Hilo Medical Center cutting staff

Hilo Medical Center is cutting staff positions and taking other cost-saving measures as it confronts a $9 million budget shortfall.

Administrators at Hawaii Health Systems Corp., the state’s public hospital system, anticipate being $48 million in the red in the next fiscal year, which begins July 1, unless they can cut and consolidate services. HHSC requested nearly $150 million in funding from the state during the recent Legislative session, but received only $102 million from lawmakers.

HHSC spokesman Miles Takaaze said Wednesday while the state partially funded collective bargaining increases for hospital employees, the remaining unfunded increases will combine with cuts in Medicare reimbursements and increases in other health care costs to leave the system $48 million in the hole.

Takaaze said he couldn’t provide an accurate accounting of the total impact the cuts will have on services because the 12 individual facilities in the state are still in the process of finalizing their plans.

“Eventually, as a system, we’ll have to do that, but not at this point. … It’s been going on throughout the year as they work on their best practices and identifying efficiencies,” he said.

Hilo Medical Center spokeswoman Elena Cabatu said this week that so far one of HMC’s two urologist positions — that of Dr. Lyric Santiago — was terminated, as well as five administrative positions and 25 temporary “traveler” nurse positions or technician positions.

She said while Santiago was let go, the hospital made it a priority to refrain from layoffs by not filling positions as they open and not renewing contracts when they come to an end.

“We’re focused on reducing costs and maintaining quality,” she said. “… We’re eliminating positions that hadn’t been filled, that were budgeted but not filled,” she said.

The hospital is also reorganizing its clinical staff to ensure patient-care services are not impacted.

For instance, Cabatu said, nurses that might currently have less contact with patients as they provide education services for other staff members would likely be asked to add more clinical duties to their schedules.

HMC is also refraining from various projects it planned for the coming year, such as the installation of solar panels and the replacement of aging equipment, including a pair of ultrasound units.

All told, the reductions are estimated to account for about $5 million of the shortfall, she said. That is the amount deemed necessary to maintain the hospital’s “status quo” of care, while the additional $4 million was budgeted to make quality and operations improvements to take the facility into the future.

Those improvements will also have to wait, she said.

Cabatu added that while the East Hawaii region of HHSC is very concerned about the cutbacks, administrators consider themselves to be in a more manageable position than other facilities in the state.

Currently, HHSC is exploring the possibility of closing the Kalaheo Clinic on Kauai and consolidating its staff and services with another clinic 4 miles away, Takaaze said.

Email Colin M. Stewart at cstewart@hawaiitribune-herald.com.