Bill to split Maui hospitals raises fears
Three Maui County hospitals would be able to leave the Hawaii Health Systems Corp. under a controversial bill that Maui advocates have been pushing for at least five years.
The House Health Committee yesterday approved Senate Bill 1792, Senate Draft 3, with amendments, and forwarded it to the House Finance Committee.
Its scope was narrowed from the proposed establishment of five regional corporate affiliates of the 12-hospital system to a regional corporation only for the Maui region for five years. Maui Memorial, Kula and Lanai Community hospitals would be affected.
A provision was added for a task force to examine the feasibility of separate corporate affiliates for all regions.
Written and oral testimony was presented from about 800 people at the hearing, chaired by Rep. Jon Mizuno (D, Kamehameha Heights, Kalihi Valley, Fort Shafter), the committee's vice chairman.
Committee Chairman Josh Green (D, North Kona, Keauhou, Kailua-Kona, Honokohau), a Big Island emergency physician with a Hawaii Health Systems Corp. subcontract, said the attorney general had ruled he could work on HHSC-related issues. But he said the House Speaker had asked him to recuse himself "so there would be no appearance of conflict."
Green said he won't vote, but he feels the Legislature should "go slow" in moving toward HHSC regional corporations. "Hospitals like Hilo, Kona and Kau can't fly on their own. We should not jeopardize their existence."
He recently spent a day with Maui Memorial Hospital doctors and said he supports a regional board "that has the kind of spending and decision-making authority doctors want."
But he said he has "grave concerns" about the impact of five separate corporations on the smaller hospitals and regions that don't have the economic clout of Maui Memorial.
"I think we can strike some type of balance," Mizuno said, calling the House-amended bill "a work in progress." He said some neighbor island facilities say the HHSC isn't hearing their concerns, which could be addressed by giving regional boards power to deal with local issues.
HHSC President Thomas Driskill said he supports an idea that the system's board be composed of two members from each regional board so neighbor islanders would be running the system.
He also suggests studying what can best be done at a systems level and what can be done at a regional level, but he cites many dangers in splitting up the $420-million-a-year state hospital system.
The Senate bill called for $100 million in revenue bonds for Maui Memorial to establish a heart, spine and brain center and Mizuno said he deleted the amount.
Asked what effect the bill would have on efforts to establish a second hospital on Maui, Mizuno said, "I wouldn't want to stop the possibility of another hospital on Maui if they need it."
Gov. Linda Lingle, who supports the proposed second hospital in Kihei, "may not necessarily like this (bill)," Mizuno acknowledged.
Testimony was overwhelmingly against a similar bill introduced in 2002 by Rep. Bob Nakasone (D, Kahului, Wailuku. Puunene, Paia, Spreckelsville).
But most of those testifying yesterday were from Maui and favored a separate regional corporation, Mizuno said.
Driskill said authorizing separate regional affiliates could result in duplicate services and higher costs for all hospitals. Maui Memorial, once the system's only moneymaker, is losing money now as well as the others.
The other islands don't want separate corporate affiliates and they don't want Maui to spin off because it represents 40 percent of the patient volume, he said. "It creates a situation that would be really competitive between Maui and everyone else."
