WAILUKU - A state health panel voted 7-4 Thursday to recommend disapproval of Kaiser Permanente's proposal to develop outpatient dialysis services in Wailuku and Lahaina.
The vote by the Statewide Health Coordinating Council represented the second time in a week that Kaiser's certificate of need application has been judged as failing to meet certificate of need standards set by the State Health Planning and Development Agency.
The agency's administrator, Ronald Terry, has until February to decide whether Kaiser should be allowed to go forward with a $3.6 million plan to set up one outpatient dialysis facility at its Wailuku clinic on Mahalani Street and at the Lahaina Gateway Plaza Shopping Center.
Members of a Certificate of Need Review Panel meeting also recommended disapproval in a meeting Dec. 11. The only panel to support Kaiser's proposal has been the Tri-Isle Subarea Health Planning Council. Its members are made up of Maui County residents. They recommended Terry approve Kaiser's plan.
After Thursday's meeting, Kaiser officials said they hope the Tri-Isle council's recommendation prevails along with the desire of more than 150 businesses, residents and Kaiser employees who publicly supported the plan through three public hearings.
After nearly four hours of testimony, Terry asked Kaiser and its chief opponent, Liberty Dialysis-Hawaii LLC, Maui's sole dialysis provider, whether they might be agreeable to mediation and/or binding arbitration.
Liberty's attorney, Ryan Prado, submitted a letter to Terry saying his company was willing to enter into mediation. But Kaiser Hawaii President Janet Liang told Terry she was surprised to hear about Liberty's letter, and she was not willing to enter into mediation.
Terry told Prado that he should have addressed his letter to Kaiser.
In its application, Kaiser has said it could save more than $4.5 million in the first full year of operation if it were allowed to develop its own in-house facilities. Responding to Terry's question, Liang said Kaiser did not take the certificate of need process "lightly" and was looking at a long-term solution to address the Maui community's health care needs and Kaiser's goal to provide patients access to services and choices.
Mediation would be a "poor, short-term solution," Liang said.
Kaiser executives said the proposed facilities would be available to Kaiser patients and the entire community. Liberty countered with skepticism and predicted it would be left caring for nonpaying and/or underinsured patients.
Both Kaiser and Liberty provided conflicting testimony about the need for more outpatient dialysis services. Kaiser claimed there was room for business for both establishments, while Liberty argued it still could add 33 percent more capacity in Wailuku and about 50 percent more in West Maui.
In the end, Statewide Health Planning Council Member Ken Shimonishi said he did not believe Kaiser had met the certificate criteria regarding need and accessibility, saying Liberty has the capacity to serve the current patient load. He also said Kaiser failed to show its proposal would not affect the state health plan negatively and said, in fact, its plan would duplicate services and be a detriment to the system in place.
Rebecca Ward, the council member who provided the second to Shimonishi's motion, said she was "comfortable" that Kaiser had met other certificate criteria, such as quality service, availability of resources, and costs and financing. However, she said she agreed with Shimonishi and was concerned about the proposed facilities' impact on Liberty.
* Claudine San Nicolas can be reached at email@example.com.