Gov may privatize
State Hospital

Cayetano says staffing problems
have made it 'dysfunctional'

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By Richard Borreca
Star-Bulletin

After failing two years ago to allow private operators to run portions of the state's Kaneohe mental hospital, Gov. Ben Cayetano says he wants to try again.

Encouraged by new legislation permitting the state and counties to use private businesses to handle certain government functions, Cayetano told reporters yesterday, he is looking at using the powers to privatize the troubled Hawaii State Hospital.

"The State Hospital has a lot of problems," Cayetano said. "We are frankly looking at privatizing the entire operation."

One of his biggest supporters is freshman Republican Rep. Charles Djou (R, Kaneohe), who wrote Cayetano Monday asking that the facility be run by a private agency.

"I believe that many of the issues facing the hospital regarding patient services, public safety, hospital personnel operations and court oversight can better be addressed by a private entity," Djou wrote to Cayetano.

Last week, U.S. District Judge David Ezra appointed U.S. Magistrate Kevin Chang as a special magistrate to oversee the hospital's operation.

Ezra's action came after the Justice Department sued the state in 1991, charging federal violations.

The state agreed to make improvements in treatment and facilities, but last week, a new report complained about overcrowding, staffing, safety and morale problems.

"That hospital and the way it is staffed has reached a point where it is dysfunctional," Cayetano said. "We have 600 employees caring for 160 patients. That is not cost-effective by any stretch of the imagination."

Djou said he has been concerned about security at the facility, which also served as a treatment facility for patients judged insane and unable to stand trial for crimes they are alleged to have committed.

Bruce Anderson, state health director, said he is exploring ways of having the state Public Safety Department, which runs the prisons, handle some of the pretrial detainees judged to have mental problems.

"We are not running a prison; we are running a mental hospital," Anderson said.

"One alternative would be to develop a secure treatment facility at Halawa (prison) or OCCC," Anderson said.

He added that the state is already using more than $30 million in private mental health services, and compared that to the $27 million annual budget for the state hospital.

One of the problems facing the hospital now, Anderson said, is that the court requires certain staffing ratios, and it makes the hospital inefficient.

"If you have too much staff, it can make it hard to supervise," he said. "We would like to have as much flexibility as possible."

Anderson and Cayetano both noted that when they tried to privatize the hospital two years ago, "we ran into a gauntlet of opposition."