KAILUA-KONA — John McDermott said if Neighbor Islands want the best care for their most vulnerable seniors then residents must do for those people what he made a career of doing for the elderly — advocate.
The mission of the long-term care ombudsman program is advocacy for residents of long-term care facilities. Hawaii is home to 1,702 such facilities serving more than 12,000 long-term care residents.
According to the guidelines set by the Institute of Medicine, that ratio demands six full-time ombudsmen throughout the state. Instead, Hawaii’s program employs only one — McDermott — rendering it the smallest long-term ombudsman staff in the country.
“The feds, the Administration on Aging, want me to visit every facility at least once a quarter,” McDermott said. “That would be 28 facilities a day. It’s not at all possible.”
Senate Bill 530 — which made its way through the Senate and was subsequently sent to the House of Representatives where it already passed one joint hearing and awaits approval from the House Finance Committee — wouldn’t afford McDermott all the help he says he needs.
But it would be a start.
If passed, the bill would allocate $150,000 to the program and allow McDermott to spend half that money to hire a full-time, paid ombudsman for Oahu. The other half would go toward hiring a part-time employee for each of the Neighbor Islands, where a system of volunteers tries to patch what gaps it can in advocacy for long-term care patients.
“My feeling is that the Neighbor Island folks have been waiting way too long, way too patiently,” McDermott said. “It’s supposed to be a statewide program providing regular and timely access to all of the long-term care residents, and instead it really has been providing mostly access to Oahu because that’s where I live and that’s also where the office is.
“We really need the Neighbor Island folks to put pressure on the legislators that this is something that’s really important.”
McDermott’s current budget is just shy of $31,000 — money he says is spent entirely on airfare and car rentals so he can catch up with as many long-term care residents as possible.
The work of the ombudsman program is crucial, he added, because many seniors have no family nearby to monitor their situations and ensure their rights are maintained, their needs are met and their voices are heard.
He said many such residents are reluctant to complain about anything, fearing retaliation. But when they begin to build a relationship with people such as McDermott, understanding they have someone on their side, that person becomes like a trusted family member.
Executive Director of Life Care Center of Kona Holly Raymer said relationships between ombudsmen and service providers operating above board tend to be positive.
Hawaii’s ombudsman program is allowed to train volunteers to fill staffing gaps. It trained nearly 180 of them during the last 15 years, according to SB 530. However, it currently staffs only eight.
Raymer said in her two years at Life Care Center of Kona, McDermott is the only resident advocate with whom she’s dealt. That’s the primary reason she supports SB 530.
“I absolutely think that one man is not enough for the whole state,” she said.
McDermott’s work load also recently increased, as Centers for Medicare Services instated a new rule that long-term care facilities must report every discharged patient to the ombudsman program. McDermott said this is needed because some facilities try to push patients out once reimbursements decrease.
“Neighbor Island folks, they really need to speak up, otherwise everything stays in Honolulu and it’s not fair,” McDermott said. “Why should you have to wait for the crumbs to fall off Honolulu’s table?”
Email Max Dible at mdible@westhawaiitoday.com.
