Hawaii’s complicated long-term care system

I’ve been a nurse for approximately 24 years. Much of my experience is in the long-term care industry working as a R.N. Case Manager. Hawaii’s long-term care (LTC) system is definitely complicated. I understand it well because of the work I do, but many of my clients don’t understand it. The terminology used within Hawaii’s LTC system (i.e. ARCH, expanded ARCH, foster home, Type 1 ARCH, Type 2 ARCH, Aging in Place facility/AIP, etc….) confuses people.

In the long-term care industry, Hawaii has both a private-pay sector as well as a Medicaid sector. The difference between the two sectors adds to the confusion of the consumer. In addition to this, there is the topic of nursing case management. Some nurse case managers work with private-paying clients only, while others will work with both private-paying and Medicaid clients.

A new development in the LTC system in Hawaii, is the popularity of LTC placement agencies. There are placement agencies popping up all over the island of Oahu and even on the outer islands. While R.N. Case Managers are capable of handling long-term care placements, somehow these businesses have found a “niche” in the long-term care industry and they seem to be thriving in Hawaii, as well as in the mainland.

I wanted to start this blog in order to discuss Hawaii’s long-term care system and to brainstorm on how to improve LTC for elderly people. I’d love to connect with positive people, especially healthcare professionals. I desire to help our community by educating and discussing topics of interest in long-term care. I look forward to giving my insights and input, but I also look forward to hearing from others.

Maile Harada, R.N., Ph.D.

Maile Case Management, LLC