Human Services
Price of Paradise · Hawaii Public Radio · aired 1995-02-19
Guests: Susan Chandler (Director, Hawaii Department of Human Services); Tom Dinell (Director, Catholic Charities Hawaii)
Duration: 1:05:01

[00:00:01] Randall Roth: Good morning. This is Randy Roth, host of the Price of Paradise Radio Show. Our topic today is Human Services in Hawaii, and with me in the studio to discuss it are Susan Chandler and Tom Dunell. Susan recently took charge of the State Department of Human Services, sometimes called DHS, and prior to that was a professor at the UH School of Social Work. Tom Dunell currently is director of Catholic Charities in Hawaii, and prior to that, he too was a professor at UH. He was in the Department of Urban and Regional Planning.
[00:00:32] Randall Roth: Susan, um, you have a very impressive resume, but it's the resume of of an academic person, and all of a sudden, here you are, director of this giant State Department of Human Services. And I think it was all of a couple of days that you were on the job, and you were hearing quotes from uh Newt Gingrich on the national level that sounded a bit threatening and and reading a report from the State Auditor uh that was highly critical of the department that you had just taken over. Uh welcome to the show, and how are you doing?
[00:01:01] Susan Chandler: Well, thank you. Yes, and welcome to DHS. Um, I know it uh it looks like I've been an academic for many, many years, and I have been teaching at the School of Social Work since 1976. But I have also been a social worker in the community for many years, and so I have been familiar with DHS and uh and other uh social welfare programs throughout the state.
[00:01:21] Susan Chandler: And uh I think I knew what I was getting into and um I'm interested in accepting this challenge and hope that I can provide some leadership to the organization and help it through some pretty difficult times. It looks pretty scary out there in terms of the changes at both the state level and the federal level. But um I like challenges and this is certainly going to be a big challenge.
[00:01:39] Randall Roth: Okay. Well, I want to come back to that in just a moment. Tom, good morning.
[00:01:42] Tom Dunell: Good morning, Randy.
[00:01:44] Randall Roth: Uh, any words of wisdom to uh another academic who's gone out into the real world?
[00:01:50] Tom Dunell: Susan's doing beautifully so far.
[00:01:52] Randall Roth: Could you tell us briefly, what is Catholic Charities and and what is director of Catholic Charities involve?
[00:01:58] Tom Dunell: Catholic Charities is one of the larger social service agencies, human service agencies in the community. And we have a number of these private providers that carry contracts with the state to provide services directly to to uh clients.
[00:02:19] Randall Roth: Do you do you serve just the Catholic community?
[00:02:22] Tom Dunell: No, we serve all kinds um people, all ages, all ethnic groups, all religions, and no religion at all. We don't ask the religious question.
[00:02:34] Randall Roth: And when you say you're under contract, uh, DHS, for example, will pay you a lump sum and ask you to to provide certain services?
[00:02:41] Tom Dunell: There are all kinds of arrangements, but that's basically it. There is a contract with the state agency, and it's either on a piece work basis, or it's a lump sum, or it's um some other kind of payment basis, and roughly, for Catholic charities, roughly 65% of our um income revenue over the years is through state contracts.
[00:03:07] Randall Roth: So you know Susan very well.
[00:03:09] Tom Dunell: Right. We have contracts, indeed.
[00:03:12] Randall Roth: All right. Susan, can you just real briefly, and I know we could spend uh several shows talking about what DHS does, but real briefly, what does DHS do?
[00:03:22] Susan Chandler: Well, generally, um its major mission is to assist people who um are unable to assist themselves independently. We have uh our largest program is a healthcare program for the poor. One component is called Quest, and the other is Medicaid, which is for aged, blind, and disabled people. We also have um cash assistance programs like food stamps, which is a federally funded program to help uh people who um have low income and uh our country believes should be able to still feed themselves adequately.
[00:03:54] Susan Chandler: We have a program called aid to families with dependent children, which is focused primarily on um out of country's concern about uh ensuring that children have adequate food and shelter. And so we pay low income people uh to to assist them to provide for their children. We also provide training and education so they can become self-sufficient and get off of those programs. And we also have a large child welfare organization where we are responsible for protecting children, where we are concerned with the abuse of children, abuse and neglect of children.
[00:04:26] Susan Chandler: And we have a small general assistance program again for people who are unemployed and can't find jobs or are disabled. So generally our mission is to assist people in their attempts to provide to care for themselves, provide them uh support so they can become self-sufficient. And we are what some people have see has called the the safety net where we um worry and have responsibility for the most vulnerable people in the society. Some of our programs are mandated by the federal government and some are um designed and funded by the state government.
[00:04:58] Randall Roth: How much money, rounding it off to the nearest 10 million or so, how much money in any given year goes through DHS?
[00:05:05] Susan Chandler: Well, counting the federal dollars and that's a very large part of it because our most expensive program, the Medicaid and healthcare programs are 50% federally funded, so is aid to families with dependent children and jobs. We're up there. We're up to about $860 million.
[00:05:22] Randall Roth: That's a lot of money.
[00:05:23] Susan Chandler: It certainly is.
[00:05:24] Randall Roth: Now, I know one of the things DHS does is to provide what some people call welfare, uh, cash assistance typically to uh to single parents of of children. And um uh there's a lot of discussion here in Hawaii and nationally about welfare reform.
[00:05:42] Randall Roth: One aspect, as I understand it, of welfare reform is is doing what you can to to get the recipients to become self-sufficient. Right after you took this job, the state auditor came out with a report that said that that the approach that DHS has been taking in the past, um was inefficient, expensive, wasteful, focusing neither on reducing welfare costs nor increasing employability. And it it worked through some numbers that made it look as though it was just an awful lot of money going into something and and not much in the way of results coming out. What's your response to that uh audit?
[00:06:20] Susan Chandler: Well, this is our Jobs program. And um I think that our Jobs program in Hawaii is very well designed. It has a philosophy that says that if you're really interested in helping women uh get the skills that they need uh in order to care for their uh their children, get jobs that um will pay them a livable wage, it's not going to be a real quick fix.
[00:06:43] Susan Chandler: Many of the women who come into our Jobs program have maybe two or three children. They're reading at an eighth grade level, many have health problems, many have um been in abuse situations themselves, either as children or as spouses. So to assume that you can put them in a six month program and then then say, okay, go get a job, which would have to be about $9.80 an hour in order for them to pay for their own healthcare, their own childcare and their own uh employment expenses, is really very difficult.
[00:07:12] Susan Chandler: Uh, there's been lots of studies done on the mainland about these kinds of programs and most of the data shows that you can do it more quickly and you can do it more cheaply, but you don't really bring people out of poverty. So our program was designed, since we had the money in those days, uh to do it a bit more comprehensively, to give people the opportunity to stay in the program a little longer and we believe that with a bit more remedial care and time and effort that we would actually be able to take people off welfare and they would stay off welfare.
[00:07:43] Susan Chandler: I think the auditor does what auditors do. They look specifically at how many people and how many dollars. Many of our people are still in the program.
[00:07:51] Randall Roth: Do you do you agree with their um dollar, their bottom line figure that on the Jobs program that it's about $100,000 that spent per success?
[00:08:01] Susan Chandler: Well, um I mean it's correct that I think that what we say is that success defined as someone who has just exited is not necessarily success. We have people in the program still who have been in it programs only two years old. So if someone's going to school and is going to complete their uh education in June, they're a success because they're getting education um but they're not finished yet. So I think what uh what the auditor and we disagree on is exactly whether or not they've given us a chance to demonstrate ourselves um effectively yet.
[00:08:32] Susan Chandler: Um, however, I'm aware that it looks like an expensive program. It is more expensive than many of the programs on the mainland and our state legislators are saying, well, that might be a good idea, but with budget cuts we'd like you to do less. And we will do less, but I think it's at some cost to the philosophy of the program.
[00:08:49] Randall Roth: Tom, do you have any thoughts on this?
[00:08:52] Tom Dunell: Yes, and um the Jobs program is a good idea of getting people permanently off welfare and if we do it on simply a low cost basis a person may get off welfare and be in the job market for a while and then come back on welfare. And just the cost Susan was mentioning um a person that goes out in a minimum wage job is unlikely to have medical coverage, is unlikely to have childcare. And as soon as they get into the first difficult situation with a medical crisis the likelihood is they'll be back on welfare. And the problem isn't welfare, the problem's poverty and we keep getting these two confused.
[00:09:38] Randall Roth: Okay. In case you joined us late, you're listening to the Price of Paradise Radio Show. I'm Randy Roth, and my guests are Tom Dunell, the director of Catholic Charities in Hawaii, and Susan Chandler, the new director of the State Department of Human Services, DHS. Our topic is Human Services in Hawaii, and listeners are invited to ask a question or make a comment by calling 955-8821. The number again, 955-8821, and neighbor islanders are invited to call collect, 955-8821.
[00:10:10] Randall Roth: Um What else? Susan, the the auditor report said you could do more with less, but as I'm hearing you, you're saying, well, they're just looking in a different direction. You're trying to make people's lives better uh for the long run, and to really get the self-sufficiency, and they're just trying to to find jobs, but they're dead-end jobs?
[00:10:31] Susan Chandler: Well, that's been a concern. Now, I think the auditor did raise some um important issues and she certainly given us some direction that uh that I think we need to uh explore very carefully. Um I I think uh that we can do it we can move people more quickly into job training programs. We've already initiated a change that uh will have every person who's applying for aid to families with dependent children uh who's able to um move into a part-time job.
[00:10:58] Susan Chandler: So we are increasing the emphasis on on early training and early education. But um I guess we just disagree on the notion that somehow this is a wasteful and inefficient program, because I think we differ philosophically about what we're attempting to do.
[00:11:13] Randall Roth: Okay. You know, I think a perception that a lot of people have is that the current welfare system provides an incentive of some sort for people to have children. And I think the feeling is on the one hand, we want to either remove that incentive or or provide some sort of disincentive, but on the other hand, there's a strong desire that that the kids not be hurt. Uh, Newt Gingrich is is uh is credited with having suggested that that people watch Boystown as though orphanages have um uh a role to play in all of this. What are your thoughts on it?
[00:11:47] Susan Chandler: I think why people have children is an extremely complex and and emotional question, and uh I have never seen any evidence that um depending on how much money a state gives someone in a welfare program that that is what uh people think about when they're deciding to have children or involved in the process of having children. Um I don't really think that that's the incentive. However, I I do think that there needs to be a message um given out to to people that people who father and mother children do need to take responsibility for those children.
[00:12:21] Susan Chandler: And uh I think our child support enforcement program is an extremely important program where we say to fathers, if you have children, you're responsible for these children, that you can't just kind of leave and assume that the mom's going to be responsible and that she can go on welfare.
[00:12:35] Tom Dunell: The Susan, there've been a lot of improvements in the child support program recently, but generally, what happens after divorce, separation, is that the woman's income goes down, and the man's standard of living goes up. Um, might also note, Randy, that the number of children per family is no larger in welfare than in the general population, either. Um, and I'll be damned if I can see people jumping into bed and saying, let's have a baby so we can get a welfare payment.
[00:13:09] Randall Roth: So both of you feel that that it's simply a misconception uh that young teenage unwed mothers uh would have fewer babies if they didn't have welfare to uh
[00:13:24] Susan Chandler: Well, I may offend I may offend my colleague here on the right, but Elizabeth Shore has a wonderful line, she's written a book on uh how to sort of revamp welfare from a positive perspective, and she says that education and opportunity is the best contraceptive, and I I believe that.
[00:13:40] Tom Dunell: Absolutely in agreement. There's no question that the best birth control devices are a series of life options that make it worthwhile.
[00:13:50] Randall Roth: We have a caller from Kapaulu. Mary, good morning, Mary.
[00:13:53] Mary: Good morning. Uh, I'm in the Jobs program now, and the uh, the original uh six week uh screening process and uh interview and education portion of the Jobs program was the most emotionally intense, spiritually uplifting, and intellectually directing program I've ever been in in my life.
[00:14:18] Mary: So uh, just some feedback from somebody that is now growing and has learned I learned a lot about myself and at 52 years old I wish I had had this program when I had when my children were younger, if I'd had it when I was in my 20s, I would have been a different person today. Uh, and I hope that there's some way that the program doesn't have to be cut totally, and maybe through a company involvement private enterprise, we can get them to sponsors aspects of the education program like through the nursing program or hotel uh service, so people uh like myself can uh get involved and maybe they could support some of the educational part of it to cut down the cost.
[00:15:00] Mary: But that training program, that six week screening and training program was marvelous, the people that do it are intelligent and sensitive and it takes us through some emotional work that I think as welfare's mothers, as battered wives, as as um some of them substance abusers like you said some of them uh not reading it at high levels and that we got we became a team and it was like I don't want to say it was like a 12-step but in a way it got real to the point that we had to look at some of our emotional responsibilities in not moving as people and not getting an education and staying stuck in welfare. And it touched those real sensitive areas beautifully.
[00:15:43] Randall Roth: Mary, I I think you're ready for a job as a promoter of the Jobs program. You you did that beautifully. Let me ask Susan if she has any response to that.
[00:15:53] Susan Chandler: Oh I think that's wonderful to hear. I I have heard many good news stories from our Jobs program's participants and um and I appreciate you calling because I know sometimes uh people only hear the other side about how expensive everything is. Um we're certainly not interested in cutting uh the strong parts of the Jobs program. We have to do some belt tightening throughout DHS, but certainly the components that deal with assessments and education and training and childcare are real crucial and we understand that. And um I'm glad to know it's working so well for you and good luck.
[00:16:25] Mary: Thank you. Could I make one other comment? Yes. One difficulty that I have had uh has been that uh I have a handicap child, emotionally handicap child, and the department of education and the uh uh special services for handicap children is in such a state of disrepair and non-service that many of the problems that I've had that have made it difficult for me to go out and work earlier were due to the lack of support and education for my handicap child. So you know, all of these state services kind of have to dovetail together to help us get off welfare.
[00:17:00] Randall Roth: Okay. Thank you, Mary. We have another caller, uh, let's see, it's Charlotte Charlotte from Kaimuki. Charlotte, good morning.
[00:17:08] Charlotte: Good morning. What can we do for you? Oh, I want to ask Susan some some questions. Uh not not really any any comments. Just a little bit of information. She mentioned that there was $860 million dollars, I believe, was spent on DHS here in Hawaii. Is that correct, Susan?
[00:17:26] Susan Chandler: Well, that's with all of the federal dollars. That's everything that comes through to the state. That's not all tax dollars.
[00:17:32] Charlotte: That's right. I was wondering if you could tell me what the breakdown is between what our state has to pay and what the federal government pays.
[00:17:39] Susan Chandler: Uh, well, actually, I don't have all my budget figures with me. I probably should know this, but um I don't. I I think that primarily the um more than 50% of the dollars come from federal programs. For instance, our food stamps program is totally funded by the federal government. Uh, our Medicaid program and quest program is 50% federal dollars, and so is our aid to families with dependent children. So probably about 65% of that is um federal dollars that flow through the state.
[00:18:09] Charlotte: Thank you. How many um uh recipients are there in uh DHS children and and adults?
[00:18:17] Susan Chandler: Well, again, I don't have that totally. I can give you the major breakdowns are um Aid to Families with Dependent Children, we have uh 48,000 children and 22,000 um cases. In our general assistance program, we have uh 16,000 people. And in our quest program, we have 120,000 people, and in our Medicaid program, which is aged, blind and disabled, we have 27,000 people. Then we have um foster care, we have um vocational rehabilitation. We have others in our Jobs programs, but I don't have one big figure.
[00:19:00] Randall Roth: Um Charlotte, let me ask, Susan, is there a booklet or is there some concise, uh communication that is available to people like Charlotte that we can get into that?
[00:19:08] Susan Chandler: Yes, yes, I probably should have brought that. We do have an annual report and
[00:19:12] Randall Roth: How could how could she get that or any listener get a hold of that?
[00:19:14] Susan Chandler: Yeah, I, um, I could certainly put some copies here if people wanted to call and leave their name and address, and we could mail them to. Do you, would you like to do it that way?
[00:19:21] Randall Roth: Okay. Uh Charlotte, if you would leave your your address with um, with our producer, then we'll be sure and get a copy of that to you.
[00:19:28] Charlotte: Thank you. Uh yeah, that's the kind of information, I think in this discussion, that people would like to have.
[00:19:33] Randall Roth: Okay, well, we'll get that to you for sure.
[00:19:35] Charlotte: All right, thank you very much.
[00:19:36] Randall Roth: Uh you know something inherent, I think in in Charlotte's question, um you've got several uh wolves at the door, I think, some threats to uh the future of of human services. One is that the economy in Hawaii is in uh bad shape, and we have at the state level what our governor has called a a fiscal crisis, and uh in their hands right now is an audit report that says DHS could do more with much less. Um how worried are you in terms of funding from the legislature this year?
[00:20:07] Susan Chandler: Yeah. Well, I'm worried. Um I think that we are going to be um getting some cuts. I know there are uh one of the ideas is that even at the state level, for instance, our general assistance program, uh which at the moment um is about $42 million. Uh, one idea is that they would just give us that and say, you have to decide what to do with that. Uh, rather than coming in for an emergency appropriation as we just did uh day before yesterday when we run out of funds.
[00:20:36] Susan Chandler: If we have more and more cases that come in, if we have more and more clients, we have um our system was that we would fund everyone who was eligible. Uh, what the state is thinking of is saying, well, you know, maybe we just give you the money and then you figure out, do you want to decrease the allocation, go less than $418 for each person, or do you want to somehow change the eligibility rules, and uh not and let people into the program quite as readily.
[00:21:03] Susan Chandler: Um, I think both of those are very uh difficult options because as we were saying earlier, these are poor and vulnerable people. And uh they need money to live on to um to even get a chance of becoming self-sufficient. So it's um it's a risky proposition to uh to take this job right at the time when they're budget cuts, but I think the legislature has to think seriously about how it wants to support its vulnerable people in the community.
[00:21:27] Randall Roth: Okay. In case you joined us late, you're listening to the Price of Paradise radio show. I'm Randy Roth and my guests are Tom Dinell of Catholic Charities in Hawaii and Susan Chandler, the new director of the State Department of Human Services. We're talking about human services in Hawaii and you're invited to ask a question or make a comment by calling 955-8821. Tom.
[00:21:48] Tom Dinell: Randy, just as a follow-up to what Susan's saying, is what we've done in welfare programs, including general assistance, is we've got set amounts, set qualifications, uh standardization, and not everyone needs the same thing or for the same length of time. And what we need is a great deal more flexibility in how we spend that money, and we need to shift the philosophy from one of maintenance, which is where we are now, and that's a fair criticism of welfare, to saying, what do we invest in this person or this family, so they can operate in their own.
[00:22:29] Tom Dinell: And a person with real skill, for instance, a woman coming off a a divorce and which she's suddenly been impoverished but has a really good background, uh educationally and work-wise, probably just needs a little assistance to get back into the job market. And someone chasing that husband too for child support. But someone else may need much more long-term, so we need to give Susan and her people a great deal more flexibility in how they spend the money they do have.
[00:23:02] Randall Roth: In in just a minute, uh I want to talk some more about that flexibility, but we have a caller. Uh I will come back to that point, and Susan, I I know you've got something to say on that too. Steve from Waikeiki, good morning.
[00:23:13] Steve: Yeah, good morning. I'm uh particularly interested in the uh part of the discussion that has to do with uh getting people out of uh dependency on welfare and into jobs, and the problem that there exists if the jobs aren't there to begin with. In other words, in the state of Hawaii, do we have an economy to which we can uh shuttle these people? Uh, and I'm particularly concerned uh about the uh the tendency on the part of some professions and some jobs and some uh industries um to want to keep the pie sliced up among a limited number of people.
[00:24:00] Steve: Uh, is DSSH, do they have a cooperation program with the unions and with the the various organizations to help people into these jobs? Uh, and once they get there, are the jobs there? That's I think a major question, which I don't think DSSH can can control. I mean, they're they're not in the jobs creation business. They may be in the training business, but they can't create the economy that can absorb these people. And unless the economy is there, what can they do?
[00:24:30] Susan Chandler: Well, I think that's an excellent question, and uh there always has been this notion, I think from people who want to reform welfare, that somehow we should just get people off these roles and into jobs. Clearly, when the economy is good and there are jobs, then that makes a lot more sense. Uh, we have um I think been establishing very good relationships with the private sector uh and we are working with the unions so that uh we can provide many of the people in our jobs programs opportunities so far.
[00:25:00] Susan Chandler: I think if the economy doesn't pick up, we will have the problem of having to find additional incentives for the private sector to uh to take our folks and give them some opportunities. And um sometimes this is done through tax credits or or other kinds of arrangements with the private sector. But you're absolutely right, if you're asking uh an employer to uh kind of take a risk on a person who doesn't have um a whole lot of job experience, doesn't have a very strong education background, maybe has some difficulties in their personal life, and and hire them when there are other people who have had who recently lost a job with lots more experience, it's it's going to be difficult.
[00:25:37] Susan Chandler: We do have some um attempts where we are asking people to um just work part-time and to give them uh, you know, some transition into the work world, which we think is important for the um person in the on on their way to self-sufficiency. But clearly, it relates to how the economy is doing, and you have poor people when the economy is not doing very well.
[00:26:00] Tom Dinell: This is Thank you. This is a nationwide problem, Steve, and just the whole change in the economy and the reduction in blue-collar jobs across the country, and what we are getting moving towards is much more of a two-tier economy in which some people do very very well, and other people are at minimum wage or a few dollars above minimum wage, which isn't enough to lift you out of poverty. And uh the problem here is exactly what you say. Are there jobs for people there?
[00:26:37] Randall Roth: We have another caller, Barbara from Honolulu. Barbara, good morning.
[00:26:40] Barbara: Good morning, Altima Radio down. I am so glad that I awoke to hear this program this morning and to be able to speak directly with uh Susan Chandler. She's a very busy lady, you can't get her in the office. My uh organization, Ajo Co-op, is not what is generally categorized as private sector. We are grassroots level, everyday human beings trying to survive.
[00:27:09] Barbara: We are people who've worked 25, 35 years and have executive experience and there are no jobs for us because of any number of reasons that it shouldn't uh be uh like age and race and that sort of thing. However, we're trying to do something for ourselves, but we can't get any attention or assistance from people who have problems finding solutions. We can be trusted to find some solutions for ourselves, and we have found one. And it's a way of working cooperatively together. If uh, for instance, our organization uh could get 50, 100 people with different skills, we could create jobs for ourselves, helping each other.
[00:27:55] Randall Roth: So Barbara, you're saying these are people who who aren't on welfare and don't want to go on welfare, but they're going to have to if they can't find meaningful work.
[00:28:04] Barbara: They're on the border, and I'm one who is on welfare after 35 years of experience, executive experience. Through it, I was blessed to be able to go to school, uh higher education even. But we had already been working on this project when that happened. So what I'm saying, number one, there are people in the grassroots level who have knowledge, expertise, and we can be trusted.
[00:28:33] Barbara: Number two, we don't want our program duplicated in the government sector. Number three, we need your attention and assistance. We're sending out faxes to all of the uh leaders, uh community leaders and and elected officials and and department heads saying, we know the cutbacks are happening, there are going to be other people like us. Please give us some attention and help us save our base.
[00:29:01] Randall Roth: Barbara, let me get uh Susan, do you have any any reaction? It sounds as though Barbara's experiencing what the folks that that you're directly trying to help are experiencing.
[00:29:09] Barbara: I am one of them.
[00:29:12] Susan Chandler: Yeah, I'm not familiar with your specific organization. Um you certainly have my attention now and um I I see that uh um what Department of Human Services really does need to do, and I think it it has in the past and we'll do more of is to to work with the private sector folks, to work with grassroots people.
[00:29:32] Susan Chandler: I don't I I see the the private sector agencies and the grassroots organizations as an extension. I don't see it I know in the past people have felt they've never been able to get a ear at DHS. And um you're quite right. I am very busy during the legislative session. I'm always over there and you can probably find me there if you're looking for me. But when the legislative session is over, um I think we do then turn our attention to looking into the community, see where there are some good ideas, where we can get some help in uh in extending our mission.
[00:30:03] Susan Chandler: We obviously cannot do it alone. We need good ideas and we need um help and support to uh to make DHS uh do the thing that it has that it wants to do.
[00:30:14] Randall Roth: Barbara, thank you for calling. I think it's safe to say you're now on the map at DHS, and uh I I think that's a good Call me on Tuesday.
[00:30:21] Barbara: That and that's good news. Call you on Tuesday.
[00:30:23] Randall Roth: That's what that's what she said. Thank you very much.
[00:30:25] Barbara: Thank you, Barbara. Bye.
[00:34:28] Malcolm: Malcolm
[00:34:29] Tom Dinell: Uh, a previous caller asked about the budget for DHS and the number of clients served, and, uh, just recently, after that, you spoke about the difficulty of placing people in jobs when the uh private economy isn't doing well. Um, I wonder if when DSSH proposes some program or writes a contract for social services, say to a uh family counseling facility on the Big Island or a medical facility, uh, drug treatment facility on Oahu. Um, what kind of cost-benefit analysis they use before uh letting this contract or, It's It's a good question. Let's see what Susan says.
[00:35:20] Susan Chandler: It's an excellent question, um, and it's one of the questions that I asked the first week I was there. I wanted to look at uh all of our purchase of service arrangements. As uh as you know, um, about uh $10 million of the DHS money goes into the private sector in terms of additional service delivery. And these are called purchase of service contracts, which we contract with a variety of private agencies.
[00:35:45] Susan Chandler: There has been a very big concern not only at DHS, but at DOH and in other agencies, about how are these dollars being spent, and um what is the monitoring and uh quality assurance arrangements so that we can be sure that the dollars are being spent properly and adequately.
[00:36:03] Susan Chandler: Uh, the governor is very concerned about this, and the Office of State Planning has put together um another initiative to uh try to standardize this effort, so that the contracts are written uniformly across the different private agencies from the public agencies, and also that there are outcome measures that are built in, so that we would know at the end of 6 months whether or not, not only whether the the clients have been served, because that data we get, we get every month how many clients have been served.
[00:36:32] Susan Chandler: But the question really is is how well were they served and are they served in a way that is moving them to meet their goals, and how many dollars are being spent efficiently? So, um, this administration is extremely interested in this, and uh Greg Pai is the person now at the uh Office of State Planning we're all meeting on Tuesday, actually on this topic.
[00:36:53] Susan Chandler: And uh many of the state agencies want to design a system that really does provide us better information, not only for monitoring this round, because we're already in the process right now, but also to rewrite some of the contracts so that we can ensure that this will happen, um, clearly right from the start next time.
[00:37:09] Tom Dinell: From the private sector viewpoint, this is exactly the direction that we want to move in. Uh, the private organizations, nonprofits, want to be accountable for what they do and they want to hold the state accountable for what the state does. And it's important to write those contracts in terms of agreed-upon outcomes and then determine, have we reached those outcomes, have we achieved them. And we need to do this as a partnership between the department and the state and not just another uh set of requirements handed down from on high. Okay. I wonder who what uh criteria you use in choosing your conference Tuesday that you're going to have.
[00:38:00] Speaker 1: Discussion, have are you familiar with life, life or risk, risk analysis? There's a it's a field of a specialty, I guess, of cost-benefit analysis that concerns itself with the idea that there is a point of diminishing marginal returns and that, in fact, returns can diminish below zero.
[00:38:25] Malcolm: Malcolm, one of my jobs as as host is to keep this from getting too academic and and losing too many listeners. I I really appreciate your call and I think the topic you're raising is is probably very important, but I think it goes beyond what what we're equipped to handle during this one-hour telephone uh call program. So I I really appreciate your call, but we're going to have to move on. All right. Uh, for those of you who joined us late, you're listening to the Price of Paradise Radio Show. My guest today are Tom Dnell, the Director of Catholic Charities in Hawaii and Susan Chandler, the new Director of the State Department of Human Services.
[00:38:57] Malcolm: The topic is Human Services in Hawaii, and listeners are invited to participate by calling 955-8821. If you want to ask a question or make a comment, the number 955-8821. Well, before we took those last few calls, the word flexibility came up. Uh, Tom in particular suggested that it was uh a good thing to be given an amount of money and some discretion and authority to to use it in in the best possible way. Susan, I think you had a comment to make about that and then I've got a couple directions I'd like to take it. Thank you. Okay. No, I appreciate you getting back to that question because I think that is a crucial question.
[00:39:35] Susan Chandler: A lot of the welfare form reform language that's happening both at the federal level and I think many of our own state legislators are also thinking of it is that if you can provide the states with more opportunities to design their programs in a more responsive way, and diminish the number of federal guidelines and requirements. The notion is that the programs might become more responsive and that you can aim your dollars more efficiently and more effectively in the community. That's the theory. And I think that's a terrific theory. And then, um, I have gone to the legislature many times and listen to ideas that they have.
[00:40:09] Susan Chandler: And I have to say, well, I'm awfully sorry that's a great idea, but because of federal requirements, we're unable to do that. We'd have to get a federal waiver in order to do this, in order to do that. So the notion of flexibility in returning the um the programming to the state is a very good idea. Can I stop you and ask you, does that mean that you and Newt Gingrich are together on on this one?
[00:40:28] Susan Chandler: Well, um, at that level, at the at the most abstract level. And and just so listeners know just what I'm talking about. Uh especially in the last couple of days, there've been a number of reports that on a federal level, the the Republican's part of the Contract with America is to uh get the federal government to stop dictating that the states would provide hot meals or what constitutes a good meal or that sort of thing. And instead, just give money and and let the folks at the state level decide what to do with it.
[00:40:57] Malcolm: But a lot of people have have criticized that. Susan, it sounds as though you think at least in in principle it makes sense.
[00:41:03] Susan Chandler: Right. I think in principle it does and it's very appealing. It's not a new idea. This is what we used to do before 1935. Um, however, the downside of it is that um, if you release all of the rules and regulations to the state, uh then some states don't behave as well as they should. Money is not assured that it will go into the most vulnerable populations, if somebody wants to build another stadium for instance, the dollars may go there as opposed to nutritious lunches for children. So, um, you then have both responsibility at the state level, but it also turns it into a somewhat more political process.
[00:41:39] Susan Chandler: And although many people are concerned about the fact that low-income folks don't have a very good lobbying force and so often times they don't get the dollars that they need. So I think we have seen some very positive aspects of flexibility. Our quest program, for instance, is a waiver from the federal government that says we can put people into managed care.
[00:42:00] Susan Chandler: And we've demonstrated that we can do it. We we're saving dollars and we're providing high quality care. Other states can't do that unless they too have a waiver from the federal government. So sometimes you can be very good, you can uh use your flexibility very positively, and I believe this state will because our governor understands the needy people in the state and what their needs are, but I worry a little bit about some other states that don't have as good a tax base and may not be able to protect people as well as they should be protected.
[00:42:29] Tom Dnell: Susan has a reason for worrying because in the welfare AFDC aid to families and dependent children, the state waivers generally have been punitive rather than uh creative. And, um, so that we have a long ways to go. Another point that's really important, the Republicans in Congress are suggesting grants to the state, lump sum grants, but they are also saying we will cap those grants. So there will be no increase in expenditures, which means over time, as inflation occurs, uh there will be less and less money for social uh programs.
[00:43:15] Malcolm: In fact, this morning's newspaper, I happened to to glance at an article in section A and I think there was a quote from Newt Gingrich saying, you can't have both the the welfare state and a balanced budget. And we're left to guess just exactly what that means. Welfare is a very small part of the national budget. The reason for our deficit oughtn't to be blamed on the poor. Okay. We have a caller from Eva Beach. Grace. Good morning, Grace. Good morning. Yeah, you're just talking about topics that I'm real concerned about. I work with uh families uh on aged dependent children.
[00:43:51] Grace: And uh one of the problems that I see facing a lot of families is drug addiction. And I want to find out um you know, what kinds of plans are out there to um help curb this problem as we get people job ready.
[00:44:10] Malcolm: Okay. Susan, I know from your resume as an academic, you did a lot of work in that area with substance abuse. What what are your plans? Actually, this is an extremely difficult um issue. Uh there hasn't been very good data to substantiate the effectiveness of most of the treatment programs.
[00:44:27] Susan Chandler: Um, you know, many people believe that uh AA is a solution and it certainly is for many people. Um, but people who have drug addiction problems often times take a long time to uh to get over them and it does have severe impacts to their family and to their um job opportunities and prospects. Um, what we're doing, we're introducing a piece of legislation this year uh that says that a person who is on general assistance, which is our state funded program, must be in a drug treatment program in order to um stay on general assistance.
[00:45:00] Susan Chandler: And this may sound punitive to some people, but uh we feel that unless we get a little stricter with the people who have alcohol and drug problems and uh tell them that they really must get into treatment and must stay in treatment if they want to get state support. And we believe that this may um push some people into treatment who aren't there yet and hopefully um bring down this uh this problem to a somewhat more reasonable level. But again, across the countries and across the states, this is an extremely serious problem, and I wish I had a better answer and solution, but I'm I don't. Let's see if Tom Dnell has any ideas.
[00:45:37] Tom Dnell: Susan, assume that the person won't take uh the drug addiction treatment, whatever the addiction may be. Yeah. What happens to the children in this case? Well, this is not in our aid to families with dependent children program. This is our general system. No, make it a general question.
[00:45:53] Susan Chandler: Well, unfortunately, Or even in general assistance, what happens to the children when you knock the person out of the program? Well, I guess this is the tough question, isn't it? If you're going to get tough with the parent, does the child end up getting hurt? Right. Well, I think the child may uh end up getting hurt. I think if the parent is really unable to care for the child, we may see the child in our child protective service program. Um, they may have to be removed from the home, which of course is a is a devastating outcome.
[00:46:20] Susan Chandler: Uh, again, we don't have an easy solution and we believe that if people are at least are told that from now on, you must be in a drug treatment program and you must be receiving treatment, we believe that uh that will at least encourage people to stay in treatment, some of them.
[00:46:35] Susan Chandler: The ones who don't may uh we may find them on the streets and their children may indeed become neglected, but our hope is that when the message is loud and clear and proactive, that people will finally uh take the step to get some treatment and uh get the benefit of treatment. Okay. Question is there is there enough treatment available? For the people that need the treatment. Boy Grace, you're asking the tough questions. Well, no at the moment there's not really sufficient slots, however, That's a problem, you know. We make these things for the legislature, and then we don't have anything to follow through with.
[00:47:08] Susan Chandler: Well, the people who are on our general assistance program also um are eligible for our quest program. So because we have a medical care program, they will be able to uh get treatment, they will be able to buy treatment and our hope is that uh that there'll be more treatment programs because there's now funding for for them.
[00:47:26] Malcolm: Thank you, Grace. Appreciate your call. Okay, thank you. We have another caller, Tom uh who started out in one area of the city, but is undoubtedly in another one by now who's in his car. Uh good morning, Tom.
[00:47:38] Tom Dinell: Uh good morning. I have a question for the uh Director of DHS. Uh when you were talking about the uh drug programs, and it sounds like you have a lot of experience in that. Um how do you deal with someone or how do you even find out? Uh as an example, I have a person who lives in a park across the street from me and gets what is claimed to be uh I don't know, $400 or $500 worth of crazy money a month, and talked to his worker and uh his worker said that he has no obligations at this time other than to come in and get recertified about approximately every six months.
[00:48:12] Tom Dinell: And uh I said, well, you know, I sit there and I watch him do crack uh or ice something in a little pie pipe that he's smoking, and he's never been convicted, and they don't have any way of saying, I mean, he doesn't, he's not required to take drug screening. How how can that person break that cycle, or how can we, you know, keep from having to support that guy's habit and uh Yeah, let's see what Susan has to say about that.
[00:48:33] Susan Chandler: Right. Well, and I think this is exactly the um the concern that the public has. Now, um we don't estimate that this is a huge uh huge number of people abuse the system, but there certainly are people who do.
[00:48:45] Susan Chandler: Uh we at the moment we do recertify so that a doctor must say that this person is addicted to alcohol and substance or substances. Oh, he's not receiving benefits as a as an addicted person. He's he he's got them convinced that he's crazy. Oh, I see. And uh he probably is, you know, he probably has uh mental health problems that need assistance judging by his behavior. But of course that behavior is exacerbated by the fact that he's uh into such heavy drugs. Right. Okay.
[00:49:13] Susan Chandler: Well, we have another initiative for this kind of person. Uh uh and Senator Andy Levin has been very interested in seeing whether or not we can't do something to solve this problem, and he has uh introduced a piece of legislation that we are we're supporting, which is called the representative payee uh bill. And that's kind of a big word that uh means that rather than give the money directly to a person who seems unable to spend it appropriately on uh shelter, which is what they're supposed to be spending it on, that um the money would go to a non-profit organization who then would dole it out more responsibly to a uh to the individual, so that they wouldn't just be going to the Department of Human Services and getting their check for $418 and then there not be any monitoring on how they spend it.
[00:49:55] Susan Chandler: So, again, this um this may affect maybe 400 or 500 people, which is not a largest percentage of the population, but it certainly um is a part that the public is concerned about and I think we do need to do a better job in monitoring the way people are spending the public funds.
[00:50:09] Malcolm: Tom Tom, we've got a couple more people who've been waiting on the line so I have to move on, but thank you very much for your call. Thank you very much. Okay. Joe from Honolulu. Good morning, Joe. Good morning. Uh, first I'd like to tell Tom that I do tend to respond to his letter asking for funds. Uh I haven't got to that yet.
[00:50:26] Joe: I got one of those too. I I wonder if everybody got one of those. Tom has reminded me that Catholic Charities gives to people who aren't necessarily Catholic, and I do tend to respond.
[00:50:36] Joe: Uh, I have a, I'm a little concerned about uh Susan, uh, just dismisses the idea that the present program as constituted does not uh does not um uh does not um promote illegitimacy and and uh and continue the irresponsibleness. Uh, you know, we call this aid to dependent children, but in my mind, it's really uh aid to uh uh mothers, uh who choose to uh have illegitimate children. Uh, except with regard to medical care, uh the money goes to uh the parent uh the the the the mothers. Now, mothers and fathers who father illegitimate children in my mind are irresponsible, uh, and it seems that uh, social workers and the department refuse to recognize the fact that uh that that men who foster, uh, who have children, and women who choose to have children without any prospect of having them in a in a loving home, uh uh, whether they're married or at least uh some commitment to be husband and wife even though there might be not might not might not be a ceremony, if they choose to do that without that context, are irresponsible people. And people who choose to have children uh with no prospect of supporting them without thought, are irresponsible people.
[00:52:04] Malcolm: Joe, does that mean uh that the children should be taken away from irresponsible people? Well, no, no, no, no. I I don't think so. Now, let me let me get Susan's reaction to the comments that you did make. One one question is, what's wrong with what's wrong with giving uh support to children? Now, the unfortunate you know, there's an unfortunate name of of of orphanages, maybe if you call them cabootzes or something else. But how about giving how about giving since we know we have your responsible people, how about giving the money to the children by some system other than just giving it [unintelligible — audio glitch] mother. in a way like a a person, a addicted person who can't spend it responsibly. That's right. Like like a representative person because because let's let's see what Susan has to say about that. Okay. I you know, I think this too is a rather emotional question and and I certainly um at times am sympathetic to to uh to your concerns.
[00:52:56] Susan Chandler: I feel that people should be responsible and uh should have children in loving homes and uh should be able to be both economically and emotionally able to take care of children before they have them. Um, unfortunately, we in society have a situation where sometimes people do get into hard straits. They uh had a loving family, but uh it's broken up for one reason or another. Um, not everyone on aid to families with dependent children has never been married, many have been married and are now not married.
[00:53:25] Susan Chandler: I think the point of the aid to families with dependent children is on protecting the children. The eligibility is based on the fact that there's a minor child in the family. And I think our society and our community needs to look and not just at DHS, but what are we doing in the communities to provide support for these families.
[00:53:43] Susan Chandler: Um, if the communities, I think the churches is a good place to uh to begin, and um nonprofit organizations as well as grassroots organizations, if those people were working with us in order to protect our children better, we wouldn't be in situations where we have to say, well, why should we be spending money on families that are um, you know, not not healthy families.
[00:54:05] Malcolm: Let's get the Tom Dnell's thoughts on that. I think we really do have to get back to the responsibility notion. We also have to do a great deal more to support in this country the importance of family. The family is taken a real hell of a beating in the last 20, 30 years.
[00:54:25] Tom Dnell: One part of that is let's put the social security numbers of the parents on the birth certificate and let's track the fathers. Uh we have of 30, 35, 40% support in terms of divorce fathers. We have almost no support from fathers where uh the birth is out of wedlock. Okay. Joe, I I appreciate your call. I've got a bunch of people waiting and we're running out of time, so I'm going to have to move on. Thank you. Oscar from Honolulu, you've been very patient. Thank you. Good morning. Good morning.
[00:55:03] Oscar: Uh this is Oscar Curren. I'm on the faculty of the School of Social Work. Another faculty member. Okay. Well you're among friends. What do you have for us, Oscar? Well, so far in the discussion, uh Susan the the situation with elderly has not come into uh discussion.
[00:55:17] Oscar: I know that over half of your Medicaid budget is devoted to paying for long-term care in facilities into hundreds of millions of dollars. Uh we know that all of the hospitals have weight lists of elderly patients who need to go to long-term care facilities and there's no room for them. And we know that each week in the emergency rooms in all our hospitals, elderly show up who are abused and uh neglected because of a breakdown their family support system.
[00:55:45] Oscar: And I know that there are each month hundreds of calls come to your adult protective services of people who are pleading for help and only a fraction are responded to. Now, my question is this, um, is there room for an approach might be similar to Healthy Start where we look at the situation at the beginning of a crisis, a problem and don't wait until the roof caves in and we provide help to these people who are beginning the long, difficult task of caregiving and provide them with a kind of supports they need so that they don't have to show up in emergency rooms or in long-term care facilities.
[00:56:22] Malcolm: Susan, can we get a quick response so we can get to the the the rest of our callers waiting? Yes. Um Oscar, I apologize for not uh discussing the elderly as one of the groups and missions that um that DHS has. We certainly are concerned with protecting the elderly and uh are concerned about adult protective services.
[00:56:39] Susan Chandler: I would hope that there would be room to initiate the kind of front end or preventive sorts of services that you're um talking about and uh I think that that is a real answer to um so that we don't see people at the other end uh as you're talking about in the emergency rooms and in uh adult protective services at the DHS. This one of the
[00:57:00] Oscar: everybody so Oscar should know that we carry out through Catholic services to the elderly, and it is and an important part of that is respite, giving a break to the caregiver, so that they can do other things beside 24 hours a day care.
[00:57:16] Randall Roth: Oscar just a real quick question of you. Did you get Tom DeNell's letter trying to get some money from you too?
[00:57:22] Oscar: How are you, Tom?
[00:57:24] Randall Roth: Great. Oscar and I await your response.
[00:57:27] Oscar: Thank you for your call. Hopefully, we can have you as a guest on one of our future shows. Thank you.
[00:57:32] Randall Roth: You're listening to the Price of Paradise radio show. I'm Randy Roth. My guests are Tom DeNell, the director of Catholic Charities in Hawaii, and Susan Chandler, the new director of the State Department of Human Services. Our topic is human services in Hawaii, and normally at this time, I would invite listeners to call in to ask a question or make a comment. But we've got some people waiting on the line and we're down to the last five minutes or so, so I'm not even going to give you the number. Bill from Kailua, you've been waiting patiently. Good morning.
[00:57:59] Bill: Good morning to you all. I mean on the initial stages of of of formative stages of a program for the information super highway, and I will very possibly be needing typing assistance to do routine things like address labels etc. And I seem to me that there would be a great many people in the the in the community who are not able to take regular jobs that might be might be skilled and have typing skills that could do this kind of work, routine work.
[00:58:37] Randall Roth: Let me see what Susan's reaction to that is.
[00:58:39] Susan Chandler: We have become very popular lately with our jobs program. We are now helping people at the food banks, Senator Matsuura has been finding people, finding jobs for our jobs people. Um if you would call uh Gary Kemp at the Department of Human Services, he's our coordinator of the jobs program, we would appreciate any um assistance we can get from the private sector to help our people learn uh training skills and job skills and we do it both on a part-time basis, and even as a volunteer basis.
[00:59:07] Bill: Okay. Thank you, Bill.
[00:59:08] Oscar: Thank you, Susan. I'll certainly do that. What's his name, Kemp?
[00:59:10] Susan Chandler: Gary Kemp, KEMP.
[00:59:13] Oscar: Thank you very much.
[00:59:14] Randall Roth: Thank you, Bill. Good morning, Anthony from Chinatown.
[00:59:18] Anthony: Hi, this is Tony uh from Chinatown. Uh I'm a consumer. I haven't heard any consumers. I haven't heard anything about self-help groups. I've been cleaning sober 25 years and I started a group when I came here for the mentally ill, who are either just mentally ill or also have uh substance abuse problems. Uh I'm very greatly saddened by the by the lack of um push uh support from doctors, the mental health groups and all the rest. And I'm going to use the word pushing because I'm hard nosed. I've seen I I've lived in five countries. Uh these people need to be pushed into these programs, and the secretaries need to sign that they have attended these meetings. It does rub off on many of them. We we get cases from the courts. I'm shocked that the Alcoholics Anonymous people here use almost four letter language, that they don't want these people from the courts. They should be made to take these people. And sadly, uh the children that are in these these very unhappy uh drunken, drug situations, mental situations, is that also, they definitely should be taken and put in in a care home uh until the family are well enough to be able to care for them because they go without, they don't get any food, they don't get any care. Uh it's a very very bad scene. I I've been to too many of them, but uh it's yes,
[01:00:44] Randall Roth: Tony, we're gonna we're gonna have to move on. Do you have a specific question you'd like to ask?
[01:00:49] Anthony: Well, um no, other than I I am writing a letter for the Board of Directors and it's going to quest in others and it's uh it's uh what you said, that was that's what caught my attention was Pat when she started this out. You you really got to do this. You you've really got to, we can, I can give you case after case the people I've pushed into DVR and they're doing wonderful.
[01:01:15] Randall Roth: Well, we have
[01:01:15] Anthony: But they need that, they need that, and they need that. And people need to hear, people need to hear that from from folks like you, Tony, and I and I really appreciate Yeah. There's nothing like self-respect from working, but interview them and find the work that that they're going to be happy in, but but but do it. But you're not getting the support from the doctors and all the rest.
[01:01:35] Randall Roth: Okay. Thank you. because they like to keep making the money by keeping them sick, and I I'm being very blunt, okay.
[01:01:40] Randall Roth: Okay. And we appreciate your we appreciate your bluntness as well as your call. Thank you, Tony. All right. Bye. We're down to just the last minute or two. Um Tom, I I I didn't give you and we simply had too many calls, but I didn't give you the opportunity to talk a little bit about Catholic Charities that I wanted to. I know at the beginning of the show, you said it's not just for Catholics. Um can you tell us in 30 seconds what it is that you're doing and what folks out there need to know about and how they can be involved?
[01:02:08] Tom DeNell: It's serving a wide range of people. It's serving the elderly, it's serving children and youth, serving uh immigrants and uh refugees. And what we're seeking to do in each of these instances is to help people, for instance the elderly to stay as independent as long as they can, helping people to make their own decisions so that they can function easily and smoothly and productively in this society. And the advantage of agencies like Catholic Charities and other human service groups is that in compared to DHS, we're relatively small. We can have the personal touch, we can make the adjustments for individual needs, and work uh with individual families based on uh very close contact. So that then in partnership with the state, it becomes a very productive approach.
[01:03:12] Randall Roth: Okay. Susan, you've got 30 seconds to tell us just what are your primary thoughts about this exciting job that that you've just taken, your your vision for the future in 30 seconds.
[01:03:23] Susan Chandler: Well, I think it's uh it's a very interesting time to uh to be in public uh service. I think that we're facing some very hard times. I think the monetary situation of the state and the federal government is going to require us to do things differently. I think the reason I took this job is that I wanted to be a part of both the change, but also to ensure that the services that are needed for our most vulnerable populations are there, and that we learn to do things more efficiently and more effectively, but with a very high quality. I'd like to leave that as kind of uh my legacy if I can at DHS.
[01:03:58] Randall Roth: Okay. Well, I'd like to thank my guest, Tom DeNell and Susan Chandler. I think one of the neat things that UH has done is to produce a couple people like you to go out into the community and and actually work on these things. The Price of Paradise's producer is Susie Roth. Technical director is Jeff Filardi. This morning, the phones were handled by Jenny Tanji. You've been listening to the Price of Paradise radio show. I'm Randy Roth. Aloha.