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Brian Yamamoto and other clients return to their residences after work and classes at Opportunities for the Retarded Inc. Helemano Plantation is Hawaii's only full-service community for adults with developmental disabilities.
Conflict of interest raised at Helemano Plantation
The plantation provides a full-service palette to its clients, but a watchdog agency worries about their independence
Osame Yamamoto, 87, and his wife, Aiko, 85, feel confident in the care that their son Brian gets at Helemano Plantation, Hawaii's only full-service community for adults with developmental disabilities.
But some observers see an inherent conflict of interest in the interlocking nonprofit and for-profit corporations at Helemano, both headed by Susanna Cheung. They say its vulnerable clients deserve independent advocates to ensure they get a fair shake.
Opportunities for the Retarded Inc. and its sister companies at Helemano take care of all of Brian Yamamoto's needs - room, board, health care, education, training, job, wages, financial management, excursions and even vacation trips. The staff also acts as the de facto guardian for Brian, 48, who has Down syndrome.
The Hawaii Disability Rights Center, a government-funded watchdog agency, believes that the arrangement could lead to financial and other abuse, and that clients might not be able to stand up for their own rights.
KEN KOBAYASHI AND SUSAN ESSOYAN
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For 48-year-old Brian Yamamoto, who has Down syndrome, Helemano Plantation near Wahiawa has provided an oasis of stability and security, where he lives and works with his peers in a homey atmosphere with gardens of roses and hibiscus.
"I have fun, we talk story," said Yamamoto with a smile after completing his shift wiping tables. "I have a supervisor. She gives me an X on my card if I do well." He has lived at Helemano since it opened in 1984 and his parents came out as volunteers to help clear and plant the grounds.
The 8-acre campus on Oahu's central plain is the only operation of its kind in the state, an all-encompassing community for adults with developmental disabilities, including mental retardation and autism. Its 42 residents live in five-bedroom homes, each with a live-in counselor, on grounds that include a restaurant, gift shop and working farm.
All the residents' needs - including meals, health care, education, training, finances and jobs - are handled by the nonprofit Opportunities for the Retarded Inc. and its related companies at Helemano, founded by Susanna Cheung.
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"Even if we die now, I feel comfortable that he can take care of himself with the help of the organization. Without the organization, I don't know where he would be."
Aiko Yamamoto / About her son, Brian, a client at Helemano Plantation. She is accompanied by her husband, Osame.
But the interlocking nature of those operations has raised the hackles of the Hawaii Disability Rights Center, the agency designated by the government to advocate for and protect the disabled. The center is concerned that some of Helemano's vulnerable residents have no independent advocates.
"The major outstanding issue that needs to be addressed is the fact that ORI is the landlord, the vocational trainer, the employer, the medical provider, the representative payee for Supplemental Security Income, the case manager and de facto guardian if there is no guardian," said Gary Smith, executive director of the center. "Everybody but ORI seems to understand what a serious conflict that is."
After hearing of possible financial misconduct and deficiencies in care at Helemano, the center tried to get clients' records, as allowed by its federal mandate. Opportunities for the Retarded Inc. refused, citing client privacy, until the center obtained a court order.
Since then, the center says it has received some information on clients who have guardians but remains in the dark about the rest. The lack of openness rankles Smith, who calls Helemano a closed community with an inherent conflict of interest.
"I was never too concerned about the people who live elsewhere and go to ORI for day health," he said. "I know that there are other people involved in their lives. But for the people who live there, I am very concerned to verify that there is some outside involvement in their lives."
The suggestion that she or her staff might be taking advantage of clients incenses Cheung. She takes the accusations personally, and accused the Disability Rights Center of acting "like a big bully like Al Capone."
"I give my heart and soul to this place. I don't deserve to be treated like that. ... Where is the abuse?" she asked, her voice rising in exasperation. "Who is the victim? Never happen! We have tourists every day, we have visitors. No one ever sees us abusing anyone."
Cheung is the president of ORI, which provides housing and other services to clients, and president of ORI Anuenue Hale Inc., which handles vocational training and is building a senior center next door. She is also president of the for-profit Helemano Plantation Inc., which runs the restaurant, farm and gift shop, and Helemano Services & Management Inc., which hires clients for jobs at military dining halls.
Of the 42 clients who live at Helemano, 19 have court-appointed guardians, including one represented by the Office of Public Guardian. Another 19 have no formal guardians, but relatives are "significantly involved" in their lives, according to ORI. Four have neither guardians nor relatives actively involved in their care.
"Some parents are gone and they leave the kid in trust of me," Cheung said. "I did not know I'd inherit them."
Officials at ORI note that their facilities are subject to regular monitoring by various government agencies. The state Department of Human Services conducted a two-month investigation last year and found no evidence of abuse or neglect.
"No program is perfect," said Ron Renshaw, ORI program director. "If we have a flaw, we want to fix it. We're very proud of what we do. ... We don't see ourselves as a closed community. We have the public here every day. The military comes in and out. Our clients go out into the community."
But one outside expert sees potential problems.
Lambert Wai, 86, has been involved with the disabled community for more than 50 years, since the birth of his daughter, Faith, who is profoundly retarded. He is considered a leader in the field. Like Cheung, he calls the Disability Rights Center heavy-handed, but he recognizes the potential conflict of interest at ORI.
"If you provide the service and you're the guardian of the client, if there is abuse, how are you going to investigate?" he asked. "Very simple: You're going to favor the agency. That's not fair to the client."
Wai helped found the Arc in Hawaii, which provides housing and services to adults with developmental disabilities at a tidy campus on the slopes of Diamond Head. Cheung worked with him there for more than a decade, before striking out on her own, and he praises her as a "good, hard-working, dedicated person."
Wai also headed the task force that launched the Hawaii Disability Rights Center two decades ago. Earlier this year, Gov. Linda Lingle appointed him as her representative on its board. Wai thinks the center would have more success if it were more collaborative and less of a "bull in a china shop."
His own organization, the Arc in Hawaii, does not act as guardian, de facto or otherwise, for any of its clients. It has given those clients who do not have guardians to the Office of Public Guardian, he said.
"We were involved heavily in getting the state to create the Office of Public Guardian because of this conflict issue," Wai said. "At first I felt, we don't need the Office of Public Guardian because we are caring people, we love the clients we are caring for," he said. "But then I could see there is a conflict."
Wai wishes the two sides could come to terms.
"It's sad because HDRC's mission is to improve the quality of life for these clients, and that's ORI's mission," he said. "Something has got to be done to bring this thing to closure. Someone has to come up with an idea so that neither side loses face."
Osame and Aiko Yamamoto moved their son Brian to Helemano when they were in their 60s and he was 24 because they wanted a stable home for him as they aged. He has thrived at Helemano, they say, and they enjoy having him come home on weekends.
"He has learned to express himself. Before he would sit and cry," said his mother, Aiko, 85. "He has matured so much. He's happy to work here."
Yamamoto reels off the names of the various military bases where he has worked as a client of ORI, and the trips he has taken to Las Vegas and even Scandinavia. Helemano clients who meet behavioral goals and earn enough money at their jobs are eligible for an annual trip out of state. Those who do not have jobs stay home. (Helemano has its own travel agency, headed by Cheung's husband.)
The Yamamotos are not Brian's guardians, and they leave management of his care and finances up to the staff they trust at ORI. They say they have not seen a need for outside guardianship.
"Even if we die now, I feel comfortable that he can take care of himself with the help of the organization," she said. "Without the organization, I don't know where he would be."