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WAILUKU – To cope with a projected $13 million budget shortfall this year, Maui Memorial Medical Center officials are considering closing Molokini II, the hospital’s adolescent behavioral health unit, but parents pleaded with administrators Wednesday to keep the facility open.
“My daughter was a patient at least half a dozen times between 2004 and 2010,” Jeff Dack said at a public meeting in the hospital’s auditorium. “Frankly, if Molokini II had not been available . . . (it’s very likely) she would’ve been part of the adult penal system and a long-term burden on society without the proper mental health care.”
Closing the ward would be “an extremely serious detriment” to the community, Dack said.
Other parents and nonprofit leaders echoed similar sentiments at the meeting, which drew about 100 attendees. Maui Memorial is the only Neighbor Island hospital that has an adolescent behavioral health unit, administrators said. If the facility were closed, adolescents needing inpatient care would be flown to Oahu for treatment at The Queen’s Medical Center or at Kahi Mohala.
At least a dozen testifiers said that sending young patients to another island would add stress to what is often already a volatile situation.
“My foster son, who’s in Molokini II right now, I don’t know where he’d be if it wasn’t for that,” said Terri Williams, a foster parent who has worked for Maui Youth & Family Services for the past three years. “Our youth . . . deserve to be treated and seen here on Maui instead of having the added trauma and all the anxiety that goes with having to catch a plane to another island and not being able to have family and friends see them while they’re in the hospital.”
A flier circulated by the Maui branch of Mental Health America posted a picture of a man in handcuffs and the question: “Are we going to transport Maui youth, who are already in distress, to Oahu like this?”
Wesley Lo, chief executive officer for the Maui region of the Hawaii Health Systems Corp., assured residents that patients would be transported “as we would any other patient,” not in shackles or handcuffs.
The problem with keeping Molokini II open has long been convincing specialty physicians to stay at MMMC, especially when other hospitals are able to offer higher salaries and less stressful working conditions, said Lo.
For three or four years beginning in 2004, Molokini II was closed because the hospital was unable to keep credentialed psychiatrists on staff, Lo said. He guessed the physicians left because of the “burden of call,” – since there were only two doctors on staff, each doctor would be required to be on call every other night.
“Even if (we) were to hire two physicians, which are very hard to find because these guys can get jobs anywhere they want because they’re in such high demand, I don’t know how long they’d stay,” Lo said, adding that the psychiatrists would also be on call for the adult unit one in every four nights.
“I can’t imagine the burden.
. . . We’d need four or five psychiatrists, which (the hospital) cannot support,” Lo said.
The seven-bed adolescent psychiatric unit served 124 patients in 2013, averaging about 1.6 patients per day. From January through March, the census dropped to 0.8 patients on average per day, Lo said.
Five hospital employees would be affected by the closure, and Lo said officials are working to place them elsewhere in the hospital.
Closing the Molokini II unit would save about $1 million, and hospital officials are considering other financing options, such as cutting $2 million in nonclinical contracts, negotiating loans with the state and deferring maintenance projects.
A private-public partnership would alleviate the need for these cuts and keep Maui Memorial a leader in health care, doctors and other medical personnel said.
“Affiliating with a larger health care system would provide much-needed investment and clinical and administrative assistance to reduce overhead and costs,” said Tony Krieg, chief executive officer of Hale Makua Health Services.
Krieg said Hale Makua, which serves about 400 patients, works with the hospital in providing long-term care to patients after they are discharged, and he said he believed that a public-private partnership would “improve the health of our hospital.”
Kula Hospital Clinic Medical Director Dr. Nicole Apoliona agreed, saying the partnership would address not only budget shortfalls, but system shortfalls.
“The state could give us all the money we need, and next year, we’d need more,” Apoliona said. “We have a system problem because we’re part of the state and we’re hamstrung by rules that the state has for procurement, contracting . . . that really makes it difficult for us to compete with others on a level playing field.”
She said a partnership with a nonprofit corporation with experience in running “efficient, high-quality, flexible health care” would be the only viable way to meet the growing needs of the community.
In the last few years, hospital administrators have been in talks with Mainland health care corporations and, more recently, possibly a local partnership with Hawaii Pacific Health. But before negotiations can begin, state lawmakers would need to pass legislation allowing the partnership to move forward. Attempts in two past legislative session to pass privatization legislation for HHSC have failed.
Lo said the closure of Molokini II is not a done deal, though Wednesday’s meeting was the first in a series of legal steps to end the service. The next step is for the HHSC’s Maui regional board to decide whether to endorse the closure plan. If so, state lawmakers would have 20 days to decide whether to fund it.
Given the length of the process, the unit would not likely be closed until November, Lo said.
* Eileen Chao can be reached at echao@mauinews.com.