Tuesday, December 21, 1999

State of Hawaii

Deadline set on
state hospital order

By Debra Barayuga


The state has until June to comply with a court agreement governing the Hawaii State Hospital or will face having the federal court take over.

U.S. District Judge David Ezra said yesterday he will appoint a court monitor within 30 days to assist the state in providing adult mental health services at the Kaneohe facility, as it is required to by law.

And Ezra challenged the state Legislature to provide the state Health Department with funding necessary to comply.

"We owe it to the people of Hawaii ... to our sense of humanity and to the law to do what is right," he said at a hearing on the issue.

In the past 10 years, Ezra said, the state has been given opportunity after opportunity to do what the law requires, and "we have run to the end of the railroad track and the court is going to get off the train."

"Let's hope the last historic opportunity to meet the requirements of the law are taken up," he said. If at the end of six months the state still has not shown substantial compliance, Ezra said he will appoint a court master who will have the authority to seize state assets to carry out what needs to be done.

Robin Frohboese of the U.S. Justice Department, which sued the state in 1991 for violating patients' civil rights, said the department is pleased with Ezra's decision to give the state one last chance to comply.

"We believe he carved out a very sound and reasonable plan for facilitating compliance," one that is in keeping with what the Justice Department recommended, she said.

While the state has shown progress in complying with the court's order, there remain five areas which compromise patient care and safety, Frohboese said.

The Justice Department's status report cites inadequate treatment; inadequate discharge plans; inadequate psychosocial rehabilitation programs; inadequate nurse interventions; and a failure to meet nursing ratios.

For example, the court order requires each patient to have a comprehensive individualized treatment plan but that still is not being done, Frohboese said.

Anita Swanson, deputy director for behavioral health, noted that Ezra recognized the state has an excellent management team which is on the right track, but is limited by a lack of funding.

The State Hospital recently was awarded a full three-year accreditation which affirmed that patients are receiving "excellent care," she said.

Funding must come immediately, though, for the Health Department to show continuing progress, she said.

The state Health Department has submitted an emergency appropriation request in excess of $6.2 million after drawing funds from the fourth quarter of the fiscal year to pay for the expansion of community-based services not funded by the Legislature, she said.

The Justice Department noted that besides funding, final compliance with the court's orders also requires stable leadership at the hospital and more thorough planning by the state as it conducts a massive restructuring of the hospital.

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