State mental
facility may close

A court settlement pact over
the Kaneohe hospital
must be met

By Craig Gima and Helen Altonn
Star-Bulletin

The state Health Department hopes to close the Hawaii State Hospital in Kaneohe by June 30, 2000, if it can get legislative approval and money to transfer the 168 mental patients now there.

They would be moved into private treatment programs in the community or other public facilities.

State Health Director Bruce Anderson said the plan is necessary to meet a federal court settlement agreement between the state and the U.S. Justice Department.

A five-member team with three people from the Health Department and two from the Justice Department hopes to come up with a plan of action by June 15 that will satisfy the court, Anderson said.

Key lawmakers were briefed at the governor's office yesterday.

Kathleen Racuya-Markrich, spokeswoman for Gov. Ben Cayetano, said it's too early for him to comment on the plan. "It's something the administration is looking into."

Anderson said, "The basic problem is, the patients are not getting the treatment and rehabilitation necessary to get them out of the State Hospital.

"They are being institutionalized and iceboxed there for much longer periods of time than necessary. This is a civil-rights issue, and the objective we have is to treat them and get them out or to house them in secure appropriate facilities elsewhere."

About 80 percent of the State Hospital patients are criminals committed there by the courts.

State 'way behind the curve'

Anderson said the hospital staff members "are not comfortable dealing with a large number of forensic patients ... and, in fact, are somewhat intimidated by those patients.

"As a result, we have had a lot of staff abuse of patients and patient abuse of staff over the years."

He said attempts have been made for years to train the staff and provide necessary support, but "we just have the wrong people staffing the hospital."

More important, he said, "the most appropriate care that can be provided for those patients is in community settings where they have wraparound services more nurturing to patients."

"This is happening across the country. Hawaii is way behind the curve in terms of recognizing this is standard care for patients today," he said.

He said it's clear that the state can't fix the problems at the State Hospital and satisfy Federal Judge David Ezra, who "made it clear he wants a plan and a clear commitment by June 15 on where we're going with this."

Joanne Lundstrom, Mental Help Hawaii chief executive officer, said the concept of moving people out of the hospital isn't new. "It's the suddenness of it."

Mental Help Hawaii, a private nonprofit agency, has facilities for about 120 mentally ill people at 13 sites on Oahu and the Big Island.

Money would be needed to provide clinical support services needed by some hospital patients, Lundstrom said.

Some secure facilities also will be needed in the community for more difficult patients who resist treatment or haven't benefited from medications and services available.

Anderson said there will not be any cost savings initially to closing the hospital, but the state will eventually save money.

One of the cost problems the state has at the hospital is that the facility is not certified to receive Medicare payments. That is not the case with private providers, Anderson said.

Employees may be retrained

About 12 patients at the hospital are considered dangerous and will need to be confined in a secure facility. Options for those patients include sending them to mainland facilities or building a new hospital annex at the Halawa Medium Security Facility.

"We're certainly not going to release those patients out in the community," he said.

The hospital employees will be offered retraining and moved to other jobs within the state, Anderson said. Anderson said he will meet with public worker unions to try and get their support for the plan.

Senate Human Services Chairwoman Suzanne Chun Oakland questioned whether there are enough private facilities to meet the needs of patients and their families.

"I think the issue is not closing the State Hospital, but how are we going to deal with the fact we're not in compliance with the State Hospital the way it's operating now," said House Human Services Chairman Dennis Arakaki.