Task force studies State Hospital crowding
A task force representing all agencies concerned with mental health and court systems is looking at issues affecting the Hawaii State Hospital population for possible changes.
Sen. Rosalyn Baker (D, Kapalua-Kaanapali-Lahaina-Maalaea-Kihei-Makena) and Rep. Josh Green (D, North Kona-Keauhou-Kailua-Kona-Honokohau) chair the group.
It has been meeting for about six months and is expected to have a report with recommendations this fall, said Dr. Thomas Hester, chief of the state Health Department's Adult Mental Health Division.
Hawaii State Hospital for the mentally ill was released from federal court oversight in December 2004 after reducing overcrowding and improving patient services.
But the population began climbing again in 2005, and the Legislature asked the governor by resolution to convene a task force of all stakeholders.
It is charged with studying and recommending possible changes in procedures, laws and policies "to minimize" the hospital census and "promote community-based health services for forensic patients."
The average daily hospital population was reduced to about 172 early this year from about 196 in December 2005, but increased court-ordered forensic patients raised the numbers during the past two months.
Assaults against patients and staff have increased with the crowding and "individuals with challenging problems," said Hospital Administrator Mark Fridovich.
"The staff is doing an incredible job, and we're being very careful, even at a higher patient census, that that doesn't increase the risk of people slipping away," he said.
Hester said the task force is looking at every aspect of the law and all procedures and policies governing the mental health and Judiciary systems.
He pointed to Hilo as "a tremendous example" of people working together to improve the mental health system. Former Hilo Circuit Judge Riki May Amano initiated the group before retiring in 2003, and it is "paying dividends," Hester said.
He said the hospital in Kaneohe is developing different placement options for patients, but "difficult-to-place individuals are an issue."
Hale Imua, a conditional release program in four cottages with 24 beds on the hospital grounds, has 16 patients so far, he said. A secure residential facility is planned primarily for forensic patients who need a higher level of security than Hale Imua in four other cottages with 22 beds on the grounds. Care Hawaii operates a specialized residential program in the cottages but is relocating to Kaneohe, Hester said.
A fence will be installed around the facility, but it will not be locked, Fridovich said.
He said it will be used for patients "who need a longer time in transition and a smaller first step out of the hospital than are currently available through Hale Imua or the Care Hawaii program."
Expanded Adult Residential Care Homes also are being developed for some patients who might have physical and psychiatric problems but do not need daily nursing, Fridovich said.