‘We can’t do this’

Most people don’t know it, but you can thank Sen. Ron Kouchi that the two public hospitals on Kauai are still open.

“I was in the room when Sen. Kouchi said, ‘We can’t do this,'” said Rep. James Tokioka Thursday morning during a recap of the legislative session. “Everyone needs to understand what happened.”

“Sen. Kouchi was very instrumental in making sure that special funding was done,” he added

About 50 people attended the meeting of the Lihue Business Association at Duke’s Canoe Club. Kauai’s legislators, including Kouchi, Tokioka and Reps. Derek Kawakami and Dee Morikawa fielded questions on transient accommodations taxes, climate change, and childhood education during the 90-minute gathering. Healthcare was another key topic.

Senate Bill 2866, which was signed by Gov. Neil Abercrombie on May 12, will provide $15 million in emergency appropriations to Hawaii Health Systems Corporations, for costs accrued during the 2013-2014 fiscal year, which ends on June 30. Of that, Kauai will receive $2.75 million.

“The emergency appropriation bill almost didn’t make it out. We were down to the last, last day when we got that bill done,” Morikawa said

Good thing it did. Scott McFarland, interim HHSC chief executive officer for Kauai operations, called that money “absolutely critical” for operations.

But it was Kouchi who was instrumental in HHSC receiving $7.3 million in emergency funds late last year that is credited with keeping Kauai Veterans Memorial Hospital in Waimea and Samuel Mahelona Memorial in Kapaa open. Before the October special session, he was told the request for emergency appropriation funding would not be on the agenda for the session in effort to limit the number of special bills to be considered.

“Are you OK with that?” Kouchi was asked.

“I said, ‘As long as you’re OK with closing the two hospitals on Kauai, then I’m fine with that.’ Without this money, they will close by Dec. 31,” Kouchi said.

Tokioka said Kouchi was being very humble in not taking credit for the stand he took during that October meeting.

“He said, ‘This doesn’t make sense for Kauai. We can come up with a better plan before we shut the hospitals down.'”

The emergency appropriation to assist Kauai’s hospitals at the time was not high on the list of state budget director Calbert Young.

“Sen. Kouchi made sure it was,” Tokiokia said.

The hospitals faced a financial crisis and emergency funds were needed. If not for Kouchi, those funds wouldn’t have come through.

“We applaud Sen. Kouchi for the steps that he took in getting that done,” he told the group gathered for the LBA meeting.

There is still work to be done, as HHSC faces continued funding shortfalls. HHSC is still well below the cash needed to offset the public health care system’s estimated $39 million shortfall for the 2014-2015 fiscal year.

Just under $17.4 million was also approved by the state Legislature and the governor to fund collective bargaining pay increases for HHSC employees for the two fiscal years between 2013 and 2015.

“While they are funded, there is a message there is only a finite amount of money,” Kouchi said.

A bill this session that would have given HHSC officials the ability to work with private health care partners was rejected by legislators.

“That bill did not make it out. We felt there was more discussion needed,” Morikawa said

“It’s uncertain if a public/private partnership would ever be accepted,” Kouchi said.

Morikawa said she initially believed the nearly $3 million recently approved for Kauai’s two public hospitals would bail them out of their financial strain and end talk of closings and layoffs. But rumblings continue.

“For me, it was troublesome hearing that. I felt we had pretty much bailed the Kauai hospitals out up to now, they should be OK to operate and tighten the belt and move forward,” she said. “That obviously is not the case.”

More funds, and reductions somewhere, will be needed to help Hawaii’s public hospitals survive as they face needs in the millions for capital improvement projects, as well as trying to maintain services.

“There are going to have to be some cost-cutting measures,” Morikawa said. “But we are in discussion.”

McFarland said while he appreciates the emergency appropriations from this session, more will be needed in the next session. HHSC announced that in September, it will close the Kalaheo Clinic and consolidate services provided there with another clinic about four miles away in Port Allen. This year, McFarland said HHSC officials are seeking to cut about $5 million in costs for the Kauai region and increase revenue.

HHSC is a regional safety net, a public health care system, that needs legislative support, he added.

“Signs are the Legislature no longer wants to provide emergency appropriation funds, so that’s very troubling,” McFarland said.

Kawakami said he supported the public/private partnership.

“I saw it as an opportunity for collaboration between a public entity and a private entity, to have the discussion on what services are redundant, how each can thrive and coexist.”

He said key is to start looking at how the hospitals can create more revenue.

“At the crux of the issue is always money,” he said.

Suggestions to look at the land hospitals sit on and draw revenue from them by creating services and provide for the needs of the community have merit, he said.

“Mahelona has a vast amount of vacant land,” Kawakami said. “You have housing there, you have public transportation, you have the beautiful path that comes there, businesses here. It could be the ideal location for affordable housing, it would be ideal location for kupuna care, assisted living facilities that we have a lack of. As our generations get older, one of the questions we’re faced with, is where do we put our elderly? How do we take care of them? There is a big gap in services we need to address.”

So they must be creative, think out of the box and address long-term sustainability, he added.

“It’s challenging, folks,” he said.

Maryanne Kusaka, former Kauai mayor, praised legislators for a job well done.

“This group has been the most productive. They have quietly brought back the most money to Kauai,” she said.

• Darin Moriki contributed to this report.