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Hawaii lawmakers scrapped a measure Friday that would have allowed a married couple to pay out of their own pocket to live together in a community care foster family home.
This type of state-regulated home currently can have three residents but two must be Medicaid recipients. House Bill 600 would have allowed the Department of Health to make exceptions for private-pay couples who are married or in civil unions.
A conference committee chaired by Rep. Dee Morikawa and Sen. Suzanne Chun Oakland killed the measure with less than 30 minutes to go before the deadline to pass bills on for full House and Senate votes before the session ends next week.
Morikawa and Chun Oakland supported the bill but were unable to get the necessary approvals from the money committee chairs. They hope to revisit the issue next year.
“We’ll keep working on it,” Chun Oakland said after consoling care home operators and their clients who had been advocating for the bill since its introduction in January.
Vice Speaker John Mizuno, who introduced and strongly supported the legislation, has worked on the bill with Jonathan Hanks, who runs an adult foster home in Kaneohe with his wife Arlene. One of their clients, Noboru Kawamoto, has appeared at several hearings and has become a symbol of the effort.
“I am unable to explain in words my emotional feelings and how a state regulation can deny a couple married for 67 years the right to live with each other.” — Vice Speaker John Mizuno
Kawamoto, 94, is a veteran who served in the 442nd Regimental Combat Team in World War II. He’s also been married to his wife Elaine for the past 67 years. Like other aging couples, they want to live together in a home where they can receive the nursing-facility level of services they need without being in an institutional setting.
But since the Kawamotos would both be private-pay clients, Hanks can only have Noboru at his community care foster family home, which has reduced the couple’s time together to weekend visits. Changing the law would have let the two live together.
“I am unable to explain in words my emotional feelings and how a state regulation can deny a couple married for 67 years the right to live with each other,” Mizuno said in a statement.
“I’m going to say something that no lawmakers would say, my whole office is crying, the Hanks and Kawamotos are crying, we’re human and we are hurt. I’m hurting inside, we are all hurt.”
Mizuno said the Human Services and Health departments, which had concerns about the measure’s potential consequence of reducing the number of beds available for Medicaid recipients, had proposed an amended draft with language that he thought all parties could support.
The amendments included a requirement for the Health Department to create rules to address possible concerns with Medicaid bed space as it relates to married couples who are private-pay, and to remove an expiration date for the bill.
Keith Ridley, who heads the DOH’s Office of Health Care Assurance that oversees these care homes, said after the meeting that he sympathized with the residents who wanted this option, but they have viable alternatives.
A different type of care home in Hawaii — an expanded adult residential care home, or E-ARCH — allows private-pay couples who require nursing-home-facility level of care, he said.
“It’s the patient’s right to live where they want to live so it’s really up to them,” Ridley said.
“If they’re at a nursing level of care, the patient should discuss that with their case manager and community care foster family home operator and potential E-ARCH operator and that’s where they need to have that conversation,” he said. “That’d all be up to them.”
Hanks and his wife said in a statement that they are upset the bill didn’t pass but will continue to live by the spirit of aloha.
“It has always been our State’s tradition to care for our kupuna,” they wrote. “We support the Kawamoto family, Noboru and Elaine, we are here for them, and will help them in any way possible.”