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Kaua‘i to get dedicated kupuna watchdog

LIHU‘E — After nearly 50 years, Hawai‘i’s long-term care ombudsman program will finally deploy full-time staff to the neighbor islands, a move that officials hope will aid significantly in the state’s attempts to combat elder abuse.

Established in 1975, the program was created to provide the state’s most vulnerable kupuna with an avenue to voice complaints if their caretakers fail to provide adequate care.

“Our role is to be an advocate for anyone living in a long-term care facility so that they understand what their rights are, and they have somebody who has their back if they’re being treated unfairly, or if they have any concerns and want to talk to somebody who doesn’t work for the facility so that there’s no conflict of interest,” said John McDermott, Hawai‘i’s long-term care ombudsman.

However, the program has lagged behind national standards for decades. A 1995 National Academy of Medicine report found that a long-term-care ombudsman program requires at least one full-time paid staff member per 2,000 long-term care beds.

Hawai‘i has almost 13,000 beds across roughly 1,700 facilities and only two full-time ombudsmen staff. As such, the state’s program has long been one of the country’s least equipped.

Throughout McDermott’s 25-year tenure as the state’s long-term care ombudsman, there’s also been multiple periods in which he was the sole staff member. As federal guidelines require that ombudsman staff visit each long-term care facility at least once per quarter, McDermott would have had to visit about 20
facilities every day, seven days a week.

“It’s really not possible,” McDermott said. “It was never possible for one person to be covering the whole state.”

Between limited staffing and logistical difficulties of interisland travel, McDermott told The Garden Island that the inability to regularly see long-term care residents has made it difficult for the ombudsmen to form meaningful relationships with and, ultimately, to protect Hawai‘i’s kupuna.

“If I’m on Kaua‘i and I find a problem, and now I have to fly home, when do I get a chance to go back to Kaua‘i to verify if the things the staff told me they’d do have actually been done?” he asked.

“It just makes more sense to at least have one full-time ombudsman on each island so that (residents) don’t have to wait for me to hop on a plane, rent a car, waste all that time sitting at an airport, and maybe I get to see two or three facilities a visit because I’ve got to turn around and get back to the airport.”

McDermott has pushed for dedicated neighbor island ombudsmen since he took the job in 1998, and after decades of work, his efforts have nearly come to fruition.

In 2022, then-Gov. David Ige and the state Legislature agreed to include in the state’s budget funding for five new ombudsman positions — an additional position for O‘ahu, one for Kaua‘i, one for Maui, one for Hawai‘i Island’s Hilo side, and one for the island’s Kona side.

And approximately a year after funding was secured, the state Department of Health has begun the search to fill the new positions.

“I’ve known almost from the beginning that this had to be a major project,” McDermott said. “I just didn’t think it would take 25 years to accomplish.”

While the program has lacked sufficient staffing for decades, the new ombudsmen positions are coming at a critical time for Hawai‘i. As the state’s median age increases, its youth — who would otherwise care for their aging ‘ohana — are increasingly being priced out of Hawai‘i.

“They’re not around, and it’s going to get worse. And so, our seniors need somebody that they can talk to, face-to-face,” McDermott said.

“They’re not really comfortable making a complaint by telephone. They don’t know who they’re talking to. They don’t know exactly if it will be followed up or if it’s just lip service … that personal touch, which is so important — especially in Hawai‘i — we cannot lose that.”

The Department of Health is currently only accepting internal applications for the new ombudsman positions, but plans to open applications to the public if any positions remain open.


Jackson Healy, reporter, can be reached at 808-647-4966 or
Source: The Garden Island

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