Within weeks, money woes
By Helen Altonn
may shut the North Shore's
only hospital
Star-BulletinLinda and James Smith of Laie have many reasons to be thankful for Kahuku Hospital, especially for their 18-year-old daughter.
Her life might have ended at four months if not for emergency treatment for a form of pneumonia attacking the bloodstream, said Linda Smith, a Kahuku High School teacher.
The baby didn't have a fever but was whimpering, and Smith felt something was wrong, she said. She and her husband talked about waiting overnight to go to Castle Medical Center, then decided to make the seven-minute drive to Kahuku Hospital's ER.
"They treated her like it was meningitis; they couldn't really tell." Later, they learned it was a kind of pneumonia that kills babies without parents' even knowing they're sick, she said. "She was touch-and-go for 24 hours, and there another four days."
Two of the couple's four children were born at Kahuku Hospital, and James Smith was treated in the ER for a kidney stone on July 4, six or seven years ago.
"It was an interesting experience to sit in ER on the Fourth of July," said Linda Smith. "A man doing a fireworks display that year blew his arm off. A lot of bloody people came in ... I was glad they were there just for something as painful as a kidney stone."
But the hospital -- running a deficit of about $1.5 million -- won't be there much longer without state and community support, officials say.
It could close "in a matter of weeks" if a $417,000 subsidy from the last Legislature isn't released, said Keith Ridley, hospital president and chief executive officer. Hospital officials explained the crisis last week to Gov. Ben Cayetano, who said he is immediately releasing $100,000 and is considering releasing more.Even if the hospital gets the entire amount, Ridley said, it won't guarantee the 26-bed facility's survival over the next year. However, it would allow time to develop plans and apply for grants to increase hospital use and revenue, he said.
Built in 1929 as a clinic to serve Kahuku plantation families, the private, nonprofit hospital has had a troubled financial history.
Noelani Kamakeeaina, on the hospital staff for 20 years, said employees voluntarily worked one day without pay every two weeks in 1996 and part of 1997 to keep the hospital going.
"People don't know how important it is to keep it here. My mom had a couple of heart attacks. My son has a heart condition, and I have asthma kids (three out of four). One is real bad. Now I have twin granddaughters. If anything happens to them, we need a hospital out here."
Ridley said the facility provides "a feeling of wholeness" for the community, as well as frequent life-saving care.
"It is a wonderful resource for the community, and much needed," said Scott Lowe, media relations and sports information coordinator at Brigham Young University in Laie.
The last of his seven children was born at Kahuku Hospital, and he and a daughter have used its emergency-room services, he said.
However, the hospital would have closed last year if not for Queen Emma Foundation funding and a hooponopono -- or gathering of the community -- to try to save it, said Richard Spencer, vice president of the hospital's board.
Board members, doctors, insurers, employers and community representatives from Kaaawa to Sunset Beach met in a three-day retreat, he said.
He said the community formed a task force with 12 committees and elected an energetic new board. Daniel T. Ditto, president and chief executive officer of Hawaii Reserves Inc., is chairman.
The hospital is being restructured "to make it fit current medical times as well as retain the community desire for certain services, such as obstetrics and emergency care," Spencer said.
This is difficult in a managed-care environment, he added. But in 45 days, he said, "We've made more improvements in the hospital than the last couple of years," lopping $300,000 off the deficit.The hospital is recruiting volunteers and members, Ridley said. Residents may become members with a tax-deductible $10 donation, or can get lifetime membership for a $150 donation.
Ridley attributed the hospital's problems to insurance restrictions and the few physicians in the area. That is changing with the addition of a podiatrist, female obstetrician and specialty services, he said.
If the Kahuku facility were to close, Castle Medical Center would be the nearest hospital for the North Shore -- more than an hour away in an emergency, said Debbie Morikawa, executive director of the Ponds at Punaluu Assisted Living Center.
"Even if there is just one (heart attack) every couple months in the area, it's a life that could be saved," she said.
Kahuku Hospital also is essential in event of a hurricane, flooding or other disaster because access in and out of the area would be cut off, said Morikawa.
The hospital has a full range of laboratory and radiology services, a pharmacy, acute care, skilled nursing, outpatient and home health care services, an emergency room and birthing center.
Spencer said records show that in the last week, without the hospital's emergency-room services, "somebody would have died even before getting by helicopter to the next hospital."
With state subsidies cut in half the past three years, he said the decision was made to close the obstetrics department. "The community reacted very strongly in a negative manner. That started a downhill spiral in terms of usage, which we are now trying to overcome."Spencer said the Laie area has a lot of young families who are helping financially and as volunteers to preserve the obstetrics and emergency units.
Ridley said many cardiac cases are seen in the emergency room. "These are not people they can stick in an ambulance or private vehicle and send down the road." They are evaluated and stabilized, then a helicopter is called if they must be transferred, he said.
The emergency room also gets a lot of accident victims, Ridley said. Last week, 11 people in a two-car accident were treated there, he said.
Tourists also seek out the hospital for problems ranging from sunburn and coral cuts to chronic conditions and accident injuries, Ridley pointed out.
"Certainly, we would hate to see North Oahu get a reputation for not having medical care and have anything detrimental happen to our tourists," he said.
The North Shore has only one ambulance, Ridley noted. If everyone had to go to town for medical treatment, a second or third ambulance might be needed, he said.
"It would cost the state a tremendous amount of money, just having the service. Certainly, the cost in potential loss of life would be significant."
