KAPAA — Better days may be ahead for the state’s public hospital system, Hawaii Health Systems Corporation, following a year of tough financial decisions, said Interim HHSC Kauai Region CEO Scott McFarland.
At the onset of 2014, the four clinics and two hospitals operated by the state-funded health care system on Kauai faced a dire reality: With about $10 million in debts that needed to be paid and only about $11,000 in the bank, the risk of cutting services severely or closing facilities was real.
But as of Friday, HHSC operations on Kauai are projected to have a $1.6 million surplus once the current fiscal year ends on June 30 — that’s after officials use about $9.6 million in cash, including about $9 million in appropriations from the state Legislature, to pay off $7.9 million in operating debts, according to HHSC financial statements obtained by The Garden Island.
“It’s an amazing turnaround,” McFarland said on Tuesday. “The region’s teams and employees have really focused and made improvements in productivity and efficiency. We are entering 2015 in a more solid fiscal position, which allows us now to stabilize our commitment to the community.”
In fact, instead of facilities facing the risk of closure, McFarland said construction is set to begin Thursday on the island’s fifth, 4,027-square-foot HHSC clinic in the Shops at Kukuiula.
“We’re looking at this as an opportunity for growth, so what we’re hoping to do is have new hires,” McFarland said. “Now, we want to make sure that all of our clinics throughout the system here are adequately staffed, so it maybe a combination of folks who have experience at one of our existing clinics, or maybe in a role at the Shops at Kukuiula.”
Specific costs and the number of employees at the clinic were not yet available Tuesday.
As a part of the plans for the clinic, which date back to 2008, Shops at Kukuiula developers will pay for the initial improvements before the clinic moves in. Regional HHSC officials, in turn, would be responsible for other medical equipment and staffing costs, McFarland said. Shops at Kukuiula developers, he said, have also allowed HHSC officials to not pay rent on the vacant space where the clinic will be.
Once the clinic is anticipated to be complete late this summer or early this fall, McFarland said the facility is slated to have a walk-in clinic for people who don’t have a primary care physician or are visiting the island, as well as primary care and family medicine services.
Specialists, including those in the primary care and women’s health field, would also visit the clinic on a regular basis.
“You’re going to see the region really grow in those two areas,” McFarland said. “We’re looking to allow the community to get to know us better in 2015.”
Although a total of 22 positions on Kauai were cut in September, McFarland said no further job cuts, or service line closures, are planned during the remainder of the 2015 fiscal year, which ends on June 30.
That staff reduction, McFarland said, amounted to nearly $300,000 in either savings or avoided costs last year.
Of the jobs that were cut, eight employees were either rehired or found another job within the state public health care system.
Still, despite the gains made this year, McFarland said HHSC officials will likely ask for another round of emergency appropriations during the next legislative session, which convenes on Jan. 21.
Some state lawmakers, however, have concerns about such a request.
“At this point, coming to us for more emergency appropriations is not going to be a very good idea,” Rep. Daynette “Dee” Morikawa, D, Koloa-Niihau, said. “I don’t know how much support the governor is going to give to HHSC — I know that they’re short statewide, so if they do come in with an appropriation request, it’ll be for the whole state, but whether they get it or not is questionable.”
What will likely be at the forefront of discussions, Morikawa said, will be potential opportunities for private-public partnerships like those recently disclosed between Hawaii Pacific Health and Maui Memorial Medical Center in Wailuku.
“Nobody really talked about the specifics yet, so until you do the pilot project with Maui, it’s hard to say how the other islands will be treated. No private, nonprofit entity is really going to do well in taking over a state facility unless they still maintain state funding and nobody seems to know exactly how much that will be or what will be funded and what won’t.”
Previous talks of a private-partnership between officials from Hawaii Pacific Health, which operates Wilcox Memorial Hospital in Lihue, and HHSC were disclosed last year, but no recent discussions have taken place, McFarland said.