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CAPITAL IMPROVEMENT PROJECTS

Maui Memorial Medical Center and Kula Hospital capital improvement projects for fiscal 2010 include:

* $5 million for 15 to 20 more long-term care beds at Kula Hospital.

* $15 million for a new hospital wing, called the Heart, Brain and Vascular Tower, at Maui Memorial.

* $7.2 million for a new dialysis facility at Maui Memorial.

* $2.3 million for a helipad at Maui Memorial.

* $1.2 million for wastewater facility improvements at Kula Hospital.

* $670,000 for a generator at Maui Memorial.

WAILUKU - The release of a $5 million appropriation to establish new long-term care beds at Kula Hospital could help to avoid furloughs and layoffs at Maui Memorial Medical Center, hospital officials said Tuesday.

Gov. Linda Lingle has not yet released the funding, but the plan calls for using the $5 million appropriation to add 15 to 20 beds for long-term patients at Kula Hospital. Then, some of the long-term patients being cared for at Maui Memorial could be transferred to Kula. Currently, Maui Memorial has 44 long-term care patients in acute-care beds.

The savings would kick in when the hospital would no longer lose $1,300 per day providing acute-level care for long-term patients at Maui Memorial. Instead, the patients transferred to Kula would cost about $80 per day, hospital officials said.

In an interview Tuesday, Maui Memorial Chief Executive Officer Wesley Lo estimated the transfer of long-term patients would realize an annual savings of as much as $10 million to $17 million.

The 1,424 people who work at Maui Memorial, Kula and Lanai Community Hospital are employed by the semi-autonomous Hawaii Health Systems Corp. and are not directly affected by furloughs of state employees that begin this month. However, Gov. Linda Lingle said semi-autonomous agencies, including the state health corporation, Department of Education and University of Hawaii would have funding cut in proportion to the amount that would be saved by furloughing employees for three days per month, about 14 percent.

That would mean Maui Memorial would need to find an annual furlough equivalent savings of $11 million, with Kula seeing a cutback of $1.6 million and Lanai $300,000.

The savings expected from transferring long-term patients from Maui Memorial to Kula would not come immediately. The Kula expansion is in the planning stages, and it would take 12 to 18 months to build the facility and make the beds available, Lo said.

Even that timetable is "aggressive," he acknowledged. "We're pushing it, but we think it can be done."

Maui Memorial is currently trying to find a consultant to help oversee the Kula long-term care facility project.

Lo presented Maui Memorial's cost-savings plan earlier this month to Lingle senior policy adviser Linda Smith and state Budget Director Georgina Kawamura. He said they made no commitments but indicated the governor's administration was looking for immediate savings.

"I think they understood the concept of what we were doing," Lo said.

Neither Smith nor Kawamura could be reached for comment on Tuesday.

Maui Memorial - the island's only acute-care hospital - stands to gain about $23 million in operational funding from the state general fund and another $44.5 million in capital improvement project funding for fiscal year 2010, which begins today.

Lo said state funding could be reduced depending on how the Lingle administration decides to fill a $729 million budget shortfall.

Aside from achieving significant cost savings for the hospital, the expansion at Kula Hospital would help address Maui Memorial's decades-old problem of housing long-term care patients, who really don't need acute-care attention yet drain the hospital of its resources. Also, at times, the number of long-term patients at Maui Memorial make it difficult to provide room for those who need acute care and have insurance and other resources to pay the full costs for it. Long-term care patients often pay only a small portion of the costs of their care.

For immediate cost savings, hospital officials are reviewing various options, but those hinge on the outcome of contract negotiations with the hospital employee unions - the Hawaii Government Employees Association and the United Public Workers.

Lo said he doesn't see furloughs and layoffs as an option at Maui Memorial, which must provide care to patients 24 hours a day, every day of the year. The hospital can't turn away people who need its services, he pointed out.

The situation is further aggravated now, because the hospital's 209 beds have been 90 percent full recently.

"We're as busy as can be," Lo said. "There's very little we can furlough without jeopardizing health care."

He said he believes the savings and possible revenue generation he could get from releasing long-term care beds at Maui Memorial would help the hospital become more financially stable.

Meanwhile, the Lingle administration has granted Lo's request for a $10 million loan to cover operational expenses through Tuesday. The hospital used the money to cover expenses plus pay down delinquent bills that today are still running about 80 days past due.

Lo said it appears that the Lingle administration also will also be releasing, on schedule, the first quarter portion of the $23 million Maui Memorial expects to receive in state operational support this fiscal year.

* Claudine San Nicolas can be reached at claudine@mauinews.com.