Noboru Kawamoto fought in the famed 442nd Regimental Combat Team during World War II.
Now, at age 93, he is fighting for a chance to be with his wife of 67 years.
"Noboru and Elaine Kawamoto simply want to live out their final years together," said state Rep. John Mizuno, who introduced House Bill 600, which would allow designated community care foster family homes established primarily for Medicaid recipients to take in more than one resident at a time who is not a beneficiary.
Noboru lives apart from his wife in a Kaneohe CCFFH, where he is a "private pay" client.
Established by the state Department of Human Services, CCFFHs were designed to save the state money by allowing Medicaid recipients to receive nursing facility-level health care in more affordable home settings at lower costs.
Under current terms, CCFFH operators can provide housing for up to three residents, two of whom must be covered under Medicaid.
Neither of the Kawamotos receives Medicaid, so Elaine was not eligible to be placed with Noboru in the home.
Elaine Kawamoto makes the long trek from Kahuku to Kaneohe to see her husband, but she is physically capable of making the trip only about once every other week, usually on Sundays.
"They’re two lovebirds. He never wants her to leave," said Jonathan Hanks, who cares for Noboru Kawamoto at his Kaneohe CCFFH.
He and other caregivers came to the Capitol on Friday to provide testimony on Mizuno’s bill to the joint committees on Health and Human Services.
The state Department of Health opposes the bill, saying in written testimony that it alters the intended purpose of foster homes and "changes the opportunity for the state to save money by allowing for a change in the pay or mix of residents in a CCFFH."
The Health Department said the bill changes the definition of a CCFFH to a residence servicing two "private-pay" residents and just one covered under Medicaid.
"If this is allowed on a wider basis, this is really kind of looking like an expanded adult residential care home rather than a CCFFH," said Keith Ridley of the Health Department’s Office of Health Care Assurance. An expanded adult residential care home requires different licensure to provide a nursing home level of care for residents, the majority of whom are private-pay clients, he said.
However, many in the caregiver community who came to Friday’s hearing were in favor of the bill.
Elma Tierra of Adult Foster Homes of the Pacific said she represents more than 400 operators on Oahu and in Hilo who struggle with taking in Medicaid patients because of strict eligibility rules.
"If we had another patient, it’s an extra income," Tierra said.
Ramon Sumibcay from the Alliance of Residential Care Administrators also said he supports the bill, proposing an amendment to allow only spouses — including those in same-sex marriages and civil unions — to be cared for in the same foster home.
"By allowing two private-pay clients in foster homes without restriction to married couples, adult care home operators (with mainly private-pay clients) will find more empty beds in their homes," Sumibcay said. "We need to consider a balancing act so not to hurt the other groups of this caregiving business."
The Department of Human Services, recognizing the need for CCFFH operators to be able to have sufficient income and the desire to keep spouses together, says its priority is to ensure availability of homes for Medicaid recipients who cannot afford to pay for nursing home-level housing.
The committees are scheduled to decide on the bill Wednesday.
"I believe that marriage is a fundamental right and, unless the state can provide a compelling reason to keep (the Kawamotos) and others like them apart, this bill needs to become law," Mizuno said.
