State of Hawaii

State Hospital fixing old unit

The repaired building will be used
relieve patient overcrowding

By Helen Altonn

Sixty patients are scheduled to move July 1 into the Hawaii State Hospital's old Guensberg building after repairs are completed to relieve overcrowding, says Administrator Paul Guggenheim.

Closure of the building in the spring last year because of deteriorating, unsafe conditions stirred an uproar among staff and patient advocates who complained that relocating patients into four other units caused overcrowding and security problems.

The state Health Department asked the Legislature for $1 million to repair Guensberg for temporary use to ease the crowding and received $400,000. Officials said money will be taken from other Health Department and hospital sources to cover the full costs, which they hope will be under $1 million.

A legislative request for $250,000 to plan and design a permanent new unit wasn't approved and will be proposed again in the next session.

Guggenheim said the Guensberg work involved repairs to leaking sections of the roof, asbestos abatement, replacement of plumbing and ceramic tiles, as well as some light fixtures, toilets, showers and drains.

"It's going to cost a chunk of change. But because of being overcrowded, we need to have that space back," he said. "The best option is to repair that building and plan to use it."

Ongoing repairs also will be needed to maintain it for three to five years since it's more than 50 years old, he said.

The hospital is operating under a consent decree resulting from a 1991 U.S. Justice Department lawsuit alleging federal violations in care for the mentally ill.

In the latest count, the facility had 160 patients, with six on various leaves. Its capacity is 168.

Guggenheim said the Guensberg building will have two coed units providing intermediate level care. One will have 16 beds and focus on substance abuse and forensic rehabilitation. The other 20-bed unit will provide forensic and substance abuse treatment and psychosocial rehabilitation.

An extended care, all-male unit with 24 beds will emphasize forensic and psychosocial rehabilitation.

Dr. Thomas Hester, state Adult Mental Health Division administrator, said Wednesday that mental illness combined with substance abuse poses the great risk for violence. Improved integrated treatment is needed for both disorders, he said.

Guggenheim said additional psychiatrists have been hired and nurses are being flown in because of the local nursing shortage.

"We're getting some other staff in line," he said. "We've done acuity and risk evaluations on all patients and all treatment teams have made suggestions about where these patients should be going.

"We're working feverishly to get some security management in Guensberg."

The repairs should be finished by todaywith inspections and licensure occurring early next week, Guggenheim said.

Meanwhile, planning is under way to streamline treatment of patients in the hospital and after discharge in the community.

U.S. Magistrate Kevin Chang filed a report with federal court in January with recommendations for the planning process. He was appointed last year by Chief U.S. District Judge David Ezra to help the Health Department meet federal requirements.

State officials are working with the court and the U.S. Department of Justice to design and implement a comprehensive mental health system. The goal is to move patients who don't need to be hospitalized into the community with support services to help them.

Guggenheim said programming for each patient is increasing and "the staff has done an excellent job as far as working with patients."

Enhanced security also has prevented any recent episodes of patient escapes into the community, he said.

State of Hawaii

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