative session, we heard the appeal for an elderly couple, one is a private pay and the other is a Medicaid beneficiary, and they wanted to be in the same family foster home. DHS strongly defended the existing regulation that family foster home program was established :0 accommodate the placement for the Medicaid clients. The family foster home program is partiy federally-funded. Undeniably, many community-based family foster homes are saving the stale millions of dollars by taking care of clients who could be in a nursing home. We are alt aware how much it costs to stay in nursing home. Are these caregivers paid enough? Do they deserve fair compensation? Are the Case Management agencies paid enough to handle the case load of foster home residents? Tne state has the responsibility responding to these questions. if only caregivers are paid in a timely manner, maybe we don’t have to discuss about late payment interest. The burden is on the State to provide fair and timely compensation. As described at the beginning, Hawaii's elderly population is growing fast and living longer. lt isjust logicai to increase the capacity of Type l home to 3 skilled-nursing levet of care residents. Mahalo for your attention.

Care Home Administrator

yd Feb 16 16 0923313 Catherine 8089810423 p.1

February 16, 2016

Acedo Adult Residential Care Home 2501 A Kinoole St. Hilo, Hawaii 96720 Phone 808 981 2909

Honorable Della-Au Belatti Chair, Committee on Health

Regarding HB2005 HDl Omnibus Caregivers Bill; My name is Melba Daak, a Care Home Provider on the Big Island. Please consider this letter as my written testimony, regarding; Part V- Section 8 License, relicense, certiﬁcation and recertiﬁcation fee -

We, the Care Home Providers of the Adult Residential Car homes, have been requesting a compensation increase since year 2007. Our current monthly compensation amount is $1,350.90, per patient. A new Certification Fee would equate to an even lesser rate of pay. Due to the nature of our business, it is very common to endure periods of time with only a couple of resident patients, due to natural life cycles. These types of unpredictable events would make the new Certiﬁcation Fee even more difﬁcult to afford. We would be agreeable to new annual certification fees, but only if our monthly compensation were increased to allow us to afford those fees. An annual Certification Fee of $50 would be very reasonable, if our compensation increase request is also approved.

Part Vl|- Section 14 Compensation for Caregivers - We, the Care Home Providers,_propose a new monthly minimum compensation amount of_§§_,000._0lJLpe_r patient, Qer month.

This proposed amount wouid still be 57% iess than the Nursing Care Facilities are being compensated. After payment of the required 4% Excise Tax, this would only leave $2880 per month, inclusive of all costs for services we provide.

Care Home Providers have been requesting a compensation increase since year 2007. From the current monthly compensation rate of $1350.90, (per month per patient), a 4% General Excise Tax is imposed, leaving only $1296.86 for all required costs and services.

Within the current $1296.86 compensation amount, the Care Home Provider is required to provide personal transportation, to transport patients for all doctor office visits. We are also required to provide a Certiﬁed Substitute to watch other home patients, while escorting a patient to a doctor’s ofﬁce or picking up prescriptions at a pharmacy. A Cancer Patient may need to visit a doctor's office, on a daily basis, for 6 weeks or more. There are no extra compensation allowances for these types of extended care costs. We are also required to carry extra Business Liability Insurance for our homes and cars. In addition, there are many incidental expenses that we cover, iike the cost of food and utilities. At the current a rate of $1296.86 per month, the State of Hawaii is now paying only $42.64 per day, inclusive of all costs. Where else in Hawaii can anyone be sustained for only $42.64 per day’? Nursing Care Facilities are being paid $7'000+ (per month, per patient). The State is now paying 418% more to Nursing Care Facilities, for the same services. it seems entirely unfair that Nursing Care Facilities are being paid $7000 to $8000 monthly by the Slate of Hawaii -for the same sen/ices that Home Caregivers are being compensated at rate of only $1350.90 per month. Thank you, Melba Daak