Question: There is a dialysis facility in the Koko Marina Center that has been open for more than six months. … However, until the state Department of Health certifies the facility, Medicare patients are not allowed to receive dialysis there; only privately insured patients may be treated. … I have called the Health Department to find out what is taking so long and received no reply. … The Hawaii Kai Community needs action on this. … Can you find out what’s going on?
Answer: It’s likely to be a few more months before the Office of Health Care Assurance inspects Liberty Dialysis at Koko Marina Center, according to the state Department of Health, which blames the delay on a lack of resources.
“The Office of Health Care Assurance, which conducts certification on behalf of Medicare, is currently understaffed. This extends the time it would normally take to complete the certification of facilities in Hawaii,” said Janice Okubo, a Health Department spokeswoman. “With two additional positions (specifically for conducting Medicare certification inspections) nearing final approval by the Legislature, we are hopeful that the office may be able to begin recruiting, hiring and training inspectors to catch up on some of the priority inspections delayed by lack of resources.”
Even once inspectors are available, DOH won’t disclose a certification date because Medicare surveys must be unannounced, Okubo said, although she did allow that “our Office of Health Care Assurance anticipates conducting the survey for certification within a few months along with their many other priority surveys as directed by Medicare.”
As you know, Medicare, the national health insurance program primarily for U.S. citizens 65 and older, covers kidney dialysis only if it is done in a Medicare-approved hospital or Medicare-certified dialysis facility.
After receiving your initial phone call, Kokua Line followed up and learned that you’ve been advocating on behalf of dialysis patients, including a family member, for several months. Besides contacting the Health Department (to no avail, as you said), you also wrote to state lawmakers urging them to make certifying the Hawaii Kai facility a priority.
East Oahu Medicare patients who could be getting dialysis close to home if the Koko Marina facility was certified instead must travel to Kaimuki, Kailua or some other Oahu neighborhood with an approved facility. Since most require time-consuming kidney dialysis several times a week, this influx affects availability for patients who live in those neighborhoods and imposes a burden on the Hawaii Kai patients.
There is a growing demand in Hawaii for kidney dialysis, a lifesaving treatment that filters waste, excess fluid and toxins from the blood of patients whose failing kidneys cannot accomplish these functions on their own. In 2014 there were 3,305 kidney dialysis patients in Hawaii, up from 2,328 in 2006, according to the Western Pacific Network LLC. These late-stage patients are just a fraction of the roughly 168,000 Hawaii residents with chronic kidney disease, brought on mainly by diabetes.
Taxpayer advocacy
The Internal Revenue Service needs Hawaii volunteers for its Taxpayer Advocacy Panel, which identifies major taxpayer concerns and recommends ways the IRS can improve customer service. The civic commitment is about 300 hours a year for three years. Volunteers must meet specific requirements, including being U.S. citizens who are current on their taxes and pass a federal background check. For more information, visit improveirs.org and select the “Join TAP” tab.
Mahalo
On Wednesday night my husband and I were parked at the Windward Mall. When we got ready to leave, we noticed a note on our windshield that said two people noticed our windows were down and that someone was looking inside, whom they told to stop. How thoughtful to do so! Several years ago, while visiting, we endured a smash and grab, and vowed to just keep the windows down to maybe avoid another. We never leave anything of value in the car. Mahalo!
— Thankful frequent visitors from Eugene, Ore.
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