After a nine-month-long review of care provided by Wilcox Health since its merger with Honolulu-based Hawaii Pacific Health, the state has decided not to withdraw the hospital’s Certificate of Need. The state Health Planning and Development Agency does suggest, however, that action be taken to “improve the health care environment in Kaua‘i County.”
The agency began looking into access to affordable care at Wilcox Health, which includes Wilcox Memorial Hospital and Kauai Medical Clinic, in response to a formal request from the Kaua‘i County Council.
The review, which has largely focused on effects of the 2001 merger, began during the middle of last year’s 126-day nurses strike and amid complaints of an exodus of doctors.
Health Planning and Development administrator Dr. David Sakamoto, who worked on the review, sent a letter last Friday to the CEO of Hawaii Pacific Health noting that withdrawal of the hospital’s certificate is not warranted but that further action to enhance service is recommended.
In an interview yesterday, Sakamoto pointed to the “obvious” lack of long-term care and coordination between different provider groups as well as specific areas needing improvement. Those areas were not specified in the letter.
On implementing change, the agency “strongly urges Hawaii Pacific Health to collaborate with the Kaua‘i stakeholders … to address the underlying issues raised by community members,” states the letter.
“I want them to sit down and identify what the needs are and meet them,” Sakamoto said.
He was quick to add that Hawaii Pacific Health is a “good company” and the agency expects HPH to follow through with the requests.
Furthermore, he said, the letter does not mean the process is over, nor does it preclude another review in the future.
Ray Vara, executive vice president of Hawaii Pacific Health, maintains that HPH has cooperated fully with the state and never doubted the quality of health care it has provided.
“We’ve never wavered in our belief that health care is improving in Kaua‘i,” Vara said yesterday.
In addition, Vara noted that long-term care is an important issue statewide that “needs to be addressed and worked on at the state level.”
To date Hawaii Pacific has not conducted an internal review of care and staffing beyond the regular monitoring of turnover rates and patient and employee satisfaction, Vara said.
The hospital’s board did ask questions in response to concerns raised, and responses were provided to their satisfaction, he added.
State Sen. Gary Hooser, D-Kaua‘i/Ni‘ihau, said the agency’s letter reinforces his previous plans to pursue a task force or public process for unanswered questions, particularly concerns raised about reduction of service to the poor and disadvantaged.
Earlier this year Hooser co-authored a Senate resolution requesting an inquiry into whether Wilcox Health has ensured access to all patients regardless of their ability to pay.
While the measure will not make it out of the Legislature before the current session ends this week, Hooser said it still served a purpose.
“Just the introduction of the resolution sent a strong message that there are concerns and we need to address them,” he said.
Hooser hopes to have a format for proceeding outlined by the end of May. He said HPH and Wilcox Health would have to participate “in order for the discussion to have any meaning.”
But Vara said HPH considers the matter “closed,” as its cooperation with various state agencies on the issue included extensive document reviews and multiple interviews.
He added that HPH will continue to meet with community health care providers to collaboratively improve care on-island.
“With the matter now resolved, it’s time to move on,” Vara said via e-mail.
According to Deputy Attorney General Hugh Jones, the state Health Planning and Development Agency is the only body with the power to revoke a Certificate of Need.
The attorney general’s office is currently looking into complaints about conflicts of interest at Wilcox that it received from Concerned Citizens for Kauai’s Healthcare Future, a group co-chaired by a former Kauai Medical Clinic physician.
• Blake Jones, business writer, can be reached at 245-3681 (ext. 251) or email@example.com.