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Judge Ezra hails
progress in isle
mental health system


Hawaii is transforming what was once a "barbaric" mental health system into one of the best in the country, says Chief U.S. District Judge David Ezra.

Ezra agreed with federal and state attorneys at a hearing yesterday that Hawaii State Hospital has made great strides in meeting court-ordered improvements under a consent decree.

But they also agreed that patient safety still is an issue.

The Kaneohe hospital and statewide community mental health system have been operating under court scrutiny since the U.S. Justice Department filed a lawsuit against the state in 1991 over allegedly unconstitutional conditions.

U.S. Magistrate Kevin Chang, special master in the case, said in his last report in July that the hospital is making progress, but workplace violence was cited as a problem by his evaluation committee.

The committee is back at the Kaneohe hospital this week for a six-months review.

Justice Department attorney Verlin Deerinwater and Paul Aucoin, private attorney from Columbus, Ohio, who represents the state as special counsel, told Ezra they are pleased with the leadership and recent accomplishments in the mental health system.

"There has probably been more positive news in the last several months than in the last several years," said Deerinwater, who has been involved in the case from the beginning.

However, he said, the state Health Department will have a hard time meeting deadlines for all the requirements.

Aucoin said a strong leadership team bolstered with new positions is getting things done that have not been done for 12 years.

Both attorneys credited Chang and special monitor Kris McLoughlin for leading the effort.

"They are always willing to bring us to the table to get tough issues solved," Aucoin said.

One of those issues is patient safety, Aucoin said. He said he and Dr. Thomas Hester, head of the Adult Mental Health Division, have spent a lot of time talking about it.

He said they believe the hospital is safe, but some staff and patients may not think so and they want to make sure everyone feels it is safe before closing out the lawsuit.

Aucoin said he believes when the evaluation team returns in six months, "we will be close to compliance. We see light at the end of the tunnel."

Ezra said the case has been "long and less than satisfying in many respects," occupying 12 of his 17 years on the bench.

"I'm pleased with the attitude change," he said.

He said reticence to comply with the consent decrees for the state hospital and the Felix decree for special-needs children thwarted progress for years. He said mental health systems have slipped in other states because of economic problems, but Hawaii is benefiting from the consent decree and continuing to move forward.

Hester said he sees "more than just light at the end of the tunnel.

"When we get an integrated system and changes are under way, we will have the best in the country," he said.

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