Award boost for ‘steersman’ trying to ride out storm

Hale Makua’s CEO: Going to take hard work to come back from financial cuts

Our CEO Tony Krieg (right) pictured with Board Chair Roy Sakamoto

August 30, 2011

By MELISSA TANJI - Staff Writer (mtanji@mauinews.com) , The Maui News

Before accepting a $10,000 leadership award Monday, the chief executive officer of Hale Makua Health Services described himself as the organization's "steersman" in "rough seas" generated by cuts to Medicare and Medicaid, the financial lifeblood of his nonprofit agency that provides nursing home care and other services on Maui.

"I would say this is the darkest and most challenging time I have ever seen in terms of funding and resources to care for an exploding frail and elderly population," said Tony Krieg, who has been at Hale Makua for three decades.

Because of the cuts, competition and other factors, Hale Makua has 60 empty beds at its nursing homes in Kahului and Wailuku. He said it's going to take hard work, extra direction and steering in the next three to five years to ride out this storm.

On Monday, Krieg received a boost as he tries to steer Hale Makua into better times. He was presented with a 2011 Ho'okele Award at a ceremony on Oahu. The award was established in 2002 by the Hawai'i Community Foundation and the Wallace Alexander Gerbode Foundation and aims to recognize and strengthen the leadership in the state's nonprofit sector.

Receiving awards with Krieg were Lea Hong, Hawaiian Islands program director for The Trust for Public Land; Robert G. Peters, head of school of Hanahau'oli School; and Leslie Wilcox, president and CEO of PBS Hawai'i.

Award recipients each receive $10,000 to be used for their professional development and personal renewal. Over the past 10 years, $420,000 has been presented to 42 recipients.
"We recognized that Hawaii was in danger of losing incredible executive talent in the nonprofit sector in part because many executives had little opportunity to renew themselves and marshal the stamina to continue their demanding work," said Kelvin Taketa, president and CEO of the Hawai'i Community Foundation. "The Ho'okele Award (which means navigator or steersman in Hawaiian) allows us to recognize, thank and reward our community's truly selfless leaders."
"I really appreciate and will take advantage of this award," Krieg said. "I'm not sure what exactly I'm going to do. Maybe take a trip with a friend and taking photographs in a couple of national parks for a couple of weeks to give me some space to reflect on the challenges ahead."

"I wish I could extend the same thing for our staff," he continued. "We work 24 hours, seven days a week for people, (that) otherwise their family can't take care of."

Krieg joined Hale Makua Health Services in 1981 and was named CEO in 1986. He oversees more than 500 employees in four programs that provide nursing home care, social work, foster care management and rehabilitation services on Maui.

His work also extends to the state's long-term plan to research, create and execute goals for Hawaii's growing frail and disabled population as part of the Hawai'i Long Term Care Commission.

At Hale Makua, Krieg said that 85 percent of its clientele are covered by Medicare or Medicaid and that cuts to those programs really hurt his agency. Since August, there has been a 3 percent cut in Medicaid payments, and in October, there will be an 11 percent reduction in Medicare payments, he said.

He added that the state's decision to privatize the Medicaid program for the aged, blind and disabled also has hurt his agency. Managed care insurance companies look for other ways to keep people out of nursing homes like Hale Makua, which can cost more compared to other alternatives, he said.

This loss of revenue led to five layoffs at Hale Makua this past year. If more cuts come, there may be more who may lose their jobs - which Krieg does not want to happen.

Through these difficult times and all these years, Krieg has stayed with Hale Makua and been driven by a desire to help those for whom their families can no longer care. He recalled an elderly woman many years ago, his girlfriend's grandmother, whom he enjoyed seeing. The grandmother ended up in a nursing home, and "it was a real sad thing," he said.

As the director of a large nursing home, he remembers that grandmother and tries to do right by her.

Krieg said that although the award is "for the guy that is steering the ship," it's his staff, board, committee members and the community who have made Hale Makua successful.

"It's been a community effort, and with the community's help, we'll get through this," he said.

* Melissa Tanji can be reached at mtanji@mauinews.com.

© Copyright 2011 The Maui News. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Resident Dolly Villarimo (pictured above) loves gardening and takes pride in the work she does for our gardens at Hale Makua Wailuku. She shared with Activities Director Lynsey Capone, that years ago Tiger Woods stopped at her house on Maui to take pictures of her beautiful garden that she worked so hard on!

Making Hand Made Cards

This week neighbors and care partners gathered at Hale Makua Wailuku on the Lanai Neighborhood for a card making class. Activities Assistant Donna Gamurot showed residents how to use different kinds of stamps and colors to make beautiful greeting cards to give to their loved ones, friends, and care partners.  

Pictured above from left is Julita Kaiama, Sozima Medeiros, Donna Gamurot, Francis Kirby, Marieta Yalon, Rosalie Alcon, and Trisha Gonsalves

Eden Alternative Tip of the Week: LifeBio's Seven Tips for Intergenerational Experiences

It's back to school season, and it is important to create a clear strategy to ensure that youth and Elders come together more and that the  experience touches and transforms people's lives in a powerful way.

Here are seven tips for success: 

1. Keep the experience short & simple (at least at first).

2. Make interaction really meaningful for everyone.

3. See everyone as a volunteer.  

4. Use technology if possible.

5. Involve the parents of youth too.

6. Involve the families of older adults too.

7. Keep the momentum going and make it FUN!

Cooking with Dr. Laura Ellis

Dr. Ellis rolls out her pasta

Our doctor, Laura Ellis, volunteer to be a guest chef at Hale Makua Kahului and cooked up some homemade pasta with Alfredo sauce, and spinach raviolis for residents to enjoy. Yum!

Juanita hams it up for the camera

Gone Bowling

Residents at Hale Makua Kahului enjoy an afternoon of on-site bowling courtesy of the Activities team, who setup a "bowling alley" in the Aloha Cafe.

Making Pickled Mango

Adult Day Health client, Marion Watanabe, helps make pickled mango to raise funds for Hale Makua Health Services' participation in the Visitor Industry Charity Walk.

Highlights from Our Eden Alternative Reregistration Interview

In order to retain our status as an Eden Alternative Registered Home, we had to submit several letters from residents, family members and care partners in support of our Luana Journey, and take part in an interview with Eden Alternative Community Builder, Denise Hyde, and Eden Registry & Community Liaison, Suzette Molina. Several care partners from Hale Makua Kahului and Wailuku participated in the interview, in addition to two residents: Alan Camora and Laura Waiohu. One of the questions that we were asked was "What are you excited about?". There were so many wonderful things that we're currently doing that I wanted to share them here:

•  At Hale Makua Wailuku's Eden Alternative Path to Mastery Milestone 1 celebration, a vote was taken to see what  types of things residents, families and care partners would like to focus on in the future, and the one with the most votes was memorializing residents. A team of residents and care partners came together to brainstorm, and what the residents came up with was that they would like to know when one of their neighbors has passed and the way that they would like to be informed was by an overhead paging announcement to be made, asking for a moment of silence in remembrance of the person who passed. The residents also wanted to create a Memorial Bulletin Board where letters, photos, etc. could be posted in memory of residents.
• Hale Makua Wailuku's Dining Committee, consisting of residents and care partners, is currently creating a new buffet-like dining process where food temperatures are better maintained, since all meals must be transported from Hale Makua Kahului.
• A gardening club has started at Hale Makua Wailuku, where residents are growing a wide array of vegetables, including cauliflower, broccoli, beans, beats, lettuce, tomatoes, onions, and herbs. The residents choose whether they want to eat the vegetables or sell them so that they can buy more seeds for their garden.
• At Hale Makua Kahului a resident who used to grow roses at home now grows her own roses in her Pikake Neighborhood and shares them with her neighbors.
• Another resident from the East Neighborhood is growing eggplant in the neighborhood garden and shares them with the care partners, who in turn sometimes make a dish with the eggplant and bring it in to share with him.
• There's a Mens' Club starting at Hale Makua Kahului where Mark Souza, our Director of Maintenance & Engineering, is working with interested male residents to work with tools on projects of their choice.
• On the Ilima Neighborhood, a resident's family member has brought in a bird and is caring for it. Residents in this Neighborhood have also asked for a two person swing to be hung outside so that they can sit and talk story with family members or care partners while enjoying being outside.
• The Resident Council at Hale Makua Kahului has met with a veterinarian to talk about how a dog might potentially be trained to live at Hale Makua. They are interested in having a dog around permanently, but have reservations about how it would work and who would care for the pet.
• Hale Makua Kahului celebrated achieving the Path to Mastery Milestone 1 by hosting a Luana Carnival for residents, families and care partners. Each neighborhood and department team highlighted one of the Ten Eden Alternative Principles and featured a fun game. Residents selected the type of games that would be played at the Carnival and mailed out the invitations to their family members.
• Both homes are working toward shared dining and creating opportunities for care partners and residents to dine together. So far learning circles have been held to gather feedback and input.
• The Nursing team in Wailuku has begun including the Eden Alternative concepts in interview questions for new nursing care partners, and has also included a resident in the new hire interview process.
• One care partner at Hale Makua Wailuku asked the residents in her neighborhood who they would like to replace her while she was on extended leave.
• Administrator, Connie Miller, and Activities Director, Lynsey Capone, are going to become Certified Eden Associate trainers this Fall so that they can come back and begin training additional care partners.
• Connie is also taking ideas from the book "Seed Packets" and putting them into action.
• A resident a Hale Makua Kahului has volunteered to take over feeding the koi and fishes in the community fish pond.
• Residents in Wailuku are starting up a music group again.
• The care partners in Kahului Activities have each selected one resident that they are getting to know better outside of their regular work duties.
• Residents have often complained about how loud the gas powered lawn mower can be, so now we use a battery powered one.

Residents Help with Luau Preparations

Residents cutting the fabric and pinning together the pieces to form a bag

Some of the residents at Hale Makua Kahului helped us prepare for our annual Ohana Luau fundraiser by sewing beautiful fabric bags for sponsor table gifts. This reflects Eden Alternative Principle #4 - a community with opportunities to give as well as receive care. This is the antidote to helplessness.

Jerry strings a ribbon through the top of a bag

Vilma shows off her work in progress

Mitsue cuts the fabric to form the bag

Resident Takes Over Caring for Our Fishes

Hale Makua Kahului Resident Harold Rawson feeds our koi and fishes. He's taken over this responsibility from our Admissions Office care partners.

Eden Alternative Tip of the Week: Embraching Change with Humor

St. John's Home in Rochester, NY is pursuing a radically new organizational model and our neighborhood teams still struggle with artifacts from the old model of care. During a recent gathering of our Neighborhood Team Guides, the group sought closure on the past few years and began to look ahead to the process of changing roles.

 
Change can be difficult to promote, as we have to encourage new approaches, while not dishonoring people for their past work. There was much concern about striking the right balance, and one of the team members, Mimi DeVinney, came up with a clever and fun way to do this. She constructed a "Mad-Lib". Each team got the list of word types they needed to come up with (e.g., adjective, verb, positive emotion, negative emotion, co-worker, regulation, etc.). After each team made their list, they were given the text to plug the words into and read back their result to the large group. The text was "A Eulogy for the Institution." The eulogy had both positive and negative associations, as in real life, and the mad-lib style made it light and humorous for all.

 
Here's how it works...

 
“We've come here today in memory of The Institution. The Institution was our (1 - relationship). It was a (2 - positive adjective) Institution, a (3 - negative adjective) Institution, and above all, a (4 - past tense strong feeling) Institution.

 
Institution lived a good life. It existed for (5 - long period of time), and it dreamt of becoming (6 - legendary place). It survived many (7 - emergency code at the home), and overcame (8 - unpleasant situation at the home). Those who knew it, know that its (9 - negative association with a nursing home) kept it from achieving all its dreams, but that didn't stop it from building a reputation for (10 - positive association with a nursing home).

 
Reputation wasn't the defining element of The Institution. It's real heart was its staff. Looking at this group of (11 - word for workers), this is evident. I see (12 - person in the room) and (13 - person in the room) here today, each of whom made The Institution very (14 - positive feeling). I see members of (15 - department at the home) here, whom Institution loved since their day of hire. I've heard stories of (16 - task at the home) at (17 - a place in the nursing home), long nights of (18 - task at the home), fond memories of eating (19 - favorite food at the home) and days spent playing (20 - game played at the home). I've heard stories of the sacrifices made for the Institution, going without (21 - necessity of life), so The Institution could have (22 - tradition at the home), and comply with (23 - nursing home regulation).

 
I think it will make it easier to say goodbye, knowing how much Institution was (24 - opinion of another) and how it was (25 - past tense feeling) in its lifetime. Institution lived a good life and may (26 - a higher power) bless it. Amen.”

 
(Ad lib activity created by Mimi DeVinney, care partner from St. John's in Rochester, NY.)

Resident Letter of Support for Luana

Dear Sirs,

Just a note to say ‘thank you’ for the good care I receive as a resident here at Hale Makua Kahului in the Pikake Neighborhood.  And while it’s true that my 1st choice would be to live at home, I know that the care I receive here is the best I could ask for.  The openness to come and go safely and be able to join any activities I care to, or to play my harmonica where I like (of course with consideration for others) helps me make the best of my time here at Hale Makua.  Thank you for Luana benefits, I don’t believe I’ve ever seen a care home in my 96 years quite as good as this one is.

Sincerely,

Harold Rawson

Resident Ignacia Quiray Celebrates 100th Birthday.

Ignacia with her daughter and four sons

Over 50 family members gathered together on July 15, 201,1 to throw a party for resident Ignacia Quiray who celebrated her 100th birthday a Hale Makua Kahului. 

Residents Enjoy a Concert by Founding Member of Kapena

Tivaini “Tiva” Tatofi (center), a founding member of Kapena, offered a free concert for Hale Makua residents July 23 in Wailuku. He performed with brother Sione (back row, from left), son Joshua, niece Litea and daughters Vika and Naite. Hale Makua residents Dolly Villarimo (from row, from left), Sarah Takatani and Tiva’s uncle, Faaoso Talanoa, enjoyed the music and dance.