As I’m sitting here reading the Civil Beat article published Jan. 23, titled “Why Hawaii’s Unlicensed Elder Care Industry Is Out Of Control,” I can’t help but be upset at the allegations about our model.

First of all, as the new president of the Aging in Place Association, I can assure you that this model is being perfected and streamlined. I find it interesting how there are so many outlandish allegations about our movement when many of the people who are pointing fingers have not even called me or given me a chance to speak with them.

I have made many attempts to speak with state Rep. John Mizuno, but he has never called me back. I’ve also invited John McDermott, the state long-term care ombudsman, and Keith Ridley, who heads the state Office of Health Care Assurance to call, but to no avail.

Over the next 30 years, the population of older Americans will grow more than 30 percent.  Courtesy: Snowpeak/

Before I further explain our new and improved model of care, I do need to say that it is not fair for a registered nurse to state that three people have died from “transfer trauma” and that we’re to blame for their deaths. This is a ridiculous claim and unfounded at that.

I, and many of the clients that I serve in the AIP model, could argue that their loved ones suffered “transfer trauma” after being moved from a regular care home to an expanded care home in order to meet the Department of Health rules and regulations. Also, many of my clients have been asked to move from a care home when they became hospice qualified. There are many situations in which our elderly can experience transfer trauma and our model’s aim is to reduce that effect on the elderly.

Regarding our new and improved model for the Aging in Place homes, we are working around the clock to fully formalize our professional organization that oversees the AIPs. Our domestic nonprofit corporation will be established in a way that allows oversight over the AIPs.

As with all nonprofit corporations, there will be a board of directors and bylaws for our organization. We will also have health care standards in place. Our health care standards will include all of the many things that Ridley (and others) are accusing us of not having; verified certified nurses’ aide training, experience working with the elderly, background checks, fingerprinting, yearly tuberculosis clearance and physical, and ongoing education.

Our Growing Kupuna Population

In addition to this, our model will align with U.S. Department of Housing and Urban Development laws, fire safety laws and any other laws pertaining to rentals and health care services offered in the community. We will also have a formal procedure in place so that any/all complaints can be investigated.

The AIPA board will be allowed to place any necessary sanctions against the AIPs that are providing inadequate and substandard care. In order to remain open, the AIP in question will have to fulfill the requirements as set forth by the board of directors. An active list of “certified” AIP homes will be faxed to all of the facilities on a regular basis.

By doing this, we (as AIPA members) are separating ourselves from any and all facilities claiming to be a part of this movement. I do understand that there are illegal businesses being run in Hawaii, but we are not one of them. We will separate ourselves and prove ourselves to be a reputable model of care in our state.

I would also like to state that I’m currently finishing up my Ph.D. in performance psychology, specializing in health care performance. I am conducting my research on the AIP model of care (using AIPA certified homes only) and plan to continue researching this model.

Our system is failing us, and I see evidence of this each and every day.

The data collected will be used to further refine this model of care (if this is needed). The community can be assured that research is being conducted on the AIP model, especially as it pertains to the quality of care.

At this point, some people might ask “why” we’re spending so much time working on this model of care when the state already has a system in place (the DOH care homes and foster homes)?

The answer is quite simple. Our system is failing us, and I see evidence of this each and every day. The licensing process is taking way too long and the oversight provided by the DOH is inefficient.

In addition to this, the cost of running the DOH program (to oversee all of the elderly living in DOH homes) is astronomical. Over the next 30 years, the population of older Americans will grow more than 30 percent. Much of the anticipated growth will occur in those over the age of 85.

This could potentially (and most likely will) have devastating effects in Hawaii, especially as it pertains to the programs that oversee care of the elderly in the community.

Because of the anticipated growth of the elderly population in Hawaii, the DOH can anticipate a tremendous growth in the Medicaid industry as well. This means that more people will be in need of long-term care in the foster home division. This program will cost Hawaii millions of dollars to maintain (in addition to what they’re already spending).

Hawaii does not have an endless supply of money to continue to hire nurse inspectors to oversee all of the elderly living in community settings! Not only is the AIP model allowing the community more options for care, but the AIP movement is trying to help alleviate unnecessary spending for the private-pay long-term care clients. Our model can provide economic relief for Hawaii!

Keeping It Legal

In regards to the legality of the AIP model of care, we are working along with attorneys to assure that we are meeting all necessary and pertinent laws. Although I see the definition of a care home being passed around the state in an attempt to close us down, I assure you that our model (at least the one that is being overseen by the AIPA) is legal.

Our clients are living in a home and have an active renter’s agreement in place. The care is NOT being provided by the owner of the home but is being provided by an independent patient caregiver. Our model does not meet the definition of a care home as defined by the law.

Additionally, all unlicensed health care personnel are supervised by a registered nurse, and the RN is delegating to the certified nursing assistants. Our families understand our model, support our movement, and have a right to place their loved ones where they want to.

The year 2018 will be a great year for the AIP movement! As we move forward, I invite legislators, the DOH, the ombudsman, Kokua Council and any and all people who want to help our elderly in Hawaii to meet with us.

Our goal, as AIPA members, is to provide an excellent system of care for our elderly. We would much rather work together in harmony than to constantly be fighting against the very people who seem to be on the same side as us.

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