WAIMEA — Kalaheo Clinic pediatrician Dr. Carla Nelson said she and some of her Hawaii Health Systems Corporation colleagues on Kauai are afraid of what lies ahead. One of her fellow pediatricians and a hospital physician in the public health care system’s Kauai region
WAIMEA — Kalaheo Clinic pediatrician Dr. Carla Nelson said she and some of her Hawaii Health Systems Corporation colleagues on Kauai are afraid of what lies ahead.
One of her fellow pediatricians and a hospital physician in the public health care system’s Kauai region have resigned. One of the HHSC’s three obstetricians and gynecologists on the island are retiring, too. And several of her colleagues are looking for jobs elsewhere.
What is equally troubling, she said, is the fact that her 2,647-square-foot clinic in Kalaheo, where she and three other doctors see patients regularly, is slated to close by September as regional HHSC officials work to offset a projected $11 million regional budget deficit by cutting costs and streamlining operations.
“I try not to be too emotional as I work,” Nelson told HHSC Kauai region board members during a standing room only meeting held Wednesday at Kauai Veterans Memorial Hospital. “I try to stick to facts and evidence-based medicine as I care for my patients. But, the truth is, my feeling of care and concern for my patients, my clinic and for those I work with drive me to accomplish certain goals, such as staying up late to read medical journals, voicing my opinion about not closing the Kalaheo Clinic, listening to the important opinions of my colleagues and talking to little boys about their mothers.”
It is a reality that everyone throughout the nation’s fourth-largest public health care system is facing as they continue to provide quality, critical access services to island residents, said Interim HHSC Kauai Region CEO Scott McFarland.
And if something isn’t done to curb the public health care provider’s expenses on Kauai, some board members warn that the region’s two public hospitals and four clinics will run out of money before the start of the next legislative session in January, when HHSC officials can ask for more emergency appropriations.
“Aligning with the future while navigating a complex current state is the needle that the board is going to thread with over the next five months,” McFarland said.
Although Kauai regional board members were expected to discuss the fate of the Kalaheo Clinic in executive session during their Wednesday meeting, the results of those talks were not public as of Thursday.
Proposed plans to not fund 34 HHSC positions on Kauai, McFarland said, could shave off about $1.4 million from the region’s operational budget, if board members authorize the move.
The Kauai region, McFarland said, would also save about $1.39 million by not filling nine funded positions recently lost to attrition, including physicians, exempt employees and collective bargaining employees who have resigned and accepted other HHSC jobs.
Board members, he added, will be analyzing existing service lines throughout the Kauai region, ranging from long-term care to women’s health, between July and November to determine what areas can be operated more efficiently.
These budget reassessments, however, also come at a time when HHSC officials and Kauai regional board members have committed to opening a new 4,027-square-foot clinic in The Shops at Kukuiula.
It’s a decision that, McFarland said, began nearly three years ago between a previous board and Kukuiula developers.
“We’re very excited about that space,” McFarland said. “That part of Koloa is underserved in terms of primary care and urgent care, so we are excited to bring that clinic forward. We understand that we are in financially strident times, but the build-out for that clinic is coming from the property owners and the leasing company … so the impact to operations is basically staffing it.”
The HHSC regional board on Kauai, he added, is determining whether it would be feasible to operate the Kalaheo Clinic and new Koloa facility using existing funds.
“The population base in the service area is underserved and the patients who come through there are then transferred into the hospital, so there is a leveraging effect to that money,” HHSC Kauai Regional Board Chair Wade Lord told state lawmakers during a public meeting on Oahu. “The positioning of that clinic was important for the long-term because of the growth in the area.”
McFarland said Kauai regional board members signed building lease agreements for the proposed clinic within the last week. A specific construction timeline and opening date, however, has not been determined.
“Folks are concerned but we’re working really hard to keep them focused on quality and compassionate care and I honestly believe that message is going through,” McFarland said. “If we keep performing the way we have been performing for the last couple of months, we’re going to stay alive. It’s up to us. If we stay focused on the right things — the community, the patients, the residents — we’re going to see positive results.”
Meanwhile, Nelson, the pediatrician at Kalaheo Clinic, still has questions.
“Is the health of our community in jeopardy,” she asked HHSC regional board members on Wednesday. “Are physicians being asked to work more hours than is possible such as Monday through Saturday? Are physicians being asked to work in a disruptive, chaotic environment where they fear they will be fired, and therefore, no longer able to care for their community? Are they afraid their nurses and clerks will be let go?”
A public meeting, hosted by the state House Committee on Health, is scheduled at 5 p.m. Monday at the War Memorial Convention Hall in Lihue to address the operational and financial stability of HHSC operations on Kauai.
Written testimony can be sent to hlttestimony@capitol.hawaii.gov or repmorikawa@capitol.hawaii.gov.
